Time to get serious? Psychiatric/mental health nurses and an evidence-informed drug policy for the USA

Abstract

In 2001, Portugal enacted what, for some, was a radical shift in its national drug policy, decriminalized drugs, and implemented a treatment-driven response to drug use. Empirical evaluation of the impacts of this policy “U-turn” continues and the evidence produced so far is both consistent and convincing. It seems by almost any measurement, the Portuguese experiment of drug decriminalization/treatment-driven responses, has been a resounding success. However, these empirical findings do not yet appear to have influenced national drug policy in the USA, which continue to regard decriminalization as “radical” and “extreme”. Similarly disturbing is the lack of substantive contributions to this debate from nurses, especially Psychiatric/Mental Health (P/MH) nurses, which is troubling in a number of ways. Therefore what the authors do in this paper is: first, highlight Portugal's drug decriminalization policy and the evidence forthcoming from evaluations. Second, illuminate the disconcerting lack of substantive contributions to this debate that have been made by P/MH nurses. Third, examine the congruence between Humanistic approaches to P/MH nursing and many of the tenets of Libertarian thinking and policies. And then in drawing these three elements together, the authors exhort P/MH nurses to fulfill their rhetorical, macro-care role and contribute to this much-needed debate.

Keywords:

• USA national drug policy
• Portuguese decriminalization
• P/MH nurses contributions
• Libertarian and Humanistic influences

Notes

1. Given the common usage of both the terms “drug” and “substance” in the relevant theoretical, empirical, and policy literature, the authors use the terms interchangeably throughout this paper.

2. Consider, for example, 22 states have passed medical marijuana legislation and 2 states have legalized cannabis.

3. The 14 states where marijuana can be grown legally in the USA include: Alaska, California, Hawaii, Colorado, Maine, Montana, Michigan, New Jersey, Nevada, Oregon, New Mexico, Washington, Vermont, and Rhode Island.

4. This creates a puzzling “legal” scenario where an individual who consumes marijuana in one of these states can simultaneously be acting legally, and yet illegally “in the eyes” of federal law!

5. That is to say, liberal by comparison to drug policies that emphasize criminalizing drug-related behavior, ‘tough’ responses to drug users, and abstinence over harm reduction.