Law school hosts discussion on addiction

Few people would put alcoholism in the same category as having a sweet tooth, yet both represent a form of substance use. And, according to Thomas McLellan, deputy director of the White House Office of National Drug Control Policy, the distinction between the two may not be as clear as some think.

Speaking on the topic of substance use disorder and drug dependency, McLellan delivered a lecture yesterday afternoon in the Law School’s Silverman Hall entitled “Can willful misconduct become a brain disease: The case of drug dependence.”

In his presentation, McLellan discussed the difficulty of defining addiction and the accompanying problem of creating effective public policy responses to substance use disorder.

Currently, only the most extreme forms of addiction are considered to be a “disease.” As a result, insurance providers do not pay for treatment in mild or moderate cases. Yet lower-level incidences of substance use often progress to more severe forms.

To address this, McLellan suggested expanding the definition of substance use disorder to cover a wide range of intensity and frequency of use. This will allow individuals with low-level dependency problems to seek medical attention early on.

In addition to revising the criteria for diagnosing substance use disorder, McLellan called for a revision of conventional wisdom with respect to treatment methods. State governments typically use criminal sanctions to punish individuals whose inability to control their substance use causes them to break the law. Yet this does nothing to address the root causes of addiction.

Instead, McLellan said, “We want to have public health interventions in concert with legal interventions.”

To prevent the progression of substance use disorders, screening and “brief interventions” have proven useful. For example, if a doctor simply informs a patient that he may be at risk of developing a substance use disorder, the probability of that individual contracting a high-level substance use disorder is drastically reduced.

If public policy makers adopt this way of thinking, McLellan believes, they will be able to more effectively address the problem of drug and alcohol addiction on a national level.

Members of the audience had mixed reactions. “If one were to apply this kind of treatment plan to a larger population, it doesn’t strike me as being very effective,” said Meridith Carter, a clinical psychology doctoral student from Widener University.

Alex Larro, a second-year Penn Law student, was more interested in the implications of the debate on national drug policy. “It’s an exciting time. It’s a new administration and new policies are being implemented,” he said. “It is interesting to incorporate science into the discussion on policy and decision making.”

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