The use of mind-altering and performance-enhancing drugs is a human behavior that has been deemed unacceptable. In the development of a drug program, one must remember that the ultimate goal of the program is to influence or change human behavior. I will begin with an exercise with which every one can identify.

Parked in your driveway is a sports car that is built for speed. You will be driving your new sports car from your house to a place 300 miles away. The road over which you will be driving is a straight, flat, four-lane interstate highway with minimal to moderate traffic. There is no speed limit or police on this road. However, before you leave, you are told that driving over 65 miles per hour (mph) is dangerous. Driving over this speed can result in loss of control of your car, and you and the passengers in your car can be injured or even killed because of this. Would you drive less than 65 mph in your new sports car?

You are now driving the same car over the same road but there is now a policy. The speed limit is 65 mph. There is still no police or radar. You once again are educated about the risks of driving over 65 mph. Would you drive less than 65 mph in your new sports car? In addition to the speed limit and the education, police with radar will now be on the road. But when they stop someone for speeding, there is only a warning issued with the necessity of having your driving re-evaluated. Would you drive less than 65 mph in your new sports car?

Finally, in addition to the police with radar, speed limit, and education, the punishment for speeding is 2 weeks in jail and loss of your license for 1 year. Would you now drive less than 65 mph in your new sports car?

Decisions in life are made by weighing the risks and benefits of the action being considered. When crossing a street, one weighs the risk of being struck by a car with the benefit of crossing at a specific moment. If a behavior is deemed to be unacceptable, the risk of performing that behavior should be sufficient to deter the behavior from being repeated. There are two parts to the risk side of the equation: (1) the risk of being discovered and (2) the severity of the punishment. If risk is deemed low or nonexistent, and benefit is deemed to be high, the behavior may be deemed acceptable by the person making the choice.

Drug use is an avoidable behavior. Drug dependence is a treatable disease. If this is the case, a program for which the goal is altering drug-using behavior should be constructed so that the goal can be reached.