Addiction: Why We Must Change Our Way of Thinking About Addiction
Addiction is a complex issue that requires a shift in our understanding and approach.
We all know what addiction is more or less and we have a general understanding of how it works. Chemical hooks that stimulate us One way or another until one can't go a few hours without getting a "hit". So now let's think about a scenario: imagine someone takes heroin, a "hard drug", for 15 days straight. What do you think will happen to that individual? Based on the conventional way of thinking about addiction and how it works, you’d say that the individual will likely become an addict. The reality of the situation is different however, because that individual could be someone who had a terrible accident and is forced to consume morphine - which is medically pure heroin - for 15 days, however that doesn’t necessarily mean they will become addicted.
Before we understand why that individual isn’t doomed, we need to understand how our current perceptions around addiction and drugs came to be. As a result of the increase in narcotic deaths from 1960 to 1970, US President Richard Nixon began the “War on Drugs”; because to him drug users were a problem that society needed to contain, rather than treat and help. After the US adopted that approach, they guided other countries to do the same and thus the war on drugs went global.
The War on Drugs sought to increase the punishment related to drug consumption or distribution so high as to distance people from drugs completely. This had scientific backing as well, there were studies[[^1]][[^2]][[^3]] that resulted in rats becoming addicted to heroin. The rats were placed in individual cages and given the choice of 2 bottles to drink from, 1 bottle of water that included some heroin, and another bottle of regular water.
In this experiment, almost all the rats drank the bottle of water with heroin and eventually overdosed. However, there has been evidence that suggests the traditional way of thinking about addiction is flawed even as early as 1980. A scientist by the name of Bruce Alexander developed a different experiment to test the hypothesis, the big difference between Dr. Alexander’s experiments and previous experiments was that Dr. Alexander didn’t keep the rats in individual cages with only the bottles available to them, instead he created “Rat Park”. Rat park was a big box which still had the 2 bottles but also had exercise wheels, cheese, cans they could hide in and most importantly, other rats they could have lots of sex with.
In this experimental setup, the rats always preferred the regular water and never died due to overdose. Dr. Alexander’s experiments paved a new way of thinking about addiction and how they work, addiction is more about an individual’s environment rather than the chemical hooks within drugs themselves.
It could be said that Dr. Alexander’s experiments on rats can’t be done on humans and thus we can’t definitively say that humans would react the same way. However, a similar “experiment” has happened previously, not on purpose but rather by accident; I’m talking about the Vietnam War.
During the Vietnam war, drug users among US troops had reached epidemic levels, and the news reports at the time were extremely worried because America was going to have tens of thousands of drug addicts in the streets when these troops came back. The Archives of General Psychology conducted a study on the troops returning and what they found was that 95% of habitual heroin users just stopped after returning home, their lives weren’t consumed by this addiction.
They weren’t consumed because they had healthy relationships they wanted to be a part of, that’s why it is extremely important to extend a helping hand to them, to allow them the opportunity to better themselves. As Dr. Gabor Mate put it: “if you wanted to design a system that would make addiction worse, you would design that system.” with regards to the system placed by the US when it comes to how they deal with drug users.
There are numerous cases throughout history that point to addiction not being entirely built upon chemical hooks and the solution to solving the drug problem not being an individual one but rather a political and societal one. Which brings us to Portugal.
In 1999, Portugal had a horrific drug problem, 1 in 10 people had used heroin and 1 in 100 people had a serious heroin problem. By 2001, Portugal became the first country to decriminalize all drugs, from marijuana to cocaine. That change came about due to a panel of scientists that was tasked with developing a national strategy on the drug problem. The panel suggested to decriminalize all drugs and, most importantly, use the money that was previously allocated to punish drug users, to now rehabilitate drug users back into society. The government initially provided addicts with free syringes to limit the spread of AIDS, shelters and help centers have sprung up to help homeless addicts.
The biggest change was that individuals who had been caught using drugs were now referred to a panel of experts rather than arrested. The 3 member panel consists of a social worker, legal advisors and medical professionals, the job of the panel was to assess each case according to: the type of drug , the level of drug use (whether that was an addiction or just habitual or casual), whether the use was in public or private, and* the economic circumstances of the offender*.
The result of all these changes were massive drops in HIV cases (from 104.2 cases/million in 2000 to 4.2 cases/million in 2015), drug use declining among those aged 15-24[[^4]], levels of drug use in Portugal are below the European average[[^5]] and more.
The cause of these drastic changes weren’t just the laws, but rather Portugal’s society’s outlook on drug users, no longer were they viewed as criminals, but rather they were viewed as victims that society had an obligation to help. Dr. Joao Goulao, who was the architect of Portugal’s decriminalization policy, said “it’s very difficult to find a causal link between decriminalization by itself and the positive tendencies we’ve seen… it’s a total package. The biggest effect has been to allow the stigma of drug addiction to fall, to let people speak clearly and to pursue professional help without fear.”
That change also must happen within a society for drug problems to truly be eradicated. A core part of addiction that it seems the evidence suggests is about not being able to bear to be present in your life, we need to start changing our outlook on drug users, to remove the stigma and allow them to be a part of society. It starts with us, then comes legislation.
Notes
[^1]: "Concurrent etonitazene and water intake in rats: Role ... - SpringerLink." https://link.springer.com/article/10.1007/BF00427336. Accessed 23 Apr. 2021. [^2]: "Voluntary morphine ingestion, morphine dependence ... - PubMed." https://pubmed.ncbi.nlm.nih.gov/1241445/. Accessed 23 Apr. 2021. [^3]: "Drug addiction. I. Addiction by escape training - PubMed." https://pubmed.ncbi.nlm.nih.gov/13376373/. Accessed 23 Apr. 2021. [^4]: "III Inquérito Nacional ao Consumo de Substâncias Psicoativas na ...." 1 Jan. 2013, https://novaresearch.unl.pt/en/publications/iii-inqu%C3%A9rito-nacional-ao-consumo-de-subst%C3%A2ncias-psicoativas-na-p-2, p. 59. Accessed 24 Apr. 2021. [^5]: "Drug policy profiles — Portugal | www.emcdda.europa.eu." https://www.emcdda.europa.eu/publications/drug-policy-profiles/portugal_en, p. 20. Accessed 24 Apr. 2021.