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.

Chris Arnade on how the other half lives

This includes two updates

Half the world doesn’t know how the other half lives.   (old saying)

Chris Arnade spent 20 years as a Wall Street investment banker, then quit in 2011 to start a new career as a photojournalist, first interviewing and photographing drug addicts and prostitutes in the Bronx, then traveling across the country to talk to working people and poor people who’ve been left behind in the new economy.

Arnade said that what he concluded was that addiction is the result of isolation, isolation is the result of rejection and the chief source of rejection is the U.S. educational system.

The U.S. educational system, he said, teaches that the way to achieve success is to go to a good college, leave home and devote yourself to achievement in your professional life.

Those who do this successfully are the elite in American life.   The problem is that not everybody is able to succeed this way, and not everybody wants to do this.

Some people put family, community and religion first.  In this respect, he said, there is little difference between black people and white people, or between Anglos and Hispanics.

Arnade calls the first group the Front Row and the second group the Back Row. The Back Row are not only disrespected, Arnade said.  The economic system is rigged against them.

Every important decision on national policy, since at least the North American Free Trade Agreement  (NAFTA) in 1994, has put the interests of the Front Row ahead of the Back Row.

The one institution in society that welcomes the back row is the churches, he wrote.  He himself is an atheist, but he said that churches welcome you, no matter what your credentials or lack of them.  I’m not sure that is true of all churches, but his point is correct.

Another place the Back Row is welcome, he said, is McDonald’s restaurants.  McDonald’s original business model was a place where you can get in and get out quickly, but McDonald’s and other fast-food restaurants have become places where you can get a nourishing meal at a low price, charge your cell phone and hang out with friends.  Most of them have an old man’s table that retirees have staked out for their own.

If you’re a Front Row person and want to break out of your bubble, stop having coffee at Starbuck’s (or the equivalent) and stop start spending time in McDonald’s (or the equivalent), Arnade advised,

Heroin addiction comes to West Virginia

As a boy and well into adulthood, I thought of heroin addiction as a product and problem of big city slums—a world completely alien to me.

My old friend Steve called my attention to a harrowing article in The New Yorker about heroin addiction in the eastern panhandle of West Virginia, just across the river from western Maryland where the two of us grew up.

The Eastern Panhandle as I remember it

I am shocked, although I know I shouldn’t be, that heroin addiction could capture so many people with the same small-town white Protestant background as me.  But in fact rates of drug addiction are higher among non-Hispanic white people than among Hispanic or black people.

Like much of Appalachia, as well as the Rustbelt along the Great Lakes, the city of Martinsburg, W.Va., lost its main manufacturing employer, the Interwoven textile mill, and nothing has ever taken its place.

Citizens of Martinsburg today are thinking of converting part of the old Interwoven plant into a drug rehabilitation center.

Margaret Talbot, the author of the New Yorker article, gives harrowing descriptions of how drug addition has become normalized.  She opens with a description of a mother and father suffering a drug overdose while attending a Little League game.

She reported on how marketing of painkillers such as Oxycontin enabled West Virginians to self-medicate for physical and psychic pain, and then how heroin was introduced as a cheaper substitute.  She went on to write:

Michael Chalmers is the publisher of an Eastern Panhandle newspaper, the Observer. It is based in Shepherdstown, a picturesque college town near the Maryland border which has not succumbed to heroin.

Chalmers, who is forty-two, grew up in Martinsburg, and in 2014 he lost his younger brother, Jason, to an overdose.

I asked him why he thought that Martinsburg was struggling so much with drugs.

“In my opinion, the desperation in the Panhandle, and places like it, is a social vacancy,” he said. “People don’t feel they have a purpose.”

There was a “shame element in small-town culture.” Many drug addicts, he explained, are “trying to escape the reality that this place doesn’t give them anything.”

He added, “That’s really hard to live with—when you look around and you see that seven out of ten of your friends from high school are still here, and nobody makes more than thirty-six thousand a year, and everybody’s just bitching about bills and watching these crazy shows on reality TV and not doing anything.”

Source: The New Yorker

As I see it, large numbers of Americans think that what gives meaning to life is economic success, or at least being able to pay your way and be a breadwinner for others.  When that meaning is no longer available, they feel worthless and fall into despair.

‘The opposite of addiction is connection’

Hat tip to Andrew Tobias.

A controversial British journalist named Johann Hari has written a book, Chasing the Scream, (which I haven’t read) , arguing that drug addiction is not caused by the body’s response to the drugs themselves.

He said addiction is caused by people being so disconnected from society and so lacking in life’s normal satisfactions that the pleasure of taking drugs is life’s best alternatives.

Hari based his conclusion on two experiments.  One involved rats.  The other involved the people of Portugal.

Experimenters in the 1950s and 1960s found that caged rats, when offered the option of self-administering heroin, would take the heroin in preference to food and water.

But another scientist, Bruce Alexander, noted that rats are social, active and sexual creatures.  A rat in a cage is equivalent to a human being in solitary confinement.  He wondered what normal rats would do if exposed to heroin.

Starting in 1977, he created a “rat park”—a kind of paradise for rats—in which there was plenty of cheese, and brightly-colored objects, tunnels to hide in, plus other rats to hang out with, including sexy members of the opposite sex.

These rats had no interest in morphine-laced water, even when mixed with sugar to make it more attractive.

Furthermore rats that had been turned into heroin addicts in cages lost interest in drugs when released into the rat park.

Portugal’s experiment began in 2001.  The country had a serious drug addiction problem, and arresting and punishing drug addicts was as ineffective there as it was elsewhere.

So the government tried a different approach.  They reduced the penalty for possession of small amounts of illegal drugs—a supply of less than 10 days—to a minor offense, equivalent to a traffic ticket.

But instead of just leaving it at that, the Portuguese government put the resources that formally went into drug enforcement to helping drug addicts lead a normal life—for example, by subsidizing salaries so they could get jobs.

There is something about this that doesn’t sit quite well with me.  Why should an addict get help from the government that is not available to someone who keeps free of addiction?  It is like Jesus’s parable of the Prodigal Son.  Why should the son who goes away and wastes his life be treated better than the faithful son who stayed at home and did his duty?

But this is not rational thinking.  The fact is that the Portuguese solution worked.  Drug addiction didn’t vanish, but Portugal has one of the lowest addiction rates in Europe.   Mercy, forgiveness and human kindness work (in this case) better than a narrow idea of justice.

If marijuana is legalized, what then?

I’m opposed to drug prohibition for the same reason that I’m opposed to alcohol prohibition, gun prohibition or any other law that can’t be enforced.  The social cost of increased addiction if the law is changed is less than the social cost of mass incarceration of young black men and of the drug wars being fought in Mexico, Colombia and other countries.

Still, I wonder whether the big tobacco companies will start to mass-market marijuana products the way they market cigarettes, and tweak THC, the active ingredient in marijuana, to make it more addictive, the way they did nicotine?  They would not be the only companies to promote an additive drug.

The war on drugs and its Mexican quagmire

All the reasons that are given for drug prohibition or, for that matter, gun prohibition are reasons for prohibiting the consumption of alcohol.

The Centers for Disease Control say that alcohol abuse is the third-largest cause of preventable death in the United States.  More than 75,000 deaths a year are attributed to alcohol.  It is involved in 39 percent of highway fatalities, one-third of suicides and 37 percent of rapes and sexual assaults.   Each year there are 3 million violent crimes in which the victim says the offender was drunk.

Given these facts, it was understandable that the United States in 1919 would try prohibiting alcohol.   The prohibition laws did not stop people from consuming alcohol, but they did stimulate the growth of organized crime to a much more powerful place in American life.

But when the Noble Experiment was repealed in 1933, things did not return to the way they were in 1919.  Organized crime did not go out of business.  It sought other activities, and is an important part of American life to this day.  All the evils that Prohibition was intended to alleviate continue to this day.  But no reasonable person wants to restore Prohibition.  It is a cure that is worse than the disease, even though the disease is very real.

After reading a report in the Washington Post by Dana Priest on the current state of the war on narco-traffickers in Mexico, I think drug prohibition will end in the same way.   She told how the CIA spearheaded the drug war and developed such close ties with CISEN, the Mexican intelligence service, that it became virtually part of the Mexican government.  The George W. Bush administration stepped up arrests of drug kingpins and attempts to shut down drug smuggling routes.  The druglords responded savagely.

CISEN discovered from a captured videotape and a special analytical group it set up that some of the cartels had hired former members of the U.S.-trained Guatemalan special forces, the Kaibiles, to create sociopathic killers who could behead a man, torture a child or immerse a captive in a vat of acid.

Anxious to counterattack, the CIA proposed electronically emptying the bank accounts of drug kingpins, but was turned down by the Treasury Department and the White House, which feared unleashing chaos in the banking system.

As the Mexican death toll mounted, [President Felipe] Calderon pleaded with Bush for armed drones.  He had been impressed by the results in Iraq and Afghanistan, two former U.S. officials said.  The White House considered the request, but quickly rejected it.  It was far too likely to result in collateral damage, they said.

By 2009, President Obama’s first year in office, horrific scenes had become commonplace throughout Mexico: severed heads thrown onto a dance floor, a half-dozen bodies hanged from a bridge, bombs embedded in cadavers.  Ciudad Juarez, a stone’s throw from El Paso, was a virtual killing zone.

… … Success against the cartels’ leadership had helped incite more violence than anyone had predicted, more than 60,000 deaths and 25,000 disappearances in the past seven years alone.

Meanwhile, the drug flow into the United States continued unabated.  Mexico remains the U.S. market’s largest supplier of heroin, marijuana and methamphetamine and the transshipment point for 95 percent of its cocaine.

via The Washington Post.

On Dec. 1, a new President, Enrique Pena Nieto, took office.  According to Priest, he is less interested in the U.S.-backed policy of arresting druglords and more in drug abuse prevention and keeping Mexico’s streets safe.  In other words, he cares more about Mexico’s problems and less about helping the United States solve its problems.

She reported that U.S. officials are worried about President Pena Nieto’s priorities.  I think we in the United States would be wise to adopt these priorities for ourselves.  The roots of the U.S. drug addiction problem are in the United States, not in Mexico, Colombia or any other foreign country.

I think the war on drugs is going to end in the same way as Prohibition.  I don’t think that will be a good result, but I think it will be an inevitable result.  In this, as in many other things, I will be pleased if events prove me wrong.

There are two wise sayings that apply here.  One is Stein’s Rule, by Herbert Stein, the chair of the Council of Economic Advisers under President Nixon.

If something cannot go on forever, someday it will stop.

The other is one of Rumsfeld’s Rules, by Donald Rumsfeld, Secretary of Defense under President George W. Bush.

If a problem cannot be solved, it may not be a problem, but a fact.

The war on drugs at a glance

Click on drugsnotthugs for the source of the chart.

Hat tip to The Agitator.

[Update 10/13/12]  The figures are more iffy than I assumed, although I still think the general point is correct.

Click on Questions on the 1315 Project Chart for discussion of the figures and where they come from.

A few astute viewers have noted that at its peak spending, the chart I’ve included only hits approximately $20 billion, which extrapolated over 40 years would yield only $800 billion.  Yet we can clearly see that the chart itself is not flat at the $20B level, but climbs sharply beginning in the mid 1980s. So in short, the chart, as shown, does not add up to $1.5 trillion.

So why did I do this?  This graphic was initially not meant to stand on its own but rather illustrate an interviewee’s assertions about the costs and efficacy of drug prohibition.  In a tight production schedule, I utilized a data set that I thought most accurately illustrated the nature and growth of the costs of the War on Drugs and that data is US federal drug control spending. But the $1.5 trillion figure, as mentioned by Jack Cole in his interview, accounts for many more costs, including state level costs, prison costs, lost productivity costs due to incarceration and others.  I trust Jack’s estimate of $1.5 trillion after a quick review of the ONDCP report from 2004 gave me confidence that he was right on the money. You can check out the ONDCP’s The Economic Costs of Drug Abuse in the United States, 1992-2002.

via Matt Groff.

Click on Reason for more about the figures.

While the $1.5 trillion figure doesn’t correspond to the numbers at right, it’s actually low.  In 2010, the AP put the 40-year tab of federal drug control spending at $1 trillion. But the massive federal drug control budget–for fiscal year 2013, it’ll be $3.7 billion for interdiction, $9.4 billion for law enforcement, and $9.2 billion for early intervention–is actually a pretty small slice of the pie. States and municipalities have their own drug war expenses–investigating, trying, and locking up drug offenders–and those expenses actually dwarf what the federal government spends.

According to The Economic Impact of Illicit Drug Use on American Society, last published by the Department of Justice in 2011, enforcing illegal drug laws imposes an annual cost on the American criminal justice system of $56 billion; while incarceration of drug offenders imposes an annual cost of $48 billion.

That’s $104 billion spent annually by states and cities on two aspects of the drug war (and doesn’t include treatment, public assistance, and a slew of other costs), compared to roughly $21 billion spent by the federal government.  For $1.5 trillion to reflect just federal spending, the federal drug control budget would need to have been $37.5 billion a year, every year, for the last four decades. It’s only slightly more than half that this year.

via Reason.com.

I expanded this post with excerpts from the links on Oct. 19, 2012.

I depend on an addictive drug

Since my late teenage years, I’ve been addicted to a drug.  I had to take it several times a day during my working years in order to function normally, and even in retirement, I need to take it at least once a day.  I see that a blogger named Jennifer Abel has the same dependency.

I’m trying to kick a drug addiction.  The monkey on my back has sunk its sharp claws deep into me in a strangled mixed metaphor no self-respecting English-major professional like me would commit to print, were her judgment not clouded by the aforementioned addiction.  Really strong, choice Colombian product — it’s become a crutch rather than a pick-me-up but I’m determined to break that crutch and my dependence on caffeine and walk on my own two legs again, by Zod. I’m feeling okay.  Yeah, I think I can do this OH MY GOD THE HALLUCINATIONS ARE STARTING THERE’S BUGS CRAWLING EVERYWHERE … no, wait, that’s not a hallucination.  That’s just me living in The South nowadays.  Damned bugs.  Screw this; I’m making some coffee.

So here I am, hooked on a strong Columbian intoxicant and suffering actual medical withdrawal symptoms when I try not-using it.  Doesn’t matter how many hours of quality sleep I get of a night; I still won’t feel well-rested until I drink that first cup of coffee.  So much for use in moderation.  The government ought to ban this poison.  You know what would really help me improve my life via ending my coffee dependence?  An armed SWAT team working in conjunction with the DEA, breaking into my house, demolishing everything within it and hauling me off to spend several years in prison. … …

It’s a good thing I picked the right thing to be addicted to.   If I were addicted to something less socially acceptable, I might have done serious prison time in my life, especially if I had not been born white and middle-class.

Click on Save Me, Uncle Sam! I’ve Lost Control for Jennifer Abel’s post on her Ravings of a Feral Genius web log.