DRUGS - CAN WE REDUCE THE HARM?

In the ongoing battle against addictive substances, we need to fight
the urge for a quick fix. Careful attention to scientific facts may be
time-consuming and, sometimes tedious, but it makes more sense

How does one respond intelligently to the drug issue? Researchers who
rely on scientific procedures face several problems when they try to
use factual information to suggest social policy.

One problem is the "we must do something now" syndrome. Unfortunately,
quick responses may not only be ineffective, or actually do harm, they
may also result in the neglect of long-range conditions that give rise
to the problem.

Of course, if your house is on fire, you try to put it out. Later, you
might focus on building codes that insist that wiring be done safely,
that fewer flammable materials are used, etc. However, you want to be
sure that your hose is attached to a water supply -- not a gasoline
tank.

When a mother has a child hooked on drugs she wants action
immediately. Thus a detoxification clinic, or some sort of immediate
treatment is welcome.

But could a program make things worse? In one large study in New York
City, a major program was offered to boys with difficulties.

A large portion of the parents, however, resisted. They did not see
the program as helpful. Later, when the treated boys were compared
with those whose parents insisted on keeping them out of the program,
the treated boys did much worse.

It is important to note that the treated boys and their families
believed that the program helped them. This is a common finding in the
vast majority of programs responding to delinquency, mental health and
a variety of problems. Despite evidence to the contrary, participants
usually believe they were helped.

Admittedly, scientific studies can tell us what happened, but they
rarely tell us why or even how things happened. Did the boys who were
treated, and their parents, give up too soon using their own
resources? Did the parents who kept their sons out of the program work
harder at solving other problems? We don't know.

A drug clinic may seem like a godsend to a troubled parent. Youths who
participate almost always believe that they were saved by the program.

But when a youth can shift the problem to the "professionals" does it
decrease his ability to cope when returning to the real world? Again,
we do not know.

A second problem such scholars face is the "democracy of ideas"
syndrome. There is a widespread faith that if all good people with a
wide variety of experience put their heads together, they will be able
to be able to develop good policies.

We want to be democratic. Everyone's opinion is important. Sharing
many different ideas makes us feel good. In reality, some ideas are
better than others. Many seemingly reasonable suggestions, when
tested, do not improve complex situations.

When my computer fails to do what I want, many of my friends have
suggestions. Sometimes I am persuaded by those who speak the loudest.
But usually some nerdy kid comes in and does things I do not
understand to make my computer behave.

Scientists who pay attention to facts rarely please people. We have
lots of hard data on drug programs that fail. For many programs that
are not evaluated scientifically, success is often declared without
any evidence.

However, as drug researchers look at empirical evidence, they
sometimes can identify a number of modestly promising approaches.

Often, however, local efforts which get enthusiastic support are not
among the more promising. This creates dilemmas. The enthusiastic
supporters feel betrayed. The promising strategies may not be very
exciting.

Will the modest evidence from the promising approaches be able to
compete with the "we must do something now" syndrome? Will facts take
precedence over the "democracy of ideas" syndrome?

How will the politicians respond? Will the loudest voices win out over
the careful assessment of empirical evidence?

Jim Hackler is the author of Canadian Criminology: Strategies and
Perspectives, now in its third edition.