Stanton responds to the new era of addiction treatment.
Response to A. O’Connor, “New ways to loosen addiction’s grip,” New York Times, August 3, 2004, pp. F1, F6.
Can we cure drug addiction with drug treatments?
Your article on drugs to attack addiction conveys a certain view of addition, and indeed of life.
You describe a model of addiction favored by some government researchers and officials: drugs create pleasurable experiences which are almost irresistible. Thus, your article features a chart entitled “Caution: May Be Habit Forming,” and then presents data on the first-time use of drugs. Once people cross a certain line, according to this view, they cannot reverse or cease their drug use voluntarily.
In fact, of all the people who try heroin, cocaine, and crack, a miniscule percentage continue to use – the National Survey on Drug Use and Health (2002 data) found that, of all people who had used these substances, 6% (in each case) had used in the last month. Even more telling, in the real world most addicts outgrow their drug use. According to the same study, while 22% of Americans 18-25 abuse or are dependent on alcohol or drugs, this is true for only 11% of those 35-39, and 3% of those 55-59. A small minority of these people have been treated.
The idea of developing therapeutic drugs to block the effects of illicit drugs, and possibly using them to inoculate people, perhaps young people, creates interesting possibilities. Will those pursuing drug sensations seek and find new outlets? The obvious candidates are alcohol and prescription drugs. As your chart indicates, use of prescription painkillers dwarfs the use of crack, cocaine, heroin, and methamphetamines. Will drugs be developed to block each type of prescribed painkiller?
If drugs can be found to successfully inoculate against the effects of illicit substances, and children are inoculated, what would be the result? Would those not inoculated, or coming off inoculation, be totally unprepared to resist or mo derate their use of drugs? In the case of alcohol, cultures which teach mo deration in drinking early in life in fact produce far lower levels of alcohol abuse and addiction.
Of course, as one researcher indicates, a drug could “rein in the reward circuitry that drives people to seek [all] drugs and other pleasurable experiences.” Will we thus have to develop antidotes and inoculations for TV, sex, and food? What will our world look like then?
In fact, you should ask each of the researchers you interviewed the following question, “Overall, do you anticipate there will be more or less addiction in the U.S. in 10 and in 20 years from now?” I predict more, just as addiction seems to be growing presently.
Stanton Peele, Ph.D., J.D.
Senior Fellow, Drug Policy Alliance