The+health+benefits+of+drug+decriminalisation

**Are we punishing those with the disease of addiction?** []
 * James Burley**
 * 08794324 **
 * Jey Rodgers **

This is an article written by Erik Kain focussing on the current debate of drug decriminalisation. The article is written to support the argument against leaving drug laws as they are through highlighting the positive findings of the drug decriminalisation in Portugal in 2001. Kain highlights that the observed decreases in drug abuse and drug crime, as well as the rise in people in rehabilitation treatment, is directly attributable to the change of laws.
 * Artefact: ‘Ten Years After Decriminalisation, Drug Abuse Down by Half in Portugal’.**

Drug addiction and drug abuse is on the rise in Australia. Rising with it is the number of people now facing severe negative health effects due to their drug addiction. Drug addiction, by definition, is a compulsive pattern of seeking and using drugs at the expense of other activities. Unfortunately, there is heavy stigma associated with illicit drug users which generates a divide between them and the help they need. This is the root cause of users developing health issues and needs to be treated as a disease that can be cured.
 * Name the public health issue central to your analysis.**

Robinson and Berridge (2003) highlight that the use of addictive substances doesn’t automatically equate to addiction. It is widely accepted that addictive drug use override and change the neural pathways involved in pleasure, incentive, motivation and learning (Kelley & Berridge, 2002). Further to this, they argue addiction is more than simply repetitive drug use – it is a compulsive pattern of seeking and using drugs at the expense of other activities due to drastic chemical changes within the brain (Robinson & Berridge, 2003). Once the ‘wanting’ neural system has been activated, in this case for an addictive drug, it can guide a person’s behaviour without them having a conscious awareness of wanting to do so (Berridge & Winkielman, 2002).
 * Literature review.**

Theories behind the nature of addiction have been developed around neuro-biologic studies on learnt behaviour and memory mechanisms (Camí & Farré, 2003). These studies have found addictive drugs can have positive and negative reinforcing effects on drug dependency (Camí & Farré, 2003). Drugs which have a positive reinforcement on the user are those which produce euphoria, while negative reinforcement drugs alleviate the negatives of drug abuse, including the physical signs of withdrawal and the dysphoria following use (Camí & Farré, 2003). Environmental stimuli have also been attributed to users suffering withdrawals or cravings in the absence of drug use (Camí & Farré, 2003).

Food, drink and sex stimulate the dopamine reward pathway (Camí & Farré, 2003). These pathways are also stimulated by illicit drugs, which eventually leads to dependence on drugs to have the ‘good’ feelings (Camí & Farré, 2003). The use of illicit drugs is as if an irreversible switch were turned on in the brain where illicit drugs are needed to complete the ‘feel good’ circuit (Kuhar, 2010). To combat the effects of drug use, the body ‘raises’ the threshold of those reward pathways affected in an attempt to reduce the severity of side effects (Camí & Farré, 2003). Unfortunately, this fuels the compulsive drug-seeking and drug-taking behaviour as the natural reward pathways are unable to reach the required trigger points, and thus more drugs are required to ‘feel good’ (Camí & Farré, 2003). As a result, poly-drug use is more frequent among those suffering addiction and results in dependence on all drugs used (Camí & Farré, 2003).

Counter to this, Vrecko (2010) highlights that addiction can occur independent of drug use, such as gambling addicts, but have found that drug treatments are still effective in treating these forms of gambling, aiding the argument that addiction is a biological change. For this reason, future research should be targeted at creating drugs which block, substitute or blunt the effects of illicit drugs to aid them in their journey to become clean (Vrecko, 2010).

Kuhar (2010) suggests addiction is a chronic relapsing brain disease, and not simply a moral or character flaw of certain people due to its neuronal basis. People suffering psychiatric disorders, particularly schizophrenia, bipolar, depression and ADHD are at a higher risk of drug abuse than those not suffering from a mental disorder (Camí & Farré, 2003). Individuals who suffer a mental disease and are dually diagnosed with substance abuse suffer much more unfavourable outcomes due to complications with management and treatment (Camí & Farré, 2003).

Over extended periods of use, the body builds a tolerance to illicit drugs (Camí & Farré, 2003). The higher the tolerance levels, the higher or more frequent doses are required to receive the same high (Camí & Farré, 2003). Withdrawals compel addicts to reuse drugs in order to combat the physical symptoms and dysphoria or other mood changes associated with coming off their high (Camí & Farré, 2003). As tolerance and withdrawal symptoms increase, more compulsive drug-seeking and drug-taking behaviours develop (Camí & Farré, 2003).

Moral Panic, as defined by the Oxford Dictionary (2013), is “an instance of public anxiety or alarm in response to a problem regarded as threatening the moral standards of society”, has led to a huge misconception and poor understanding of the link between drug use and drug crime. This has given politicians and special interest groups the ability to act hastily and without critical analyses of the problem as they are able to mask it as responses to public outcry. A moral panic forms in society due to public, political, law enforcement agents and media concerns about a particular issue, behaviour or phenomenon present in society. If a clear and concise evaluation of the impacts of the issue were assessed, it would likely reveal that there really is no concern to society from the issue.
 * Cultural and social analysis.**

The simplest and most common social theory surrounding drug addiction is the ‘Opponent Process Theory of Addiction’ (Robinson & Berridge, 2003). This theory suggests that addictive drugs are taken initially just to achieve a high, and then after addiction to avoid withdrawal lows (Robinson & Berridge, 2003). Drugs are also taken to avoid life stresses, as these make us feel sad or down in a similar way to coming off of a drug high (Robinson & Berridge, 2003). Thus, people in society who often feel down about themselves or their situations, who feel they can’t get a break or everything goes against them, are more likely to be affected by drug addiction. Conversely, people of high ranking positions in business or enterprise can feel overwhelmed by their work, that there is no way to escape the constant stress of being successful and turn to illicit drug use to unload and unwind. Given the current moral panic driven prohibition laws, and the negative stigma surrounding those who use drugs, it becomes extremely difficult for those suffering from addiction to seek help. They are scared to ask for help for fear of criminal prosecution or social exclusion from friends and family. These negative views and social treatment are further perpetuating user’s habits and making the cleaning process harder to complete. Critical thought and analyses needs to be used to make drug addiction a more approachable subject and to open people’s minds to the concept that users aren’t a detriment to society, but the views and treatment of users is.

Following the Portugal system where offences are removed from users and offered help instead of criminal punishments has been a major influence in removing the negative stigma associated with drug use. Public health workers, and in particular policy makers around the world where illicit drug use is impacting society, need to have a serious look at decriminalisation. Evidence is showing this is having a much stronger influence in cleaning people up and reducing drug related crime than current prohibition laws are.

This article is a really good supporter for the arguments against drug prohibition. There is substantial evidence out there based on Portugal’s laws that suggests decriminalising drugs has had a more positive impact on users than the previous prohibition laws did. Reflecting on this, my initial thoughts throughout the semester were not only to continue prohibition laws, but to expand these laws to include alcohol and tobacco. Seeing the results of the Portugal law changes has left me more open to the idea of decriminalisation, though I am still sceptical of it. I do still feel that tobacco products should be prohibited but have eased my stance on alcohol. Evidently, taking a stone hard stance against illicit drugs through prohibition laws and the idealism that it is an antisocial behaviour hasn’t had much success. In fact, many researchers feel that it is having the opposite effect, and actually perpetuating more and more people developing addiction. Both this wiki page and the tutorial program have definitely changed my approach to this topic. I wouldn’t go so far as to advocate for the decriminalisation of illicit drugs, but from a public health perspective I’m certainly not against it so long as similar support systems to those of the Portugal system are put in place. Berridge, K. & Winkielman, P. (2002). What is an Unconscious Emotion? (The Case for Unconscious ‘Liking’). //Cognitive Emotion in Press//.
 * Analysis of the artefact and your own learning reflections.**
 * Bibliography**

Camí, J. & Farré, M. (2003). Drug addiction. //The New England Journal of Medicine, 349//(10): 975-986.

Dunbar, D., Kushner, H. & Vrecko, S. (2010). Drugs, addiction and society. //The London School of Economics and Political Science, 5(//1): 2-7.

Kelley, A. & Berridge, K. (2002). The Neuroscience of Natural Rewards: Relevance to Addictive Drugs. //Journal of Neuroscience, 22//(1): 3306-3311.

Kuhur, M. (2010). Contributions of basic science to understanding addiction. //BioSocieties, 5//(1): 25-35.

Oxford University Press (2013). Moral Panic. Oxford University Press, Oxford, UK. Retrieved: []

Robinson, T. & Berridge, K. (2003). Addiction. //Annual Review of Psychology, 54//(1): 25-53.

Vrecko, S. (2010). ‘Civilizing Technologies’ and the control of deviance. //BioSocieties, 5//(1): 36-51.

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 * Wiki comments**

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