Drug War Vs Self Medication

Commenter John at The Soros Plan For The 2012 Election had this to say.

Drug users aren’t in chronic pain, and drug use isn’t self-medication. That’s a cop-out.

Which brought to mind a number of old articles I wrote on the subject. So I left a LOT of links in the comments. One of the links was to the following article which has not yet been posted here. Thanks for the opportunity John.

(note: this article is from 2005 and some of the links may be dead)

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A Well Known Secret

I have been a monomaniac for the last three years promoting the idea that most drug users are self medicating for undiagnosed conditions. A lot of PTSD, some bipolar, some ADD/ADHD etc. Below I have reprinted two reports from the field. One a drug counselor and another from a doctor.

Both point to the fact that a lot of problem drug users are self medicating. Clayton Cramer, with whom I have been having a most interesting private discussion, has brought up a number of interesting questions. The most important is this: he does not doubt that some chronic users may be self medicating (although which users and which conditions is still in contention), what he does believe, though, is that there might actually be a large number of recreational users to whom harm is being done (we will leave out the libertarian question of whether self inflicted harm is any of the governments business, except for the up coming war on food eaters). And with that question although I have my beliefs I have no proof.

Which brings up a most important question. Why don’t we have better studies on this question? We are studying drugs deeply. Why aren’t we studying drug users?

REPRINTS

First what a drug counselor says:

From Winds of Change:

#3 from Guy Hall on April 26, 2003 03:08 AM

As a drug and alcohol counselor, I agree wholeheartedly with pain being the main cause of alcoholism and chemical dependency. PTSD is but an extreme example of the pain that alcoholics and drug addicts suffer. For many of my clients, abuse both phyisical and emotional was the means used to teach them destructive beliefs. The more “energy” used in the abuse, the more pain carried into adulthood.

Consequently, that results in more “energy” needed to overcome those beliefs.

Oh, and the one emotional pain that I see? Shame…..whether it be men or women, it is shame that routinely surfaces as the undelying pain being covered up with drugs/alcohol. Women who suffered incest speak more about the pain they felt when, after the deed was done, they got the look of scorn and disgust from their father.

And then this bit from a doctor commenting on a study I reviewed on Adolecent Drug Use.

Originally posted at Grand Rounds 29 Sept ’05

The Grand Rounds for this week is up and they have been kind enough to comment on a recent post of mine More Vindication.

Power and Control shares a compelling review of research supporting the hypothesis that drug abuse is self medication for pain/anxiety. This is one of the self-evident “truths” that most of us accept without good science to back us up. Last week I suggested an antidepressant medication for a man who drinks heavily – smokes marijuana often, and uses cocaine to “keep stable.” But he doesn’t want to take a medication for fear it will alter his physiology. “Man – you ARE taking medications” I meekly suggest. He doesn’t see it that way.

Cross Posted at Power and Control

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In answer to a comment on how self medication can be detrimental, I made this counter comment:

Anon. says that it is dangerous for folks to self medicate because that makes the problem worse.

So how does a doctor treat the problem? He asks the patient questions. Gets a history and prescribes the latest and greatest (according to the ads) from big pharma. He tells the patient to take the drugs on such and such a schedule, for so long, and then come back for an evaluation.

Then he asks how did it work? What are the side effects? Want to try something else? Very good.

Now how is that any different (aside from the consult) from what people do when they self medicate? They try drugs. See if they work to reduce the mood swings or make them tolerable and if not or the side effects are too much they try something else.

My bottom line is not that these folks shouldn’t get better help and better drugs if that is what is needed.

My bottom line is that we should not be putting them in jail.

I might add that putting their suppliers in jail is not going to help either.