the GLOB BY: ROBERT L. DUPONT, M.D., PRESIDENT, INSTITUTE FOR BEHAVIOR AND HEALTH, INC.
To understand the future of drug testing, we first need to understand the root cause of the modern drug problem. Drugs are chemicals that produce an immediate and intense brain reward commonly resulting in addiction. Because drugs also impair thinking and erode character, drug addiction is different from tobacco, obesity and gambling addictions.
O
ver the past four decades the exposure to drugs has exploded because of the
dramatic increases in the globaliza- tion of drug supply and in the pro- motion drug using behaviors. This has resulted in a menacing global drug abuse epidemic that is fed by recent cultural changes, led by the media and the entertainment indus- try, encouraging impulsive pleasure- producing behaviors. Unfortunately these cultural changes are espe- cially effective with youth, the most vulnerable age group for substance use disorders. The challenge today is to identify cost-effective strategies, compatible with contemporary laws and values that reverse these trends and protect the public health, espe- cially youth, from substance abuse.
The enormity of the potential for growth of the drug problem inter- nationally with its impact on public health and public safety is almost completely unrecognized. In think- ing about the threats of the modern global drug abuse epidemic, con- sider the growing danger of new syn-
28 datia focus
thetic drugs specifically developed to avoid anti-drug laws and drug tests. Then consider the dramatic rise over the past two decades in prescrip- tion drug abuse, which in some ar- eas now eclipses the abuse of street drugs. Last year, for the first time, drug overdose deaths in the US ex- ceeded the number of motor vehicle fatalities. This alarming increase in deaths is driven by the explosive growth of the nonmedical use of pre- scription opiates.
While some characterize the current balanced and restrictive American drug policies as failing, these policies, including keeping the sale and use of these drugs illegal, have protected this country reasonably well from the threat of drugs of abuse. In the United States there is a stark contrast between the prevalence of past month use of all illegal drugs combined (22.6 million) compared to that of two common legal drugs alcohol (131.3 million) and tobacco (69.6 million).1 These figures are striking as 8.9% of the population age 12 and older
spring 2012
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