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Hard Drugs Essays

Drugs and alcohol abuse college campuses, popular essay topics.

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A First Encounter With Hard Drugs

A glimpse of the path to drug abuse..

Posted July 2, 2021 | Reviewed by Kaja Perina

Note from the author: In this excerpt from our book, The Craving Brain: Science, Spirituality , and the Road to Recovery , my coauthor James B. describes his short journey from alcohol addiction to using cocaine. —Anderson Spickard Jr., M.D.

__________________________________

I stared down at a partially constructed assembly line and tried not to panic . My job was to finish setting up the line and create a plan to train the workers—and I didn’t want to blow it. But after a night of hard partying, my mind was feeling fuzzy. An electrical engineer was explaining to me a wiring process that we both knew I should be able to understand, but he might as well have been speaking a foreign language.

It was my fourth year as an engineering student, and thanks to a fraternity brother, I had landed a high-paying internship with a multinational telecommunications company. After three months of boring grunt work, I had discovered a way to make a small but critical change in a bar code label that saved the company a lot of money. A short time later, I was tapped as the project manager to set up an assembly line being relocated from Canada.

It was an amazing opportunity, with one small problem. Since joining a fraternity in my junior year, my party life had begun spilling over into my workday. My usual six to eight beers had become ten or twelve, with a couple of shots of liquor, and I was getting blackout drunk, not just on weekends, but during the week. One night, a fraternity brother and I made a pact to get drunk every day for a month. We both rose to the challenge, and afterward, to prove to an angry girlfriend that I didn’t have an alcohol problem, I quit drinking for an entire month.

Shortly after starting my internship, I was invited to a party by a group of fraternity guys who were among the elite of the elite in the Greek system. They all came from families with money and power, and as a kid from a middle-class family without connections, I knew my ticket was getting punched for only one reason—my reputation for being able to party like a rock star.

An hour or so into the party, I was invited into a back room.

“Help yourself,” the host said, gesturing to some lines of cocaine on the table.

I hesitated. My childhood yearning for the approval of cool kids had never died and accepting his invitation would take me to a new level of acceptance and belonging. But cocaine was something I had promised myself never to do. It had nearly destroyed my father, and the last thing I wanted was to become like him.

Then again, as I looked around at the guys in the room, I could see they were handling cocaine just fine. They were the sons of doctors and congressmen and lawyers. Maybe nothing’s wrong with the drug itself. Maybe there’s just something wrong with my father. He was too weak to handle drugs, but things will be different for me.

I would use cocaine socially—like normal people.

A single line gave me an immediate jolt of energy and pleasure. A second line was even better. After a couple more drinks, I realized I had finally found the perfect recipe for my partying. Cocaine gave me energy, and alcohol calmed the drug’s jittery edge.

Cocaine also solved my drinking problem. I had always been an upbeat guy with a lot of friends, but it was taking more drinks to get a buzz on, and too much alcohol made me belligerent or blacked out. With just a little coke, I could drink more, act like less of a jerk, and be more attractive to women. I could also stay awake for the drive home.

Of course, there was a downside. Since my partying lasted longer, it was harder to get up in the morning. My boss began to notice my late arrivals, and I was having trouble staying focused at work.

And now, here I was, standing at the assembly line, struggling to understand how it was wired. Feelings of panic flooded through me. To prevent the engineer from seeing my fear and confusion, I excused myself and went to the men’s room. After throwing water on my face, I gave myself a pep talk. You can do this job. You have to do it. Everything is on the line—not just your career but your social status. My tuition and living expenses weren’t cheap, and by now I was buying my own cocaine, instead of just using at parties.

Somehow, I pulled myself together and went back to work, forcing myself to focus on the engineer’s directions. Within a few days and with the help of other employees, the assembly line was wired and put together, and the workers trained. Another bullet had been dodged, a crisis averted.

Not bad, I told myself. A job well done and good times at night. What more could anyone want?

Anderson Spickard, Jr., M.D. , was an Emeritus Professor of Medicine and Psychiatry at Vanderbilt University Medical School. He passed away in 2021.

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• Essay on Drugs

Hard Drug Use {type) To Use As A Writing Model

Type of paper: Essay

Topic: Drugs , Hard , Drug , Disapproval , Marijuana , Heroin , Alcoholism , Alcohol

Words: 1100

Published: 03/08/2023

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U.S has a high number of adolescents hooked to illicit drug use and the percentage of drug abusers is increasing at an alarming rate. There are several reasons for an adolescent to indulge into drug abuse. Factors such as anxiety, depression, getting bored of many things in life, believing that drugs relieves stress, or to forget the painful memories of the past, and building a faith that drugs will help them fit into all situations are few causes that attract the drug abusers. Hundreds of drugs are available in the market depending on the user preference, categorized as hard drugs and soft drugs. People initially begin with lighter drugs like marijuana, and when it starts giving a good feeling, they move to hard drugs, to experience an even better feeling. At this stage the personal disapproval of using of a particular drug becomes strongly defensive against use, and it is difficult to analyze the effects of the use of one drug over another. Many states support the use of marijuana and disapproval towards this drug does not seem to decrease in the near future. With the legalization of marijuana in many states, the young and the adolescents are prone to use the drug without any fear of being penalized. It may be tough task to prevent the young people and adolescent from using other forms of health hazardous things like tobacco, alcohol, or marijuana, but legal steps can be taken to prevent to the users from getting addicted to the multiple hard drugs. As there is a rise in the number of marijuana users and decrease in the use of disapprovals it is required to know if the sale of marijuana or other drugs reduces disapproval towards the use of possible hazardous drugs. Hard drugs are the ones that are dangerous to health, hard drugs include powder cocaine, crack, heroin, amphetamine, ecstasy, and lysergic acid diethylamide (LSD). Hard drugs, and cigarette are known to have the highest risk factors. The strongest protective factor not to use drugs is the disapproval of low level drug such as marijuana. It is not yet certain if regular use of marijuana reduces disapproval towards the use of the hard drugs. Many marijuana users not only mark out other drug users at lesser levels, but also defame users’ addicted to hard drugs such as heroine, ecstasy or powder cocaine. Young people aged 18-24 are the main users of drugs, and the risk of this type of craving in common is seen in children of alcoholics or drug addicts. If the drug addiction starts at a very young age then the person is more likely to try hard drugs at the earliest. Mortality rates are higher in people abusing hard drugs when compared to marijuana users. Using hard drugs makes the person lose concentration on higher priority things in life and neglect other responsibilities. Literature indicates that disapproval by peers in one’s birth cohort is a robust factor predicting use, over and above individual attitudes . Students who used marijuana also use alcohol because it is not as strong as the hard drugs and addiction towards both of them are similar. In females disapproval of crack use or being highly religious increases the odds of disapproval toward crack use, and use of alcohol, cigarettes, or multiple hard drugs that lessen the probabilities. Hard drugs also induce many health effects that may include unintentional death by drug poisoning, injury, and suicide; infectious diseases such as human immunodeficiency virus (HIV). Any overdose of drugs causes’ death and the hard drug opioids is majorly known to increase the number of deaths, which refrains drug abusers to disapprove the drug that they are addicted to. Drug users who have been using heroin for a long period of time are known to be chain smokers than the people who use other forms of hard drugs than heroin. Smoking and drinking are related with heroin use, and people who use cocaine and not heroin are at a higher risk of death. Though the drug users are aware of the risks associated with each hard drug, they disapprove to use any other drug because they are used to the feeling and bodily changes that their drug provides. With regard to LSD disapproval, identifying as female, black, or religious increased the odds of disapproval, and high parent education and alcohol, cigarette, and hard drug use decreased the odds of disapproval . Hard drug users mainly use only hard drugs to satisfy themselves, and in case of the absence of most hard drug users had also used alcohol (94 %), cigarettes (77 %), or marijuana (81 %) , but did not disapprove of using their existing drug. Alcohol is normally weak when related with disapproved drugs, and it is normal that the hard drugs users may always not support themselves with alcohol in the absence of cocaine or heroin. A person using multiple hard drugs always wants to disapprove about the type of hard drug used; however, use of only one hard drug reduces the probabilities of disapproval towards the drugs other than crack and heroin. The constant use marijuana predicts lower disapproval towards the use of LSD, amphetamine, and ecstasy, as these drugs seem to be more socially acceptable than the other hard drugs such as powder cocaine, crack, and heroin. Marijuana users are very much less likely to disapprove LSD, ecstasy and heroin as marijuana induces perceptual changes and altered state of consciousness. Disapproval may not be a disgrace as the policy makers do it regularly to legalize or regularize about the personal disapproval towards the hard drugs, while considering personal disapproval as self-protective. It is required by the legislation to create stringent rules for the hard drug abusers, as once an individual begins the use of a hard drug, that person will disapprove the use of any other hard drug which are at lower levels. It is quite important to focus on the prevention of the use of any of these “harder” illicit drugs, but it is also important to collate these illicit and illegal drugs and educate users about each and every negative effect of every hard drug, so that disapproval rates can increase and we have a healthy nation.

Works Cited

Palamar, Joseph. "Predictors of Disapproval toward “Hard Drug” Use among High School Seniors in the US." Society for Prevention Research 15 (2013): 725-735. PDF.

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The Effects of Drug Addiction on the Brain and Body

Signs of drug addiction, effects of drug addiction.

Drug addiction is a treatable, chronic medical disease that involves complex interactions between a person’s environment, brain circuits, genetics, and life experiences.

People with drug addictions continue to use drugs compulsively, despite the negative effects.

Substance abuse has many potential consequences, including overdose and death. Learn about the effects of drug addiction on the mind and body and treatment options that can help.

Verywell / Theresa Chiechi

Drug Abuse vs. Drug Addiction

While the terms “drug abuse” and “drug addiction” are often used interchangeably, they're different. Someone who abuses drugs uses a substance too much, too frequently, or in otherwise unhealthy ways. However, they ultimately have control over their substance use.

Someone with a drug addiction uses drugs in a way that affects many parts of their life and causes major disruptions. They can't stop using drugs, even if they want to.

The signs of drug abuse and addiction include changes in behavior, personality, and physical appearance. If you’re concerned about a loved one’s substance use, here are some of the red flags to watch out for:

• Changes in school or work performance
• Secretiveness 
• Relationship problems
• Risk-taking behavior
• Legal problems
• Aggression 
• Mood swings
• Changes in hobbies or friends
• Sudden weight loss or gain
• Unexplained odors on the body or clothing

Drug Addiction in Men and Women

Men and women are equally likely to develop drug addictions. However, men are more likely than women to use illicit drugs, die from a drug overdose, and visit an emergency room for addiction-related health reasons. Women are more susceptible to intense cravings and repeated relapses.

People can become addicted to any psychoactive ("mind-altering") substance. Common addictive substances include alcohol , tobacco ( nicotine ), stimulants, hallucinogens, and opioids .

Many of the effects of drug addiction are similar, no matter what substance someone uses. The following are some of the most common effects of drug addiction.

Effects of Drug Addiction on the Body

Drug addiction can lead to a variety of physical consequences ranging in seriousness from drowsiness to organ damage and death:

• Shallow breathing
• Elevated body temperature
• Rapid heart rate
• Increased blood pressure
• Impaired coordination and slurred speech
• Decreased or increased appetite
• Tooth decay
• Skin damage
• Sexual dysfunction
• Infertility
• Kidney damage
• Liver damage and cirrhosis
• Various forms of cancer
• Cardiovascular problems
• Lung problems
• Overdose and death

If left untreated drug addiction can lead to serious, life-altering effects on the body.

Dependence and withdrawal also affect the body:

• Physical dependence : Refers to the reliance on a substance to function day to day. People can become physically dependent on a substance fairly quickly. Dependence does not always mean someone is addicted, but the longer someone uses drugs, the more likely their dependency is to become an addiction.
• Withdrawal : When someone with a dependence stops using a drug, they can experience withdrawal symptoms like excessive sweating, tremors, panic, difficulty breathing, fatigue , irritability, and flu-like symptoms.

Overdose Deaths in the United States

According to the Centers for Disease Control and Prevention (CDC), over 100,000 people in the U.S. died from a drug overdose in 2021.

Effects of Drug Addiction on the Brain

All basic functions in the body are regulated by the brain. But, more than that, your brain is who you are. It controls how you interpret and respond to life experiences and the ways you behave as a result of undergoing those experiences.

Drugs alter important areas of the brain. When someone continues to use drugs, their health can deteriorate both psychologically and neurologically.

Some of the most common mental effects of drug addiction are:

• Cognitive decline
• Memory loss
• Mood changes and paranoia
• Poor self/impulse control
• Disruption to areas of the brain controlling basic functions (heart rate, breathing, sleep, etc.)

Effects of Drug Addiction on Behavior

Psychoactive substances affect the parts of the brain that involve reward, pleasure, and risk. They produce a sense of euphoria and well-being by flooding the brain with dopamine .

This leads people to compulsively use drugs in search of another euphoric “high.” The consequences of these neurological changes can be either temporary or permanent. 

• Difficulty concentrating
• Irritability 
• Angry outbursts
• Lack of inhibition 
• Decreased pleasure/enjoyment in daily life (e.g., eating, socializing, and sex)
• Hallucinations

Help Someone With Drug Addiction

If you suspect that a loved one is experiencing drug addiction, address your concerns honestly, non-confrontationally, and without judgment. Focus on building trust and maintaining an open line of communication while setting healthy boundaries to keep yourself and others safe. If you need help, contact the SAMHSA National Helpline at 1-800-662-4357.

Effects of Drug Addiction on an Unborn Child

Drug addiction during pregnancy can cause serious negative outcomes for both mother and child, including:

• Preterm birth
• Maternal mortality

Drug addiction during pregnancy can lead to neonatal abstinence syndrome (NAS) . Essentially, the baby goes into withdrawal after birth. Symptoms of NAS differ depending on which drug has been used but can include:

• Excessive crying
• Sleeping and feeding issues

Children exposed to drugs before birth may go on to develop issues with behavior, attention, and thinking. It's unclear whether prenatal drug exposure continues to affect behavior and the brain beyond adolescence.  

While there is no single “cure” for drug addiction, there are ways to treat it. Treatment can help you control your addiction and stay drug-free. The primary methods of treating drug addiction include:

• Psychotherapy : Psychotherapy, such as cognitive behavioral therapy (CBT) or family therapy , can help someone with a drug addiction develop healthier ways of thinking and behaving.
• Behavioral therapy : Common behavioral therapies for drug addiction include motivational enhancement therapy (MET) and contingency management (CM). These therapy approaches build coping skills and provide positive reinforcement.
• Medication : Certain prescribed medications help to ease withdrawal symptoms. Some examples are naltrexone (for alcohol), bupropion (for nicotine), and methadone (for opioids).
• Hospitalization : Some people with drug addiction might need to be hospitalized to detox from a substance before beginning long-term treatment.
• Support groups : Peer support and self-help groups, such as 12-step programs like Alcoholics Anonymous, can help people with drug addictions find support, resources, and accountability.

A combination of medication and behavioral therapy has been found to have the highest success rates in preventing relapse and promoting recovery. Forming an individualized treatment plan with your healthcare provider's help is likely to be the most effective approach.

Drug addiction is a complex, chronic medical disease that causes someone to compulsively use psychoactive substances despite the negative consequences.

Some effects of drug abuse and addiction include changes in appetite, mood, and sleep patterns. More serious health issues such as cognitive decline, major organ damage, overdose, and death are also risks. Addiction to drugs while pregnant can lead to serious outcomes for both mother and child.

Treatment for drug addiction may involve psychotherapy , medication, hospitalization, support groups, or a combination.

If you or someone you know is experiencing substance abuse or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357.

American Society of Addiction Medicine. Definition of addiction .

HelpGuide.org. Drug Abuse and Addiction .

Tennessee Department of Mental Health & Substance Abuse Services. Warning signs of drug abuse .

National Institute on Drug Abuse. Sex and gender differences in substance use .

Cleveland Clinic. Drug addiction .

National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction Drugs and the Brain .

American Heart Association. Illegal Drugs and Heart Disease .

American Addiction Centers. Get the facts on substance abuse .

Szalavitz M, Rigg KK, Wakeman SE. Drug dependence is not addiction-and it matters . Ann Med . 2021;53(1):1989-1992. doi:10.1080/07853890.2021.1995623

Centers for Disease Control and Prevention. Drug overdose deaths in the U.S. top 100,000 annually .

American Psychological Association. Cognition is central to drug addiction .

National Institute on Drug Abuse. Understanding Drug Use and Addiction DrugFacts .

MedlinePlus. Neonatal abstinence syndrome .

National Institute on Drug Abuse. Treatment and recovery .

Grella CE, Stein JA.  Remission from substance dependence: differences between individuals in a general population longitudinal survey who do and do not seek help . Drug and Alcohol Dependence.  2013;133(1):146-153. doi:10.1016/j.drugalcdep.2013.05.019

By Laura Dorwart Laura Dorwart is a health journalist with particular interests in mental health, pregnancy-related conditions, and disability rights. She has published work in VICE, SELF, The New York Times, The Guardian, The Week, HuffPost, BuzzFeed Reader, Catapult, Pacific Standard, Health.com, Insider, Forbes.com, TalkPoverty, and many other outlets.

Home — Essay Samples — Nursing & Health — Drugs — Drugs: Effects and Solutions Explored in Research

Drugs: Effects and Solutions Explored in Research

• Categories: Drug Addiction Drugs

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Published: Dec 3, 2020

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Introduction, drugs in general, drugs and society, drug abuse solutions.

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Head to Head

Should drugs be decriminalised no, joseph a califano, jr.

The National Center on Addiction and Substance Abuse at Columbia University, 633 Third Avenue, New York, NY 10017-6706, USA

Recent government figures suggest that the UK drug treatment programmes have had limited success in rehabilitating drug users, leading to calls for decriminalisation from some parties. Kailash Chand believes that this is the best way to reduce the harm drugs cause, but Joseph Califano thinks not

Drug misuse (usually called abuse in the United States) infects the world's criminal justice, health care, and social service systems. Although bans on the import, manufacture, sale, and possession of drugs such as marijuana, cocaine, and heroin should remain, drug policies do need a fix. Neither legalisation nor decriminalisation is the answer. Rather, more resources and energy should be devoted to research, prevention, and treatment, and each citizen and institution should take responsibility to combat all substance misuse and addiction.

Vigorous and intelligent enforcement of criminal law makes drugs harder to get and more expensive. Sensible use of courts, punishment, and prisons can encourage misusers to enter treatment and thus reduce crime. Why not treat a teenager arrested for marijuana use in the same way that the United States treats someone arrested for drink-driving when no injury occurs? See the arrest as an opportunity and require the teenager to be screened, have any needed treatment, and attend sessions to learn about the dangers of marijuana use.

The medical profession and the public health community should educate society that addiction is a complex physical, psychological, emotional, and spiritual disease, not a moral failing or easily abandoned act of self indulgence. Children should receive education and prevention programmes that take into account cultural and sex differences and are relevant to their age. We should make effective treatment available to all who need it and establish high standards of training for treatment providers. Social service programmes, such as those to help abused children and homeless people, should confront the drug and alcohol misuse and addiction commonly involved, rather than ignore or hide it because of the associated stigma.

Availability is the mother of use

What we don't need is legalisation or decriminalisation, which will make illegal drugs cheaper, easier to obtain, and more acceptable to use. The United States has some 60 million smokers, up to 20 million alcoholics and alcohol misusers, but only around six million illegal drug addicts. 1 If illegal drugs were easier to obtain, this figure would rise.

Switzerland's “needle park,” touted as a way to restrict a few hundred heroin users to a small area, turned into a grotesque tourist attraction of 20 000 addicts and had to be closed before it infected the entire city of Zurich. 2 Italy, where personal possession of a few doses of drugs like heroin has generally been exempt from criminal sanction, 2 has one of the highest rates of heroin addiction in Europe, 3 with more than 60% of AIDS cases there attributable to intravenous drug use. 4

Most legalisation advocates say they would legalise drugs only for adults. Our experience with tobacco and alcohol shows that keeping drugs legal “for adults only” is an impossible dream. Teenage smoking and drinking are widespread in the United States, United Kingdom, and Europe.

The Netherlands established “coffee shops,” where customers could select types of marijuana just as they might choose ice cream flavours. 2 Between 1984 and 1992, adolescent use nearly tripled. 2 Responding to international pressure and the outcry from its own citizens, the Dutch government reduced the number of marijuana shops and the amount that could be sold and raised the age for admission from 16 to 18. 2 5 In 2007, the Dutch government announced plans to ban the sale of hallucinogenic mushrooms. 6

Restriction

Recent events in Britain highlight the importance of curbing availability. In 2005, the government extended the hours of operation for pubs, with some allowed to serve 24 hours a day. 7 Rather than curbing binge drinking, the result has been a sharp increase in crime between 3 am and 6 am, 8 in violent crimes in certain pubs, 9 and in emergency treatment for alcohol misusers. 7

Sweden offers an example of a successful restrictive drug policy. Faced with rising drug use in the 1990s, the government tightened drug control, stepped up police action, mounted a national action plan, and created a national drug coordinator. 10 The result: “Drug use is just a third of the European average.” 11

Almost daily we learn more about marijuana's addictive and dangerous characteristics. Today's teenagers' pot is far more potent than their parents' pot. The average amount of tetrahydrocannabinol, the psychoactive ingredient in marijuana, in seized samples in the United States has more than doubled since 1983. 12 Antonio Maria Costa, director of the UN Office on Drugs and Crime (UNODC), has warned, “Today, the harmful characteristics of cannabis are no longer that different from those of other plant-based drugs such as cocaine and heroin.” 13

Evidence that cannabis use can cause serious mental illness is mounting. 13 A study published in the Lancet “found a consistent increase in incidence of psychosis outcomes in people who had used cannabis.” 14 The study prompted the journal's editors to retract their 1995 statement that, “smoking of cannabis, even long term, is not harmful to health.” 15

Drugs are not dangerous because they are illegal; they are illegal because they are dangerous. A child who reaches age 21 without smoking, misusing alcohol, or using illegal drugs is virtually certain to never do so. 16 Today, most children don't use illicit drugs, but all of them, particularly the poorest, are vulnerable to misuse and addiction. Legalisation and decriminalisation—policies certain to increase illegal drug availability and use among our children—hardly qualify as public health approaches.

Competing interests: None declared.

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In conversations about the dangers of addiction, two confusing terms are sometimes thrown around — “hard drugs” and “soft drugs.” These arbitrary categories have no clear criteria or definition, and they also have no scientific basis. Most people will say that hard drugs should be avoided like the plague. Some mistakenly think that soft drugs are mostly safe, while others believe they serve as gateway drugs to harder substances.

In reality, there are many differences between hard and soft drugs — but the differences might not matter as much as you think.

Hard Drugs vs. Soft Drugs

The hard and soft categories people use to describe drugs are chosen more for dramatic impact than anything else. They tell you nothing about the harmfulness of one substance compared to another. Hard drugs are considered more toxic and addictive. Many people have the misconception that they are more dangerous than soft drugs as a result, which isn’t necessarily true.

Most drugs are categorized as hard or soft based on public opinion rather than clear criteria. Consider prescription opioids. These painkillers are chemically similar to heroin and are among the most misused substances in the world. Yet, few people would describe a prescription medication as a hard drug.

What Is Considered Hard Drugs?

While it’s difficult to define hard drugs, these substances are those seen as more potent and toxic, both physically and mentally. These highly addictive drugs are usually injectable, causing the most damage to organs and natural functions in the shortest amount of time.

The following substances are different types of hard drugs:

• Crystal methamphetamine
• Cocaine and crack
• Hallucinogens, such as LSD

Soft Drug Definition

Soft drugs are considered less harmful than hard drugs, producing little to no physical or mental damage. The term “soft drug” is often used interchangeably with the phrase “gateway drug.” The drugs in this category are either there because they are legal to use or more socially acceptable than hard drugs. Soft drugs include:

• Psilocybin mushrooms, also called shrooms

While soft drugs are perceived as less physically and mentally addictive and less harmful, that’s not necessarily the case. Alcohol, nicotine and marijuana can lead to serious health problems, like liver disease, impaired brain function and several forms of cancer.

Why Misusing Any Substance Is Dangerous

Today, many people use the hard versus soft drug debate as an excuse to make certain substances more socially acceptable than their hard counterparts. The truth is that all drugs, whether hard or soft, have the potential to cause severe physical and mental harm.

Substance use is not safe or healthy. Regardless of how people try to categorize drugs, those who fall into patterns of misuse can experience many health complications due to addiction.

Whether you find yourself drinking too much or you struggle with a serious opioid addiction, help is available at Gateway Foundation. We treat addictions to both hard and soft drugs. We want to see you break free from substance use. Contact us today to learn more about our individualized addiction treatment programs.

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Gateway Foundation

Gateway Foundation is a recognized leader in evidence-based addiction treatment proven to get results. Our experts in Addiction Medicine—including highly educated clinical and medical professionals and expert psychiatrists and nurses—deliver care that never stops. For over 50 years, Gateway Foundation has been helping individuals and their families recover from addictions and behavioral health issues and is the only provider that covers the entire state of Illinois with 16 facilities from the Wisconsin Border to the Kentucky Border. Gateway has specific programs focusing on substance use disorders, trauma, depression, anxiety, and other co-occurring issues. We’re licensed by the state of Illinois and accredited by the Joint Commission. We are in-network with all the major commercial insurance plans. Gateway Foundation: Addiction medicine, saving lives.

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The Science of Drug Use: A Resource for the Justice Sector

Why do people use drugs.

People use drugs for many reasons: they want to feel good, stop feeling bad, or perform better in school or at work, or they are curious because others are doing it and they want to fit in. The last reason is very common among teens.

Drugs excite the parts of the brain that make you feel good. But after you take a drug for a while, the feel-good parts of your brain get used to it. Then you need to take more of the drug to get the same good feeling. Soon, your brain and body must have the drug just to feel normal. You feel sick, awful, anxious, and irritable without the drug. You no longer have the good feelings that you had when you first used the drug. This is true if you use illegal drugs or if you misuse prescription drugs. Misuse includes taking a drug differently than how your doctor tells you to (taking more or crushing pills to "shoot up" or snort), taking someone else’s prescription, or taking it just to get “high.”

Drug use can start as a way to escape—but it can quickly make your life worse. Besides just not feeling well, different drugs can affect your brain and body in many different ways. Here are a few:

• Alcohol: You might have trouble making decisions, solving problems, remembering, and learning.
• Marijuana: You might forget things you just learned or have trouble focusing.
• Prescription pain relievers (opioids) or sedatives: Your heart rate and breathing may slow to dangerous levels, leading to coma or death.
• Heroin: Similar to opioid pain relievers, your heart rate and breathing may slow to dangerous levels, leading to coma or death.
• Prescription stimulants (e.g., ADHD medications): Your body temperature could get dangerously high, or you may have an irregular heartbeat, heart failure, or seizures.
• Cocaine and methamphetamine: You may get violent, have panic attacks or feel paranoid, or have a heart attack.
• MDMA (Ecstasy or Molly): You may feel confused for a long time after you take it and have problems with attention, memory, and sleep.
• LSD: Your emotions may change quickly, and you might not be able to recognize reality; frightening flashbacks can happen long after use.
• Inhalants: Your heart, kidneys, lungs, and brain may get damaged; even a healthy person can suffer heart failure and death within minutes of sniffing a lot of an inhalant.

Many drugs can also make driving a car unsafe. Marijuana can slow reaction time, make you judge time and distance poorly, and decrease coordination (how you move your body). Cocaine and methamphetamine can make a driver aggressive and reckless. Certain kinds of sedatives, called benzodiazepines, can make you dizzy or drowsy. These effects can lead to crashes that can cause injuries and even death.

What is drug addiction?

Drug addiction is when you can’t stop taking the drug even if you want to. The urge is too strong to control, even if you know the drug is causing harm. The addiction can become more important than the need to eat or sleep. The urge to get and use the drug can fill every moment of your life. The addiction replaces all the things you used to enjoy. A person who is addicted might do almost anything—lie, steal, or hurt people—to keep taking the drug. This can lead to problems with your family and friends, and can even lead to arrest and jail. You can get addicted to illegal drugs as well as prescription drugs if you misuse them.

Drug addiction is a chronic disease. That means it stays with you for a long time, even if you stop using for a while. It doesn't go away like a cold. A person with an addiction can get treatment, but quitting for good can be very hard.

Can I just use willpower to stop using drugs?

At first, taking drugs is usually your choice. But as you continue to take them, using self-control can become harder and harder; this is the biggest sign of addiction. Brain studies of people with addiction show physical changes in parts of the brain that are very important for judgment, making decisions, learning and memory, and controlling behavior. Scientists have shown that when this happens to the brain, it changes how the brain works and it explains the harmful behaviors of addiction that are so hard to control.

If I stay off drugs for a while (e.g., in the criminal justice system or in residential treatment), will it be easy to remain drug-free?

Sometimes people quit their drug use for a while because they’re away from triggers that remind them about their drug use. Away from home, drugs might be less available. Once you go back to normal life, you’re likely to start using again unless you take action to avoid your triggers. This return to drug use is called a relapse. People recovering from addiction often have one or more relapses along the way if they don’t take steps to avoid their triggers.

What is a trigger?

A trigger is anything that makes you feel the urge to go back to using drugs. It can be a place, person, thing, smell, feeling, picture, or memory that reminds you of taking a drug and getting high. A trigger can be something stressful that you want to escape from. It can even be something that makes you feel happy. People fighting addiction need to stay away from the people and triggers that can make them start using drugs again, just like people with breathing problems need to avoid smoke and dust.

People who have stayed sober for a while, either because they were in jail or in treatment, should know that they are at a high risk of overdose if they relapse and take the same amount of drug they used to. Their cravings may not have decreased, but their tolerance has, meaning their body can’t handle high doses of the drug anymore. Without immediate treatment, overdose often leads to death. This is why you often hear about people dying of an overdose soon after leaving rehab.

What makes people more likely to get addicted to drugs?

• Trouble at home.  If your home is an unhappy place, or was when you were growing up, you might be more likely to have a drug problem. When kids aren't well cared for, or there are lots of fights, or a parent is using drugs, the chance of addiction goes up.
• Mental health problems.  People who have untreated mental health problems, such as depression or anxiety, or untreated attention-deficit/hyperactivity disorder (ADHD) are more likely to become addicted. They might use drugs to try to feel better.
• Trouble in school, trouble at work, trouble with making friends.  Failures at school or work, or trouble getting along with people, can make life hard. You might use drugs to get your mind off these problems.
• Hanging around other people who use drugs.  Friends or family members who use drugs might get you into trouble with drugs as well.
• Starting drug use when you're young.  When kids or teens use drugs, it affects how their bodies and brains finish growing. Using drugs when you're young increases your chances of becoming addicted when you're an adult.
• Your biology.  Everyone's bodies react to drugs differently. Some people like the feeling the first time they try a drug and want more. Other people hate how it feels and never try it again. Scientists don’t have a test yet that will predict how each person will react.

Can drug addiction be treated?

Yes. People who get treatment and stick with it can stop using drugs. They can change their lives so they don't go back to taking drugs. But they have to try hard and follow the treatment program for a long time. Recovery from addiction means you have to stop using drugs AND learn new ways of thinking, feeling, and dealing with problems. It’s best not to use in the first place. If you do get addicted, it’ll be a long and difficult road.

After you've stopped using the drug, you still have a lot to do:

• You have to relearn how to live without using drugs.
• You have to work on the problems your drug use caused with your family, your job, your friends, and your money.
• You have to stay away from people you used drugs with and places where you used.
• You have to learn what makes you want to take drugs again (your triggers), so you can avoid or work on those things.
• You may also need treatment for problems that led to your drug use, such as depression, anxiety, or other mental health problems.

Where to Get Help

You can call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357) (toll free) or go to FindTreatment.gov at any time to learn more about substance use treatment and recovery support resources near you. If you or someone you know is experiencing severe symptoms or is in immediate danger, seek immediate medical attention by calling 9-1-1 or visit an emergency department.

If you or someone you know is experiencing a substance use and/or mental health crisis or any other kind of emotional distress, call or text 988 or chat www.988lifeline.org to reach SAMHSA’s 988 Suicide and Crisis Lifeline . Trained counsellors are available 24/7 to help you.

Loved ones of people with substance use disorders may be interested in SAMHSA’s Resources for Families Coping with Mental and Substance Use Disorders .

For information and help to quit smoking, visit SmokeFree.gov or call the National Cancer Institute Quitline at 1-877-44U-QUIT (1-877-448-7848).

Prevention Resources

For adults needing information for their own children or for children they care about:

• Underage Drinking Prevention: Talk. They Hear You  (SAMHSA)
• Partnership for Drug-Free Kids  (Drugfree.org)
• Alcohol Use: Conversation Starters  (Health.gov)
• Above the Influence

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Notre Dame Philosophical Reviews

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• The Legalization of Drugs: For & Against

The Legalization of Drugs: For & Against

Douglas Husak and Peter de Marneffe, The Legalization of Drugs: For & Against , Cambridge University Press, 2005, 204pp., $18.99 (pbk), ISBN 0521546869.

Reviewed by William Hawk, James Madison University

In the United States the production, distribution and use of marijuana, heroin, and cocaine are crimes subjecting the offender to imprisonment. The Legalization of Drugs , appearing in the series "For and Against" edited by R. G. Frey for Cambridge University Press, raises the seldom-asked philosophical question of the justification, if any, of imprisoning persons for drug offenses.

Douglas Husak questions the justification for punishing persons who use drugs such as marijuana, heroin, and cocaine. He develops a convincing argument that imprisonment is never morally justified for drug use. Put simply, incarceration is such a harsh penalty that drug use, generally harmless to others and less harmful to the user than commonly supposed, fails to justify it. Any legal scheme that punishes drug users to achieve another worthy goal, such as creating a disincentive to future drug users, violates principles of justice.

Peter de Marneffe contends that under some circumstances society is morally justified in punishing persons who produce and distribute heroin. He argues a theoretical point that anticipated rises in drug abuse and consequent effects on young people may justify keeping heroin production and distribution illegal. According to de Marneffe's analysis, however, harsh prison penalties currently imposed on drug offenders are unjustified.

The points of discord between Husak's and de Marneffe's positions are serious but not as telling as is their implicit agreement. Current legal practices and policies which lead to lengthy incarceration of those who produce, distribute and use drugs such as marijuana, heroin, and cocaine are not, and cannot be, morally justified. Both arguments, against imprisoning drug users and for keeping heroin production illegal, merit a broad and careful reading.

The United States has erected an enormous legal structure involving prosecution and incarceration designed to prohibit a highly pleasurable, sometimes medically indicated and personally satisfying activity, namely using marijuana, heroin, and cocaine. At the same time, other pleasure-producing drugs, such as tobacco, alcohol, and caffeine, though legally regulated for the purposes of consumer safety and under-age consumption, can be purchased over the counter. As a result, while the health and safety risks of cigarettes may be greater than those proven to accompany marijuana, one can buy cigarettes from a vending machine and but go to prison for smoking marijuana. A rational legal system, according to Husak, demands a convincing, but as yet not forthcoming, explanation of why one pleasurable drug subjects users to the risk of imprisonment while the other is accommodated in restaurants.

Drug prohibitionists must face the problem that any "health risk" argument used to distinguish illicit drugs and subject offenders to prison sentences runs up against the known, yet tolerated, health risks of tobacco, as well as the additional health risks associated with incarceration. "Social costs" arguments targeting heroin or cocaine runs up against the known, yet tolerated, social costs of alcohol, as well as the additional social costs of incarceration. Even if one were to accept that illicit drugs were more harmful or exacted greater social costs than tobacco and alcohol (and the empirical studies referred to in the text do not generally support this thesis), that difference proves insufficient to justify imprisoning producers, distributors or especially users of illicit drugs.

Decriminalizing Drug Use. Douglas Husak presents a very carefully argued case for decriminalizing drug use. He begins his philosophical argument by clarifying the concepts and issues involved. To advocate the legalization of drugs calls for a legal system in which the production and sale of drugs are not criminal offenses. (p. 3) Criminalization of drugs makes the use of certain drugs a criminal offense, i.e. one deserving punishment. To argue for drug decriminalization, as Husak does, is not necessarily to argue for legalization of drugs . Husak entertains, but cautiously rejects the notion of a system where production and sale of drugs is illegal while use is not a crime. De Marneffe advocates such a system.

Punishing persons by incarceration demands justification. Since the state's use of punishment is a severe tool and incarceration is by its nature "degrading, demoralizing and dangerous" (p. 29) we must be able to provide "a compelling reason … to justify the infliction of punishment… ." (p. 34) Husak finds no compelling reason for imprisoning drug users. After considering four standard justifications for punishing drug users Husak concludes that "the arguments for criminalization are not sufficiently persuasive to justify the infliction of punishment."

Reasons to Criminalize Drug Use . 1) Drug users, it is claimed, should be punished in order to protect the health and well being of citizens . No doubt states are justified in protecting the health and well being of citizens. But does putting drug users in prison contribute to this worthy goal? Certainly not for those imprisoned. For those who might be deterred from using drugs the question is whether the drugs from which they are deterred by the threat of imprisonment actually pose a health risk. For one, Husak quotes research showing that currently illicit drugs do not obviously pose a greater health threat than alcohol or tobacco. For another, he quotes a statistic showing that approximately four times as many persons die annually from using prescribed medicines than die from using illegal drugs. In addition, one-fourth of all pack-a-day smokers lose ten to fifteen years of their lives but no one would entertain the idea of incarcerating smokers to further their health interests or in order to prevent non-smokers from beginning. In sum, Husak accepts that drug use poses health risks but contends that the risks are not greater than others that are socially accepted. Even if they were greater, imprisonment does not reduce, but compounds the health risks for prisoners.

2) Punishing drug users protects children . Husak here responds to de Marneffe's essay which focuses on potential drug abuse and promotes the welfare of children as a justification for keeping drug production and sale illegal. Husak finds punishing adolescent users a peculiar way to protect them. To punish one drug-using adolescent in order to prevent a non-using adolescent from using drugs is ineffective and also violates justice. Punishing adult users so that youth do not begin using drugs and do not suffer from neglect -- which is de Marneffe's position -- is not likely to prevent adolescents from becoming drug users, and even if it did, one would have to show that the harm prevented to the youth justifies imprisoning adults. Husak contends that punishing adults or youth, far from protecting youth, puts them at greater risk.

3) Some, e.g. former New York City mayor Guiliani, argue that punishing drug use prevents crime . Husak, conceding a connection between drug use and crime, turns the argument upside-down, showing how punishment increases rather than decreases crime. For one, criminalization of drugs forces the drug industry to settle disputes extra-legally. Secondly, drug decriminalization would likely lower drug costs thereby reducing economic crimes. Thirdly, to those who contend that illicit drugs may increase violence and aggression Husak responds that: a) empirical evidence does not support marijuana or heroin as causes of violence and b) empirical evidence does support alcohol, which is decriminalized, as leading to violence. Husak concludes "if we propose to ban those drugs that are implicated in criminal behavior, no drug would be a better candidate for criminalization than alcohol." (p. 70) Finally, punishing drug users likely increases crime rates since those imprisoned for drug use are released with greater tendencies and skills for future criminal activity.

4) Drug use ought to be punished because using drugs is immoral . In addition to standard philosophical objections to legal moralism, Husak contends that there is no good reason to think that recreational drug use is immoral. Drug use violates no rights. Other recreationally used drugs such as alcohol, tobacco or caffeine are not immoral. The only accounts according to which drug use is immoral are religiously based and generally not shared in the citizenry. Husak argues that legal moralism fails, and with it the attempts to justify imprisoning drug users because of health and well-being, protecting children, or reducing crime. Husak concludes, "If I am correct, prohibitionists are more clearly guilty of immorality than their opponents. The wrongfulness of recreational drug use, if it exists at all, pales against the immorality of punishing drug users." (p. 82)

Reasons to Decriminalize Drug Use. Husak's positive case for decriminalizing drug use begins with acknowledgement that drug use is or may be highly pleasurable. In addition, some drugs aid relaxation, others increase energy and some promote spiritual enlightenment or literary and artistic creativity. The simple fun and euphoria attendant to drug use should count for permitting it.

The fact that criminalization of drug use proves to be counter-productive provides Husak a set of final substantial reasons for decriminalizing use. Criminalizing drugs proves counter-productive along several different lines: 1) criminalization is aimed and selectively enforced against minorities, 2) public health risks increase because drugs are dealt on the street, 3) foreign policy is negatively affected by corrupt governments being supported solely because they support anti-drug policies, 4) a frank and open discussion about drug policy is impossible in the United States, 5) civil liberties are eroded by drug enforcement, 6) some government corruption stems from drug payoffs and 7) criminalization costs tens of billions of dollars per year.

Douglas Husak provides the conceptual clarity needed to work one's way through the various debates surrounding drug use and the law. He establishes a high threshold that must be met in order to justify the state's incarcerating someone. Having laid this groundwork Husak demonstrates that purported justifications for drug criminalization fail and that good reasons for decriminalizing drug use prevail. For persons who worry about what drug decriminalization means for children, Husak counsels that there is more to fear from prosecution and conviction of youth for using drugs than there is to fear from the drugs themselves.

Against Legalizing Drug Production and Distribution. Peter de Marneffe offers an argument against drug legalization . The argument itself is simple. If drugs are legalized, there will be more drug abuse. If there is more drug abuse that is bad. Drug abuse is sufficiently bad to justify making drug production and distribution illegal. Therefore, drugs should not be legalized. The weight of this argument is carried by the claim that the badness of drug abuse is sufficient to justify making drug production and sale illegal.

De Marneffe centers his argument on heroin. Heroin, he contends, is highly pleasurable but sharply depresses motivation to achieve worthwhile goals and meet responsibilities. Accordingly, children in an environment where heroin is legal will be subjected to neglect by heroin using parents and, if they themselves use heroin, they will be harmed by diminished motivation for achievement for the remainder of their lives. It is this later harm to the ambition and motivation of young people that, according to de Marneffe, justifies criminalizing heroin production and sale. As he puts it:

… the risk of lost opportunities that some individuals would bear as the result of heroin legalization justifies the risks of criminal liability and other burdens that heroin prohibition imposes on other individuals. The legalization of heroin would create a social environment -- call it the legalization environment -- in which some children would be at a substantially higher risk of irresponsible heroin abuse by their parents and in which some adolescents would be at a substantially higher risk of self-destructive heroin abuse. (p. 124)

Are the liberties of individual adult drug producers, distributors and users sacrificed? Yes, but this may be justified by de Marneffe's "burdens principle." According to the burdens principle, "the government violates a person's moral rights in adopting a policy that limits her liberty if and only if in adopting this policy the government imposes a burden on her that is substantially worse than the worst burden anyone would bear in the absence of this policy." (p. 159) According to this, de Marneffe claims that burdens on drug vendors or users may be justified by the prevention of harms to a particular individual or individuals. As he puts it:

What I claim in favor of heroin prohibition is that the reasons of at least one person to prefer her situation in a prohibition environment outweigh everyone else's reasons to prefer his or her situation in a legalization environment, assuming that the penalties are gradual and proportionate and other relevant conditions are met. (p. 161)

According to this view, the objective interest of a single adolescent in not losing ambition, motivation and drive justifies the imposition of burdens on other youth and adults who would prefer using drugs. Although Johnny might choose heroin use, his objective interest is for future motivation and ambition that is not harmed by heroin use.

De Marneffe's "burdens principle" seems to hold the whole society hostage to the objective liberty interests of one individual. Were this principle applied to drug producers or distributors who faced imprisonment it seems that imprisonment could not be justified. I suspect a concern for consistency here gives de Marneffe reason to make drug production and distribution illegal but without attaching harsh prison sentences for offenders. He advocates an environment where drugs are not legal, in order to protect youth against both abuse and their own choices that may cause them to become unmotivated, but recognizes that prison sentences are unjustified as a way to support such a system.

In The Legalization of Drugs the reader gets two interesting arguments. Douglas Husak makes a compelling case against punishing drug users. His position amounts to drug decriminalization with skepticism toward making drug production and sale illegal. On the other side, Peter de Marneffe justifies making drug production and sale illegal based upon the diminishment of future interests of young people. De Marneffe introduces a "burdens principle" which is likely much too strong a commitment to individual interests than could ever be realized in a civil society. In both instances, the reader is treated to arguments that effectively undermine current drug policy. The book provides philosophical argumentation that should stimulate a societal conversation about the justifiability of current drug laws.

Canada took a step toward decriminalizing hard drugs. Here's what it can learn from other countries

Advocates say decriminalization alone won't stop canadians dying, because the drug supply is uniquely toxic.

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When British Columbia decriminalizes small amounts of some illicit drugs next year, Canada will join a growing number of countries that have taken strides toward removing penalties for drug use.

But as many Canadian public health experts call on lawmakers to go a step further — and replace black market street drugs with a regulated safe supply — their international counterparts say they are watching to see what their countries can learn from one another.

Ottawa  announced last week  that from Jan. 31, adults in B.C. will be allowed to possess up to 2.5 grams of opioids, cocaine, methamphetamine and MDMA — a signal it will treat addiction as a mental health issue rather than a judicial one.

The federal government has not yet made any commitments about a regulated safe supply; in fact, a private member's bill from the NDP calling for a strategy that would include one was defeated in the House of Commons on Thursday. 

But advocates have proposed a number of safe supply models for Canada, with options ranging from prescribing pharmaceutical-grade drugs — as already happens to a very limited degree  — to allowing drugs to be sold at licensed entertainment venues or dispensaries. 

If adopted, those more liberal models would put Canada in uncharted territory internationally, says Jonathan Caulkins, a professor of operations research and public policy and a drug policy researcher at Carnegie Mellon University in Pittsburgh.

"No country in the world has gone farther, faster than Canada has in that direction with cannabis, and no country in the world has even really seriously thought about doing that for heroin or fentanyl or cocaine."

• Second Opinion Why decriminalizing drug possession won't fix Canada's toxic supply
• 'Heroin buyers club' vision unveiled for legal heroin sales in B.C.

So as Ottawa navigates decriminalization, jurisdictions around the world say they'll be watching to see what, if any, safe drug supply model is adopted.

And CBC News spoke with some of those international drug policy experts to see what Canada might learn from their countries' experience with decriminalization. 

Estonia's fentanyl crisis

When Estonia decriminalized all drugs in 2005, the black market for illegally manufactured fentanyl was on the rise.

With almost no harm reduction measures or treatment options in place, the country quickly became Europe's drug overdose capital .

Estonia's fatal overdose rate began to fall from 2017 after a major fentanyl bust – but it's still playing catch-up on harm reduction.

"We don't have a safe supply, and we don't have safe consumption rooms and we don't have state-supported drug checking," says Aljona Kurbatova, the head of the Drug Abuse and Infectious Diseases Prevention Centre at Estonia's National Institute for Health Development.

"Having harm-reduction responses as basic as needle and syringe exchange programs has been quite a challenge for us in the last two decades because of a very strong public opposition to it."

She said it's encouraging that Canada already has a strong harm-reduction model ahead of decriminalization, and Kurbatova said she's hopeful it will have "the courage to try out new things" — including a regulated supply of drugs.

"If Canada will introduce safe supply, it will definitely be an argument even for our politicians to actually listen up and say that perhaps we also, in order to avoid a repetition of previous mistakes, should have something like that."

The Portuguese model

Back in 2001, faced with a crisis of heroin overdose deaths, Portugal became the first country in the world to decriminalize the possession and use of all illegal drugs. Instead of sending people to court for drug possession, its model focuses on education, treatment and harm reduction.

• How Portugal tackled its addiction epidemic to become a world model

Portugal's drug-related death rate is four times lower than the European average, according to the continent's drug-monitoring agency in 2017. 

And those figures are despite all of the country's drugs coming from a black market.

To date, fentanyl hasn't emerged as an issue there, though it's likely only a matter of time, says Dr. João Goulão, the main architect of Portugal's decriminalization model and head of the country's General-Directorate for Intervention on Addictive Behaviours and Dependencies.

• How Europe's heroin capital solved its overdose crisis

As a result, a safe supply model isn't part of the plan now.

"We are comfortable with what we have," Goulão said. Of course, we are open to innovate, but this core discussion about the legal framework for drugs is not the primary concern."

Instead, Goulão is focused on expanding harm reduction services, like drug checking and safe consumption sites, which are in their infancy in Portugal. 

"I saw more resources in downtown Vancouver than what we have all over the country," Goulão told CBC News in an interview from Lisbon, before flying to Canada for a panel discussion on decriminalization at the University of Waterloo this week.

Portugal isn't looking to export its decriminalization model, he said, but it does hope to inspire other countries to evolve.

"You in Canada, and the Americans, you are living a moment that is similar to our epidemic in heroin in the '90s … This is, in my view, a window of opportunity to change things."

A safe supply of heroin

Although Switzerland has yet to decriminalize drugs, it took a groundbreaking step toward safe supply in 1994 by prescribing pharmaceutical-grade heroin to long-term users. 

The result was fewer overdose deaths , as well as falling rates of HIV and hepatitis C infections and a drop in crime.

"The outcome is: you don't have people on the street [using drugs], you don't have people dying from overdoses in the street or in private places … And there is a very good relationship between the people [using drugs] and the health sector," said Jean-Félix Savary, secretary general of the Romand Group of Addiction Studies (GREA) in Geneva.

During the pandemic, the country allowed people to use prescription heroin at home instead of restricting its use to supervised sites. 

"It was a very big success," Savary said.

Although far fewer people access prescription heroin than other treatments such as methadone, there is now debate in Switzerland about expanding prescription heroin.

"There is still this moral thinking that if you give a drug to somebody, it has to be nasty … so we prefer to give methadone — which is really bad for the body —  than to give heroin," Savary said, noting heroin is much better than methadone from a medical perspective.

 "It's just a medication."

Decriminalization south of the border

If Canada wants to know what decriminalization looks like without a safe supply of drugs, it only needs to look about 600 kilometres south of the border. Faced with rising opioid-related deaths, Oregon became the first U.S. state to decriminalize drugs in 2020, following a referendum.

• Oregon decriminalizes small possession amounts, including for heroin, meth and cocaine

Since then, deaths have continued to rise – as they have in Canada – as the drug supply has become more toxic in both countries.

"Just decriminalization isn't going to stop people from dying from drug overdoses," said Tera Hurst, executive director of the Oregon Health Justice Recovery Alliance.

She and other drug reform advocates in Oregon are still working to implement safe consumption sites and other harm reduction measures, which they hope will keep people safer over time.

"We're trying to solve these huge problems with these incremental steps, and incremental steps are sometimes the only thing you can get people to get done."

As street drugs become increasingly dangerous on both sides of the border, Hurst is watching closely to see if Canada — where she grew up — listens to the calls for some form of a regulated safe supply.

"Safe supply feels like such an important conversation when we're watching so many people die right now," she said. "And it feels so far from where most people are when it comes to drugs."

ABOUT THE AUTHOR

Laura McQuillan is an online journalist with CBC News in Toronto. She covers general news, social issues and science and has a special interest in finding unexpected answers to unusual questions. Laura previously reported from New Zealand and Brazil.

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