David Bearman: Strong Families Our Best Defense Against Drug Abuse

Our efforts should be focused not on dispensaries, but on a supportive and educational approach toward prevention

By David Bearman, M.D. | Published on 03.02.2010

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There is an old cliché that says if you ask the wrong question, you’ll get the wrong answer. When it comes to substance abuse, the question is not, how do we stop the supply? We’ve tried for 100 years. We can’t, and the costs are too dear. The question is, how do we decrease demand?

Railing about the presence or absence of dispensaries that supply medicine to the ill and infirm does nothing toward effecting a decrease in demand motivation.

Santa Barbara City Councilman Frank Hotchkiss had it correct when he observed at a recent Ordinance Committee meeting that the presence or absence of dispensaries has little or no relevance to teenage substance abuse.

This position is supported by the work of Mitch Earleywine, Ph.D., of State University of New York, Albany & Karen O’Keefe, Esq., who rebutted this allegation in their September 2005 article “Marijuana Use by Young People: The Impact of State Medical Marijuana Laws.”

They wrote: “While it is not possible with existing data to determine conclusively that state medical marijuana laws caused the documented declines in adolescent marijuana use, the overwhelming downward trend strongly suggests that the effect of state medical marijuana laws on teen marijuana use has been either neutral or positive, discouraging youthful experimentation with the drug.”

In an effort to pass the blame rather than solve the problem, we have overlooked the obvious solution to continuing to decrease substance abuse: raising a child who feels loved in a nurturing, safe home and community environment. Numerous studies bear this out.

Dr. Ira Chesnoff’s work in Chicago with mothers with a history of cocaine abuse during pregnancy revealed that their children did well when the family was provided a comprehensive program of services, including drug abuse treatment, Head Start, parenting skills, counseling and good nutrition. Chesnoff found that these children of former cocaine-abusing mothers, who had experienced this comprehensive intervention, on entering first grade had an IQ that was higher than children of the prenatal noncocaine-using moms.

When I was medical director of the Santa Barbara Regional Health Authority (now CenCal Health), we received a grant from the Robert Wood Johnson Foundation to develop a program to stop the cycle of dependency created by dual diagnosis. We came to a similar conclusion as Chesnoff, that dysfunctional families play an important role in the social dynamics of substance abuse. We recognized that comprehensive services to at-risk populations were necessary to reduce the substance abuse risk in those populations.

So, parenting skills, couples communication and relationships based on reality — not fairy tales — should be emphasized as a more realistic and effective approach to substance abuse prevention and early intervention than a strict prohibitionist, law-and-order effort. The criminal justice system should be used rarely, such as when the use of drugs contributes to behavior that is a clear danger to others (e.g., DUI, domestic violence, child abuse, mayhem or murder).

Harvard University economist Robert Barro wrote of the damage caused by our drug policies in his paper “Getting It Right: Markets and Choices in a Free Society.”

“The experience with drug enforcement shows that prohibition of recreational drugs drives up prices, stimulates illegal activity, has only a moderate negative effect on consumption, and imposes unacceptable costs in terms of high crime, expansion of prison populations and deterioration of relation with the foreign countries that supply the outlawed products,” he said.

We should learn from our approach to alcohol and tobacco and focus the lion’s share of our efforts to help people use recreational drugs in moderation or not at all. Our approach should have a family focus and be supportive, primarily educational and medical.

Some years ago, under former Santa Barbara County Superintendent of Schools Lorenzo Dall Armi, I served as a consultant to a program on substance abuse prevention and intervention. The program created teams that included a parent, student, teacher, administrator and counselor at nearly every school in the county. The focus was on developing self-esteem, accepting and managing personnel responsibility, and teaching decision-making skills. This skill-building approach is very compatible with our educational goal of having an intelligent, responsible citizenry able to think through issues and make sound decisions based on science and solid analysis.

Christopher Farrell, in a Feb. 28, 2005, Business Week article titled “How Is the Return on That Investment?” asks what has been the return on the investment in our drug policy. His answer: “Abysmal.”

He points out that “the demand for illegal marijuana, cocaine and heroin remains strong. Drug lords and their cartels terrorize nations and local communities. Crime and corruption derived from the illegal drug trade flourish. U.S. prisons are crowded with drug-law offenders — more than 54 percent of federal prisoners sentenced in 2004 were sent away for breaking drug laws.”

Farrell suggests that “a shift in focus would free up scarce government resources at a time when the twin demands of an aging population and the war on terror are putting stress on the fiscal purse.”

Until we spend more time and money on promoting family values, teaching acceptable parenting techniques, creating an economy that allows parent and children quality time, addresses anger management and early intervention to prevent family violence, while recognizing the role of genetics and the contribution of dysfunctional families to ADHD, PTSD, OCD and bipolar disorder, we will continue on what has become a more and more destructive and ineffectual drug policy path.

By changing the drug policy paradigm from crime and punishment to medicine, prevention and treatment, we can reduce the level of hysteria on this topic, have stronger families, repair the Constitution and actually help people. This approach could also help decrease the rancor, anger and confrontation in this country being fostered by the forces of demonization of drugs and people who use them.

— Dr. David Bearman has nearly 40 years of experience working in substance and drug abuse treatment and prevention programs.

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» bbraisin on 03.03.10 @ 09:14 AM

Dr. Berman’s thesis is excellent.  My only comment would be that it is just as difficult to change parenting skills as it is laws regarding substance abuse. Morals and values to be sure are learned from nurturing and loving parents but it is not are role to tell anyone how to raise their child.  Our country must re-think the primary principals that we were given by those who came before us and if we believe them and encourage them then we will lead by example for our children. Ours is currently a society of too much compromise about right and wrong. If we don’t stand tall and true to what is right human conduct we will surely “fiddle while Rome burns”!

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» downtownres on 03.03.10 @ 10:22 AM

This is a really flawed article. The basic premise goes like this: imagine if we had open sewers running through our streets, and people thought this was normal. Now imagine that kids of all ages got into all kinds of trouble from being around, near, and in those open sewers. The answer to this is not ‘hey parents, you need to do a better job of keeping your kids out of those open sewers.’ The answer is that we as a society need to stop creating open sewers for kids to fall into with our permissiveness on alcohol and particularly pot (and Bearman is completely biased on the latter subject).

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» CharityBee on 03.03.10 @ 03:14 PM

I appreciate your emphasis on education.  I would like to see our Surgeon General take a high profile approach to drug use as Dr Koop did with tobacco use. There appear to be many recreational drug users who need to understand that their behavior contributes to the violence of the drug cartels.

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» jway on 03.03.10 @ 04:07 PM

7,000 people were murdered by the cartels last year because we kept marijuana illegal. This year they’re on track to kill at least 9,000. Who supports keeping it illegal?

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