On drug ad­dic­tion and mar­i­juana

The Philippine Star - - OPINION - Email: el­fren­[email protected] ELFREN S. CRUZ SUN­DAY

Ihave avoided writ­ing about the “war on drugs” un­til to­day. I be­lieve most peo­ple would agree that drug ad­dic­tion must be stopped. Even the United Na­tions launched a ten-year global war on drugs in 1998. I think the dif­fer­ent opin­ions lie in the method­ol­ogy. Also, I view drug lords and drug push­ers as crim­i­nals. I see drug ad­dicts as vic­tims of a sick­ness that is cur­able with the proper care.

My in­ter­est in writ­ing about this topic was sparked by an ar­ti­cle I re­cently read: “The War On Drugs: A Con­flict As Old As Hu­man­ity” by Ian Mor­ris. In his ar­ti­cle he says: “An­cient Peru­vians were us­ing the San Pe­dro cac­tus, which con­tains mesca­line, 9,000 years ago. Ex­ca­va­tors sus­pect that the old­est ev­i­dence of bread pro­duc­tion, at Shubayca, in Jor­dan about 13,000 years ago was a by prod­uct of brew­ing beer, and ar­chae­ol­o­gists have long spec­u­lated that Ice Age cave painters, some dat­ing back 40,000 years, un­der hal­lu­cino­gens. Given the dif­fi­cul­ties of de­tect­ing drug use in the ar­chae­o­log­i­cal record and the fact that fully mod­ern hu­man be­hav­ior be­gan only 60,000 years ago, it’s prob­a­bly safe to say that drugs have al­ways been with us.”

Drugs, like opium, have also in­flu­enced his­tory. China is now said to be one of the ma­jor sources of drugs. But it was the Bri­tish who in­tro­duced opium to China. In the late 18th cen­tury, the Bri­tish East In­dia Com­pany started smug­gling opium from In­dia into China. The Chi­nese Em­peror passed sev­eral edicts against opium in 1729 to 1831. But the trade flour­ished and even the Amer­i­cans joined by bring­ing opium from Tur­key to China. Opium trade is es­ti­mated to have re­sulted in four to 12 mil­lion Chi­nese drug ad­dicts and dev­as­tated the large coastal cities. In 1839, the Chi­nese Em­peror sent a let­ter to the Queen of Eng­land ask­ing to halt the opium trade. His plea was ig­nored and he is­sued an edict or­der­ing the seizure of all opium in Can­ton.

These acts even­tu­ally led to the Opium War of 1856-1860 wherein Bri­tish forces fought for the le­gal­iza­tion of the opium trade. The Bri­tish were able to force China to grant more treaty ports un­der the con­trol of for­eign gov­ern­ments and the opium trade con­tin­ued to flour­ish.

Drugs are ac­tu­ally chem­i­cals that can af­fect the body and the brain. Dif­fer­ent drugs have dif­fer­ent ef­fects. Some drugs have health con­se­quences that are long last­ing or per­ma­nent. All mis­used drugs can af­fect the brain. They cause large amounts of dopamine – a neu­ro­trans­mit­ter that helps reg­u­late our emo­tions, feel­ings and mo­ti­va­tions of plea­sure to pro­duce a “high”. Drugs can change how the brain works and change be­hav­ior. Over time this be­hav­ior can turn into sub­stance de­pen­dence or drug ad­dic­tion.

Can ad­dic­tion be treated suc­cess­fully? Ac­cord­ing to the Na­tional In­sti­tute on Drug Abuse (NIDA), ad­dic­tion is a treat­able dis­or­der. Can ad­dic­tion be cured? Like other chronic dis­eases such as heart or asthma or kid­ney, treat­ment for drug ad­dic­tion usu­ally is not a cure. But ad­dic­tion can be man­aged suc­cess­fully. Treat­ment en­ables peo­ple to coun­ter­act ad­dic­tion’s dis­rup­tive ef­fects on their brain and be­hav­ior and re­gain con­trol of their lives.

If after treat­ment or re­cov­ery, there is a re­lapse to drug use, does this mean it has failed? No, be­cause the chronic na­ture of ad­dic­tion means that for some peo­ple, re­lapse or a re­turn to drug use after an at­tempt to stop, can be part of the process. If peo­ple stop fol­low­ing their med­i­cal treat­ment plan, they are likely to re­lapse. Ac­cord­ing to NIDA, the re­lapse rate for drug use are sim­i­lar to the rates for other chronic med­i­cal ill­nesses.

The most im­por­tant thing to re­mem­ber about treat­ment of drug ad­dic­tion is that like treat­ment of chronic dis­eases, it in­volves chang­ing deeply rooted be­hav­iors. For ex­am­ple, heart or kid­ney dis­or­ders mean chang­ing di­ets, al­co­hol, tak­ing reg­u­lar med­i­ca­tion and hav­ing reg­u­lar check ups. When a per­son re­cov­er­ing from an ad­dic­tion re­lapses, it means that the per­son must im­me­di­ately speak with their doc­tor or psy­chol­o­gist to re­sume treat­ment, mod­ify it or try an­other treat­ment.

Since drug ad­dic­tion is an ill­ness, NIDA states that re­search has shown that when treat­ing ad­dic­tion, med­i­ca­tion is the first and nec­es­sary line of treat­ment. This should be com­bined with some form of be­hav­ioral ther­apy or coun­selling.

Sev­eral other or­ga­ni­za­tions, like the Amer­i­can Med­i­cal As­so­ci­a­tion (AMA) and the World Health Or­ga­ni­za­tion (WHO) con­sider drug ad­dic­tion as a dis­ease.

Mar­i­juana

Whether as a joke or not, Pres­i­dent Duterte’s com­ment about mar­i­juana has brought this sub­ject to pub­lic at­ten­tion. Firstly, mar­i­juana is a name for the cannabis plant. Se­condly, the le­gal­iz­ing of cannabis has be­come a global topic. While the use of cannabis for recre­ational pur­pose is pro­hib­ited in most coun­tries, many coun­tries have adopted a pol­icy of de­crim­i­nal­iza­tion. This means that sim­ple posses­sion is a non-crim­i­nal of­fense. The med­i­cal use of cannabis have been le­gal­ized in many coun­tries – Aus­tralia, Canada, Chile, Colom­bia, Ger­many, Greece, Is­rael, Italy, Nether­lands, Peru, Poland, Sri Lanka and the United King­dom in­clud­ing 33 states in the United States. Uruguay, Canada and ten states in the United States have fully le­gal­ized the con­sump­tion and sale of cannabis for recre­ational use.

There have been many rea­sons ad­vanced for le­gal­iz­ing cannabis. Two of the most com­pelling are the fol­low­ing. First, cannabis has le­git­i­mate med­i­cal ben­e­fits. Among the af­flic­tions that cannabis has been shown to al­le­vi­ate are epilepsy, pain from AIDS, nau­sea from chemo­ther­apy, Crohn’s dis­ease, mus­cle spasms re­lated to mul­ti­ple scle­ro­sis. The other rea­son is that cannabis is less harm­ful than al­co­hol or tobacco; and is even less ad­dic­tive. The New York Times ex­plains that cannabis has never been di­rectly linked to any se­ri­ous dis­ease the way tobacco has with can­cer or al­co­hol with cir­rho­sis. Per­haps it is time for the Philip­pines to con­sider le­gal­iz­ing mar­i­juana or cannabis at least for med­i­cal use.

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