July 5 juillet 8:30 – 10:00
Room CPCL-101
Chair: Gregory Baum
, McGill University
Gone are the days when public health was concerned solely with physical–that is literal–disease. Today, public health means behavioral–that is metaphorical–disease. In this sense, the public health movement is one of the greatest threats to liberty and responsibility that we face today: It is a moralistic crusade masquerading as medicine, implemented by government–the “therapeutic state” Thomas Szasz accurately warned us of this about 40 years ago. The logic of the positions taken up by this extension of “public health” concerns leads its proponents into areas which are not strictly matters of public or private health, but rather of personal morality and political control. They tend to find themselves drawn into imposing, by political means, a particular morality on others–a “duty to be healthy”–and depriving those others of the liberty to engage in certain behaviors.
For example, the war-on-people called the “war on drugs” is waged by government in the name of public health: Drugs are pronounced “dangerous.” The drug-legalization movement called “harm reduction” is waged by the private sector in the name of public health. Drugs are pronounced “addictive” and addiction is pronounced “treatable.” The “anti-tobacco crusade” is waged by government and the private sector in the name of public health. The tobacco industry and its products are pronounced dangerous; both are said to cause addiction and addiction is said to be a disease.
In this presentation, the contradictions and false premises on which these three public health crusades are based are outlined and discussed.
A pilot project began in August 2000 in association with the local maternal substance abuse program. Originally, the pilot was to last one month, but due to its success, the program continued an additional four months. The women are referred from the W2 program, the jail diversion program and the criminal justice system. The women are drug users who are usually pregnant or young mothers, or jailed or recently convicted female users.
The women voluntarily choose acupuncture to treatfor cocaine, marijuana and alcohol abuse. Treatment occurs while the women participate in various daytime group-counseling sessions. The procedure is the official treatment protocol endorsed by the National Acupuncture Detoxification Association (N.A.D.A.) that was pioneered 25 years ago in Hong Kong and at Lincoln Memorial Hospital in New York City. Yale Medical School has confirmed the effectiveness of this protocol.
The official program consists of daily acupuncture treatments, urinalysis tests and counseling sessions. The counseling staff report the women receiving acupuncture are less hostile, more cooperative and improved in multiple withdrawal symptoms and cravings.
With 40% of inmates affected by alcohol and drug addictions, it is possible that the jail population could be decreased if acupuncture treatment were offered. The local sheriff has expressed a willingness to try incorporating acupuncture in the local jails. Acupuncture could also help prevent the pain and cost of crack babies.
In Novosibirsk, drug addictive disorders (DAD) are a serious
and steadily–growing problem, especially among young persons and teenagers. In
1999 and 2000, the number of heroin users was greater than it was between 1995
and 1998. Today, approximately 90% of Novosibirsk’s chemical addicts are using
heroin or home-made opiates. The sex ratio of addicts has also changed: female
youths and adolescents now constitute 30% of those hospitalized at the Drug
Addiction Center. A higher incidence of viral hepatitis B and C was observed
among these heroin addicts, as indicated by abnormal liver functional tests
(ALT, AST in 80 patients). In addition, four cases of AIDS were diagnosed.
Serum acute phase proteins (APP), including C-reactive protein (CRP),
alpha-1-proteinase inhibitor (PI) and albumin l (negative reactant of APP), were
studied in group of 142 users of home-made opiates who tested negative for viral
hepatitis infection using polymerase chain reaction (PCR), and who had normal
ALT, AST values. The results show serum CRP increased several times during the
early withdrawal period in this group of teenagers. Decreased albumin levels and
PI activity were also noted. The duration of hospitalization was 21 days.
Following treatment, albumin levels remained low, whereas CRP and PI activity
had a tendency to approach normal values. The APPs studied have been suggested
as possible biological markers of DAD. As such, restoring of APP levels may change the biological
mechanisms of dependence, and advance the treatment of DAD.
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