The+Roots+of+Addiction+Run+Deep

Artefact
==== The image of the black and white tree represents addiction in three levels, the soil, the roots and the branches. The soil and the roots represent the deeper levels of addiction which are not seen by society. The branches and leaves of the tree represent how the addiction manifests and is seen society. The visual artefact is an effective representation as it illustrates addiction not just as one person, one event or one concept but as a complex mixture of elements both current and past. ====

Public health issue
==== The public health issue the artefact represents is disease of addiction and the many different levels. The artefact represents the many components that make up addiction; the image of the tree depicts the different levels or angles of the public health issue. Addiction is not a simple issue with one root to the problem; addiction is a complex mix of causative factors. Currently in Australia incarceration is the main way to deal with individuals with disease of addiction, but to simply punish a person without dealing with the deep seeded issues below is redundant (Brennan, 2008). Only when the roots and soil of addiction are dealt with suitably can those with this disease be reintegrated back into society. Currently that is not the approach in Australia, we treat the branches and leaves of the individuals’ problem but fail to dig deeper (Brennan, 2008). ====

Literature review
==== The Australian Institute of Health and Welfare (2013) states there is more than 10 million people imprisoned worldwide and it is evident there is a clear link and cyclic effect between drugs, criminal behaviour and incarceration (Fazel & Baillargeon, 2011). Research by the National Council on Alcoholism and Drug Dependence (2013) state that 70-80% of inmates are imprisoned as a result of drug abuse and nearly 50% are clinically addicted. Furthermore 70% prison entrants used illicit drugs in the 12 months prior to prison; the research shows the clear link between drug abuse and incarcerations (National Council on Alcoholism and Drug Dependence, 2013). ==== ====Reports from the National Institute on Drug Abuse (2009) discusses that drug addiction is a complex illness and effective treatment requires detoxifications, treatment of underlying issues and relapse preventions. A number of methods are used in the treatment phase such as counselling, motivational incentives and cognitive-behavioural therapy which aims at getting the patients to recognise, avoid and cope with future challenges relating to their dependence (National Institute on Drug Abuse, 2009) ====

====Over the last 10-20 years there has been a large number of studies into brain functioning and chemistry of those with disease of addiction. It is understood that addictive drugs usurp neural activity involved in incentive motivation, pleasure and learning ability (Robinson & Berridge, 2003). Research is essential component in treating addiction as the better the disease is understood the better treatment can be developed and offered. Simply detoxing addicts in jail is not enough, the chemical changes and dysfunctional tissue with in the brain are resilient and once released 95% of drug addicts who did not receive treatment will return to drug use (Australian Institute of Health and Welfare, 2013). ====

====Countries such as Portugal and Norway have taken alternative approaches to dealing with drug addiction and treatment. In 2001 Portugal was the first country to officially decriminalise drug use. Portugal abolished all criminal penalties for personal possession of drugs, including marijuana, cocaine, heroin and methamphetamine ( Vale de Andrade, 2010). By 2006 the prevalence rates virtually declined for every substance and a majority were halved. There was a 17% reduction of new cases of drug related HIV, almost 50% reduction in drug related deaths and the numbers of Hepatitis B and Hepatitis C infections were greatly reduced ( Vale de Andrade, 2010). ====

====The results from Portugal demonstrate that increasing laws, penalties and jail time for those with disease of addiction is redundant and has the opposite effect. The results from Portugal again supports the idea that treatment, harm minimisation and education are better option to deal with the problem of drug addiction opposed to incarceration and isolation. ====

====Halden prison in Norway in located in the south east and stands amongst 30 hectares of lush forestry where inmates have a scenic view over the woodlands from their cells (Milianovic, 2010). Halden prison resembles a retreat rather than a harsh and cold prison that is normally seen in western society. Halden prison has been described as most humane rehabilitation program (Milianovic, 2010). The Prison includes 72 acres of recreational gardens, recording studios, interior mural designs and endless pieces of art throughout. The state of the art prison provides a standard of living which is above that of the population. Norway has taken a different approach to dealing with those with disease of addiction, their aim is to rehabilitate, reduce reincarceration rates, and re-establish inmates back in to society as contributing members (Dilip & Amanda, 2001). ====

====Norway’s utilitarian approach has been hugely successful and well surpassing the conventional western system. In the United States and UK 50-60% of those released from prison will reoffended (Milianovic, 2010). In Norway only 20% of those rehabilitated and released from prisons reoffended (Granheim, Johnson & Helgesen, 2011). ====

====Although the system Norway employed showed positive results there are limitations. Costing $252 million US to build Halden prison it would not be seen as a cost effective measure to implement in Australia to deal with this public health issue (Granheim et al., 2011). To ask the Australian tax payer in to be funding this type of facility would attract a great deal of conflict and media attention. ====

====Benefits of treatment rather than incarceration can definitely be noted, when it comes to nonviolent drug offenders, systems that favour treatment over incarceration not only produce better health outcomes but are financially more feasible (Douglas, Nosyk, Jaffe, Urada, & Evans, 2013). By diverting nonviolent drug offenders from the correctional system and into treatment, on average over $2,300 per offender can be saved, over a 30-month post-conviction period (Anglin et al., 2013). This research demonstrates that investing in public health and prevention for those with disease addiction yields valuable returns on investment. Prisoners experience higher rates of mental illness, HIV, Tuberculosis, Hepatitis B and Hepatitis C. It is estimated that Hepatitis B infection for prisoners range 1.0-3.7%, compared with the general population which is about 0.4-0.5% (Fazel, & Baillargeon, (2011). ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Those incarcerated have a substantially lower level of health compared to the general population and as Fazel, & Baillargeon (2011) discusses the health disparity between prisoners and the general population could be attributed to various behavioural and socioeconomic factors. This increase in disease amongst prisoner’s places an increased demand on the health care system, awareness of this issue is essential. Diverting nonviolent drug offenders from the correctional system and into treatment seems to be a more feasible option (Lorenc //et al////.//, 2012). ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">The artefact demonstrates that society and culture play the soil for which the roots of addiction grow. Failure to acknowledge and treat addiction at the soil and the roots results in wasted time, money, resources and can cost lives. Society and culture need to be considered when dealing with drug addicted people as it can be such a large part of the addiction. Transitioning from punishment to treatment for those with disease of addiction is important to consider if we want to effectively deal with the issue. ====

<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Drug addiction is constantly in the media and there is moral panic generated around the issue.
====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">The consequences of moral panic are normally changes in the law such as increasing penalties and as it’s been discussed increasing legislation is redundant and has the opposite effect. ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">The media and politics continue to create moral panic by announcing statements like “we are declaring a war on drugs”, these sorts of statements are often used to mobilise fear and as a political asset <span class="citationauthor" style="font-family: 'Times New Roman','serif'; font-size: 16px;"> ( <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Lawson, 2007). Creating this fear tends to demonise the drugs and those with abuse issues, this results in those with disease of addiction refraining from seeking treatment because of the fear and the stigmas attached. These stigmas are powerful and denote all users as evil or bad people, acting this way can only be seen to have a detrimental effect. The study also found that by decriminalising drugs younger people (13-17 years old) felt more comfortable to discuss drug use and more likely to abstain from drug use ( <span class="citationauthor" style="font-family: 'Times New Roman','serif'; font-size: 16px;">Stanton, <span class="citationdate" style="font-family: 'Times New Roman','serif'; font-size: 16px;">2005) <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">. ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">The social groups that are at an increased risk of developing addiction problems include those aged 14-16, those unemployed (24.9%), who had never been married (24.4%), those who identified as being Aboriginal or Torres Strait Islander (25.0%) and those who identified as homosexual/bisexual (35.7%)(Australian Institute of Health and Welfare, 2013). ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Drug addiction is an important public health issue to address as it affects a large number of people directly and indirectly. In 2010 39.8% of the Australian population had used illicit drugs at some point in their life (Australian Institute of Health and Welfare, 2013). ==== ====<span style="color: #000000; font-family: 'Times New Roman','serif'; font-size: 16px;">Illicit drug users are were more likely to be diagnosed/treated for a mental illness and reported higher levels of psychological distress compared with those who had not used in the last 12 months <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">(Australian Institute of Health and Welfare, 2013). ====

====<span style="color: #000000; font-family: 'Times New Roman','serif'; font-size: 16px;">Drug addiction is a complex multi facet issue which contributes to disease, injury, family disruption, violence, crime and thousands of deaths each year <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">(Australian Institute of Health and Welfare, 2013).Collins & Lapsley (2008) estimated in 2004 to 2005 the economic burden of drugs to Australia was $56.1 billion dollars with 15% of this due to illicit drugs. Creating strategies to e <span style="color: #000000; font-family: 'Times New Roman','serif'; font-size: 16px;">ffectively deal with the issue it would lessen the <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">financial burden on the economy and save lives. ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">As a result of this analysis public health experts should be looking at alternative ways to manage those with disease of addiction and take lessons from other countries such as Portugal and Norway and their management of this public health issue. Public health experts should also be looking to target funding and campaigns at the groups most at risk as highlighted earlier. ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">From this analysis public health experts need to understand how much of an impact this issue has on society and really think what the outcome 20 years from now will be if the same systems are still employed to deal with the issue. Disease of addiction needs to be treated as a health issue rather than a law and order issue if society wants to implement and see change. ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">The three aspects of addiction as depicted in the artefact are a good representation of those with disease of addiction and how deep the problem stems. This is a good ‘case in point’ as it effectively illustrates that if we want to stop the cycle of addiction we need to treat the deep roots of the issue not just the leaves and branches on top. ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Through my research I have broadened my knowledge of those with disease of addiction; I have gained a deeper understanding of what creates, maintains and perpetuates addiction in an individual. There are a number of different factors that create an addiction and it is not just an individual making a wrong decision as I had been previously taught to believe by my family and society. ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">My thoughts on treating those with disease of addiction were challenged when I started to look at how other countries dealt with illicit drugs. The major awareness I have gained though doing this research is that when I treat a patient who has an addiction I will be consciously aware of the deeper roots that led them into the circumstances they are in as addiction is never as simple as it appears on top ====

<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Reflection

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====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Australian Institute of Health and Welfare (2011). //2010 National Drug Houshold Survey Report.// Retrieved from [] ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Brennan, G. (2008). Crime and punishment: An expressive voting view. //European Journal of Law and Economics, 26//(3), 237-252. doi: 10.1007/s10657-008-9068-4 ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Dilip, K. D., & Amanda, L. R. (2001). The police in Norway: A profile. //Policing, 24//(3), 330-346. Retrieved from [] ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Douglas, M., Nosyk, A., Jaffe, A., Urada, D., & Evans, E. (2013) Offender Diversion Into Substance Use Disorder Treatment: The Economic Impact of California’s Proposition 36. //American Journal of Public Health,// 103(6), 1096-1102. doi: 10.2105/AJPH.2012.301168 ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Europe: Treating, not punishing; Portugal's drug policy. (2009, Aug 29). //The Economist, 392//, 43-44. Retrieved from [] ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Fazel, S., & Baillargeon, J. (2011). The health of prisoners. //The Lancet, 377//(9769), 956-65. Retrieved from [] ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Granheim, P., Johnsen, B., & Helgesen, J. (2011). Exceptional prison conditions and the quality of prison life: Prison size and prison culture in Norwegian closed prisons. //European Journal of Criminology.// //8//(6), 515-529. doi: 10.1177/1477370811413819 ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Lawson, L. (2007). Why moral panic is dangerous. //Journal of Forensic Nursing, 3//(2), 57-59. Retrieved from http://search.proquest.com/docview/236445889?accountid=13380 ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Lorenc, T., Clayton, S., Neary, D., Whitehead, M., Petticrew, M., Thomson, H., Cummins, S., Sowden, A., & Renton, A. (2012). Crime, fear of crime, environment, and mental health and wellbeing: Mapping review of theories and causal pathways. //Journal of Health and Place 18//(4), 757-765. Retrieved from [] ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Milianovic, N. (2010). Norway’s new prisons: Could they work here. //Stanford Progressive.// Retrieved from [|//http://www.stanford.edu/group/progressive/cgi-bin/?p=653//] ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">National Institute on Drug Abuse. (2009). Drug Facts: Treatment Approaches for Drug Addiction. Retrieved October 16, 2013, Retrieved from [] ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Robinson, T., & Berridge, K. (2003). Addiction. //Annual Review of Psychology, 54//, 25-53. Retrieved from [] ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Stanton, B. <span class="citationdate" style="font-family: 'Times New Roman','serif'; font-size: 16px;">(2005) <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">. <span class="citationarticleorsectiontitle" style="font-family: 'Times New Roman','serif'; font-size: 16px;">"School drug education in New South Wales: moral panic and the individualisation of youth drug use. <span class="citationsource" style="font-family: 'Times New Roman','serif'; font-size: 16px;">//Social alternatives// <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">, <span class="citationvolume" style="font-family: 'Times New Roman','serif'; font-size: 16px;">24 <span class="citationissue" style="font-family: 'Times New Roman','serif'; font-size: 16px;">(4), 50-54. Retrieved from [] ====

====<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Vale de Andrade, P. <span class="citationdate" style="font-family: 'Times New Roman','serif'; font-size: 16px;">(2010) <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">. <span class="citationarticleorsectiontitle" style="font-family: 'Times New Roman','serif'; font-size: 16px;">Drug decriminalisation in Portugal. <span class="citationsource" style="font-family: 'Times New Roman','serif'; font-size: 16px;"> //British medical journal,// <span class="citationvolume" style="font-family: 'Times New Roman','serif'; font-size: 16px;">341(10), <span class="citationspagevalue" style="font-family: 'Times New Roman','serif'; font-size: 16px;">4554 <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">- 4559. doi: 10.1136/bmj.c4554 ====