America's drug policy resembles Europe's approach to the Black Plague.
The Stanton Peele Addiction Website, June 3, 2008. This blog post also appeared on Stanton's Addiction in Society blog at PsychologyToday.com.
So, you think we're going to end addiction soon?
Returning from Ireland, I read Barbara Tuchman's 1978 best selling history, A Distant Mirror: The Calamitous 14th Century. The 14th Century included the Black Death, which killed between a third and two-thirds of Europeans. Authorities could not address the epidemic because they didn't know microbes caused disease. So, instead of improving sewage treatment, people slaughtered Jews.
Before we laugh or cry over our benighted forbearers, we should reflect on our own inability to stem a number of tides. The one I am chiefly interested in is addiction. Ireland is currently revising its drug policy. Everyone agrees substance abuse is worse now than when the policy was introduced. But just as clearly as that policy failed, the new policy will contain the same principal ingredients.
American policy is worse. The Irish are steeped in prohibitionism and zero-tolerance, as we are. More recently, some efforts have been made to incorporate harm reduction. But the Irish - like Americans - see addiction as an alien force invading our society (like the Jews poisoning wells to create the black plague), and that the task is to eradicate the invading scourge, in this case through eliminating drugs and drug use.
Here are the five chief reasons this approach is impossible, will never succeed, and yet will be continued ad infinitum:
1. The myths of addiction. Addiction is not a drug side-effect. People seek experiences from drug and non-drug involvements that they require and cannot otherwise obtain, and become irrationally and dysfunctionally attached to them - i.e., addicted. But in the drug area, the Bush Administration's aversion to the fact-based world is widely shared by leading scientists. Thus, the National Institute on Drug Abuse pursues a research agenda based on erroneous ideas - that some drugs are inevitably addictive (fewer than 10 percent of regular cocaine, heroin, and crack users become addicted), that addiction is irreversible (a much larger majority of heroin, crack, and alcohol addicts quit on their own than smokers), and that addiction to drugs is a qualitatively different experience from other addictions (so that, for instance, the AMA was forced to beat off an onslaught from distraught parents inquiring about kids' addictions to video games).
2. Fear and loathing of drugs. In ways it is impossible to reverse, Americans and the Irish have come to hate and fear drugs (and, in a more ambivalent way, alcohol) as a malignant, magical, uncontrollable force in their midst. Thus everyone believes that the mission of the NIDA and Irish drug task force should be to abolish these things - or, in the case of alcohol, at least abolish drinking by kids. This has been the policy for many decades in both countries with results around for all to see - leading both countries to redouble their futile efforts.
3. Addiction is mainstream. When we say we want to eliminate drugs, of course we mean illicit drugs. We are foisting, happily, more and more powerful psychoactive drugs on our kids. Concerta is as addictive a stimulant as amphetamines (Adderall IS an amphetamine). The fastest growing drug use among adolescents is of prescription pain killers. American adolescents are the fattest in the world and the cumulative health consequences of their obesity and food addictions are far greater than they suffer from illicit substances. We are self-addicting, and becoming more so all the time.
4. We cannot comprehend the forces causing addiction. Americans protect their kids more than any kids have been protected in history. We try to keep them away from drugs and everything that will hurt them. Yet they are less capable of taking care of themselves than kids have ever been, more prone to addiction, and less content than even the miserable generations (like us) that preceded them. And we cannot reverse these trends - when confronted with childhood misery, we strive to take away more freedom and self-control from children, creating more hair-of-the-dog.
5. Liberals hate drugs like conservatives, and are more likely to believe in diseases. While conservatives rail against drugs (at the same time as Jeb Bush's daughter, Cindy McCain, conservative commentator Rush Limbaugh, et al. have had major prescription drug joneses) liberals' own views are worse. For instance, liberal icon Bill Moyers (and his son William Cope Moyers) are two of the most ardent purveyors of drug-addiction-as-disease-requiring-spiritual-redemption narratives - because calling what used to be a sin a disease seems so humane, even though the same thinking underlies both sin and disease.
The solution? As I outline in Addiction-Proof Your Child, it involves recognizing substance use as a regular, necessary part of contemporary human existence and producing young people able to cope with it, along with all of the other addictive experiences to which they will be exposed. Impossible? Right you are. So the Irish - and Americans - will be having the identical drug problems and debates fifty years from today that they are having now.