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Barthwell maintains call for tough-minded drug policy

August 24, 2014
by Gary A. Enos
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Former federal drug policy official Andrea G. Barthwell, MD, who now directs addiction treatment centers in Illinois and North Carolina, pulled no punches in an Aug. 24 talk at the National Conference on Addiction Disorders (NCAD) when discussing today's policy landscape. While Barthwell's talk sought to make sense of the many changes occurring in substance use service delivery and payment systems, she left no doubt that she sees harm reduction and legalization initiatives as a significant threat to the field and the families it serves.

Citing data about the negative consequences of marijuana use among young people, Barthwell used several stages of her presentation to criticize initiatives to legalize marijuana for medical or recreational use. She said the mindset of legalization supporters can be summed up as, “We intend to legalize all drugs.”

Barthwell will participate in an Aug. 25 panel event at the St. Louis conference; it is the annual meeting's second consecutive panel presentation on marijuana policy, this time focusing on how treatment professionals should process and respond to the public's evolving outlook on marijuana policy. The Aug. 22-26 NCAD is presented by the publisher of Addiction Professional and Behavioral Healthcare.

Barthwell's comments about drug policy did not come without some accompanying criticism. One NCAD attendee live-Tweeted from the plenary session room and suggested that she was distorting arguments regarding topics related to harm reduction. One of his posts read, “If she had her way she would use incarceration and coercion for everything.”

Impact of ACA

Barthwell is a practicing addiction medicine specialist who directs the Two Dreams treatment centers in Chicago and the Outer Banks of North Carolina. She formerly served as a deputy director for demand reduction at the Office of National Drug Control Policy (ONDCP). As part of her talk she posted slides depicting numerous tenets that she lives by, including, “In the USA, we have the resources to treat everyone with this disease.”

And while she said the Affordable Care Act (ACA) clearly is bringing an influx of new patients to the front doors of accessible treatment, she added that this has come with new challenges. Families often need to bridge a 30-day wait for newly purchased insurance coverage to take effect, and policy buyers often have encountered quality-related problems that mean that some of the new plans appear less adequate than Medicaid or Medicare coverage, she said.

She focused a great deal of her talk on enforcement and prevention policy decisions that affect non-users of drugs, non-dependent users, and dependent users. She said that harm reduction strategies such as needle exchange cause problems for all of these subgroups, as they legitimize use for some individuals and actively reinforce/encourage use for others.

Barthwell also faulted the field and society at large for not sounding a clearer message about drugs' harms. “We have not done enough to communicate the downsides of these substances to our young people,” she said.

She also called into question some aspects of the use of medication-assisted treatment such as methadone or buprenorphine treatment for opioid addiction. “We have to recognize that medication-assisted treatment maintains an underlying dependence on the person's drug of choice,” Barthwell said.

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Comments

If you really want to protect families from a drug proven to destroy lives and families, then you should be up in arms, protesting the legality of booze.

Alcohol is the number one cause for traffic fatalities and domestic violence by a huge landslide.
Why doesn't that concern you even more?

Regarding "The Children",

Let's not use "The Children" as an excuse to prohibit and criminalize adult use of a natural plant far less dangerous than perfectly legal alcohol because nobody condones child use, and this is about allowing adults only to choose marijuana.

It's our responsibility as parents by to educate our children on drug use. It's not the government's job to force Draconian Marijuana Laws upon every adult citizen under the guise of protecting "The Children".

What message are we sending our children when it is easier for them to obtain marijuana now with it being illegal than it is for them to buy alcohol?

It doesn't take the intellect of a genius to understand that stores card kids for I.D. Thugs and gang members do not. They also push the real hard drugs on children. Stores do not.

Marijuana legalization will make it harder for children to obtain it.

What message does it send our children when the President of The United States himself alongside a long list of successful people openly admit regular pot use at one time or another in their lives?

While we tell our kids how it will ruin their futures, and then insure so, by allowing our government to to jail our children and give them permanent criminal records when they get caught with a little Marijuana. Especially, if they are the wrong skin color or from the "wrong neighborhood". Which in turn, ruins their chances of employment for life.

The Prohibition of Marijuana is the wrong message to send our children while we glorify, advertise and promote the much more dangerous use of alcohol like it's an all American pastime.

The worst thing about marijuana and our children is what happens to them when they get caught up in the criminal justice system due to it's prohibition.

Protect "The Children" and Our Neighborhoods Through The Legalization and Regulation of Marijuana Nationwide!

Fear of Marijuana Legalization Nationwide is unfounded. Not based on any science or fact whatsoever. So please all you prohibitionists, we beg you to give your scare tactics, "Conspiracy Theories" and "Doomsday Scenarios" over the inevitable Legalization of Marijuana a rest. Nobody is buying them anymore these days. Okay?

Furthermore, if all you prohibitionists get when you look into that nice, big and shiny, crystal ball of yours, while wondering about the future of marijuana legalization, is horror, doom, and despair, well then I suggest you return that thing as quickly as possible and reclaim the money you shelled out for it, since it is obviously defective.

The prohibition of marijuana has not decreased the supply nor the demand for marijuana at all. Not one single iota, and it never will. Just a huge and complete waste of our tax dollars to continue criminalizing citizens for choosing a natural, non-toxic, relatively benign plant proven to be much safer than alcohol.

If prohibitionists are going to take it upon themselves to worry about "saving us all" from ourselves, then they need to start with the drug that causes more death and destruction than every other drug in the world COMBINED, which is alcohol!

Why do prohibitionists feel the continued need to vilify and demonize marijuana when they could more wisely focus their efforts on a real, proven killer, alcohol, which again causes more destruction, violence, and death than all other drugs, COMBINED?

Prohibitionists really should get their priorities straight and or practice a little live and let live. They'll live longer, happier, and healthier, with a lot less stress if they refrain from being bent on trying to control others through Draconian Marijuana Laws.

"...she sees harm reduction and legalization initiatives as a significant threat to the field..."

Sure. Without the court system feeding clients to her, she stands to lose a lot of money. These people aren't going to show up on their own, because in most cases because they're not problem users. Of course, when you define non-addictive substances as addictive, suddenly everyone is a "problem user." How convenient.
By the way, we should "legalize all drugs." The government has no business dictating how grown-ups spend their free time.