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I STRONGLY SUPPORT TREATING ADDICTION IN AMERICA AS A PUBLIC HEALTH ISSUE.

Essay by Bill Bruzy, MHS, LCDC

I grew up in a family where alcohol and drug abuse had deadly consequences and I learned first hand of the devastation that addiction can levy on a person, a family, a community. Having grown up in a time where the use, variety, potency, criminal economy of drugs grew radically, I observed and experienced that using law enforcement as the only tool to combat drug abuse only creates a savvy criminal underground with massive resources and a revolving door of incarceration. The process of incarceration not only costs significant amounts of money, but also destroys lives that could be salvaged from drug use.

Many years ago I tried fixing my broken feelings with drugs and I saw first hand that drugs work. I also saw that the short-term fix from distress that drugs offered are purchased on a credit card that has a very high interest rate. The high we want is not only soon gone, but we are in a much worse place than where we started. Our problems amplify rather than diminish.

We Americans have a problem and this problem has the potential to destroy us. In a recent year, the United Nations Office on Drugs and Crime reported that world wide 14% of all global agricultural exports were in the form of illegal drugs. Even more shocking was the data that the United States, representing something around 4% of the the world's population, was using two thirds of those drugs. We are gluttons. When you add the pathological misuse of home grown and home produced drugs, legal drugs, pharmaceuticals, and alcohol we see a massive problem with mood altering and addiction in our country.

As a young boy I watched my mother die of what was most likely an alcoholism related liver disease when she was 39. I watched my father stay inebriated for years, failing in business, abandoning his children to their own devices and dying when he was only 52. I tried, even as a child, to get him into Alcoholics Anonymous. He didn't go. I watched my sister ruin a good law career with alcoholism. I quit drinking when I was 20 but I continued to experiment with drugs. I smoked marijuana for too many years attempting to quell the grief I felt, but did not know how to address.

I searched for answers. I studied sociology, psychology and philosophy in undergraduate school looking for those answers. Attending graduate school I went on to Johns Hopkins University School of Public Health where I studied alcoholism program planning. It was a time when there was legislation favorable to utilizing a wide array of resources to deal with alcohol addiction. Those days ended with change in administrations and political climate in Washington. As perspectives narrowed, I left the addictions field, but continued to personally explore other ways to heal, including art, expressive therapies, and spiritual disciplines. Eventually I went back into the field working as a therapist at an eating disorders treatment program that used an addictions model. I taught courses on alcoholism and drug abuse to counseling, paramedic and criminal justice students at a local community college. Over time I started a private practice in addictions counseling as a Licensed Chemical Dependency Counselor.

My personal and professional experiences have led me to see our addiction problem as an ecological problem. Like any ecology, this problem is part of a larger array of interacting forces. Addressing only one facet, with one tool, is doomed to failure. AA is a powerful tool. It is about saving those already lost in addiction, but it is not effective with everyone and is not about prevention. Recovery needs to be part of the larger ecology of change and pool of knowledge.

Teaching the history of legislation in drug abuse, I realized the war on drugs has been going on for about 100 years now. Prohibition is probably the best laboratory for a strictly law enforcement only approach. It almost literally legislated into existence a criminal underground. The descendants of the prohibition underground today are smart, ruthless, and have no rules to play by like law enforcement does. They have more mobility and freedom of action. Frequently, they have a lot more money. The drug dealing underground encourages use, often flooding markets with cheap product creating a need. Crack cocaine is an example of what was a diabolical marketing tool. It offers entry at a very cheap price, produces a huge dramatic change of consciousness and has an extremely high potential for addiction. Customers will return. We do need law enforcement and we need drugs like crack to be illegal and dealt with harshly. Law enforcement attempts to address the supply facet of our drug problem, but alone it is clearly not enough.

The effectiveness of medicine's effort to treat addiction is limited when it is the only approach. A few medications can substitute for addictive drugs or block the action of drugs or help with withdrawal symptoms but there isn't a drug to cure drug abuse. The disease concept is the influential model and most of the medical research appears to go into looking for the genetic component of addiction. But I suspect, since America, the melting pot of the world, is made up of a huge genetic diversity, a simply medical and genetic answer isn't likely. At least to this point, it hasn't been found. But medical knowledge is vital, showing us the pathways of action, the brain changes, the physiology and biochemistry of drugs.

There are other vital research areas we've largely ignored. Public health, sociology, psychology, economics, city planning and other disciplines have an immense amount to add to our understanding and our eventual healing of our national drug problem. The public heath model specifically, has the potential to be a central organizing point where collected research in epidemiology, biostatistics, psychology, sociology, criminal justice, economics, medicine, and international relations can be brought together to add real substance to our understanding of the significant problems we face. Bringing our best effort and expertise forward, we, as Americans, are so very capable of real solutions.

We take all these drugs for a reason. We need to recognize that our vulnerability to drug abuse in all its forms comes from who we are as a nation. We need to look in the mirror and see why we feel and act the way we do. We need to understand and take action to save ourselves from what is perhaps the greatest threat to America. Us.

We have a public health problem, let's treat it as such.