[Article] Legal Drugs Pose Greatest Health Threat, WHO Says

yellum

Legal Drugs Pose Greatest Health Threat, WHO Says

http://story.news.yahoo.com/news?tmpl=story&cid=594&ncid=594&e=6&u=/nm/20040318/hl_nm/health_drugs_dc

RASILIA, Brazil (Reuters) - The health threat from legal drugs like alcohol and tobacco is much greater than that from illegal narcotics, the World Health Organization (news - web sites) said on Thursday.

The first report of its kind by the global body found that dependence on alcohol and cigarettes has a much greater cost for societies than illegal drugs like cocaine and crack.

The Neuroscience of Psychoactive Substance Use and Dependence report said that drug addiction is a growing problem, especially in poor countries which have rising rates of alcohol consumption and smoking.

There are about 200 million illegal drugs users worldwide, or 3.4 percent of the world population, it said. Illegal drugs contributed 0.8 percent to global ill health in 2000, while alcohol accounted for 4.1 percent and cigarettes 4 percent.

The percentages are based on a measurement used by WHO which gauges the burden that premature deaths and years lived with disability impose on society.

The "main global health burden is due to licit rather than illicit substances," the report said.

Men in rich countries are especially vulnerable to suffer from alcohol- and cigarette-related bad health.

"Health and social problems associated with use and dependence on tobacco, alcohol and illicit substances require greater attention by the public health community," WHO Director-General Dr. Lee Jong-Wook said in a statement.

The report also found that it may not be possible to fully cure drug dependence because of long-term changes to the way the brain works.

Health experts need to consider a range of factors in treating drug dependence because it is a disorder caused by genetic disposition, as well as psychological and cultural factors, it said.

"Like major psychiatric disorders, substance dependence may not be curable but improved effectiveness of available treatment has contributed significantly to recovery," said Dr. Catherine Le Gales-Camus, assistant-director general of noncommunicable diseases and mental health at WHO.

The global launch of the report took place in Brazil, a country with spiraling drug-related violence, which has in the past led to rough treatment of drug users.

Any person can become a drug addict and that dependence is a disorder, making it crucial to eradicate the stigma suffered by drug users that can make treatment more difficult, the report said.

Zombrex

Maybe I read it wrong, but isn't it because there are far more legal drug users than illegal drunk users?

DadaKopf

It's a question of how we perceive definitions.

In summary: 'good drugs' = controlled by state; 'bad drugs' = uncontrolled by state.

The problem isn't so much "because there are far more legal drug users than illegal drunk [sic] users" but because we've learned to not conceive of official drugs to be just as damaging as illegal drugs.

The difference is that illegal drugs' benefits have become delegitimised by politicians, doctors and pharmaceutical companies (often for completely rational reasons, other times for financial reasons). We continue to take legal drugs because we're constantly told they're good for us by those same people.

But legal drugs are, obviously, just as damaging as illegal ones, it's just that we accept the doctors' authority to control our health through the superior/inferior relationship that's established by the medical sector. Subsequently, we began internalising that attitude to the point where we're now permitted to self-medicate to a limited extent. So all in all, we've become a lot more dependent on drugs in general, whether self-medicated or otherwise. This leads to problems.

Much of our incorrect attitude to drugs is due to false advertising. "Pain where it hurts" implies painkillers are magical drugs that target pain but leave everything else well alone. Painkillers are blunt instruments, often opiate derivatives, that numb our entire body and cause damage if used long-term.

dr_manhattan

Agreed DadaKopf - though I honestly believe that the resons for controlling substances are entirely financial, because the fight to control them happened way before anyone gave a **** about addiction. If anything, addiction was seen as a boon by, for example, old captains of industry and colonial barons: hence the liquor sold to natives, the opium wars in china, etc.

ther's also a clear body of evidence to suggest that the illegalisation of Cannabis was entirely an economic mnove, to cut off small farmers economically etc.

After all, if our governments really cared about our health, would they sell us as much booze as we want?

Wicknight, I accpet your point, but there is also the way that illegal drugs are consumed compared to legal drugs however, which tends to blur statistics, too: if hard booze (spirits) were produced ilegally, with no constraints or guidelines, there's be a hell of a lot more alcohol related deaths, for example.

And it's also possible that if opium were served in a 4-5% volume beer, that there's be a hell of a lot less crazy addicts than when it's sold as a refined powder or tar.

I'm in no way saying that any illegal drugs are harmless, don't get me wrong, to be frank I think they're all pretty much the same level of danger according to personality type. But I can't help thinking that if any drug had been involved in 2 recent dublin late night kickings that resulted in deaths, there'd be uproar.

Fact is, there's only been about 10 or 15 ecstacy related (directly) deaths in the past 10 years, which compared to alcohol is ridiculous. Mind you, I'm not saying ecstacy is harmless either, ahem ;-)

Earthhorse

Wouldn't one problem with studies such as this be that the sample size of legal drug users is far larger than that of illegal drug users?

It's all fine and dandy saying alcohol and tobacco do more damage but wouldn't a similar study of say fat in people's diets, yield the same results?

dr_manhattan

Err... earthhorse:

someone just asked that: wicknight, above.
And some people tried to answer it.

Might be a move to read the thread before posting?

Earthhorse

Apologies, I did actually read the thread before replying but it was Friday and I was tired. I thought Wicknight was trying to make a slightly different point, but I'm not entirely sure what that might have been now!

In any event I'm not particularly convinced by either response.

Dadakopf, you say that we've learned to not conceive of official drugs to be just as damaging as illegal drugs, which is true of pharmaceutical medications but not of alcohol and tobacco. I imagine, though I don't think the article distinguishes, that the majority of deaths caused by legal drugs are by these two customers. We're constantly being told how bad these are for us and it has had no effect on consumption, broadly speaking. Indeed it might be possible to argue it has had the reverse effect.

Dr. Manhattan, I do understand what you're saying about how making alcohol illegal might make it more lethal, however I don't think that would lead to more deaths. Firstly less people would have access to the drug. Secondly less people would want access to the drug precisely because it was more lethal.

I think the article says less about issues of legality than it does about human behaviour.

rubadub

i think it was also the WHO that said a higher % of alcohol and tobacco users die per year than the % of all the illegal drugs put together. Thats % users not number of users. The % of users of illegal drugs also is underestimated compared to that of legal drugs due to the stigma attached during questioning. therefor the % of deaths of illegal drug users is probably artificially high.

"Secondly less people would want access to the drug precisely because it was more lethal." - that is true but look at heroin. many doctors want it legal since most of the deaths are due to contamination- even though legalisation of heroin may lead to more users the actual deaths are predicted to drop not just the % of user deaths.

Stark

Legalisation of heroin would make it easier for heroin addicts to get treatment without fearing prosecution.

Gurgle

Legalisation of heroin would make it easier for heroin addicts to get treatment without fearing prosecution.

To my knowledge, heroin addicts don't get prosecuted for using heroin, more for stabbing tourists / robbing petrol stations etc. to fund the heroin habit.

A self-sustaining problem as long as heroin is illegal.

Apparently heroin can be produced at consistant high quality, minus rat poison, at approx. €1 per gram (ahem ... 'i heard it in the pub').

If thats even vaguely true, then legalize the damn stuff.

Wouldn't we all be better off if the city's heroin addicts all had €2 per day habits ?

dr_manhattan

Sorry earthhoorse, whilst you may have been more scatty, I think i was more snotty on friday ;-)

As to your points, I kind of agree, but...

"I do understand what you're saying about how making alcohol illegal might make it more lethal, however I don't think that would lead to more deaths."

Hmm... not *exactly* saying that it would, I'm talking about if alcohol had *always* been illegal, if you get me - a true reversal of the situation. It's very hard to predict what would happen in things changed overnight. However I do think that illegal booze is much, much more dangerous than a lot of illegal drugs - witness the amount of people that poitin kills every year... and that's *with* legal booze. If booze were a cheap high, I'd say it would kill many people.

(the scandal over PEG in wine in italy in the late nineties is another case in point: I'm also talking about how criminal minded most booze suppliers are, and what they're sell us if it wasn't for the law)

continuing:

"Firstly less people would have access to the drug."

Hmmm.. see above. Even with booze, many people make illegal booze. I cite prohibition in the US as a case in point, when all indications are that more booze was sold than when it was illegal.

"Secondly less people would want access to the drug precisely because it was more lethal."

Again, hmmm.... (chin stroking ;-))

I wouldn't overestimate the public concern for its own health, especially where getting a buzz is concerned. People would eat human faeces to get high IMHO... but I take your points as being at least possible, if unlikely ;-)

As for gurgle's point about heroin being as cheap as €1 per gramme - i'd imagine that's expensive at the price. €1 per gramme would be for something that's actually hard to get and process, like saffron or something ;-)

Zombrex

Originally posted by k.oriordan
Legalisation of heroin would make it easier for heroin addicts to get treatment without fearing prosecution.

It would also probably lead to a hell of a lot more people using heroin.

I would be far more on for the de-criminalising of drug users to allow them to seek help without constant fear of prosecution, than the legalisation of hard drugs such as heroin that would make it impossible to try and curb the number of people using the drug.

DadaKopf

Dadakopf, you say that we've learned to not conceive of official drugs to be just as damaging as illegal drugs, which is true of pharmaceutical medications but not of alcohol and tobacco. [...] We're constantly being told how bad these are for us and it has had no effect on consumption, broadly speaking.

Somebody else brought up this point, too. I'd say the answer is a bit of both: on one hand, alcohol provides an important (though not always healthy) social ritualistic function; on the other, it's a substance that can cause damage to people's health, their families and society at large.

I think the answer lies somewhere in between. The danger of booze and its social value have to be balanced in terms of its positive and negative effects. It also has to be balanced in terms of any state's ability to control it. Since it's pretty much an uncontrollable substance, politicians have tacitly accepted it is here to stay, that is plays a social role. It should be regulated in a way that preserves its accepted ritualistic function but sets very real limits on when and why people should consume alcohol. Generally speaking, people accept that its sale should be controlled (depending on the society's mores) but that its consumption should be self-regulated be each individual as a member of society. The hope would be to alter people's inner self-regulatory mechanisms.

It's a trade-off between public and private 'goods', or 'bads'. A nice co-optive strategy by the state.

Tobacco is similar. I hate smoking, but clearly it provides similar social functions in other cultures. In the Middle East, people go for a smoke and a coffee instead of a pint, not least because Islam prohibits alcohol.

rubadub

Originally posted by Wicknight
It would also probably lead to a hell of a lot more people using heroin.

Thats what i have always wondered. would you, your friends or relations take up heroin simply because it was now legal? knowing how addictive it was.

i initially thought many of my friends would not try heroin if legal, but then i think of how many of them smoke cigarettes already knowing that they are MORE addictive than heroin.

i saw a program showing heroin addicts in the UK, apparently many doctors are heroin addicts and get a steady clean supply, they lead perfectly normal lives working as doctors and have families just like many nicotine addicts i know.

Gurgle

I would be far more on for the de-criminalising of drug users to allow them to seek help without constant fear of prosecution

Still does nothing about the quality of the drugs, addicts will keep stabbing / mugging and generally terrorising society to pay for it and organized crime gangs keep their main income.

Prescription heroin ?

dr_manhattan

Prescription heroin would be the closest to an answer: however it's not exactly the kind of problem that an "answer" can be found to, is it?

As people say above, it's mostly a matter of people self-regulating, which is the big issue. Illegal drugs are very much a component of an industrialised society that places huge pressures on its members, and then punishes them for taking an easy way out. Only 20, 30 years ago it was a shameful secret to be, for example, an alcoholic. People thought it meant you were weak, of low character, couldn't "cut it" in the real world.

Now we are more understanding, but the pressures that drive people to substance abuse are often just as strong: pressures to perform and conform can sometimes be enough to put people in a place where drugs *are* the answer. And that's not really *their* fault, is it?

So once you legalise drugs, it becomes that much more difficult to place people under the serious stresses our society expects everyone to cope with (doctors being just the perfect example here - hospitals do not function unless medical staff push themselves beyond certain physical limits. The combination of long hours, emotionally draining work, and hard partying is a recipe for addiction, yet there is not other way to run hospitals in a society like this)

So what's to be done?

This is the problem with addiction is that addiction is an understandable, only too understandable, response to a very difficult world. If we are to expect people to manage their own lives in this regard we can't just change one thing and expect everyting to resolve itself around that one thing. We need a serious look at the way our society functions, a serious look not just at the way we live our lives and function day-to-day.

But unfortunately, the drugs / drink issue is just chock full of politicians and hysterical lobbyists who provide lousy short term solutions or worse, simply don't care as long as their position catches the votes. As usual.

One thing i'd definitely say though is decriminalisation is a bad option: as Gurgle says, it does nothing for users or victims of crime, all it does is clear the way for more revenue for organised crime. If drugs laws are going to be relaxed, then IMHO he government should sell that **** directly: that way a record can be kept of people's health in relation to the available dangerous substances.

Or something ;-) - IMHO it's not the easiest problem to propose a solution for, period.

Stark

And of course the fact that these drugs are physically addictive. It's a by-product of a capitalist society. Addictive substances are a goldmine for unscrupulous businesses looking to make money. Look at Coca-Cola, started out putting cocaine in their cola, when they were no longer able to do that they started putting caffeine (another addictive substance) in their cola claiming it was for "the taste" when in fact (along with the sugar) it was getting kids addicted. Same with tobacco companies, same with drinks companies, all huge earners. MacDonald's food is addictive due to all the sugar and fat, another huge earner there. Basically if an addictive substance can be sneaked into something, it will. Noone cares really if a substance is addictive/harmful or not, it's all economics. That's why the illegal drugs are illegal, and caffeine, alchohol and nicotine are all legal. It's something every knows clearly, and yet something that gets ignored when we talk about "it's bad because it's harmful/addictive m'okay". I'd say legalise everything, at least you'll kill the evil of hypocrysy.

dr_manhattan

Agreed, k:

"Noone cares really if a substance is addictive/harmful or not, it's all economics."

Exactly what i thought when I heard that the irish vintner's association (read: irish drug dealers profit protection agency) said that they'd sue against the smoking ban if their livelihoods were damaged.

Thanks, guys - you lovable vintner types, you. What I get from that is "**** all of your health issues, that is not our concern. We will have an issue in this IF and only if we lose precious cash: otherwise, carry on"

Honestly, for all the vitriol aimed at drug dealers ("scum", "vermin", etc) I have yet to see heroin packaged in a sweet wrapper and aimed at kids. However, every time enter an off license, bottles of what look like Mr. Freeze assail from all sides, packed with booze, for the sweet toothed kid market: and the purveyors of alcohol demand a place as respectable traders? yah right.

Oh and to add to the list of products with addictive ingredients: Cat food. Cats go mad for ceratin brands because they are alced with caffeine.

Anyways, back to work ;-)

Victor

Originally posted by Gurgle
Prescription heroin ?

Eh, methadone? Not heroin, but used as a less strong replacement.