Drugs: What America gets wrong about addiction and policy | Big Think

Drugs: What America gets wrong about addiction and policy

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"Why are some drugs legal and others illegal? ... if you ask how and why this distinction got made, what you realize when you look at the history is it has almost nothing to do with the relative risks of these drugs and almost everything to do with who used and who was perceived to use these drugs," sats Ethan Nadelmann.

In this video, Maia Szalavitz, public policy and addiction journalist; Carl Hart, professor of neuroscience and psychology at Columbia University; Ethan Nadelmann, founder of the Drug Policy Alliance; and Harvard University economist Jeffrey Miron dissect why American society's perceptions of drug addiction and its drug policies are so illogical.

Drug addiction is not a moral failure and the stereotypes about who gets addicted are not true. Policy that is built to punish drug users for their immorality only increases harm and death rates.

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TRANSCRIPT:

MAIA SZALAVITZ: Addiction is compulsive behavior despite negative consequences, and it's really important to start by defining addiction because, for a long time, we really defined it very poorly. We used to think that addiction was needing a substance to function and what that resulted in was that cocaine was not addictive because cocaine does not produce physical withdrawal that is noticeable. You may be cranky and irritable and crave cocaine, but you won't be puking and shaking and have the classic symptoms that you would see with alcohol or heroin withdrawal. So, cocaine wasn't addictive. Then crack came. And we realized that defining addiction in that way not only harms people by telling them that cocaine is not addictive. It also harms pain patients because people who take opioids daily for pain will develop physical dependence, but they are not addicted unless they have compulsive behavior despite negative consequences.

CARL HART: Addiction. Typically we think of it as people may exhibit tolerance to a substance. They may go through withdrawal when they don't have the substance. They may spend an increasing amount of time engaged in the behavior to obtain or use the substance. They may have had unsuccessful, a number of unsuccessful attempts to cut down their use of the substance. They may use despite the fact that they are having psychological or physical problems. These are the hallmarks of addiction.

MAIA SZALAVITZ: Addiction is a learning disorder because it can't occur without learning. You have to learn to associate the drug with some kind of relief or pleasure, and you need to do that repeatedly over time before you can become addicted.

CARL HART: Crack in the mid-1980s, one of the worst myths is that one hit, and you are addicted for life. We saw that in the 1980s and we are seeing it again with methamphetamine today: 'One hit and you are addicted.' And it's simply not true. Addiction requires work. Not that people should go out and experiment or do this themselves, but the fact is that's a myth. And the concern is that it's dangerous because when people perpetuate such myths and then when young people or people actually try methamphetamine or crack cocaine and find that that doesn't happen to them, now they disregard everything that comes from these official sources.

MAIA SZALAVITZ: So the learning is involved where you learn that this works to fix a problem and you basically then fall in love with the substance. And once you've fallen in love with somebody or something, you will persist despite negative consequences in order to sustain that relationship because the biology is going to tell you that your life depends on this. It basically acts in a brain region that is involved in survival and reproduction and those are the two fundamental purposes of biology. So that creates really, really strong cravings and it changes your priorities tremendously. This is a condition that can affect not just anybody but people who are in some sort of emotional pain. Addiction kicks people who are already down.

In order to overcome addiction you need to figure out what purpose the addiction was serving. In my case I had a lot of depression and I was very, I had a lot of difficulties connecting with people. I was also sort of overwhelmed by my senses and emotions a lot of the time and opioids turned that down very nicely. So I needed to sort of figure out what was up and deal with those...

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