I worked as an Aide in a hospital where I directly took care of patients, many of them were there because of sustained drug use. I won't go into the more graphic details, but they were all very incapable people that needed help to do the very smallest of things. In the United States as well as in the majority of developed countries universal health coverage exists, a system to cover people in cases of health problems. These patients that were in the hospital for drug use had no way of paying for their expenses so that falls on the tax payers in a universal health system. This type of situation certainly affects others not just the person themselves.
In ways like this I think Huemer overlooks all the angles that really occur in cases of the use and misuse of drugs. In a realistic sense, and acting as a member of society, I can't think up any case where one persons drug use has absolutely no impact on anybody but themselves. Although I am not totally opposed to the idea of legalizing drugs I just don't think it can ever be proven to only impact the user. Any thoughts?
I think your work with severe drug users may be biasing your perspective. To be clear, I'm not really going to make the argument that drugs are good for a person and others - I just think that them being unhealthy is a unique case, and that it certainly doesn't always affect other people.
ReplyDeleteTo start with a simplistic (perhaps cheating) example to counter your notion that its impossible to use a drug without having an impact on others: caffeine is a drug. Many people consume this drug on a regular basis, yet I don't see any obvious harms that my drinking caffeinated soda has had the people around me. To generalize this case, while drugs can certainly be abused in a way that harms others, there are likely many harmless drug users who do not attract either medical or legal attention because their usage does not influence others. Drug usage may be much more prevalent than you realize, its just that your work in a medical setting makes you only see the most severe of cases. Alcohol is similar - most adults drink recreationally on a periodic basis. Alcoholics and drunk drivers undeniably harm the lives of other people. But, those who chose to have a few drinks occasionally in private settings (i.e. most users) don't seem to be that harmful. Similar things could be said about most drugs I think, even illegal ones.
As for health effects, some drugs certainly are not good for a people. However, I think that many of the negative health effects that they have tend to be from not taking care of one's self, rather than the actual effects of the drugs. But furthermore, we do unhealthy things all the time. The most obvious example that I can think of that has a much larger effect than drugs is obesity - this is probably the leading cause of death in the developed world as it is strongly associated with a large list of health conditions such as diabetes, chronic heart disease, etc. This effects others in that it increases costs substantially in the healthcare system and dying an early death/not being able to participate in certain activities undeniably has a negative impact on the people around them. People who are severely obese are similar to the addicts that you describe - some of them are unable to even get out of bed or take care of themselves. Yet, it seems like it would be very extreme to have a government ban on all unhealthy foods just because some people abuse them.
But, I'm inclined to still agree with you that drugs aren't really healthy and that they tend to have a negative impact on one's live and the people around them. Perhaps the best remaining argument for ending prohibition is that by making it illegal, we prevent people from getting help. It seems as if making them illegal doesn't really deter people who want to use them from doing so. Decriminalization seems like it could be more effective if we simply want to reduce usage - Portugal decriminalized all drugs in 2000, offering rehabilitative services to addicts and those who are caught with very large quantities of certain drugs. They also started a needle exchange program where drug users can exchange used syringes for clean ones. This has been quite successful in reducing drug usage and its associated issues (such as spread of HIV, overdoses, etc.). https://en.wikipedia.org/wiki/Drug_policy_of_Portugal
That some people end up being hospitalized due to drug are sad yet extreme cases of drug use. A lot more people use drugs for recreational purposes but don't go to the hospitals. In terms of judging whether drug use has serious negative externalities, it's not objective to merely focus on heavily addicted users.
ReplyDeleteI agree there are recreational drug users but there are cases where a drug can be used once and cause drastic health problems.
DeleteI think you make a valid point about Huemer falling short on the extent to which drug use impacts society as a whole. Drug users are more likely to engage in risky and illegal behavior (not just illicit drug use). They are more likely to have health problems that come with both the effects of drug use on the body (e.g. smoke inhalation) and the ancillary impact that comes from being a chronic drug user (e.g. weight loss, compromised immune system). In that way, they do affect the whole of society because they act as a cost on the system as a whole.
ReplyDeleteWhat it really comes down to is what the government has the right to regulate. Is it the job of the state to determine how people live their lives, because it potentially creates a huge cost to the rest of society, which could be seen as harmful? With the implementation of the Affordable Care Act, I worry that the answer increasingly slides in favor of state regulation. Looking specifically at substance abuse, the Affordable Care Act classifies substance abuse treatment as one of 10 essential health benefits that must be covered by insurance companies in order for their plan to be on the public health market. This to me has the potential to create a slippery slope argument for regulating individual’s health and lifestyle choices in order to regulate the cost these types of programs would incur on society as a whole. Don’t get me wrong, I’m not against efforts to ensure that those with addictions get the help they need, however it is important to consider the cost that would be imposed on society as a whole in order to implement these policies. Of those arrested for drug offenses in 2002, the median income was barely above minimum wage. Treatment for substance abuse problems averages around $10,000 for out-patient and between $20,000 and $30,000 for in-patient. That creates a very serious cost on the system as a whole if this type of behavior is condoned.
With that being said, Katelyn makes an excellent point with relating this line of thinking with obesity and other chronic illnesses. Drug addiction has comparable relapse rates with diseases like diabetes, asthma, and heart disease. Those who are obese are at a higher risk of health problems and many would make the argument that they have caused those higher health risks by their own personal choices. When comparing it to similar chronic illnesses, it seems almost ridiculous to think that these would be potentially regulated the way drug use is regulated and stigmatized. If society is to accept the disease model of addiction (and this is still strongly debated), then it would follow that addiction should be treated as any other disease. By further extension to obesity, it would also follow that because we don’t regulate what people are allowed to eat we shouldn’t regulate what drugs people use.
At the end of the day, there is a balance that must be struck. Addiction does cause a cost to society that can be seen as harmful to others, which Huemer does overlook. The question that must be answered is whether the government has the right or obligation to regulate drug use because of those costs it can impose when they do not regulate other similar disease causes like poor eating and obesity. To me, the government does not have a right to make those choices for a person. Their job is to protect against infringement of others rights, not just protecting them from harm. While these costs are important to assess, they are not enough to validate an actual infringement on anyone else’s rights.