At Bioephemera, Jessica Palmer notes a disturbing double standard:
[T]here's a huge double standard in the media, and in society in general, when it comes to drug abuse treatment. I spent two years as a AAAS Fellow at the National Institute on Drug Abuse, and it was both depressing and inspiring: I was deeply impressed with the dedication of the staff, and horrified by the immensity of the problem of addiction in this country. That's why it upsets me that while research to help smokers quit is generally portrayed as necessary and important, increasingly, I'm seeing politicians complain that research to help other drug addicts quit is a waste of money.
Maybe it's because these other addicts are meth addicts, or potheads, or heroin addicts - probably not people you relate to or approve of. That makes it pretty easy for the media to take cheap shots at crack, etc. addicts, and question whether we should waste money trying to help them. But we should get angry about these cheap shots. A crack addict will die faster than a smoker. A crack addict can rarely hold down a job or be a parent. His/her illegal addiction poses a bigger danger to society than a smoker's does. Most importantly, a crack addict, like a smoker, can quit. Tobacco is still a significant public health problem, and I want to do all we can to help smokers (like my mom) quit, but crack, meth, etc. utterly destroys families and communities. We should be leveraging scientific research every way we can to help these people - not throwing them away or taking shots at them because they're "bad," or because we can't relate to them. They're real people. They have families.
You should, as they say, read the whole thing.
Here, I want to pick up on the question of what kind of research the public (or the pundits trying to prod the public one direction or another) have a hard time getting behind. We've discussed the general issue before, and even spent a little time talking about the specific issue of research with addict populations. But we haven't dealt head-on with the kind of objection that a segment of the American public may have, specifically, with putting up public funding to support research on the effects of drugs on people's bodies, brains, behaviors; on effective ways to treat or manage dependence or addition; on genetic or environmental factors that might make some people more susceptible to dependence or harm.
That objection is described fairly succinctly in one of the comments on BioE's post:
A very large and vocal swath of America views illegal drug use as a moral failing. These same people nearly always believe that those with moral failings deserve to suffer. In their eyes, anything that reduces the suffering of those with moral failings is evil. ...
The problems you have described are a direct result of our culture's long standing tradition of framing undesirable behaviors as moral failings.
Let's consider the proposal that resistance to funding scientific research on drugs of abuse or on treatment is, at bottom, motivated by the view that taking drugs is a moral failing.
(I'm curious to know how many people holding this view include alcohol and tobacco as drugs. Or caffeine. Or psychiatric drugs. Or drugs to reduce cholesterol, or acid reflux, or wrinkles. Or drugs to address erectile dysfunction, or diabetes. Where on the "drug facts" label is the language that will identify which of the many substances that interact with our bodies and brains are moral and which are immoral? Is legality the relevant line here, as the commenter I'm quoting suggests, or something else? If the "legalize it" crowd were to succeed in the push to get marijuana decriminalized, would its use move to the morally acceptable column?)
The implication of the view that taking drugs is a moral failing is that if you make this wrong choice, you fully deserve everything that follows from this choice -- and you ought not receive any assistance in undoing the mess that your wrong choice got you into.
(Drug use is a moral failing but investment in mortgage-backed securities is not, apparently.)
Science can ask all the questions it wants about drugs, then, but not on our dime. We already know everything we need to know about drugs. Using them is bad ... which must mean only bad people use them. Bad people deserve punishment, so the nasty effects of drug use are entirely appropriate.
Of course, even if we were ready to stipulate that the people who take drugs are all bad, they are not the only people who get to deal with the nasty effects.
These effects may impinge on their ability to do their job, which can impact their employers, their co-workers, the people who depend on the goods or services their workplace produces, not to mention, further out, impacts on things like tax revenues and GDP.
There are also people too young to be holding jobs to consider here. The kids who are taking drugs may be impacting their ability to grow into responsible adults, who can hold jobs and otherwise contribute to their communities. They may be making things even harder for the teachers trying to teach them in school, or for the kids sharing the classroom with them to learn. Even if you're prepared to let a child suffer lifelong consequences for a choice you see as morally wrong, it's not clear that they won't be causing significant harm to others on the way -- including their families, their friends, their neighborhoods.
(Having kids of my own, this is not an abstract question for me. I know my kids are likely, in the process of growing to adulthood, to make some choices I'd rather they didn't. My hope is that this happens in a way that avoids permanent damage all the way around.)
If the nasty effects of their bad choice are such that folks taking drugs can't get or keep jobs (or otherwise take care of their families), there may be impacts on social service programs (whether governmental or private) that they rely on for help getting food and housing, or that might be called in to intervene if the safety of their kids or partners or elders were in question. There may be impacts on hospitals, where the folks taking drugs may end up relying on the emergency room for medical care (since if you can't keep a job, chances are good you don't have the health insurance that would cover regular non-emergency medical visits). These costs will get shared with the rest of the public -- even the people who have avoided the moral failing of taking drugs.
As will the costs of law enforcement, if the people taking drugs resort to crime to support their drug habits. As will the costs of incarceration, if the people taking drugs are taken off the streets to protect the rest of us from that crime. We get to foot the bill for the effects of other people's "moral failings" here as it is. Why, then, should it be so objectionable to consider spending some public money to figure out how to help people stop? Is it so important that people be punished for their moral failings that we're willing to sustain large-scale societal collateral damage just to enact that punishment?
Because honestly, I'm not sure that this kind of vengeance is terribly moral. Even if it were fair to the person making the choice you view as morally wrong, it seems pretty unfair to all the other people who will also be hurt.
Why can't we, as a society, turn to scientists to get reliable information on how drugs impact human bodies, brains, and behaviors? Why can't we fund scientific research to develop effective ways to treat drug dependence -- to help people who want to stop doing this thing so many people view as morally wrong? Why can't we get behind research efforts to determine what kinds of genetic and environmental factors make people -- including kids -- more vulnerable to dependency, or to the harms that may impact a much larger circle of people?
Couldn't better knowledge help people make better choices?
Couldn't better knowledge help society minimize some of the collateral damage from the bad choices that have already been made?
And really, seriously, are we committed to a one-strike policy with bad choices, with no room for compassion or fresh starts? Is that really who we want to be as a society?
It's not who I want us to be. I'm not ready to take a stand that amounts to throwing away a family member, a friend, a coworker or student, a neighbor, even a stranger, for one bad choice -- especially if they are looking for help to change. I'd rather we be a society that stands ready to help people change -- and to help get them the best information we can that will support the change they're trying to make. It's not just in their interest, but in ours, too.