Drug abuse as an epidemic - Eaglewatch by Leonardo A. Lanzona Jr.

July 18, 2016
While making persistent pronouncements about the need to eliminate drug pushers and users, President Duterte, in one surprising speech, branded the members of the terrorist group Abu Sayyaf as being noncriminals. What then makes certain activities criminal and others as defensible acts of desperation?



Several social scientists, in fact, view certain illegal activities, such as using prohibited drugs and unlawfully possessed guns, which eventually lead to violence, not as crime but as an epidemic. Hence, these acts are not criminal but should be seen as health problems.
By definition, epidemics occur when diseases affect particular communities disproportionately, multiply through exposure and can spill over into new areas after reaching a certain threshold. In this case, the drug problem is an epidemic for at least two reasons. First, and most basic level, it’s an epidemic in terms of its unequal effect on the population. Based on the 2014 survey data of the Dangerous Drugs Board (DDB), men, 30 years of age, single and unemployed but with college education are affected at a rate much higher than other men and women. They come from below middle-income class levels (with an average monthly family income of P15,423) and reside mainly in the urban area, particularly Metro Manila.
Second, the level of violence among that population is at an epidemic level. Based on DDB data, there had been an increasing admission of drug use over the years. In 2014 alone, a 34-percent increase in drug- dependence admissions was recorded from the previous year. This is a significant improvement from the 19-percent increase in admissions noted in 2013.



Furthermore, the drug problem moves in epidemic-like patterns across the regions. In the course of the current administration’s war on drugs, more than 4,000 users and peddlers of drugs surrendered in Tagum City, Davao; 1,592 across the Bicol region; and 762 in Taytay, Rizal. Called the “Duterte effect,” several hundreds have also come out in faraway places, like Palawan, Isabela and Western Visayas.
These recently published numbers seem to point out that drug abuse spreads like HIV infection: One is more likely to “catch” the disease if one engages in risky behaviors with someone who might be infected. And it’s not just friends who affect their likelihood of getting exposed to the disease, but also the friends’ friends. This is similar to the transmission of HIV, where past sexual partners of one person affect the current partners, even if they are unknown to the latter. The spread of drug abuse is achieved through networks defined in terms links between and across individuals.
Treating drug abuse as an epidemic has a number of implications. First, drug activities are not simple market transactions involving supply-and-demand functions. These are commodities that, under full information, people do not want and need, but receive and consume it anyway for some (possibly illogical) reason. There are patterns of transmission that go beyond aggregate factors, such as education, age, gender and income. On an individual level, social networks—the people one hangs out with—can predict a given person’s likelihood of being addicted and even killed. In this social-network approach, the analogies about an “epidemic” of diseases must be considered seriously, applying what we know from public health and epidemiology to understand, quite literally, who gets hurt and how to localize the problem. We can use that information not only to understand drug problem better, but to leverage it for intervention and prevention. Effectively, the local information can be used to increase the immunity of persons across varied regions from this “disease.”
Second, when this problem is depicted in the media and by the government, it’s often in terms of bad actors, good actors and the innocent people in between. The network approach requires a redefinition of the offenders and co-offenders to victims. This is where science and policy need to come into conversation with each other, because the majority of victims are young men often with criminal records, and for a long time, the policy toward those people has been to treat them as offenders, not victims.



If the goal is to reduce criminality, then the policy is not to drive the number of victims down. Criminality remains if this drug-war policy thwarts mostly the victims, not the social and political sources of the problem. New and younger victims will only emerge, as communities remain vulnerable to such threats. This requires different solutions in the form employment opportunities and services.
Finally, in the short term, the goal is to isolate the social sources of the disease, not just the actors involved in the activity. A major part of this approach is to better understand the victims of drug violence, so they don’t just get lumped into categories. The methods used in different areas of science seek to understand how particular individuals may or may not be in harm’s way. The idea is to understand who within a community is at the most elevated level of risk today. These may include both drug pushers and users who have no access to community services and systems.
The long-term solution, in terms of addressing the inequities in drug abuse—not just the absolute number of crimes, but the differences among regions—requires fixing communities. Period. Studies have shown that, when a youth is exposed to higher levels of drugs and commits a drug-related crime, he loses time for school or work experience. But what mitigates this is having a mentally healthy mother who will care for him. Having health care for mothers and improving family welfare can go a long way.
The kinds of support systems needed have to do with monitoring and supporting communities from a public-health standpoint. When a community experiences a drug problem or violence, there should be systems in place that can be put into effect. As a former mayor, President Duterte should appreciate the importance of community development.
Leonardo Lanzona Jr. is professor of economics at the Ateneo de Manila University and a senior fellow of Eagle Watch, the school’s macroeconomic research and forecasting unit.