How Law Enforcement Can Help Drug Addicts

Drug Use and Addiction
Today, tens of millions of Americans routinely use some type of illicit drugs, and the search for ways to help those who become addicted to substances continues in earnest. In the interim, growing numbers of law enforcement organizations have taken assertive steps to help individuals who have developed an addiction to drugs receive the interventions they need to overcome these potentially life-threatening behaviors. The purpose of this paper is to provide a review of the relevant literature concerning drug use and addiction in the context of deviant behaviors, the subculture that exists among drug users and addicts, and their potential for participation in illegal activities. In addition, a discussion why an understanding of this subculture is important for those involved in law enforcement and how understanding can facilitate prevention, recovery, community service, and law enforcement is followed by a summary of the research and key findings concerning these issues in the conclusion.
Review and Discussion
Overview of Drug Use and Addiction
In modern American society, the use of a wide range of drugs is regarded as acceptable behavior that does not deviate from the norm. For instance, people drink alcoholic beverages and coffee which contains caffeine, smoke cigarettes which contain nicotine and a majority of Americans take some type of over-the-counter drugs such as aspirin without violating any social norms (except for tobacco use which is being increasingly restricted and viewed as unacceptable behavior to some extent). While these types of behaviors are not considered deviant, the line is crossed when people continue to use illicit drugs or misuse prescription drugs even when such behaviors cause them enormous problems in life, including the loss of family, employment and involvement with the criminal justice system..
It is important to note, however, that humans have been using mind-altering substances since time immemorial, so views about deviant behavior are temporally and culturally specific. Indeed, this process is evinced by changing social views about the cannabis use, with Mexico and Canada as well as a majority of states having legalized medical marijuana in recent years, and growing numbers are legalizing it for recreational use as well. This situation is in very sharp contrast to just a few years ago when the possession of even small amounts of marijuana carried stiff fines and even incarceration. It is also important to note that the harm reduction model being used by many countries which places a higher priority on help those who have become addicted to drugs achieve recovery rather than penalizing them criminally is a fairly recent trend as well (Pereira & Scott, 2017). Notwithstanding these considerations and for the purposes of the discussion that follows below, drug use and drug addiction will be operationalized as involving illicit substances such as nonprescription opioids.
While intensive research continues into the antecedents of drug use and eventual addiction, a growing body of evidence indicates that the condition is a medical disease rather than a personality deficit that compels certain people to abuse various substances, most of which have some type of addictive quality. In this regard, Miller (2009) emphasizes that, “Most scientists now consider drug addiction a biomedical rather than a psychological condition, or a failure of will, as many laypersons still believe” (p. 14). The rationale in support of the harm reduction model is therefore based on the same thinking that applies to diseases such as diabetes or cancer wherein sufferers are not treated as criminals but are rather provided with the interventions they need to survive and restore them to complete health to the maximum extent possible.
The American Psychiatric Association and the American Medical Association as well numerous other health care organizations currently define drug addiction as “a brain disease that causes an uncontrollable, compulsive drug craving, seeking, and use even in the face of negative health and social consequences” (Miller, 2009, p. 14). This definition further underscores the baffling nature of drug addiction for people who have never suffered from the disorder, and this point is consistently stressed by twelve-step organizations such as Alcoholics and Narcotics Anonymous.
In addition, it is also important to differentiate drug addiction with drug dependence, with the former referring to the potential for so-called “drug sickness” or the psychological and physical withdrawal symptoms that take place in the event that the use of the drug is discontinued (Miller, 2009). In those cases where drug sickness is not a potential eventuality and the primary adverse reaction to the discontinued use of the drug is psychological, the condition is considered drug addiction. As Miller notes, “Certain drugs, such as heroin and alcohol, create physical dependence, while other drugs, such as cocaine, produce very few symptoms of physical dependence and are therefore referred to as primarily creating psychological dependence” (2009, p. 14).
Some additional definitional clarity is available from the DSM-5 criteria for substance abuse which also takes into account the fact that some individuals appear to be psychologically predisposed to developing drug addictions (Hartney, 2018). Likewise, the DSM-5 criteria for substance use disorders includes the tendency for afflicted individuals to continue their drug use despite the problems that they experience as a result of these behaviors (Hartney, 2018).
The substance use disorders covered by the DSM-5 cover a wide range of problems that tend to result from continued substance use, including the following:
· Taking the substance in larger amounts or for longer than intended;
· Wanting to cut down or stop using the substance but unable to do so;
· Spending an inordinate amount of time acquiring, using, or recovering from use of the substance;;
· Cravings and urges to use the substance;
· An inability to manage what should needs to be done at work, home, or school because of substance use;
· Continuing to use in the face of problems in relationships;
· Sacrificing important social, occupational, or recreational activities as a result of the substance use;
· Using substances repeatedly despite the potential for danger;
· Continued use of the substance despite a recognition that it is causing psychological and/or physical problems that are exacerbated by the behavior;
· Increasing tolerance levels to the drug;
· Experiencing withdrawal symptoms that can be relieved by taking more of the substance (Hartney, 2018, para. 3).
Furthermore, the DSM-5 criteria for substance abuse provides a framework in which clinicians can specify the severity of the behaviors along a continuum depending on what type of problems the behaviors are causing as well as their duration. In this regard, Hartney (2018) advises that, “The DSM 5 allows clinicians to specify how severe or how much of a problem the substance use disorder is, depending on how many symptoms are identified. Two or three symptoms indicate a mild substance use disorder; four or five symptoms indicate a moderate substance use disorder, and six or more symptoms indicate a severe substance use disorder” (para. 4). In addition, the DSM-5 diagnostic criteria for substance abuse allow clinicians to specify whether the disorder is “in early remission,” “in sustained remission,” “on maintenance therapy,” or “in a controlled environment” (as cited in Hartney, 2018, para. 3).
Taken together, it is clear that there has been an enormous amount of scholarship focused on drug use and drug addiction, due in large part to the profoundly adverse effects these behaviors have on individuals and the larger society in which they live. Just as clinicians continue to seek to better understand the etiology of drug use and addiction in order to formulate more efficacious interventions, so too do law enforcement authorities need to understand the subculture that exists among these individuals as discussed further below.
Subculture of Drug Use
It is reasonable to posit that the type of subculture that exists among drug addicts depends in large part on what type of drug is involved. For instance, cannabis addicts in Colorado can simply use their Uber app to order the legal limit of grams of marijuana for home delivery without exposing themselves to any danger whatsoever and only a minor inconvenience in terms of time invested. By sharp contrast, methamphetamine or heroin addicts may be forced to venture into unknown dangerous territories and spend a great deal of time in search of their drug of choice (Guadian & Worley, 2016).
There are some defining characteristics of all drug subcultures, however, that can provide law enforcement authorities with some valuable insights concerning the lives of these individuals. For example, according to Lisk (2016), “Drug abuse may be viewed as a subculture characterized by a distinct language, methods of consumption, and social relations” (p. 248). While short-term use of drugs may not result in affiliation with a drug subculture, the longer individuals use drugs and eventually develop an addition, the greater the potential for their involvement with their respective drug subcultures (Lisk, 2016). Interestingly, the same gratification that some people receive as a result of becoming a member of a street gang due to their being affiliated with a larger group of like-minded individuals, drug addicts may likewise derive a sense of purpose and even success when they are able to facilitate their drug use behaviors as a result of affiliation with their respective drug subcultures, an outcome that is especially pronounced among ethnic and cultural minority groups (Lisk, 2016).
Although law enforcement authorities are not social workers or health care providers, they are on the front lines when it comes to helping drug addicts recover from their disorder. The potential for police and correctional officers to become jaded to the suffering that is experienced by drug addicts remains high, though, especially given the consistently high recidivism rates for drugs addicts that become involved with the criminal justice system, but remaining vigilant for opportunities to refer drug addicts to the community-based resources they need to overcome their addiction represents an important part of the job (Amaral & Hess, 2018).
Conclusion
Although tens of millions of Americans routinely use legal drugs of all types, including powerful prescription medications, these behaviors are not regarded as deviant because they fall under the umbrella of socially acceptable. When drug use transforms into drug addiction, however, afflicted individuals can suffer a wide array of psychological and even physical problems due to their increased potential for experiencing a violent crime while in search of their drug of choice. The research was consistent in emphasizing the need to view these behaviors as part of a disease and that people suffering from a disease should not be treated as criminals but should rather receive the assistance they need to restore their lives to a healthy condition, Because of their direct involvement with drug subcultures, law enforcement authorities are in a good position to facilitate this assistance provided they gain an understanding of the underlying factors that cause drug addiction.




References
Amaral, J. A. & Hess, A. (2018, January 1). The dynamics of providing support to crack cocaine addicts in open-air drug scenes: The lessons learned by the 'Helpers' Intervention Project.: International Journal of Action Research, 14(1), 30-33.
Guadian, A. & Worley, R. M. (2016, October). Code of the suburb: Inside the world of middle-class drug dealers. Theory in Action, 9(4), 90-94.
Hartney, E. (2018, September 26). A guide to DSM 5 criteria for substance abuse disorders. Dotdash Publishing. Retrieved from https://www.verywellmind.com/dsm-5-criteria-for-substance-use-disorders-21926.
List, Y. (2016, July). If the barn Is burning, let the house burn as well: Patterns of drug abuse among FSU immigrant drug addicts in Israel. Journal of Drug Issues, 46(3), 247-251.
Miller, R. (2009, February). Advancing understanding of drug addiction and treatment. Science Scope, 32(6), 14.
Pereira, M. & Scott, J. (2017, January 1). Harm reduction and the ethics of drug use: Contemporary techniques of self-governance. Health Sociology Review, 26(1), 69-73.