Drug use prevention and treatment

The drug problem has been conducted as a campaign almost entirely about the drugs themselves, which has uncoupled drug abuse and drug trafficking from the other social and economic problems in which they are embedded. From a methodological and organizational standpoint, this “stand-alone” approach has weakened society’s ability to address drug abuse and related health and social problems. All countries in the Western Hemisphere have established national Drug Commissions. Their roles vary from country to country, but one of their principal functions is to coordinate the Government’s response to the problem of illicit drugs, and bring the power of the Ministries to bear on their pertinent piece of the action. In fact, the coordination function in many countries is inoperative, since the senior Ministers of Government simply don’t show up to meetings, or find that their departments are overwhelmed with other pressing problems. National Drug Commissions are often too weak or too focused only on illicit drugs that they do not make some very obvious connections between, inter alia, drug use and crime; drug use and a number of communicable diseases such as STDs; drug use and social isolation (marginalization); drug use and family breakdown; the role of drug use in the trafficking of persons for prostitution and other purposes, and so on. The national Drug Commissions themselves, therefore, have taken over functions that are probably better performed by line Ministries, which have larger budgets and institutions already in place. A case in point are the Ministries of Health which, with a few notable exceptions, have declined to engage in the problem of drug abuse and dependence, preferring to leave drug treatment and rehabilitation to under-resourced, and under-qualified non-governmental organizations or faith-based groups. By detaching themselves from the drug abuse and dependence problem, the Ministries of Health are, by and large, failing to put at the disposal of drug addicts the full panoply of health care services available in the country. A person living with HIV who is also a drug user typically has to go to one clinic for retroviral treatment and to another for drug counselling. A better way is to have drug abuse and dependence treated in the normal course of health care, just as asthma and diabetes are treated in family clinics and general medicine, which of course need to be linked to the full array of social services.