Once again, I find that I need look no further than the local newspaper to face yet another example of the infestation of progressive thought in the formerly great conservative state of Virginia.
This particular time, one of the Fredericksburg Free Lance-Star opinion writers laments the “drug problem,” stating that “nothing we have tried has worked,” 40 years of drug awareness education has not helped, and that “the war on drugs has been a miserable failure.” Donnie Johnston appears to understand that societal factors may be at work, since he refers to Americans’ dependency on “their fix,” and the failure to focus on prevention as “a sad commentary on our society.” But he then proceeds to profess bewilderment as to what might be done:
“The question is where do we go from here? I have no idea.” [1]
His underlying premise seems to be that substance abuse is here to stay, so we might as well stop trying to fight it. This is obviously a progressive position, articulated in detail by the American Civil Liberties Union (ACLU). [2] Mr Johnston’s references to the failure of the war on drugs and the legalization of drugs are also familiar refrains we hear from the progressive camp. [3] Although I am not sure whether he is a thorough-going progressive – he doesn’t have that strident, controlling, overbearing tone we usually hear from progressives – I believe his opinion to be important, because it is probably representative of the thinking of many in our community.
However, what I find hard to understand is his failure to even briefly consider scrutiny of possible causes for the rampant substance abuse in the United States. Our society is beset by severe societal traumas, many of which could conceivably be related to substance abuse. Would it not make sense to at least look into these societal issues as possible causes?
Risk Factors for Substance Abuse
Fortunately, solid, long term survey data on this issue is readily available. The National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health (NIH), has been conducting surveys continuously since 1975, designated “Monitoring the Future (MTF),” with a primary focus on youth and young adults. [4] The Substance Abuse and Mental Health Services Administration (SAMHSA), within the U.S. Department of Health and Human Services (HHS), conducts the annual National Survey on Drug Use and Mental Health, a “comprehensive household interview survey of substance use, substance use disorders, mental health, and the receipt of treatment services for these disorders in the United States.” [5]
A complicating aspect of the substance abuse phenomenon is its dynamic nature. Many drugs have affected various segments of the population in different ways at different times. Progress can be quickly offset by the sudden rise of new abuse behaviors. Vaping and the use of heroin with fentanyl are two of the latest dangerous substance abuse behaviors, but they have arisen while abuse of other substances has declined or remained stable:
“The most important finding to emerge from the 2018 survey is the dramatic increase in vaping by adolescents . . . Given that nicotine is involved in most vaping and is a highly addictive substance, this presents a serious threat to all of the hard-won progress in reducing cigarette smoking among adolescents since the mid-1990s.” [6]
“Disproportionate increase in drug overdose deaths associated with opioids and with heroin use (CDC data) related to synthetic opioids mixed into heroin (e.g.: fentanyl).” [7]
The onset of these most recent drug threats should not be be allowed to conceal the fact that progress has been made with other drugs:
“Over the past four decades, MTF has documented some good news, along with the worrisome news. From the late 1970s to the early 1990s – and again in the late 1990s – the use of a number of illicit drugs declined appreciably among 12th grade students, and declined even more among college students and young adults in the U.S. These substantial improvements – which seem largely explainable in terms of changes in attitudes about drug use, beliefs about the risks of drug use, and peer norms against drug use – have some extremely important policy implications. One clear implication is that these various substance-using behaviors among American young people are malleable – they can be changed. It has been done before. The second is that demand-side (rather than supply-side) factors appear to have been pivotal in bringing about most of those changes.” [8]
These findings demonstrate that there are indeed ways in which substance abuse behavior can be influenced. Similar conclusions were reached by HHS, in the 2016 SAMHSA National Survey on Drug Use and Health:
“Whether someone engages in substance use is associated with several risk factors that are typically correlated with an increased likelihood of substance use (e.g., perception of low risk of harm from using a substance, easy availability of substances) and protective factors that are typically associated with a decreased likelihood of substance use (e.g., exposure to prevention messages). Risk and protective factors include variables that reflect different domains of influence, including the individual, family, peer, school, community, and society.” [9]
These conclusions are confirmed by other sources as well. The Mayo Clinic cites a broad list of risk factors which contribute to addiction, including family beliefs, attitudes, and involvement, peer group influence, genetics, family history of addiction, mental health disorders, early use, and drug addictiveness. [10] The Centers for Disease Control, in its web page on High Risk Substance Use Among Youth, lists ten risk factors: Family history of substance use, favorable parental attitudes towards the behavior, poor parental monitoring, parental substance use, family rejection of sexual orientation or gender identity, association with delinquent or substance using peers, lack of school connectedness, low academic achievement, childhood sexual abuse, and mental health issues. That same page lists five prevention factors for high risk substance use among adolescents: parent or family engagement, family support, parental disapproval of substance use, parental monitoring, and school connectedness. [11]
Note that the majority of these, both negative and positive, are family-related.
The MTF survey for secondary school students in 2018 made this key observation:
“Young people are often at the leading edge of social change, and this has been particularly true of drug use. The substantial changes in illicit drug use during the last 50 or so years have proven to be largely a youth phenomenon. MTF documented that the relapse in the drug epidemic in the early 1990s initially occurred almost exclusively among adolescents. Adolescents and adults in their 20s fall into the age groups at highest risk for illicit drug use. [12]
The research findings reviewed above show that significant progress can be achieved if youth are involved in social environments which assist them to form attitudes, risk perceptions, and peer relationships which discourage rather than foster substance abuse.
The Family and Substance Abuse
Given the importance of family influence relative to substance abuse, I propose that the family is the key social environment in which substance abuse can either be deterred or fomented. If that is the case, then the substance abuse crisis can be attributed in large part to family dysfunction. Pope St. John Paul II made exactly that case in a 1987 message to the International Conference on “Drug Abuse and Illicit Trafficking”:
“Many factors contribute to the dramatic increase in drug abuse. Surely a primary one is the breakdown of the family.”
“If it is true that the youth of today are the greatest consumers of hard drugs, then it is legitimate to ask if this is due to the kind of society in which our young people are being reared.” [13]
There is evidence that the Pope is right about this. A study reported in the Journal of Marriage and Family in 2002 concluded that:
” . . . adolescents who reside in single-parent or stepparent families are at heightened risk of drug use irrespective of community context. Moreover, adolescents who reside in single father families are at risk of both higher levels of use and increasing use over time.” [14]
Dr. W. Bradford Wilcox of the National Marriage Project at the University of Virginia reports that:
“Children of cohabiting couples face worse outcomes than children raised by single parents in areas like substance abuse, high school graduation rates, and psychological well-being.” [15]
Here is evidence that children in non-traditional family settings are more vulnerable to substance abuse. But that fact by itself would not have significant impact unless such families comprise a large sector of society. The following statistics from the Pew Research Center show substantial societal dysfunction relative to family structure in the United States:
“The share of U.S. children living with an unmarried parent has more than doubled since 1968, jumping from 13% to 32% in 2017. “
” . . .the share of children living with two married parents, down from 85% in 1968 to 65%.”
“Increases in divorce mean that more than one-in-five children born within a marriage will experience a parental breakup by age 9, as will more than half of children born within a cohabiting union.” [16]
This means that a very large percentage of the children in the United States are now being raised in family environments which are deficient or suboptimal. Children with unmarried parents or parents who are divorcing face risk of instability and emotional stress. Children living with only one parent are missing the benefits that either a mother or father would bring.
The degradation of family health in the United States has also been accompanied by a decline in religious faith. As reported in April 2019:
“Gallup finds the percentage of Americans who report belonging to a church, synagogue or mosque at an all-time low, averaging 50% in 2018. . . . The past 20 years have seen an acceleration in the drop-off, with a 20-percentage-point decline since 1999 and more than half of that change occurring since the start of the current decade. [17]
And just as with the weakened family unit, weakened religious faith is associated with increased substance abuse. A study by the National Center on Addiction and Substance Abuse at Columbia University found in 2001 that religious belief and practice are strongly and inversely related to substance abuse among both teens and adults. For example, consider the following conclusions resulting from that study:
Teens who never attend religious services are twice as likely to drink, more than twice as likely to smoke, more than three times likelier to use marijuana and binge-drink and almost four times likelier to use illicit drugs than teens who attend religious services at least weekly.
Teens who do not consider religious beliefs important are almost three times more likely to drink, binge-drink and smoke, almost four times likelier to use marijuana and seven times likelier to use illicit drugs than teens who believe that religion is important. [18]
Deterioration of the traditional family unit and religious belief are associated with increases in substance abuse, and the degradadation of these traditional foundations of society have happened on a very large scale. So then it is not hard to accept the astonishing prevalence statistics for substance abuse among young people from the NIH:
“In 2017, the rank order by age group for annual prevalence of using any illicit drug was college students (42%), all 19- to 28-year-old young adults (41%), 12th graders (40%), 10th graders (28%), and 8th graders (13%).” [19]
Think about this. These figures tell us that almost half of all young adults in this country use illicit drugs. This is an extremely troubling statistic, especially considering the early age at which this affliction begins. 8th graders are barely out of elementary school, yet in 2017, one in seven 8th graders were already users of illicit drugs within the last year. That number is even worse if all (rather than past year) drug use is counted:
“In total, 23% of all 8th graders in 2017 have tried some illicit drug (including inhalants), while 9%, or one in eleven, have tried some illicit drug other than marijuana or inhalants.” [20]
Our culture has failed in its responsibilities toward such young people. The wounded family environments for these 8th graders are not strong enough to enable them to withstand the forces they will confront as they advance in school, such as peer pressure and drug availability, so that by the time they get to the 12th grade, the percent of children succumbing to illicit drug use balloons to 40%. The risks to which vulnerable children are subjected in high school are overwhelming the protective family factors which otherwise should inhibit illicit drug use.
In the United States, it is customary to assume that we are far better off than most of the world. But not when it comes to drug use among our children:
“American secondary school students and young adults show a level of involvement with illicit drugs that is among the highest in the world’s industrialized nations.” [21]
The Progressive Propensity to Solve the Symptom
Now let’s examine the progressive “solutions” to substance abuse while keeping in mind the risk factors described above which have been identified by the research. Progressives tend to focus on a couple of main ideas to address the symptoms rather than the causes of substance abuse: legalization and harm reduction. The legalization argument, as presented by the ACLU, is based on the flawed morality of the progressive movement:
“The ACLU believes that unless they do harm to others, people should not be punished — even if they do harm to themselves.” [22]
This is nothing less than a particular application of the progressive impulse toward an exaggerated and irresponsible expression of personal liberty, which does not take into account the incentives and consequences resulting from such unfettered liberty. When legalization is assessed against the substance abuse research, it becomes clear that it actually supports rather than deters substance abuse. Legalization implies societal approval, which is a risk factor associated with increased substance abuse. Legalization increases drug availability, another risk factor, which can be devastating in terms of addiction and overdose. A good example of this is the current crisis resulting from fentanyl-related opioid abuse. And although legalization may keep users and dealers out of jail, it does nothing to confront the fundamental cultural causes for substance abuse.
“Harm reduction,” the other main theme of the progressive approach, is presented as focused on “saving lives and reducing the harmful effects of drug use.” [23] It includes things like safe injection facilities and syringe access programs. Harm reduction abandons prevention efforts:
“Drugs are here to stay — let’s reduce their harm. The universality of drug use throughout human history has led some experts to conclude that the desire to alter consciousness, for whatever reasons, is a basic human drive.” [24]
Safe injection sites and syringe access programs signal societal approval, and therefore can act as risk factors contributing to substance abuse. This is a prototypical example of how progressives look only at symptoms, and fail to assess the perverse incentives they are creating by their programs. All the harm reduction and legalization in the world will not do anything to deter the prospective first-time user: in fact, such initiatives will probably encourage such behavior, since that prospective first-time user knows society will attempt to mitigate the resulting risks.
The progressive position on marijuana also demands attention. Progressives think that marijuana is relatively harmless, as in this typical statement:
“Marijuana is often treated as separate from other controlled substances based on a growing body of research that supports its use in medical settings and suggests that it is not susceptible to abuse.” [25]
But marijuana is anything but harmless. It is associated with pregnancy issues, “earlier onset of psychosis in youth known to be at risk for schizophrenia,” and “opioid misuse, heavy alcohol use, and depression in youth 12-17 and young adults 18-25.” Marijuana is also linked to “poor school performance and increased drop out rates,” “decline in IQ that doesn’t recover with cessation,”and “an increased risk for later psychotic disorder in adulthood.” [26]
The progressive approaches to substance abuse in the United States are not responsive to the underlying causes, will not provide solutions, and instead will actually exacerbate the problem.
Conclusions
Unfortunately, there are some worrisome warning signs in the latest research data. Fentanyl has been a major contributor to the rapid rise in drug overdose deaths involving opioids:
“Among the more than 70,200 drug overdose deaths estimated in 2017, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (other synthetic narcotics) with more than 28,400 overdose deaths” [27]
Trends among young people are distressing as well:
“The very large number of 8th graders who have already begun using so-called gateway drugs (tobacco, alcohol, inhalants, and marijuana) suggest that a substantial number are also at risk of proceeding further to such drugs as LSD, cocaine, amphetamines, and heroin.” [28]
“Unfortunately, current conditions are well suited for a second relapse phase in drug use among youth and young adults in the U.S. Perceived risk for marijuana has fallen substantially in recent years as the recent string of states that have legalized recreational marijuana use for adults have led some youth to believe the drug is safe and state-sanctioned. [29]
A serious approach to dealing with substance abuse in this country would focus on repairing family and religious life, because those institutions exercise the protective factors which most effectively inhibit substance abuse. Since, however, American culture is already fully engulfed by the progressive destruction of its traditional moral and social foundations, the outlook for progress in the fight against substance abuse is poor.
References.
1. Johnston, Donnie. “U.S. drug problem seems to defy all solutions.” The Fredericksburg Free Lance-Star: To The Point, March 2019.
2. “Against Drug Prohibition.” American Civil Liberties Union. Accessed 6/20/2019. http://www.aclu.org/other/against-drug-prohibition
3. Pearl, Betsy, and Perez, Maritza. “Ending the War on Drugs.” Center for American Progress. June 27, 2018. https://www.americanprogress.org/issues/criminal-justice/reports/2018/06/27/452786/ending-war-drugs
4. Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2019). Monitoring the Future national survey results on drug use, 1975–2018: Volume I, Secondary school students, p.1. Ann Arbor: Institute for Social Research, The University of Michigan. http://monitoringthefuture.org/pubs.html#monographs
5. McCance-Katz, Elinore. “National Survey on Drug Use and Health: 2017.” U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration. Presentation, p.2. Accessed 5/12/2019. https://www.samhsa.gov/data/sites/default/files/nsduh-ppt-09-2018.pdf
6. Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2019). Monitoring the Future national survey results on drug use, 1975–2018: Volume I, Secondary school students, p.10. Ann Arbor: Institute for Social Research, The University of Michigan. http://monitoringthefuture.org/pubs.html#monographs
7. McCance-Katz, Elinore. “National Survey on Drug Use and Health: 2017.” U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration. Presentation, p.4. accessed 5/12/2019. https://www.samhsa.gov/data/sites/default/files/nsduh-ppt-09-2018.pdf
8. Schulenberg, J. E., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Miech, R. A. & Patrick, M. E. (2018). Monitoring the Future national survey results on drug use, 1975–2017: Volume II, College students and adults ages 19–55, p.26. Ann Arbor: Institute for Social Research, The University of Michigan. http://monitoringthefuture.org/pubs.html#monographs
9. Lipari, R. N., Ahrnsbrak, R. D., Pemberton, M. R., & Porter, J. D. (2017, September). Risk and protective factors and estimates of substance use initiation: Results from the 2016 National Survey on Drug Use and Health, Introduction. NSDUH Data Review. https://www.samhsa.gov/data
10. “Drug addiction (substance use disorder).” Mayo Clinic. Causes and Risk Factors. Accessed 6-/19/2019. https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
11. “High-Risk Substance Use Among Youth.” Centers for Disease Control and Prevention: Adolescent and School Health. Accessed 7-17-19. https://www.cdc.gov/healthyyouth/substance-use/index.htm
12. Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2019). Monitoring the Future national survey results on drug use, 1975–2018: Volume I, Secondary school students, p.5. Ann Arbor: Institute for Social Research, The University of Michigan. http://monitoringthefuture.org/pubs.html#monographs
13. John Paul II, Pontifical Message [MESSAGE OF THE HOLY FATHER JOHN PAUL II TO THE REPRESENTATIVES OF THE INTERNATIONAL CONFERENCE ON “DRUG ABUSE AND ILLICIT TRAFFICKING], Vatican Website, 4 June 1987, p.1. https://w2.vatican.va/content/john-paul-ii/en/messages/pont_messages/1987/documents/hf_jp-ii_mes_19870604_conferenza-vienna.html
14. Hoffmann, John P. “The Community Context of Family Structure and Adolescent Drug Use.” Journal of Marriage and Family 64, no. 2 (May, 2002), pp. 314-30. Abstract. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1741-3737.2002.00314.x
15. Jones, Kevin. “In a Changed Country, Poor Americans Miss the Benefits of Marriage Most.” National Catholic Register. April, 2019. https://www.ncregister.com/daily-news/in-a-changed-country-poor-americans-miss-the-benefits-of-marriage-most
16. Livingston, Gretchen. “About one-third of U. S. children are living with an unmarried parent” Pew Research Center: Fact Tank. April 27, 2018. https://www.pewresearch.org/fact-tank/2018/04/27/about-one-third-of-u-s-children-are-living-with-an-unmarried-parent
17. Jones, Jeffrey, M. “U.S. Church Membership Down Sharply in Past Two Decades.” Gallup: Politics. April 18, 2019. https://news.gallup.com/poll/248837/church-membership-down-sharply-past-two-decades.aspx
18. “So Help Me God: Substance Abuse, Religion and Spirituality. A CASA White Paper.” Columbia Univ., New York, NY. National Center on Addiction and Substance Abuse. Key Findings, p. 2. November, 2001. https://www.centeronaddiction.org/addiction-research/reports/so-help-me-god-substance-abuse-religion-and-spirituality
19. Schulenberg, J. E., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Miech, R. A. & Patrick, M. E. (2018). Monitoring the Future national survey results on drug use, 1975–2017: Volume II, College students and adults ages 19–55, p. 9. Ann Arbor: Institute for Social Research, The University of Michigan. http://monitoringthefuture.org/pubs.html#monographs
20. Schulenberg, J. E., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Miech, R. A. & Patrick, M. E. (2018). Monitoring the Future national survey results on drug use, 1975–2017: Volume II, College students and adults ages 19–55, p. 26. Ann Arbor: Institute for Social Research, The University of Michigan. http://monitoringthefuture.org/pubs.html#monographs
21. Schulenberg, J. E., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Miech, R. A. & Patrick, M. E. (2018). Monitoring the Future national survey results on drug use, 1975–2017: Volume II, College students and adults ages 19–55, p. 28. Ann Arbor: Institute for Social Research, The University of Michigan. http://monitoringthefuture.org/pubs.html#monographs
22. “Against Drug Prohibition.” American Civil Liberties Union. Accessed 6/20/2019. http://www.aclu.org/other/against-drug-prohibition
23. Pearl, Betsy, and Perez, Maritza. “Ending the War on Drugs.” Center for American Progress. June 27, 2018. https://www.americanprogress.org/issues/criminal-justice/reports/2018/06/27/452786/ending-war-drugs
24. “Against Drug Prohibition.” American Civil Liberties Union. Accessed 6/20/2019. http://www.aclu.org/other/against-drug-prohibition
25. Pearl, Betsy, and Perez, Maritza. “Ending the War on Drugs.” Center for American Progress. June 27, 2018. https://www.americanprogress.org/issues/criminal-justice/reports/2018/06/27/452786/ending-war-drugs
26. McCance-Katz, Elinore. “National Survey on Drug Use and Health: 2017.” U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration. Presentation, pp. 35, 50. Accessed 5/12/2019. https://www.samhsa.gov/data/sites/default/files/nsduh-ppt-09-2018.pdf
27. “Overdose Death Rates.” National Institutes of Health, National Institute on Drug Abuse: Advancing Addiction Science. Figure 2. January, 2019. https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
28. Schulenberg, J. E., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Miech, R. A. & Patrick, M. E. (2018). Monitoring the Future national survey results on drug use, 1975–2017: Volume II, College students and adults ages 19–55, p. 26. Ann Arbor: Institute for Social Research, The University of Michigan. http://monitoringthefuture.org/pubs.html#monographs
29. Schulenberg, J. E., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Miech, R. A. & Patrick, M. E. (2018). Monitoring the Future national survey results on drug use, 1975–2017: Volume II, College students and adults ages 19–55, p. 27. Ann Arbor: Institute for Social Research, The University of Michigan. http://monitoringthefuture.org/pubs.html#monographs