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Posted May 4, 2004
Lawyers, Doctors Unite To Push for Treatment-Oriented Drug Policies
Group Calls for Alcohol Screening in Emergency Rooms

The nation should tackle its substance abuse problem from a public health point of view that emphasizes scientifically proven treatments, U.Va. law professor Richard J. Bonnie said at an April 20 press conference at the National Press Club where the creation of Physician and Lawyers for National Drug Policy: A Public Health Partnership (PLNDP) was announced.

Bonnie
Prof. Richard Bonnie

“Only by using a scientifically based and evidence-driven approach will we be able to mount a more effective drug policy,” said Bonnie, who co-chairs the group with Dr. George D. Lundberg, editor-in-chief of Medscape General Medicine from WebMD. “We’d like to see less ideology and more science. We want to know what works, not what sounds best in a campaign speech.”

The initiative builds on the work of Physician Leadership on National Drug Policy, formed in 1997, and revives a collaboration begun in the 1950s when lawyers and doctors joined to push for pragmatic anti-drug policies, an effort that eventually resulted in the Controlled Substances Act of 1970 and other legislation that emphasized treatment programs.

Since then the policy consensus on a public health approach has “unraveled,” Bonnie said, as politicians have traded accusations about being “hard” or “soft” on those who sell or use drugs. Meanwhile, too, lawyers and doctors have developed wary relations over medical malpractice litigation, which one profession sees as a problem and the other as a solution. The latest initiative, funded by the JEHT Foundation and the Robert Wood Johnson Foundation, represents a new pragmatic and non-partisan approach to national policies that have become polarized and ineffectual, he asserted.

PLNDP’s aim to restore the public health consensus is based on three ideas, he said. First, drug policies should be evidenced-based so that accountability is possible. Second, policies must take a public health approach, emphasizing the health and welfare of people and not a goal “to stamp out evil.” Third, more innovation should be encouraged at the state and local level.

More specifically, Bonnie said, the PLNDP will advocate for widespread alcohol screening at trauma treatment centers and emergency rooms because about half of patients in these settings had been drinking when they were injured. Research has shown that alcohol counseling at such times is “a teachable moment” with positive behavioral results.

“Drunk driving is still a major public health problem and we need to stay focused on improving policy and practice in this area. We also need to give much more attention to the most serious drug problem among our nation’s youth—underage drinking,” said Bonnie, who recently chaired a National Academy of Sciences study on the problem. One in eight eighth-graders and 30 percent of high school seniors report recent heavy drinking and the age of first use is now 14, he said. “The social cost of underage drinking, conservatively estimated, is $53 billion,” he noted.

“In general, the PLNDP perspective is that drug and alcohol testing and screening can be a useful public health tool when it can help identify people in trouble and promote their recovery, but that it should not be used an instrument of harassment and punishment.”

The PLNDP will also support policies that emphasize treatment rather than incarceration for non-violent offenders who have drug problems. “The group will seek to remove legal and financial barriers to treatment for people addicted to alcohol and other drugs,” he said.
• Reported by M. Marshall

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