Addiction, depression and the war on drugs

Hat tip to Pete’s Politics and Variety.

Johann Hari is the author of Chasing the Scream: the First and Last Days of the War on Drugs (2015) and Lost Connections: Uncovering the Real Causes of Depression—and the Unexpected Solutions (2018)

In the first book, he argued that drug addiction is not mainly a chemical dependency; it is an escape from pain and misery.  In the second, he argued that depression is not mainly a result of a chemical imbalance, it is a reaction to pain and misery.

The answer to both addiction and depression, Hari believes, is to enable people to fulfill their basic needs, material and psychological.

Late last year he was in Brazil, promoting the Portuguese-language version of Lost Connections, and did a wide-ranging interview with Glenn Greenwald about addiction, depression and drug policy.

The most interesting part, to me, starts at about the 38 minute mark.  It is about Switzerland’s successful drug legalization policy, which began in 1991.  

In Switzerland, a heroin addict can visit a clinic and get a medically-supervised injection of heroin.  This does not, as I might have thought, lead to an increase in heroin use.  Just the opposite!

The reason is that Switzerland uses the money saved from not enforcing drug laws to help addicts obtain jobs. housing and therapy.  Over time they commonly find they no longer want to escape from reality.

This fits in with the famous “rat park” experiment.  Scientists found that rats in cages prefer heroin to food and water to the point where they literally will die of starvation.  But one scientist decided to create a “rat park,” containing everything that might constitute a good life from a rat’s point of view.  Happy rats had no interest in heroin.

Unfortunately I don’t think such an experiment is feasible in the United States.  The reason is that millions of Americans, maybe a majority of the population, are stressed and fearful.  Many can’t pay their medical bills.  Many are burdened with student debt. Many are losing ground economically.

I think they would be very jealous if the minority of the population who are addicted to drugs are guaranteed jobs, housing and even drugs themselves.  It is actually more practical to make things better for the American public as a whole than for a targeted group, such as addicts.

Brazil’s newly-elected President Jair Bolsonaro and the Philippines’ President Rodrigo Duterte say the way to end drug addiction is to kill drug dealers.  Greenwald and Hari say this isn’t going to work.

Glenn Greenwald, by the way, is the author of a well-know study of drug de-criminalization in Portugal since 2001.  The difference between de-criminalization and legalization is that, in the first, possession and use of addictive drugs is not a crime, but selling them still is.

Portugal, according to Greenwald, was afraid to go beyond de-criminalization because of pressure from the United States.  But the government still was better able to help addicts turn their lives around, as in Switzerland.

LINKS

A Discussion With Johann Hari on Addiction, Depression and the Optoid Crisis by Glenn Greenwald for The Intercept.

Drug Decriminalization in Portugal: Lessons for Creating Fair and Successful Drug Policies by Glenn Greenwald for The Cato Institute (2009)

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5 Responses to “Addiction, depression and the war on drugs”

  1. silverapplequeen Says:

    Reblogged this on silverapplequeen and commented:
    Another great read. The way American goes about things is so wrong.

    Like

  2. maryplumbago Says:

    Very interesting. The US is driven by unhealthy forces that are designed for welfare of the few, rather than the many.
    It will never change here, because of corporate profit agendas, refusal to pay more taxes to help lift everyone and religious fanaticism.

    Like

  3. Fred Says:

    I have a long and intimate association with depression. There are many times that meaningful work and close ties to people are simply impossible. It is easy to blame the government or the corporations or whatever big bad du jour. It does not explain why 3 people in almost identical situations have three different reactions. One sinks into depression, one soldiers on, compartmentalizing the bad and enjoying the good, and one is actively happy almost all the time.

    If you analogize the blues with depression, then depression is like living life wearing a blue filter built into your very being. Plenty of good things may happen but they aren’t recognized as such. Ordinary things are tinged with sadness. And there are those who wear rose colored glasses. I used to hate those people because they didn’t have a clue what was going on inside me and showered me with impossible and unrealistic advice. Now I merely find them annoying.

    I am convinced there are multiple routes to clinical depression. There is strong evidence that if there is a genetic predisposition for depression. I am also convinced that environmentally mediated depression for long enough time can make changes in brain structure and chemistry that mirror those in genetic depression.

    You don’t see nearly as much depression in tribal/family based cultures so I suspect some of us just aren’t as equipped to deal with modernity as others. Bulimia, for example, was unheard of prior to the industrial revolution. Religion offered both an alternative family when the secular world rejected one and hope for a better future no matter how many times one got kicked around in this one. You are also unlikely to become depressed when you must spend your entire day doing hard physical work to survive.

    No matter what the self-help gurus say, depression is not a not choice. If you can simply change your life with a perspective shift, you aren’t really depressed. In some cases, it is possible to alleviate depression by removing those things in your life that are depressing you. That is often impossible. And when it is possible, many people have discovered that depression returns once you are used to the new situation and the temporary euphoria is over.

    We use antidepressants, especially SSRIs, because the depth of help a deeply depressed person needs is simply beyond what is otherwise possible. It is good to say we need to change society but that isn’t going to happen. It is good to have intensive therapy but there will never be enough therapists to go around and they will always be too expensive for most. I do not doubt that many people are on SSRIs who ought to be exercising or playing with a puppy instead. But humans like the notion of a pill for a problem. We are lazy that way and “Big Pharma” is always happy to help.

    An SSRI prescription is cheaper than a warm puppy and doesn’t have to be taken for walks. For that matter, a depressed person may not have the psychological will to maintain an exercise program long enough to see benefits. Despite this, having a pet and taking regular exercise are demonstrably superior in results and have almost no adverse reactions when compared to simply popping pills. (Self-reported data through “23 and Me” depression research,) Most employee health plans do not cover a gym membership or veterinary care.

    Singing and hot baths also appear to help. Therapy is the most common line item but has some bad reactions, probably from bad therapists. However, if you combine all the different drugs together, drugs are MANY times more commonly used than therapy.

    I believe it is important to catch depression in children as early as possible. Chronically depressed adults don’t tend to report their depression began as adults. It often starts in the hormone rush of adolescence and many clinically depressed people report that they have been depressed *their entire life*.

    Cognitive behavioral therapy seems to be the best therapeutic option and there are experimental programs to deliver it by computer. (Perhaps not an optimal delivery system but the human therapist supply is limited.)

    I agree 100% that most drug abuse (rather than occasional recreational use) is self-medication for emotional pain. There is overwhelming evidence that if you fix the source of the pain the abuse will generally fade. Some drugs are more addictive than others and some are more immediately damaging to mental and physical health. It is abundantly clear that the legal system is not the proper venue to handle addictive drugs.

    Liked by 1 person

  4. philebersole Says:

    Thank you for sharing this, Fred.

    Like

  5. Addiction, depression and the war on drugs — Phil Ebersole’s Blog – The Pixie From Everywhere Says:

    […] via Addiction, depression and the war on drugs — Phil Ebersole’s Blog […]

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