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For Drugs, a Moral Model

By Robert M. SchwartzRobert M. Schwartz is a clinical psychologist in private practice and adjunct assistant professor of psychiatry at University of Pittsburgh School of Medicine. / November 2, 1990



PRESIDENT BUSH'S declaration of war on drugs shifted the prevailing metaphor in our struggle against drug abuse from the medical to the military model. The medical model defined alcoholism, and by extension drug addiction, as an illness requiring ``treatment.'' As the ``disease'' of drug abuse spread to epidemic proportions, however, the prevailing metaphor - fueled by anger about the social ills that the drug problem spawns - has shifted to war. It's doubtful that such a war can be won, whatever its budget. A recent New York Times headline announced that ``Bush Officials Say War on Drugs in the Nation's Capital Is a Failure.'' Federal officials blame the city of Washington, and the city blames William Bennett, the national drug-policy adviser, for failing to back the program with adequate funds. Thus, the argument will swing between allocating more resources for a war on drugs versus more money for treating the ``illness'' of drug addiction.

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To be sure, drug rehabilitation programs are vital, and battles have been won against drug trafficking. Both should be supported, but neither is sufficient. Soon after several battle successes against Colombian drug barons, a new chemical drug called ``ice,'' which creates higher highs and more bizarre post-high behavior, began invading continental US from makeshift laboratories in Hawaii. Even if we succeed in halting the influx of natural drugs, underground laboratories will fill the vacuum with more destructive chemical compounds. The drug war seems to have a parallel to the Vietnam war.

The futility of our efforts against drug abuse reflects in part the inadequacy of our guiding metaphor. We are, as my Italian barber phrased it in one of our chairside chats, a ``nation of moral orphans.'' We lack a moral consensus that abuse of drugs and alcohol not only is bad, but is wrong, and that self-control, discipline, restraint, and temperance are essential virtues that bind the fabric of society. Only a spiritual and moral model can add backbone to the prevailing medical and military models.

Even if biochemical imbalances or childhood deprivations make certain individuals susceptible to the influence of drugs or alcohol, it remains their responsibility to exert the additional control needed to avoid addiction. To the extent that addiction is a disease, it is one that can be treated by accepting a Higher Power, adopting a new outlook on life, and using the social support network that is provided by self-help groups.

Medical and psychological models alone will not succeed in ``curing'' the country of drug abuse; while the war on drugs alone will drain the country's treasury and end in futility. We need to treat those who abuse drugs and punish those who provide them. But we also need to send the plain message that there is something fundamentally wrong in misusing any substance.

Drug-education programs attempt this, but the message lacks the full weight of moral conviction that is required to foster controls within many individuals. Only a strong moral structure can establish clear expectations of right and wrong, foster strong inner restraints, and mete out decisive external consequences for both virtuous behavior and unacceptable deviations.

Despite some recent changes, drinking and even light drug use are socially acceptable. The teetotaler, if not a recovering alcoholic, is regarded as an oddity. Peer pressure and seductive advertising abound. In contrast, during the 19th century, abstinence became the hallmark of middle class respectability and one of the keys to upward social mobility.

This is not a cry to return to a climate of prohibition, which was as much a failure as our present drug wars are likely to be. But we must have a program of social, cultural, and moral transformation that defines excessive alcohol and drug use as the evil it is for the individual abuser, the family, and the society. Perhaps the relative success of the anti-tobacco campaign can be instructive. With the force of scientific research and government sponsored advertising, the image of cigarette smoking has been transformed from socially desirable to weak, if not pathetic - from good to bad.

School textbooks of the 19th century (McGuffey's Reader) were filled with anti-alcohol images that linked the ``devil rum'' to criminality, perversion, and social ruin. Spearheaded by powerful temperance societies and religious groups, the anti-alcohol message was reinforced by school teachers, parents, preachers - and local barbers. Although exaggerated, the message shaped the minds and attitudes of the intellectual elite, the children, and large segments of the society.

Only a balanced approach that includes the moral model will strengthen the necessary internal controls to steer individuals and ultimately society away from the demand for an improper release from pain and an excessive pursuit of pleasures. Some will consider this anachronistic or reactionary; others will be pessimistic about any regeneration of values. But if morality grew out of and transformed barbarism, it can certainly be revitalized.

Our age lacks a moral consensus about what constitutes right and wrong. While we cannot reestablish this consensus generally, we can at least hope to with respect to the specific values associated with alcohol and drug use.

If there is a disease to combat, let part of the cure be to make the concept of virtue respectable again. If there is a war to fight, let it be to reintroduce into our national vernacular the language of moral virtues - of self-control, discipline, balance, and moderation. Let this nation of moral orphans adopt the right metaphor in solving our drug problem.