Besides writing two columns (including this one) and being active in the queer community, I also serve the greater Fresno community as a member of the county’s Alcohol and Drug Advisory Board. Over the last two-plus years, I’ve slowly come to the realization that scarce monetary resources are being squandered on a strategy that has failed nationally.
I won’t burden the reader with endless statistics and will cut to the bottom line. We have poured billions of dollars nationally (and millions locally) into prevention. What have we gotten for all that money? Very little. Alcohol and drug use continue to escalate nationally and locally.
“Prevention” is now code for “prohibition.” I subscribe to a national listserv for prevention professionals. About all they talk about is prohibiting this and prohibiting that. Several months ago, Taco Bell came out with a nonalcoholic drink using the name “margarita.” The prevention folks were aghast. Immediately, many of them called for a campaign against Taco Bell—call the corporate offices and hassle the local franchisees until they remove this terrible item. One of the latest discussions is mandated drug testing for every middle school and high school student (and some would like to test K-6 students also).
The following is from a posting on the listserv recently, a week after the November election: “In a recent conversation with a leader in the field of substance abuse prevention, a question was raised as to the single most important area that needs change in our current strategy to combat substance abuse. The consensus was that we need clearer, stronger messages against the legalization of any additional substances that intoxicate and render impaired the minds of our nation’s people. I note how often proponents of legalization (marijuana and other substances) refer to the fact that their drug of choice is no more or even less dangerous than alcohol which is legal. Those same proponents then accuse those of us who oppose further widening the legalization trap of being prohibitionists, and, they note with glee, prohibition failed miserably.
“How interesting that one would choose as the benchmark of relative harmlessness a substance that costs our nation over $400 billion annually and takes the lives of nearly 100,000 each year in our country alone. How frightening to think that this becomes the ‘norm’ for any culture. What motivates a person to justify their desires by the destruction and misery of millions of persons and families? I know from personal experience that the drug seeking mind can conjure some very intricate, convoluted and specious logic.”
This is the mindset of the “prevention” industry. I believe the money that’s been poured down the prevention rat hole can be better spent. I have—reluctantly–come to the conclusion that the prevention effort is just another government feel-good program, with minimal measurable results, and that it should be de-funded.
Where should this money go? In my opinion, it should be allocated for harm reduction and treatment services. Fresno County recently approved several million dollars in contracts aimed at providing prevention services to youth 12–20. In the meantime, there’s no county money going for treatment. And the state eliminated all money for Proposition 36 treatment. In the case of Prop 36, the courts are bound by the law—drug defendants in many cases cannot be sent to jail, they have to be referred to treatment, but there’s no money to pay for it. To all intents and purposes, the only treatment available for Prop 36 clients who can’t afford to pay for it in Fresno County are the 12-step programs, because the state-funded general treatment providers are usually at capacity.
Since the health reform bill was signed into law, the message from the county to the treatment providers is that there’s going to be all kinds of money available to pay for treatment when the law fully kicks in during 2014 and everyone has to have health insurance. The theory is that the insurers will have to pay for treatment on demand, meaning there’ll be millions of dollars out there to keep treatment programs afloat. I ran this idea up the flag pole with a longtime counselor and he could only laugh at it. His comment: “Show me the money, because there isn’t any.”
Because health reform likely isn’t going to be the cash cow some think it will be, the prevention money should be moved to treatment. There is a desperate need for treatment in Fresno County.
As for harm reduction (otherwise known as needle exchange) in the county, public funding is practically nonexistent. And, through no fault of its own, it may still be illegally operating. When the county Board of Supervisors approved a “harm reduction program” almost two years ago, it was authorized as a one-year pilot program and the approval was tied to several contracts being put in place by county staff. The plan was to get the contracts approved quietly by the Board as a consent item, but the contracts have never gone to the supervisors for a variety of excuses. This needs to get done soon.