In response to: What the Opioid Crisis Can Teach Us about the War on Drugs
America has seen a veritable explosion of serious drug abuse over the past two decades. In 1999, the year the Centers for Disease Control switched to a new system for tallying causes of death, Americans suffered fatal overdoses at a rate of six per 100,000. By 2015 the rate was 16 per 100,000, a total of over 50,000 deaths. In the official statistics that year, nearly two-thirds of drug overdoses involved an opioid of some kind—an undercount since many overdoses are not properly coded as opioid-related. Around 60 percent of the opioids on which users overdosed were illicit drugs like…
There are several ways of understanding how people can become addicted to drugs. It has been described as a brain disease, as a developmental learning disorder, or simply as a bad habit. When construed as a habit, addiction is always understood to be a condition from which addicts could free themselves by an always possible, if seldom made, sustained effort of will.
Addiction as a brain disease is the view most widely shared by healthcare professionals today. What makes drugs addictive, says Dr. Nora Volkow, director of the National Institute on Drug Abuse, is that they “increase dopamine in brain reward regions.” They hijack the reward-motivation conditioning in the brain, according to recent studies. With many diseases, we don’t put the responsibility for illness on the sufferer, and we should not for drug addiction either, Volkow argues.
At the opposite end of the spectrum are psychologists who believe addicts can and do make rational decisions, and can choose to stop taking drugs. One is Gene Heyman of Boston College, who has written that most addicts “quit using illegal drugs by about age 30” and do so “without professional help.” Dr. Heyman listed “the correlates of quitting” as “legal concerns, economic pressures, and the desire for respect, particularly from family members,” among other factors.
A major proponent of the view that drug addiction is a developmental-learning disorder—which falls somewhere between the aforementioned stances—is a former cocaine addict, the neuroscientist and professor of developmental psychology, Marc Lewis, who emphasizes what he calls “neuroplasticity,” and “the brain’s capacity to change.” This last matches the approach taken by journalist Maia Szalavitz in her new book Unbroken Brain: A Revolutionary New Way of Understanding Addiction.
I am obliged to Patrick Lynch for his thoughtful reply to my four posts concerning drug policy.
Mill’s “very simple principle” is important for two reasons. First: This harm principle is, at least in my experience, adduced quite often in some form or other by those who argue that drugs should be produced, sold, and consumed like any other commodity. In trying to reach this conclusion, advocates are right to quote it because of the second reason: Once the principle is breached, it has been admitted that public authorities, however they are constituted, may legitimately interfere in the matter. This having been conceded, it becomes a question of the best policy to follow, and not one of applying a simple, fundamental, and universal principle to the problem.
It is generally assumed that the onus of justification is on those who would prohibit an item of consumption or a manner of behaving.
Continuing from my initial post, the second main argument in favor of the legalization of drugs whose consumption (or at least possession) is presently prohibited is that the harms associated with drug-taking are caused more by their illegality than by their pharmacological or other effects. Their illegality means that their production and distribution are necessarily criminal activities; while the artificial expense of obtaining supplies that results from criminalization leads consumers, particularly addicts, into criminality in order to obtain sufficient money to buy them.
There are two main arguments, one philosophical and the other practical, for the legalization of drugs whose consumption is currently prohibited. I will take up the former here, and the latter in a separate post.