The first step in planning a drug abuse prevention program is to assess the type of drug problem within the community and determine the level of risk factors affecting the problem. The results of this assessment can be used to raise awareness of the nature and seriousness of the community’s problem and guide selection of the best prevention programs to address the problem.
Controversies Over Court-Ordered Treatment: Court-ordered treatment and the use of court authority from the criminal justice system has sparked controversy. Community treatment providers often think about drug treatment and law-enforcement control of drug use as opposites. In this view, treatment stands on one side as "the good guys," and law-enforcement control stands on the other side. In fact, many community treatment providers believe that law-enforcement authorities disrupt the relationship between the drug offender and the program offering treatment. However, research shows a much different picture. Drug offenders under criminal justice authority generally remain in treatment longer and as a result have better treatment outcomes. Another reason for controversy is that many community drug- treatment providers believe that substance abusers should enter treatment voluntarily. They believe that a person must want to stop using drugs, and that forcing a reluctant person to enter treatment has little chance of ending drug use. Others have felt uneasy about the reliance of health agencies on the criminal justice system to change drug abusers' behavior. Another concern is that drug testing may in some cases violate the civil rights of someone on probation for a drug offense. Despite controversy, drug treatment provided in the criminal justice system has had enough success to justify a continuing effort to improve the policy.
Only under a physician's supervision can opioids be used safely with other drugs. Typically, they should not be used with other substances that depress the CNS, such as alcohol, antihistamines, barbiturates, benzodiazepines, or general anesthetics, because these combinations increase the risk of life-threatening respiratory depression.
A study by the National Center on Addiction and Substance Abuse at Columbia University confirms what many criminologists have long known: alcohol is associated with more violent crime than any illegal drug, including crack, cocaine, and heroin. Twenty-one percent of violent felons in state prisons committed their crimes while under the influence of alcohol alone. Only 3% were high on crack or powder cocaine alone and only 1% were using heroin alone.