Synopsis: Many people have misconceptions about what addiction is and is not. A noted British journalist explains how these myths fuel the war on drugs, and alternatives that might really curb addiction and drug trafficking.
Host: Nancy Benson. Guest: Johann Hari, author, Chasing the Scream: The First and Last Days of the War on Drugs
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The Nature of Addiction
Nancy Benson: Forty years ago the United States government launched the war on drugs to stamp out drug addiction and trafficking. But some authorities wonder how effective our multi-billion dollar drug policy has been. For example, according to the Centers For Disease Control And Prevention, deaths caused by heroin have risen sharply since the war on drugs started. In the last 15 years alone, they’ve more than tripled. A number of journalists have set out to find out why the war on drugs hasn’t had its intended effect. What one of them learned may surprise you.
Johann Hari: One of my earliest memories is of trying to wake up one of my relatives and not being able to, and as I got older, I realized that we had drug addiction in my family. And about four years ago, a little bit less, I realized we were coming up to a hundred years since drugs were first banned, and I had been watching my other relatives in a bad way, a partner I had in a very bad way. And I realized that although I think of myself as a pretty well informed person about this issue, I realized there were loads of really basic questions about this subject I just didn’t know the answer to. Like why did we go to war against drug users and drug addicts a hundred years ago? Why do we continue when a lot of people think it doesn’t work? What are the alternatives like in practice, and what really causes drug use and drug addiction?
Nancy Benson: That’s Johann Hari, author of the new book Chasing The Scream: The First And Last Days Of The War On Drugs.
Johann Hari: So,, I ended up going on a very long journey across 30,000 miles, nine countries. To really sit with people whose lives are changed in one way or another by this approach and by the alternatives. The main thing that I learned is that almost everything we think we know about this subject is wrong drugs aren’t what we think they are, drug addiction is not what we think it is, the drug war is not what we’ve seen on our TV screens for a hundred years. And the alternatives aren’t what we think they are so, in a way it was kind of a thrilling journey but it’s daunting to realize just how different the reality is from what we’ve been told.
Nancy Benson: For example, the commonly held belief about addiction is that that if 20 people used heroin for 20 days, all of them would become drug addicts.
Johann Hari: And I certainly believed that, you know, that that’s the main cause of an addiction. The first thing that alerted me to the fact that there’s something wrong with that story is if I was hit by a car and I break my hip. I’ll be taken to a hospital and it’s quite likely I’ll be given a lot of diamorphine. Diamorphine is heroin. It’s much stronger heroine than you would score on the streets, because it’s not contaminated by drug dealers. Now, I’ll be given that diamorphine for quite a long time. There are lots of people being given heroin in hospitals for long periods of time. If what we believe about addiction is right, those people should leave hospital with addiction problems, with heroin problems. There’s lots of scientific evidence showing that virtually never happens. Your grandmother was not turned into a junkie by her hip operation.
Nancy Benson: It’s true that after several weeks of use, Grandma would become physically dependent on opioid painkillers and have to be tapered off their use, but most patients do that without problems. They don’t become addicts, ignoring everything else in their lives. Hari says addiction is more dependent upon what drives people to take drugs in the first place. Hari went to visit Dr. Bruce Alexander, a psychologist and professor emeritus at Simon Fraser University in Vancouver, British Columbia. Alexander is one of the world’s foremost researchers into the nature of drug addiction, using his famous Rat Park experiments.
Johann Hari: The idea of addiction we have, the one that we take for granted, comes from a series of experiments that were done earlier in the twentieth century. You get a rat and you put it in a cage and you give it two water bottles. One is just water and one is water laced with either heroin or cocaine. If you do that, the rat will almost always prefer the drug water and almost always kill itself quite quickly. So, there you go, that’s our theory of addiction. Bruce comes along in the seventies and says “Hang on a minute, were putting the rats in an empty cage they’ve got nothing to do. Lets do this differently.” So, Bruce built Rat Park, Rat Park is like heaven for rats. Anything a rat wants, it’s got in Rat Park. it’s got chairs, and water bottles, and colored balls, and it’s got friends, and it can have loads of sex. And it’s got both the water bottles, both the drug water and the plain water.
Nancy Benson: Alexander found that rats in Rat Park hardly ever used the drugged water and never overdosed. He concluded that the accepted theories about drug addiction were wrong.
Johann Hari: It’s not your immorality. It’s not your brain. It’s your cage. Addiction is to a large degree an adaptation to your environment. Something as complex as human addiction has many different causes. A very significant factor, and one that has been underrated in the popular understanding up to now, not because it’s not scientific evidence but it’s very strong scientific evidence, but it hasn’t broken through into the public consciousness, is that people are much more vulnerable to addiction if they are isolated, distressed or cut off from sources of meaning then if they aren’t.
Nancy Benson: The Centers For Disease Control And Prevention is pursuing another lead in the search for the roots of addiction. Scientists are conducting a long-term ongoing study called the “Adverse Childhood Experiences” or “ACE” study. It links long-term health and social consequences, including addiction, to childhood trauma.
Johann Hari: He looks at basically ten traumatic things that can happen to a child and then follows them through their life to see how that correlates with outcomes later on. And the results are really extraordinary. For every traumatic category of experience that happens to a child, they are two to four times more likely to grow up to be an adult drug addict. If you had six of the traumatic categories of experience you were 4,600 times more likely to grow up to be an adult injecting drug user then if you had none of those categories of traumatic experience.
Nancy Benson: Treatment for drug abuse has included imprisonment and isolation. But lessons based on Rat Park have prompted efforts to reconnect addicts with society. Hari says Portugal’s experience shows it can be very effective.
Johann Hari: So, say that you’re a mechanic and your life fell apart. You’ve got an addiction, but when you’re ready they’ll go to a garage and they’ll say if you employ this guy for a year as a mechanic we’ll pay half his wages. To get you back into work, to get you back into that sense of purpose or there’s loads of micro loans for addicts to start up small businesses like removal firms and so on. The goal of the Portuguese decriminalization was to make sure that every addict in Portugal wakes up with something to do that morning that they want to be present in the world for and it’s been nearly fifteen years now and the results are in. And they’re quite striking! Injection drug use is down by 50% 5-0 percent, overall addiction is down, HIV transmission among addicts is massively down, overdose is massively down.
Nancy Benson: Hari’s investigation leads him to agree with policies in Portugal and other nations around the world that back away from punishment. He says decriminalization of drugs is a politically charged concept, but it’s the key to recovery.
Johann Hari: The vast majority of people already think that we should treat addicts with compassion rather than punishment. Americans are good and compassionate people, and they can see that addicts are in terrible pain and suffering and inflicting more pain and suffering on them is not the solution. We need to transfer the money that we currently spend on making addicts worse and use it to make addicts better. So, we should be spending that money on reconnecting addicts with society not cutting them off.
Nancy Benson: And it could happen. Hari has great hope for the changes he’s seen in attitudes towards drug addiction.
Johann Hari: We’ve already begun to end the drug war in the United States. Marijuana is now legal in Washington State and in Colorado, and Alaska other states have now voted to do it and in Washington DC in fact other states have started to do it. Very striking. Everywhere I went, they had moved beyond the drug war. Very few people regret it. When people see these things in practice, they realize that the things that they totally legitimately fear about legalization or ending the drug war do not come to pass. If the things that people were worried about were real, I would be opposed to legalization. If it really did mean that you’d have a massive increase in drug use and you’d have a massive increase in criminality, of course I would be opposed to that as well, but it’s very important that when people see these things in practice they realize that that’s not what happens. In fact, things get significantly better rather than worse.
Nancy Benson: You can learn more about Johann Hari and his book, Chasing The Scream: The First And Last Days Of The War On Drugs, through a link on our website radiohealthjournal.net. Our writer/producer this week is Polly Hansen. Our production director is Sean Waldron. I’m Nancy Benson.