Conditioning Model of Drug Tolerance



Conditioning Model of Drug Tolerance

Introduction

The U.S. emphasis on abstinence and zero-tolerance in both the treatment and law-enforcement paradigms generates political pressure against incorporating harm-reduction practices into broader policy. For example, while methadone treatment has been available in the United States since the 1970s, the U.S. government has never favored needle-exchange programs (Roshanpour , Ghasemi, Riazi, Rafiei-Tabatabaei, Ghahremani & Dehpour, 2009). The use of federal money to support them was forbidden from 1988 to 2009. Similarly, while there is some research on harm reduction through the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA), the Office of National Drug Control Policy's (ONDCP) National Drug Control Strategy for 2002—the first drug policy strategy of the George W. Bush presidency and written approximately 20 years after Nancy Reagan's “Just Say No” campaign—specifically rejected harm reduction as a euphemism for legalization (Klaassen, 2001).

Discussion

The current harm reduction movement could be said to have its genesis in the Merseyside Medical Authority prescription program in England as well as the liberalization of drug polices and Junkie Union movement in the Netherlands in the 1970s and 1980s. The Merseyside Medical Authority, near Liverpool, England, began a harm reduction program to combat the rise of heroin use in the 1980s. The Merseyside program offered a full range of services to users that included education, needle exchange, therapy, employment and housing services, and medical care. A key service of the Merseyside program was the implementation of prescriptions for illegal drugs, which were administered under medical supervision (Roshanpour , Ghasemi, Riazi, Rafiei-Tabatabaei, Ghahremani & Dehpour, 2009).

Drugs such as heroin and cocaine are prescribed in smokeable, as opposed to injectable, form. In the Merseyside model, prescriptions were viewed as a means of outreach and retention, serving as an intermediate goal in the overall improvement of the users' lives. Law enforcement officers were also important partners in the program. Police officers referred users to Merseyside while at the same time reducing their presence in the vicinity of the outreach center so users did not fear arrest when accessing the facility (Klaassen, 2001).

Zero Tolerance and Drug Policy

Although the term zero tolerance dates from the early 1980s, the concept had already been established as a popular method for dealing with substance abuse in the United States since the “War on Drugs” initiated by President Richard Nixon in 1971, which emphasized prosecution and incarceration of drug users (Pratt, 2001). The Rockefeller drug laws introduced in New York State beginning in 1973, which imposed mandatory minimum sentences for many types of drug crimes including sale or possession of even small quantities of marijuana, are another product of this attitude. Other states adopted similar laws although they were often repealed or modified in later years (as they were in New York State in 2009). Some school districts imposed zero tolerance policies for drug and alcohol possession in the early 1980s, but zero tolerance did not become federal law until 1989 when Congress passed the Drug-Free Schools ...