Treating Meth Addiction as a Health Issue
This Thursday, Congressmen Russ Carnahan (D-3rd/MO) and George Radanovich (R-19th/CA) introduced groundbreaking bipartisan legislation that is a major step forward in providing universal access for substance abuse treatment and wide-reaching social, health and economic assistance to people struggling with methamphetamine-related problems. The Universal Access to Methamphetamine Treatment Act of 2010 (H.R. 5768) would increase funding for treatment facilities, provide vouchers to people seeking treatment, offer comprehensive services to ensure recovery and prevent relapse, and increase research into effective treatments.
In addition to expanding funding for methamphetamine treatment generally, the bill provides additional funding for underserved populations to eliminate historical disparities in treatment between men and women, urban and rural areas, whites and people of color, and heterosexuals and lesbian, gay, bi-sexual, and transgendered individuals. The legislation would also help keep families together by referring certain pregnant and post-partum women to treatment instead of jail. Funding would also be used for health care, housing assistance and job training services that have been shown to reduce relapse and assist recovery.
The legislation provides additional funding for studies that look at cutting-edge methamphetamine addiction treatments, such as replacement therapy. Under replacement therapy, doctors prescribe one or more pharmaceutical drugs to people with substance abuse problems to eliminate or reduce their use of problematic drugs and improve their mental and physical well-being. The most commonly known replacement therapies are the nicotine patch for cigarette addiction and methadone for heroin addiction.
In a 2008 report, "A Four Pillars Approach to Methamphetamine," the Drug Policy Alliance evaluated scientific literature that shows promising results for various replacement therapies for methamphetamine use and misuse. The Universal Access to Methamphetamine Treatment Act of 2010 would provide crucial funding for the further research needed to develop replacement therapy medication for methamphetamine and other stimulants.
A federally-funded report prepared for the National Institute of Justice, a division of the U.S. Justice Department, concluded:
Poor results with [antagonist] drugs has encouraged a further look at the use of replacement or agonist therapies in the treatment of amphetamine/methamphetamine abuse, much like the approach used with methadone in the treatment of opioid abuse. As with methadone, the approach relies in part on a harm reduction model, in that it replaces the illicit drug, methamphetamine, with a legal, controlled dose of a stimulant or replacement drug, provided, however, in a therapeutic setting where supportive services can be supplied. The replacement of, for example, dextroamphetamine for methamphetamine would ideally reduce problems related to crime, injection practices, family and economic issues, and health problems related to escalating illegal use. Grabowski and colleagues (2003) have reviewed the available and somewhat limited research on using replacement (agonist) therapies in the treatment of methamphetamine or amphetamine abuse. These studies are often small and involve self selected samples and self report of behavior changes. However, many indicate that using oral dextroamphetamine to stabilize illicit amphetamine users' dependency can provide some reduction in the use of other drugs, injection behavior and criminal activity.
After decades of failed methamphetamine policy - from increased sentences for nonviolent meth-related offenses to making every American show ID to buy cough medicine - Congress is finally learning what teenagers learn in high school economics: as long as there is a demand for something, there will be a supply to meet it. Worse than simply being ineffective, supply-side strategies drive immutable market forces to expand production and trafficking, generate unintended consequences and, in many instances, ultimately worsen the problem. Representative Carnahan and Representative Radanovich should be commended for putting forth a health-based strategy for reducing the problems associate with methamphetamine use and misuse.