This is a topic I have written about before, but not in this forum. Whac-a-Mole is a carnival game. You hold a hammer, and try to pound a mole back into its hole. Depending on the complexity of the game, you have a number of holes to monitor (nine is a common number) and you can learn to anticipate patterns. The theory is that whacking one mole back in lets it pop up somewhere else. I have used this analogy to discuss public policy choices to try and eliminate certain behaviors (symptoms) and not a root cause (adverse childhood experiences). I don’t think Whac-a-Mole works as a public policy choice.
A few years ago, methamphetamines were the political opponent of choice. Programs were developing to address the meth epidemic. Various policies were discussed, but ended up being the same. We need more police, prosecutors and prisons (3P’s) to address the problem. Find 'em, prosecute 'em and lock 'em up. Today, the district attorney serving Anchorage is going around to community councils to address the newest scourge (there always is one)—heroin. [LINK HERE] So guess which policy options will probably get the nod again? If you guessed the 3P’s, you are probably right.
We know from the ACE Study that a male child having 6 or more ACEs is 4,600% more at risk of becoming an IV drug user later in life. Both causation and correlation are clear. But the attributable risk factor and percent of adults who become IV drug users is relatively small. That because there are many other behaviors that provide what Dr. Vincent Felitti, co-principle investigator of the CDC-Kaiser Permanent ACE Study, refers to as personal attempts at healing trauma.
As I have discussed before, we have a variety of behaviors we can select from to help us alleviate the feelings associated with our trauma. I style them as positive (praise, achievement, attention from the opposite sex); neutral (retail therapy, risk taking-without injury, gambling-non addictive) and negative (smoking, alcohol, drugs, violence). It is this choice (and I don’t mean that we sit down and deliberately choose behaviors -- our brain may do that for us) that gives rise to the Whac-a-Mole of public policy. If we target a behavior -- smoking and drug use come to mind -- do we cause a traumatized person to shift to another behavior to avoid the negative penalties we attach to our public policy choices? Smoking, for example, is increasing subject to fines and penalties, and the areas where smokers can go is increasingly restrictive. Does this restriction of the behavior lead to to other behaviors? Does domestic violence, drug use or alcohol abuse increase as smoking behaviors decrease?
I believe they do. I watched someone I loved smoke for their entire adult life, and finally succumb to lung cancer. As she dealt with her alcohol use, her smoking and gambling increased, in measurable ways.
By targeting certain behaviors as the flavor-of-the-moment, we run a risk of increasing other behaviors. So when Alaska targeted meth use years ago, did that cause a shift to heroin? If we don’t pay attention to Whac-a-Mole and target the root cause of behaviors with healing, perhaps we will have a different result. Look at what Portugal did when it addressed drug use through decriminalization. They not only impacted drug use, but a host of other behaviors and negative outcomes as well. [LINK HERE]
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