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The impact of legalization on treatment income

“Follow the money.” Always good advice when considering the motivations of prohibitionists. Certainly it’s true with the true drug warriors, including DEA, police unions, etc.

And, while the treatment industry is comprised of both the truly caring and the avariciously opportunistic, the general sense has been that most of their vocal opposition to legalization has come from those who see legalization as a threat to their revenue.

Well, Kevin Sabet has been pushing back against that with his own notion that legalization will actually result in an increase in profits for the treatment industry (and even for the enforcement industry).

Kevin Sabet tweet:

Repeating this for the uninformed: if drugs were legal, I, and the treatment and enforcement sectors, would be MUCH richer. > use = > need

He seems very sure of himself, but I’d advise you not to take any financial advice from him, ’cause assuming he actually believes what he says, his analytical skills are crap.

The notion that enforcement would profit from legalization is so laughable it’s not worth my time to address, but let’s look at treatment.

if drugs were legal

– Which drugs, how regulated?

> use = > need

– Unspoken assumption that legalization leads to greater use, which may not be true in all situations.

– Conflation of use and abuse.

– What about all those referred to treatment by criminal justice and others, including many for cannabis who don’t need treatment?

– What about the fact that addictive illegal drugs have more uncertain dosages/purity causing serious problems for addicts? How would that differ with regulated drugs with controlled purity?

– What about substitution? Legal pure amphetimines would cause less treatment problems than homemade meth.

– No thought is given to the notion that those who wouldn’t use while a drug is illegal, but would when it is legal, are less likely to become addicted.

Now personally, I don’t think that Kevin is in this racket for the money. My sense is that he’s hitched his career wagon to the anti-legalization movement and likes being a “leader” in it, regardless of whether he benefits financially (although he wouldn’t mind getting both).

_____

For more on Kevin Sabet and SAM, see Where now for opponents of cannabis law reform? at Transform.

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48 comments to The impact of legalization on treatment income

  • Tony Aroma

    Time’s running out for people like Mr Sabet, so they need to start pulling out all the stops. Within 2 years, the world will know if their predictions of doom are going to come true in at least 2 states. If not, then ranting about the evils of legalization is going to become a lot less lucrative.

  • strayan

    Greater use equals greater need for treatment?

    Odd that “Over 90% of the estimated 37 million people who have stopped smoking in this country since the Surgeon General’s first report linking smoking to cancer have done so unaided.” http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000216

    • allan

      phenomenal isn’t it? No SWAT raids, no cigarette sniffing dogs, no tobacco courts…

      • Matthew Meyer

        Yeah, but just imagine how much further along in our societal smoking cessation efforts we’d be if we’d used jackbooted Bubbas dressed in uniforms of brutality!

        Or not.

    • claygooding

      Smoking tobacco was the hardest quit of any drug I ever quit,harder than cocaine for damned sure,,I walked away from cocaine and never looked back when I made my mind up to quit,before it owned everything I had,,I am still addicted to nicotine but I quit smoking and took up dipping instead,,,my doctor said that dipping was 40% safer than smoking.
      I figure it took 45 years of smoking to ruin my lungs,,if it takes 40 years for my bottom lip to fall off the gals I am dating then won’t give a shit,,,as long as I can pay for supper and get them back to the rest home before curfew.

  • Would treatment admissions increase under legalization? I will only speak to that which I have the most experience with, namely opiates/opioids. (For the record I think with cannabis the answer is clearly no) Let’s suppose heroin and all the other opium derivatives and synthetic opioids are sold like alcohol.

    First assuming casual users were ineligible for treatment, would addiction increase? Maybe, hard to say for sure. I tend to think most people predisposed to developing a chemical addiction (for whatever reason) probably are already addicted. This would most likely mean a shift from alcohol and benzodiazepines to opiates, a net gain since pharmaceutical (pure, sterile) opiates are far less harmful to the body than alcohol and, unlike benzos, far less likely to cause death upon rapid withdrawal. It is possible that alcohol and opiates will be used as complements, but I think that is unlikely. Most users prefer one or the other, certainly historically bars and opium dens were very different places.

    If opiate addiction were to increase, perhaps correlating with a decrease in alcohol addiction, would treatment demand increase? First of all the only one’s seeking treatment would be those that need it.This is the way it should be. Drug courts that offer treatment in place of jail really offer no choice at all. Nevertheless, drug courts are not the only reason addicts go to treatment. Many seek detox not to “recover” but simply to get out of the cold (if homeless), get a break from the daily hustle while being fed and medicated, and lower their tolerance before heading back to the streets. Following legalization they would not need a respite from the daily grind of coming up with $30, 50, or 100+ dollars per day.

    There will of course still be people seeking means to end their opiate addictions, this was true when opiates were legal and will most likely be true into the future. Even following legalization opiate addiction will likely be stigmatized, though hopefully less so. The fact that junkies won’t be stealing for opiates anymore will certainly change some perceptions. Maybe “junkie” will go back to what it originally meant, someone who supported their habit by collecting junk metal. The homeless opiate addicts under legalization will be collecting cans instead of engaging in robbing, shoplifting, prostitution and petty dealing.

    To summarize, assuming (1) heroin is sold like alcohol and (2) opiate addiction increases, would treatment demand increase? The loss of involuntary clients, and individuals merely seeking refuge from the pressures of addiction could hardly be called voluntary, might be balanced by the increase in addiction prevalence. If the increase in opiate addiction is accompanied by a decrease in alcoholism (or other chemical addictions, which assumes the rate of chemical addiction in a given society is constant), the total number of addicts seeking treatment would decrease and thus the number of potential clients. All in all there are a lot of unknowns (I think I used the word assume multiple times), though I would certainly say Sabet’s smug assertion is unwarranted.

    One possible good following legalization is that the treatment industry might finally adopt evidence based practices. Sadly most treatment does no good, not because the evidence isn’t there, but because ideology trumps evidence. I tend to think a large involuntary and semi-voluntary client base only encourages this to continue.

    • divadab

      Well-reasoned and written post, Sir! I would support your logic with some actual evidence, from a true democracy that among other things also has a true citizen militia – Switzerland. They haven;t been successfully invaded in over 1,000 years so they must be doing something right!

      Heroin addicts in Switzerland are provided their daily dosage of heroin by a public health nurse in a clinical setting. They aren’t forced into degradation and oppressive jail terms – in fact, over 70% of them are employed!

      Isn’t this more sensible than our wasteful, cruel, stupid system of criminalizing a public health problem? I mean, all the outcomes are worse under our system of outright prohibition and criminal sanction than under the Swiss system. And no junkies are breaking into cars to pay for their fix – as someone who has had his laptop stolen fro my locked car, I would prefer the Swiss system. Give the junkies their drugs (at a cost of about $0.90 per day – legal heroin is cheap) and get them the heck out of having to rob me.

      • War Vet

        open up the markets to all sorts of drugs and add education, we might not see as much ‘health problems’ with the harder drugs . . . constant experimentation could reduce the amount of time one uses the addictive stuff.

      • I am familiar with the Swiss program. From what I have read the Swiss program came about largely because Switzerland has a form of democracy that allows for a popular vote on national laws and their rate of voter participation is much higher than the US. In the 1980’s the Swiss faced a heroin “epidemic,” yet only 10% of the population favored a prison sentence for addicts. Politicians, faced with the real possibility of the people legalizing heroin (God forbid) by popular vote, offered heroin maintenance as a sort of compromise. If heroin were legal, the Swiss would be in violation of international treaties (sound familiar?) and, being an island of refuge in a global war against people who enjoy opiates, worried about drug tourism and becoming a haven for junkies seeking asylum. Heroin maintenance, being ostensibly a medical program, solved both these issues. Medical use is allowed under treaties and it could be limited to Swiss citizens.

        The Swiss program suffers from two major flaws:

        1. Heroin remains prohibited to the general population, but by virtue of having violated that prohibition and perhaps also due to the personal and social chaos wrought from that choice, the individual then becomes eligible to receive free heroin on the government’s dime. Going on by degrees, perhaps we should offer alcohol maintenance clinics for alcoholics, and nicotine maintenance clinics for smokers (I think Mark Kleinman advocates this), all while ostensibly claiming it as medical treatment for the disease of addiction. The end result is to give doctors more power over our lives in the name of treating disease, what Thomas Szasz called the “Therapeutic State”. Anti-drug fundamentalists also see it as giving drugs to addicts as taxpayer expense, this does not engender goodwill.

        2. Addicts had to surrender their drivers licenses due to fears of driving while intoxicated. They also had to dose at the clinic, due to fears of diversion. The half-life of heroin is such that the “patients” need to dose 2-3 times per day. Having to go to the clinic 2-3 times a day combined with having no driver’s license means that the addicts’ chances of having some sort of a normal life is seriously impaired. They can’t go on vacation, nor get a job, or live, far from the clinic. And yet some people wonder why unemployment remained high among the “stabilized” addicts.

        Imagine if medical cannabis was administered like methadone, where clients could only dose at the dispensary and patients had to take regular piss tests to make sure they weren’t using any other naughty substances (refusal means being kicked from the clinic/dispensary). Never mind the fact that any medicine diverted to the grey market is a tiny drop in the bucket of black market alternatives. Ultimately though I don’t think it is the answer to opiate prohibition.

        Don’t take this to mean I’m against heroin assisted therapy (HAT), far from it! It makes eminent sense as a public policy matter, for some of the reasons you mentioned. The program could also be optimized, for example why doesn’t anyone try using opium? It would probably give an effect many are looking for.

        Canada has also started implementing some small scale forms of narcotic maintenance. Other countries are following suit. Clinical trials are done and the results are unequivocal, HAT works at improving the quality of life of the addicts and lowers crime. Both acquisitive crime and drug-sales “crime”.

        • divadab

          Thanks for the info. The only item I would take issue with you on is your conclusion that not being able to drive means a high proportion of the Swiss addicts in the program are unemployed. I suppose that a 25-30% unemployment rate is high compared to the general population. However, the fact that over 70% of the addicts in the program are employed is off the scale compared to addict employment rates in countries where addiction is criminalized. In Switzerland you do not need a car to get to work because they have a good system of public transportation. Perhaps this system would not work in the US, where the public transportation network is poor in much of the country. In most countries, where the government actually works for the people, not the profits of the wealthy, public transportation networks are strong and a practical alternative to the car.

  • claygooding

    Kevin Sabet’s new job,besides SAM,is trying to convince investors to build the rehab centers necessary to handle every marijuana possession conviction as a rehab qualifier and without those court ordered “treatments”,marijuana addiction has the same addiction level as caffeine,,when we start seeing ads for caffeine addiction then it will be time to start worrying about being addicted to marijuana.

    The bottom line is,,so what if a person is addicted to anything,,as long as they can afford it and it is availabl to keep them happy.

    The last I heard,,only appx 10% of the people in rehab for marijuana were walk-ins,people seeking help,and the rest were either court ordered,job related or family intervention,,Sabet is once more,,full of shit.

  • Francis

    “Repeating this for the uninformed”?

    Indeed you are. Of course, that’s true of everything you say, Kev. Still, it’s not something I would have expected to see you admit.

  • Freeman

    Kevin Sabet tweet:

    Repeating this for the uninformed: if drugs were legal, I, and the treatment and enforcement sectors, would be MUCH richer. > use = > need

    He seems very sure of himself.

    This is a rhetorical device I’ve seen a lot of. It insinuates that anyone who disagrees is ignorant and stupid. The message must be “repeated” for the benefit of the “uninformed”. It comes from Kevin Seebat, phd, so of course he’s sure of himself and he wants you to be sure of him too. The false suggestion that it goes against his personal financial interests is intended to suggest that it is informed by something more important than that. It’s nothing but propaganda for those unable to think for themselves.

    Good article at the transform link. I left a comment there, but it’s currently awaiting moderation.

  • kaptinemo

    Ah, the imperious arrogance of the ideological apologists for a failed policy never ceases to amuse…and provide glimpses into the mindset behind that arrogance.

    He believes himself to be amongst the sage and wise anti-drug cognoscenti, huh? The keepers of wisdom? The very same folks who wasted a BILLION of our taxpayer dollars on a laughably ineffective anti-drugs media campaign?

    A campaign in which the results seem to indicate that, rather than dissuading young people from using illicit drugs, it may have actually peaked their interest?

    It would seem that the self-described ‘informed’ have a problem with their message as well as its’ delivery. Because, as has been observed time and again, no amount of work can turn a lump of mud into an apple pie. Their message is mud, and the intended audience is figuratively not buying any.

    And, soon, they literally won’t be. A tectonic shift has occurred, offshore and deep underground, and a tsunami is coming. The demographics are shifting daily, and those who were receptive to the prohib’s message are being reduced in number in direct correlation to their replacement’s rise…and their replacements have no interest in listening, having been lied to (and bullied by) those sending their anti-drug messages. In WA and CO they sent a message of their own, one that will be echoed in other States.

    They will not want to pay for the DrugWar with their taxes. Which means that ultimately, DrugWarriors had best dust off their resumes…and perhaps look into local Private Industry Council grants for retraining in a new career.

  • Dante

    My Fellow Anti-Prohibs:

    When we win the day, and the drug war is no more, there will still be scores to settle. Those who have spent their lives enriching and empowering themselves, at the expense of We The People, while actively harming America with their ignorant ideologies and violent pre-dispositions, must be harshly dealt with.

    I hereby propose that Kevin S. will be first.

    • The world needs ditch diggers too

      .
      .

      I’m sure we can put them to good use. E.g. I have a toilet that needs scrubbing and ditches that need digging. I’m sure that some rich lady will adopt Kev-Kev and let him ride around in her purse. Does anyone know if he’s housebroken?

    • Francis

      There will indeed be a few scores to settle when that day comes. After all, weakness is not the same thing as compassion. Uh oh, now why does that sound familiar?

      Just to be clear, I’m not really criticizing your comment. I’ve made my share of very similar ones. And I think they can be a useful way of “flipping the world on its head” and shocking people into questioning their assumptions. (“Wait, you’re saying they’re the criminals?”) But really, and just speaking for myself of course, I don’t actually want Kevin Sabet hauled off and locked in a cage for the rest of his life or anything like that. (Feel free to insert your own revenge fantasy here.) I think the world has seen enough violence. I WOULD like him and the rest of the drug warriors to grasp the enormity of the suffering and injustice they’ve helped to perpetrate. Then again, that might make me the most vindictive one here.

  • Stuck in the middle with you

    .
    .

    The clown brigade finally got it together and came up with a [stupid joke about pot] statement about A-64 and I-502:

    Former DEA [jokers]: Nullify Colorado, Washington Marijuana Laws

    It must really, really suck to have your entire world collapse around you. At least I hope it does. For the children.

    • Matthew Meyer

      Disappointing that the AP article didn’t even mention that there is just no way for the feds to compel those states to enforce federal drug policy.

      Some folks still seem unclear on that point, it’s worth repeating over and over until everyone gets it.

      • pothead patriotism

        I’m not sure that they can figure it out. 16 years after the fact they’re still gazing at the horizon in anticipation of the imminent arrival of the Federal cavalry riding in to strike down the California Compassionate Use Act.

        One of the greatest disappointments that I’ve suffered pursuant to my obsession with this issue is learning the true level of ignorance of my fellow Americans when it comes to our laws, system of governments, and history. My greatest satisfaction comes from the opportunity I’ve had to immerse myself in those very same things. Now I’ve got to stop before I start with the jingoisms.

        **************************************************

        Somebody made the mistake of uttering the name of C@!vina F@y recently. Well speak of the Devil and in she walks.

        “The ex-DEA heads are issuing the statements though the Florida-based Save Our Society from Drugs, a national group lobbying against legalization.”

      • darkcycle

        Heh. It’s the czars. Detached from reality, and drifting ever further into the realm of that crazy old Uncle nobody wants to invite to holiday dinners.
        Nullify? How? With what power?

    • Peter

      Calvina and the former DEA drones don’t have to stand for election, so are not concerned about how the majority of voters will react to this proposed high-handed interference in WA and CO. I’m guessing that Democrats in the administration are much more focused on the potential voter backlash should they be seen to openly defy the will of the voters, hence their nervous hesitancy on what to do next.

      • re-legalize it

        read an article in the LAT yesterday talking about how irrelevant Repubs are making themselves in CA. If trends continue (according to the article) in two more prez election cycles registered independents will outnumber Repubs. The ranks of Dems and independents are growing among the young, non-whites and females. The profile of today’s CA repub is over 40, male and white. All other registered demographics vote at a higher percentage.

        Repugnicans are making themselves irrelevant by continuing to embrace the looney right fringe of evangelical creationists, climate change deniers, homophobes and that whole melange of the cognitively disconnected.

        I suspect that is what states like ID, WI and AL will become – havens for the exclusionists.

        There is change afoot and we are part of it. I suspect few outside of the drug policy payers-attention circles are aware, yet, of how key the whole drug issue is to everything else.

        Overturning or doing any major fooling w/ states voters’ will, will not sit well. Congress approval rating is at what? 10%?

        C’mon there Prez Choom, we’ve given you the keys to the excavator and you can rip a gaping hole in the WOD wall. Dr King said that the right time to do the right thing is always right now. Just do it.

    • claygooding

      What is sad is that this exposes the public to intelligence level of the former Admins that hel[ed spend over 2 trillion dollars making criminals and themselves rich.

      If the federal government can’t “sue” and stop medical marijuana production and distribution,,how in the hell could they stop recreational production and distribution just by suing the states. Either one is in contradiction with the CSA.

      • primus

        And, seeing as the only part of the constitution which allows the CSA is the interstate commerce clause, how does that harmonize with WA and CO removing cannabis from their naughty list? Surely now that two states have legalized, the ICC must regulate cannabis commerce between those two states and foreign countries which might wish to do commerce with citizens in those states. Regulate does not mean ban. After all, that is what the ICC was/is all about.

  • Servetus

    Once drugs are legalized and regulated, addiction will no longer be a problem to be taken up by moralizing prohibitionists like Sabet. It will be treated as the true medical problem it is. Treatment will be conducted by real medical doctors with real medical degrees, not PhDs. Kevin is either lying, or in denial about his future relevancy.

    Control freaks like Sabet and others will be forced to give up their grandiose dreams of presiding over vast drug treatment complexes that look and are run like detention centers. In the near future, a medical professional will be able to prescribe a medicine that permanently reverses developed cravings for certain addictive drugs. Treatment will be simple and immediately effective.

    Drug treatment centers are currently used because the law doesn’t allow doctors to treat addiction in their offices, nor in regular hospitals. Under prohibition, treatment centers are regarded as virtual leper colonies by uptight residents who say they don’t want the facilities in their back yards. Eliminating prohibition solves the problem. Legalization eliminates the criminal stigma, and optimizes the treatment options, which are then widely dispersed among regular doctors. Under a system of voluntary treatment, the job gets done.

    Sabet is not trained in medicine, nor in science, so he’ll be shown the door.

  • I made the U.N. very, very angry

    .
    .

    Is this what they call a coordinated attack? Look who just showed up at the party:

    United Nations says changing U.S. marijuana laws violate international drug conventions

    They may look real scary but all their guns do is to ejaculate a little flag that says bang!

    • stlgonzo

      Nobody is scared of soldiers dressed in light blue.

      • It's a girl!

        Do they let the girls dress in cute little pink outfits?

      • Plant Down Babylon

        Ever notice how the TSA is blue too?! Get the public to get used to ‘blue’ officers and it’ll be easy to just stick the UN in their place.
        It’s coming soon…

        Notice how a lot of the border patrol agents speak english like it might be their second language?

        • stlgonzo

          I may not be the smartest man in the world, but by-lingual border patrol seems like a good idea. Not the laws they are enforcing necessarily, but they do deal with allot of Spanish speakers.

        • divadab

          You know, there is an oppressive world government in the works, with an immense amount of power over sovereign governments. But it’s not the UN. The UN is a convenient whipping boy of the corporatist right wing. The real world government is the Oil Oligopoly. They created the great recession with manipulated world oil prices at over $160 a barrel. They caused Iraq to be invaded on our dime for what? To raise the world oil price by taking Iraq’s oil offline.

          Don’t believe me? What was the price of a gallon of gas when GW Bush took office? And what was it when he left office? Over 3 times higher. This is what happens when the oil oligopoly takes over the US government.

    • kaptinemo

      For a proper rejoinder to the UN’s statements on this issue regarding their view of American sovereignty, please click here. Nothing more need be said.

      Really, every instance I ever have to think about the UN, I can’t help of also think of this clip from a very old (and very racy) movie called the ‘Groove Tube’. It matches both the relevance and the content perfectly.

  • CJ

    I agree. Kevin Sabeet would be a manager at McDonalds if not what he does now. He was in the right place at the right time with the right idea.

    Too bad his side lost.

    Its not too late to follow me kevin, i am the leader of the heroin people. i can make you deputy shogun. come along bubbles, if you have to close your eyes, bite your lip and think of fairies the first time thats ok, the needle is here to help, not hurt.

  • strayan

    OT

    Someone posted an official US Gov document here in the last month which I’m fairly sure contained an estimate of federal cannabis law enforcement expenditure.

    It definitely wasn’t the Blumenauer & Polis whitepaper (although that does contain an estimate of 5.5 billion).

  • Radical Russ – “No direct correlation between driving impairment and THC concentration”

    http://tinyurl.com/bk9y2yr

  • Servetus

    Bloomberg Businessweek Technology has published an article saying that Silicon Valley tech workers have made marijuana their choice of drug for a number of good reasons:

    Johnson says that Silicon Valley’s predilection for marijuana shouldn’t come as a surprise. The tech industry employs a lot of intelligent people, he reasons, and a lot of smart people smoked marijuana in college and never lost the habit. “Pot is an extremely functional drug. Coders can code on it, writers can write on it,” he says. “I see good days ahead for pot.”

    If coders can code on it, and writers can write on it, and drivers can drive on it, who needs the rehab? Maybe prohibitionists who can’t code, write or drive?

    • Chris

      I smoked with the team during my job interview in Silicon Valley for the programming job I am presently doing work for. Refactoring code is like maintaining a garden, nice and calm.

  • darkcycle

    Don’t know if I’ve said this recently, but thanks, Pete, for maintaining this site and letting all of us camp out on your couch.
    And it’s a privlege to call you couch potatos my friends. Really. G’night. Tomorrow’s Holder’s big announcement. It’s going to be a busy day for us web crusaders.

  • I’m all atwitter waiting for Holder’s hearing tomorrow. Good piece over at Alternet:

    US, International Drug Warriors Attack State Marijuana Legalization

    my favorite part:

    “It is not surprising that these ex-heads of the marijuana prohibition industry are taking action to maintain the policies that kept them and their colleagues in business for so long,” said Mason Tvert, communications director for the Marijuana Policy Project and an official proponent of the Colorado initiative. “Their desire to keep marijuana sales in an underground market favors the drug cartels, whereas the laws approved in Colorado and Washington favor legitimate, tax-paying businesses. Marijuana prohibition has failed, and voters are ready to move on and adopt a more sensible approach. It’s time for these former marijuana prohibitionists to move on too.”

    As for INCB, it essentially plays the role of toothless nag, said Eric Sterling, the executive director of the Criminal Justice Policy Foundation. It is mandated by the United Nations to report on adherence to global anti-drug treaties, but has only the power to hector, not to enforce.

    “The INCB has no power other than to issue reports,” he said. “It can’t issue indictments, it can’t call for a resolution in some other body to condemn a nation. It’s strictly hortatory, and for many years, it’s bordered on the preposterous in the condemnations it’s made. The INCB thinks that nations ought to suppress music or motion pictures or books that ‘send the wrong message’ about drugs. In that sense, it is completely out of step with Western Civilization. They would reject art and music and probably science if it were contrary to their abstinence focus on drug use.”

  • cy Klebs

    So lets get this straight; Peter B is asserting that MMJ regulation is contravening Iran or Malasian modalities of policy, is that it?

  • peter

    sabets tweet is the smoking gun for his dishonesty and corruption. he knows well that very few would enter treatment for “cannabis addiction” if they weren’t forced by the courts. it disingenuous to pretend that numbers would go up if it were legalised.