The war on drugs doesn’t work


General William Sherman said, “War is cruelty. You cannot refine it.

Our war on drugs, which has lasted for generations, must be seen through this prism. The damage caused by this war is too great. We need to come together as Mississippians and as a nation to discuss the way forward.

The destruction of people that accompanies war is inevitably justified by appealing to the justice, or at least the utility, of the cause. In cases like the War on Drugs, where these arguments fail, the cruelty of war is emphasized even more.

How did a cardiovascular surgeon become passionate about pharmaceutical policy? A lifetime ago I was an enthusiastic young conservative Republican. William F. Buckley, Jr., was the smartest man on my Earth.

Twenty-five years ago, its National Review magazine wrote: “… we believe that the war on drugs has failed, that it diverts intelligent energy from how to deal with the problem of drug addiction, that it wastes. our resources, and that it encourage the civil, judicial and criminal proceedings associated with police states.

This has always been my intellectual position, but my career has put a more personal stamp on it.

I did my general surgery residency in Richmond, Virginia at one of the busiest trauma centers in the country. Richmond was a key town in the illegal drug trade on the east coast, and I had to deal with many teens and men who were shot – often at each other, sometimes by the police – so that armed gangs were fighting in drug lands. Law enforcement officers were also occasional victims.

Opinion: Everyone benefits by ending our criminal approach to drug use

The volume and severity of the injuries would leave no doubt in anyone’s mind that this was indeed a war. Imagine a teenager with his arm almost cut off at the elbow by an AK-47 bullet. If the photo is from a combat zone in Africa, how easily we react with pity for this child, embroiled in a war that is not of his own initiative. If the photo is from an American trauma center, how quickly do words like “thug” and “gangbanger” quickly appear in our minds?

We make the cruelty of war bearable by creating a psychological distance between ourselves and those we define as adversaries.

But these “adversaries” are not always armed and dangerous. These are often members of our own families who are struggling with a substance use disorder.

Data from the Centers for Disease Control and Prevention from 1999 to February 2019, shows that more than 770,000 Americans have died of drug overdoses, many of which are the result of intravenous injections of drugs, often opiates. The current opioid crisis began in the late 1990s as an increase in the use of prescription narcotic pain relievers. The ensuing “crackdown” on prescriptions led, as Prohibition always does, to increasingly potent versions of heroin, then fentanyl, supplied through the illicit market.

My current career in heart surgery exposes me to a new group of war victims: patients whose intravenous drug use has resulted in endocarditis – infection and destruction of one or more heart valves. I can replace a broken heart valve, but I can’t protect my job if these patients can’t get treatment for their main disease – drug addiction.

America’s War on Drugs saves its greatest cruelty for addicts. In our efforts to create the psychological distance necessary for war, we use terms like “junky”, “dopehead” and “scumbag”. Drug addiction is the one disease that too often we treat not with doctors, nurses and drugs, but rather with handcuffs, jail cells and life sentences.

We all have different perspectives on this war, shaped by our values, our education and our life experiences. I know we all want the same things: the safety of our children, less crime, less destroyed lives. It is time that we stop fighting, that we take these products out of the criminal realm and legalize and regulate them, as we do with other dangerous substances like alcohol and prescription drugs.

Dr. Carr McClain is a cardiovascular surgeon at Forrest General Hospital. He lives with his family in Hattiesburg.


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