Dan: 2018

"The solution to the problem of drugs doesn't lie in punishing youth by shaming them, but in the effective cooperation of members of the society," finds Dan Tõnus.

I'm writing this article because of two reasons. The first one is a phone call I recently received from a friend of mine:

"Dan! I need your help. The school has started a witch-hunt for people who have used drugs. People are pulled straight out of class and are taken to do drug tests - this is not okay! There must be a better way. It can't be that the school or parents are not able to pay attention to people at the right time and when things get out of hand then people who have used drugs will be shamed to scare others and have their lives ruined. This doesn't lead to results, this will make the youth only rebel more. You have been in touch with this topic. How to prevent all of this? How to reach young people earlier? How to talk about different substances reasonably without having the youngsters rushing to try them out?”

The second reason for writing this is Toivo Tänavsuu's interview with dr. Irja Ivarinen, the lead doctor of the youth psychiatric department in The North Estonia Medical Centre. For me, this was a highly valuable reading, because of a few reasons. The reader gets a feeling about the frighteningly high rate of depression among young people. From dr. Ivarinen's answers, you can tell that the people working with depressive youth are doing their best within the limits of the resources they can use. In my opinion, a warm attitude and understanding are extremely important regarding this subject. According to dr. Ivarinen, many young people use drugs like amphetamine, ecstacy, and LSD to treat themselves. They decline mainstream medicine, because some of them believe doctors to be "slaves of big pharma", whose goal is just to make money from selling mainstream drugs.

While the answers from dr. Ivarinen make me feel safe about our doctors at least being on the right path in terms of treating depression, I'm not so sure about the way drug problems are being dealt with. There are examples of solutions from around the world, which help reduce the use of drugs among young people without the latter being shamed or having the rebel. We should work for the same goal in Estonia - to find ways that satisfy all sides.

I don't know how much parents have read about drugs. How psilocybin, which exists in the so-called magic mushrooms, may help in treating depression. And how MDMA (the main ingredient in ecstacy pills) has been found in some studies to be twice as effective in treating post-traumatic stress disorder than other methods. As a non-medical example - how the rapper A$AP Rocky, Apple founder Steve Jobs as well as Francis Crick who discovered the DNA helix have all publicly disclosed that their experiences with LSD have helped them to be more creative or to think of unexpectable solutions.

Steve

No wonder young people want to try. Even more so: from my peers I’ve heard that young people have mostly had positive experiences with these substances. These positive experiences include dancing to techno music like never before while under the influence of an ecstasy pill and feeling endless love towards their friends. Or feeling as they have become one with the world and its essence on LSD, while experiencing what their mind can do to a whole new extent through the myriad of colours and patterns they see in front of their eyes.

In the light of these experiences, all the scare stories they hear from teachers and parents seem like fraud. The same goes for doctors. In the beginning the thought of doctors being slaves of big pharma seemed like jargon of conspiracy theorists, but it's no joke that there are problems with research regarding the effectiveness of antidepressants.

As with a big proportion of science, the research on antidepressants has to deal with the reality in which significantly more articles are published about experiments where the results match the hypothesis. At the same time, most of the experiments where the hypotheses are not supported by the results - for example, the results don't reveal any effect for antidepressants - have a much lower chance of getting published or won't be formed into a scientific article. In addition, a good proportion of these studies are funded by pharmaceutical companies producing the drugs, something that creates bias in the researchers evaluating the effectiveness of a drug. Finally, most antidepressants have sedative effects, which in itself doesn't equal to reducing depression.

Having heard how easily antidepressants are prescribed, I also find myself wondering if doctors are on the payroll of pharmaceutical companies. Once a friend of mine visited their GP to get a blood test, because of having a sudden fear of death once every month, on average. Nothing was found from my friend's blood, however, antidepressants were prescribed (which my friend threw away). As it is revealed by dr. Ivarinen's answers there is a big shortage of staff to deal with the situation. Obviously it seems easier to prescribe antidepressants rather than get to the core of the problem each individual has.

Of course, antidepressants help thousands of people suffering from major depression to avoid suicide. 60% of biomedical research conducted in the USA is funded by the private sector. Without this money we would probably be doing much worse when it comes to all sorts of prescription drugs.

And indeed, the aforementioned recreational drugs are not without risks - a strong link is believed to exist between the use of psilocybin, MDMA or LSD and hallucinogen persisting perception disorder (HPPD). Especially with MDMA long-term use has shown negative effects on a person's memory, anxiety and depression.

But parents, healthcare professionals, and policy makers have to ask themselves: Do young people even care about it if these substances are demonized? Or do we we dare to talk to youngsters about the different effects of drugs and let them choose for themselves? I believe it would be better in any way than prohibition and having a witch-hunt for users.

In June 2015, Johann Hari held a speech at TED Global London called "Everything you think you know about addiction is wrong". He has also written a book about this topic and answered criticism regarding his main viewpoints.

Hari gives a detailed description of an experiment conducted in the 70's called the "Rat Park".

In an earlier experiment about addiction, researchers had put rats inside small cages supplied with opium water and regular water. Rats became addicted to the opium and drank the water until they died. Conclusion: opium creates a deadly addiction.

In the "Rat Park" experiment, in addition to opium water, researchers supplied the rats' cages with wheels, delicious food and - probably most importantly - other rats to play and mate with. The result: "Rat Park" rats didn't become addicted to opium water. Moreover, when rats from isolated cages were moved to cages in "Rat Park" then they stopped consuming opium water. Hari's poetical conclusion: "Addiction is the adaptation to your environment. It's not you - it's the cage you live in."

Hari brings parallels to the human society and explains that instead of discarding addicts and labeling them we should try to understand them, and to direct the money spent on the war on drugs to help people who have used drugs back on the right path. On a path, where they have a social network and a goals to exist in life, which is not connected to the drug at hand. This might be seen as utopia if it weren't for Portugal, where they're already doing something like this.

Johann Hari (TEDxLondon): 'Everything you think you know about addiction is wrong' (CLICK TO WATCH)

13 years ago, Portugal decriminalized (a word that scares many) the use of drugs. The government started treating drug use as a social problem, not as a criminal problem. The use of drugs is still illegal, but the user is confronted with different consequences than before. The people who have not behaved according to the law will be invited in front of a committee, where they are talked about the background of the situation and the effects of the drugs used.

The committee has the right to sentence the person to a fine (similar weight as with a traffic offence), community service, treatment at a treatment service, or to issue a form that affects how well the person will get a job later in life. Importantly, none of these things have to be done if the person is ready to change themselves. One of the representatives of these committees has said that it often seems to other countries that drug users are let off the hook easier after the decriminalization. But actually, the opposite is true. Before decriminalization, the attention went only towards dealers while now every single person caught with substance use has to go in front of one of these committees.

The results? Drug-related HIV infections have gone down 90% compared to 2011. Drug-related deaths are almost the lowest in Europe. Only three people out of a million die annually because of overdosing. The average number in the European Union is 17.3 people out of a million. In 1998, 23 500 people received treatment for their addiction while the number has now risen to 35 000 - the availability of beds, medical facilities and medical support has increased. An estimated 400 million euros has been taken out of Portugal's illegal drug market because of this.

While Portugal can serve as a role model for how to approach drug policies in general, the small but powerful Iceland has recently come into spotlight for showing a way to deal with addiction among young people. Their prevention-focused approach is based on three pillars: evidence-based practice, community-based solutions and a dialogue between science, politics and practice.

How Iceland Saved Its Teenagers - BBC News (CLICK TO WATCH)

This means that every year, all children in Iceland fill in a survey about different risk factors in their life: self-esteem, alcohol and/or drug use, family circumstances, neighborhood situation and support, attitudes towards school, recreational activities, religiosity, the quality of parental support, love and guidance, support from peers, anxiety, depression, suicidality etc. Based on the results of the survey, communities create better opportunities for spending free time, families work with creating stronger bonds, youngsters are being taught independence as well as how to relate to their peers. There's a person within each municipality to whom researchers explain results and who organizes meetings between parents, teachers, coaches and instructors to discuss the current situation and how to make it better. Portugal and Iceland show that there are ways to mindfully address issues like the ones that (young) Estonians face.

I invite our people to make an effort for our youth and to end the scaring and labeling. Instead, let's direct our energy towards understanding each other and towards a scientific approach - use surveys to gather feedback from all youngsters in Estonia, and then pay attention to the aspects which most need it. Let's bring together the people who can start creating a healthy environment for the youth - young people themselves, their parents, teachers, coaches, and maybe even law enforcement.

Probably then, love will follow.
REFERENCES:

Dan

kolmapäev, 14. märts 2018

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