I write from Killarney, where yesterday I delivered the keynote address at a conference on "Addiction-Proofing Our Communities." The conference opened with a speech by Ireland's drug czar, Desmond Corrigan, an academic pharmacologist who, unlike his American counterpart, provided hard data and humility.

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The Stanton Peele Addiction Website, October 4, 2008. This blog post also appeared on Stanton's Addiction in Society blog at PsychologyToday.com.

Straightening the Irish Out About Addiction (before they become as crazy as us)

KillarneyI write from Killarney, where yesterday I delivered the keynote address at a conference on "Addiction-Proofing Our Communities." The conference opened with a speech by Ireland's drug czar, Desmond Corrigan, an academic pharmacologist who, unlike his American counterpart, provided hard data and humility. Nonetheless, he still communicated an unbalanced and inaccurate image of drugs, one destined to exacerbate the problem. (Oddly, the czar indicated this was true in the past, when he had predicted drops in drug use, following which drug use in fact increased. As a result, he said, "I no longer make predictions.")

That night, I asked Dr. Corrigan to examine his own data showing that, of all those in Ireland who had ever tried illicit drugs (cocaine, heroin, marijuana, mushrooms, meth), ten percent or fewer currently used them (the data are similar here). Of course, this image is totally at odds with what the czar was trying to communicate: that drugs are an irresistible scourge that human beings cannot control and must avoid at all costs. When I asked him to explain the results, he said, "people quit when they get jobs, have families, and mature. Actually, they tell us ‘I simply didn't wish to continue using'."

I then directed his attention to the remarkably skewed usage patterns his data showed. While illicit drug use was largely self-limiting, pharmaceutical drugs use, drinking, and smoking were not. (Although the Irish use fewer illicit drugs than us - about a quarter have used one in their lives, compared with half of Americans -- a higher percentage currently drink - about three quarters, compared with half of Americans.) The czar answered by indicating that, although his province was only drugs, they intended to become as heavy-handed with alcohol as they already are with drugs. "Based on the work of Robin Room, we are arguing to raise the drinking age from 18 to 21, and to tax alcohol heavily."

By the time my speech rolled around the next day, of course, the czar was long gone. I noted that it would have been stressful for him to listen to my talk, and I appointed one of the conference organizers to stand in his stead. In my own imitable style, interacting with the czar stand-in, I then made the following points:

Given that his mission was to reduce drug use, it was remarkable that he did not note that the vast majority of people do so on their own, and (until I asked him) why and how they did so.

I told the "czar" that he was disingenuous when he said he no longer made predictions - "You are here predicting the steps you are taking will improve the situation."

I then turned to the audience (by now on the edge of their seats) to ask what it meant that the czar's predictions were previously disproved, and they correctly shouted out - "He has failed." And so, I pointed out, "he is now proposing more of the same." (Of course, the Irish drug czar is worlds apart from his American counterpart, for example in endorsing methadone, needle exchange, and other harm reduction techniques that can only be employed sub rosa in the U.S.)

I then pointed out that the Irish - like Americans - were tremendously culturally ambivalent about alcohol. I cited data showing that Irish men are the least likely to drink daily (2%) and most likely to binge once weekly (roughly half) in Europe.

These data are almost exactly reversed for Italian men, who have high daily drinking rates, but rarely binge. I then reviewed data showing that three percent of Italian youth binge drink three or more times a month, compared with a quarter of Irish youth - the highest figure in Europe.

To his stand-in, I then said, "So what do you think you will accomplish by imposing more restrictive alcohol regulations? By the way, do you drink? And how did you introduce your children to alcohol?" His stand-in admitted that both he and the czar drank wine with meals, and had taught this custom to their children. Of course, this is the approach Italians take (the drinking age in Italy is 16, and parents can give children of any age alcohol at a restaurant).

"So, I said, you feel the best approach for you and those you love is mild social drinking, and teaching this to youngsters, but for the Irish at large, you intend to raise the drinking age and make it harder for them to afford alcohol. In other words, they can't be expected to learn the healthy patterns you yourself practice."

I continued, "And by how much do you realistically expect to lower the prevalence of Irish drinkers (90% 0f who have imbibed)? Of course, what you will really accomplish is to exacerbate the ambivalence and uncertainty with which the Irish already drink, so that you can come back in future years to admit how you failed in this area also."

At this point, I stepped back and said to the "czar," "I understand -- as the Chairperson of the National Advisory Committee on Drugs -- you are primarily concerned with drugs. Really, what this means (as it does for the director of the American National Institute on Drug Abuse - with whom I would never be permitted to share a venue) is that you must constantly terrorize people about illicit drug use. On the other hand, examining your data - showing fewer than five percent of the Irish use marijuana, .5% use cocaine, and "0.0%" (actual figure) use heroin, while much higher percentages use a pharmaceutical (10% use sedatives and a similar number anti-depressants) while three-quarters drink, the Irish people are not getting good value from paying your salary. (Recently, in the U.S., the head of the NIDA - Nora Volkow - following as she always does my insights but years later - has labelled pharmaceutical abuse as the number one drug problem in America.)

"I, on the other hand, am the sole member of the Intergalactic Commission on Addiction. I am only interested in harmful substance use, not with banning or discouraging use of disapproved substances. So let us speak here today about how we can best aid our children in avoiding harmful substance use, and addictions of all kind (the audience immediately agreed that addiction was not limited to drugs and alcohol)."

Of course, everywhere - even the countries, like Ireland and the UK, closest to the U.S. in their screwy attitudes toward alcohol and drugs -- there is greater diversity of opinion permitted on the subject of drugs. I was invited by a group in Kerry County who teach "Life Education" in the schools (none of whom would at all agree with my remarks to the czar!) -- their mission is "to help children make healthy choices." You can see already why they would have me, creator of the Life Process Program, come to speak. We both agree that the key to avoiding unhealthy substance use, along with all addiction, is to encourage positive life attiudes and to arm young people with the knowledge and skill to live such a life.

In the U.S., where education programs are called "Drug Prevention," meaning their mission is to say the scariest things possible at all times about both drugs and alcohol, here is no room for my voice at all. Thus, I will be speaking in London and Paris shortly - in France addressing the national association of substance abuse counsellors. But you will never hear my voice in Washington D.C.