What I Wish From Our New Administration
David A. Gross, MD, DFAPA

Dear Mr. President:

Congratulations on your successful bid for the presidency. Your job will not be an easy one, considering the national and international crises that you are faced with.

It is my hope that these issues do not distract you from the erosive impact substance abuse has on our society. I have been a practicing psychiatrist on the frontlines of substance abuse treatment for the past thirty-five years. Sadly, treatment successes are in the minority while the failures keep mounting up. Besides the wasting of lives and the frequent fatalities encountered in the drug scene, drug abuse destroys families, ruins neighborhoods and imperils economic productivity.

By the time the addict gets to my office for treatment, it is often too late. The damage to brain, psyche and support systems has already been done. My role is often relegated to damage control while others pick up the pieces.

This painful perspective allows and qualifies me to make a plea for prevention. We must improve the resilience and resistance of our children before they get lost in the quagmire of addiction. Prevention must address several levels of the addiction process.

The core component of a prevention program must equip the child with enough knowledge, willpower and motivation to resist drugs when offered. I take issue with the harm reduction movement and disagree with the “factoid” that our children will use drugs no matter what. The drug legalizers have successfully spun this concept for the past 3 decades, making the general public believe it to be fact. It does not have to be reality if we make a concerted effort that is supported by the government.

There are precedents for this concept. Poliomyelitis was epidemic among young people during the first half of the previous century. Did we assume that our children would contract polio no matter what and therefore reduce harm by preparing them for the use of leg braces and wheel chairs? Or, when our youngsters begin to crawl and are at risk for accidental poisoning from the contents of floor level cabinets, do we expect this poisoning and teach common toxic antidote therapies to parents? Fortunately, science and common sense prevailed, and coordinated scientific advances resulted in the polio vaccine. Similarly, parents take a common sense approach and make sure that their toddler accessible cabinets are locked and therefore safe.

There are numerous other public health initiatives (vaccination/immunization, pasteurization of milk, fluoridation, iodized salt, etc.) that make the same point; prevention is the only honest harm reduction approach. Prevention implies that the risks encountered can be avoided. This approach requires that we direct our efforts, funds and creativity towards the avoidance of exposure to the risk.

Mr. President, the harm reduction concept has been masterly spun and transformed into ballot initiatives and state referenda. The public relations successes of the drug legalizing cabal are admirable, but they certainly have not been in the best interests of our children, and they definitely do not represent prevention. True harm reduction and prevention will require a concerted effort to educate parents, children, teachers and social agencies. If the scientific advances and educational initiatives of the National Institute of Drug Abuse were fully understood and appreciated by these groups, there would be a sea change in attitude about harm reduction. It would immediately become clear that the only humane approach is one of prevention.

The school becomes the most practical and accessible arena of social change to accomplish these goals. We must provide the funding to educate our teachers and social workers. These professionals can then share the message with their students and respective families.

Education alone will not be sufficient. Recent neuroscience research has demonstrated that our adolescents behave the way they do because their brains are still developmentally immature, they have deficient brain frontal lobe cortex responsible for responsible behavior, delay of gratification, control of impulses and multi-step problem solving. Adolescents are primed for addiction upon exposure to drugs and peer pressure. We must protect them as we protect the toddler from the medicine chest or chemicals in the cleaning closet. One of the most successful protective initiatives is student drug testing. The ability to identify those at risk for ongoing substance abuse allows us to assign appropriate interventions. This will also require school-based substance abuse treatment and counseling.

So Mr. President, please do not let the spin magicians lull you into believing that harm reduction as it is now practiced represents a responsible approach to the substance abuse problem. Prevention is the only direction that truly respects the best interests of our children. Thank you for your time.

Yours truly,

David A. Gross, MD, DFAPA
Chair, International Scientific and Medical Forum on Drug Abuse

Author Information
David A. Gross, MD, Distinguished Fellow of the American Psychiatric Association

Dr. David Gross is the chair of the international scientific and medical forum on drug abuse. Dr gross has devoted the bulk of his career to the treatment and prevention of drug abuse. He is in the private practice of psychiatry in delray beach, florida, a distinguished fellow of the american psychiatric society, and past president of the florida psychiatric society. Dr. Gross’ numerous publications and lectures have reflected his interests in the psychobiology of behavior.

Conflict of Interest Statement
I declare that I have no proprietary, financial, professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled except for the following:

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