September/October 2009 Issue

Reshaping the Nation’s Approach to Drugs
By Christina Reardon
Social Work Today
Vol. 9 No. 5 P. 6

The generals leading the federal government’s “war on drugs” appear to be changing their battlefield strategy. In May, former Seattle police chief R. Gil Kerlikowske became director of the Office of National Drug Control Policy (ONDCP), one of the major entities involved in the government’s efforts to reduce illicit drug use and its criminal, societal, and health consequences. In his first few months on the job, Kerlikowske has signaled that the ONDCP will move toward an approach that favors treatment and rehabilitation over punishment and incarceration.

Those signals have fueled speculation among social workers and other addiction professionals that the Obama administration will usher in a new era in which human services professionals play a larger role in fighting the nation’s drug problems.

“It’s an exciting time to be in human services. There are a lot of opportunities to make a positive difference,” says Linda Rosenberg, MSW, president and CEO of the Washington, DC-based National Council for Community Behavioral Healthcare. “We just have to make sure we’re ready to step up to the plate.”

A Paradigm Shift
An examination of Kerlikowske’s public statements since his arrival at the ONDCP indicates that the Obama administration is distancing itself from the tough-on-offenders approaches favored by its predecessors. For example, Kerlikowske advocated for an expansion of drug treatment and substance-abuse prevention services in a June 24 statement issued at the release of the United Nations Office on Drugs and Crime’s 2009 World Drug Report.

“In the United States, we are moving away from divisive ‘drug war’ rhetoric and focusing on employing all the tools at our disposal to get help to those who need it,” Kerlikowske said. “We recognize that addiction is a disease and are seeking public health solutions. My top priority is to intensify efforts to reduce the demand for drugs which fuels crime and violence around the world.”

This shift is favored by many members of the public. A national survey of 1,000 people conducted by the Hazelden Center for Public Advocacy last year found that 79% of respondents believed the war on drugs has been unsuccessful. Eighty-three percent of the respondents agreed that first-time drug offenders should get treatment rather than prison time.

It remains unclear which specific changes the Obama administration will want—and be able—to make to national drug policy. But that hasn’t stopped observers in the addictions field from discussing what they would like to see. Many addiction professionals say a top priority for the Obama administration should be pouring resources, monetary and otherwise, into making high-quality drug treatment services available to more people.

“Definitely, the more we can focus on treating these individuals, what we will see is a decrease in crime and the social ills plaguing our communities,” says Christopher Shea, MA, CAC-AD, CRAT, clinical program director at Father Martin’s Ashley, a treatment center in Havre de Grace, MD. “We will create more productive people in our society.”

Many observers say another priority should be increasing the number of drug courts. Such courts combine judicial supervision, treatment, drug testing, and interdisciplinary cooperation to promote recovery among substance abusing offenders. An expansion of drug courts would help prevent the damage incarceration inflicts on families and communities, says Chad Dion Lassiter, MSW, an adjunct lecturer at the University of Pennsylvania’s School of Social Policy & Practice in Philadelphia and a member of the Philadelphia Prison System’s Board of Trustees.

Lassiter believes the federal government should revisit the Anti-Drug Abuse Act of 1986, which established mandatory prison sentences for drug possession. Opponents of the law argue that its requirement of especially harsh sentences for possession of crack cocaine has unfairly targeted poor blacks and Latinos. “It looks like it was a war on drugs, but it was in fact a war on poor black and brown people,” Lassiter says. “There needs to be a paradigm shift. We can’t just incarcerate people.”

William Knack, PhD, a clinical psychologist in Chappaqua, NY, shares many addiction professionals’ excitement about the possibility of the federal government focusing more resources on treating drug-addicted individuals. However, he says, a truly effective approach to the nation’s drug problems requires a comprehensive solution that targets families and communities through educational programs, prevention programs, alternative activities, and greater recognition of the connections between mental health and addictions.

“When you do all of these things, you have a very powerful and effective approach,” Knack says. “If you do only some of these, it weakens the approach and makes it look like treatment is not as effective as it is.”

Ready for Change?
A comprehensive approach to drug policy could provide many opportunities for social workers who want to pursue careers in the addictions field, says Flavio Marsiglia, PhD, director of the Southwest Interdisciplinary Research Center at Arizona State University’s School of Social Work. Their ecological perspective and understanding of resiliency makes social workers especially well positioned to fight addiction, he says. However, new opportunities created by changes in federal policy will come with new responsibilities to ensure that those changes are worth the investment, Rosenberg says.

“There are going to be opportunities for social workers, but what we do will have to be effective or the pendulum will swing back [toward a law enforcement model],” she says. “Just being well meaning doesn’t mean that you’re going to be effective. Social workers need to do their homework to focus on evidence-based practices and successful interventions. We have to use the best techniques and measure outcomes.”

The addictions community also must focus more of its attention on workforce development, says Daniel Guarnera, government relations director with Alexandria, VA-based NAADAC, the Association for Addictions Professionals. The organization supports efforts to increase the availability of loan forgiveness and training scholarships for people who want to work in addictions.

Schools of social work have a vital role to play in workforce development as well. Too few schools adequately teach students about effective treatments for addiction and addictions research, Marsiglia says. “Schools should take this opportunity to offer more training so their students will come out feeling confident and well prepared,” he says.

Social workers need to see themselves not only as people who treat addictions but also as advocates for their profession and the people they serve, says William C. Moyers, executive director of the Hazelden Center for Public Advocacy in Center City, MN. This advocacy will be especially important as politicians debate the future of healthcare reform and health plans begin implementing changes under the Wellstone-Domenici Mental Health Parity Act of 2008 aimed at expanding insurance coverage for mental health and addiction treatment services.

Advocacy is also vital in this time of economic turmoil when funds for addiction services are in danger of being diverted to other areas, Moyers says.

“Social workers and addiction counselors need to do a better job about speaking out not only about the problems of addictions but also the solutions,” he says. “They need to become advocates for the success of what they do.”

— Christina Reardon is a freelance writer based in Harrisburg, PA, and an MSW candidate at Temple University.