Controlled drugs and public health

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For the individual user, substance abuse associated with controlled drug use is usually associated with distinct morbidity and mortality. However assumptions about drug use and drug pathologies are often made by the public, their politicians and health care professionals on this basis, without relating to the complexities of substance abuse and social stability. This has lead to increased lethal violence, increased communicable-disease transmission, discrimination, forced displacement, unnecessary physical pain, and poor individual health sometimes distinctly changing at a national border. For example in Mexico, where since 2006 the military was used against drug traffickers, this was associated with a massive increase in homicides related to trafficker created violence so resulting in reduced life expectancy in the country. The economic hardship imposed on rural populations in countries like Afghanistan has been seen by some to be a factor in their instability, but more importantly their public health problems[1]. The general safety of say opioids in acute pain is not necessarily the case with poor use in chronic pain which is likely to have been a factor in causing an epidemic of overdose deaths in the USA[2].