Healthcare

Want to fix immigration? Fix addiction

Two social concerns dominating today’s headlines — the epidemic of drug addiction and waves of illegal immigration — are pieces of the same puzzle. There is a common and cost-effective solution to this puzzle, and all we need to do is more of something we’re already doing.

{mosads}The bulk of our country’s supply of illegal, addictive drugs comes from Mexico and Central America, as does the lion’s share of our illegal immigrants. Building any kind of wall to stem these flows is a failure — the drug dealers and human traffickers already have tunnels and boats.

Furthermore, the “War on Drugs” has taught us that every time we arrest one drug dealer on a street corner, or bust one cartel, another one pops up. Why? Because there’s too much money to be made in the drug trade.

Our other policy failure has been the effort to cut off the demand for addictive drugs by punishing drug users. Our mishandling of the crack cocaine epidemic amply proves that drug addiction cannot be punished away. The hallmark of a drug addict is taking the drug despite adverse consequences, so additional punishments won’t help.

Thankfully, we seem to be handling today’s heroin epidemic more realistically than the crack epidemic. We now acknowledge that addicts need treatment, support and incentives (jobs, family connections, a better life) to stay clean. The treatments that work actually do exist: medication for withdrawal, counseling for relapse prevention, self-help groups and therapeutic communities to build supportive networks. But none of these exist in sufficient quantities. We could be doing more.

What does this have to do with immigration? Most of the immigrants, especially child immigrants, are from violent countries controlled by drug cartels and gangs: El Salvador, Honduras, Guatemala and some areas of Mexico. Honest, innocent, frightened families do the best they can to escape the poverty and danger or at least send their children to safety. 

The only way to truly eliminate drug suppliers is to dry up the demand for their product. We can do this by effectively treating addicts.

How much will effective drug treatment reduce drug demand? We don’t know for sure, but information from the market for our most popular legal drug — alcohol — is informative. Based on national surveys, we know that the top 10 percent of drinkers account for almost 75 percent of alcohol sales. In other words, alcoholics keep the alcohol industry alive.

It stands to reason, therefore, that drug addicts keep the drug trade alive. According to the White House Office of National Drug Control Policy statistics, the recent rise in the number of heroin addicts parallels the rise in hectares of opium poppy production in Mexico. Today’s newly formed heroin addicts will keep the drug cartels alive and well-funded for the next couple of decades.

So, let’s put these pieces together and solve this puzzle. We know treatments that work, but are not as universally available as they could be. We need more addiction clinics, counselors and insurance coverage (all of which are cheaper and more cost-effective than military operations, courts, prisons and walls).

The Affordable Care Act has already created the framework for this solution by mandating parity for mental healthcare with the rest of healthcare. Wherever there is a clinic, its doctors can get paid to treat addicts. The medical industry stands to gain from adding more services for drug treatment, not to mention the human lives that can be saved.

There is no perfect solution to this problem, and this will not be a one-off effort, but an ongoing one. But even small successes in addiction treatment will lead to reductions in demand. Based on estimates, if half of all heroin addicts stayed clean for six months out of a year, then heroin producers would have a 19 percent surplus of their product, driving down prices and profits. If 10 percent of heroin addicts got completely clean, there would be a 7.5 percent reduction in demand per year.

Granted, there will be other drugs once heroin goes out of style; teenagers will always experiment. But if we get the heroin epidemic right, then we will have the infrastructure in place for the next drug fad.

And if that infrastructure is sound, then we can keep the cartels from having a reason to exist, and the innocent immigrants from having a reason to flee their homes, thereby addressing two of our country’s most pressing social issues.

Schramm-Sapyta is a visiting assistant professor at the Duke Institute for Brain Sciences at Duke University.