Having finally closed the Wired story that sent us out to Kenya last fall, we’ve moved on to another big project for the magazine. This time the focus will be on addiction, which means you should expect plenty of drug-policy posts in the coming months. We’ll kick off the fiesta today by noting this paper out of Britain, in which the authors make a truly contrarian claim: that heroin use needn’t always lead to abuse:
Our findings suggest that sustained heroin use does not inevitably lead to dependency, and that dependency will not always cause users significant problems – particularly involvement in crime and personal degeneration. We have demonstrated that, for some people, using heroin does not strip them of the ability to make conscious, rational and autonomous decisions about their drug use. The descriptions of heroin use presented here contradict the stereotypes that are to be found in the media’s treatment of the topic and political statements about it. They almost certainly conflict with popular beliefs about the drug.
The authors are careful to note that they’re not trying to infer that heroin is harmless, or that it can be used rationally by every addict. But as their case studies reveal, there is a large population of British heroin users who do not lose everything to the narcotic. Rather, they manage their use by remaining aware of its power. Several of the users surveyed, for example, strictly adhere to rules when dabbling in heroin—they force themselves to spend only a certain amount on the drug each month, for example, or they refuse to use until other priorities (such as work or family) have been taken care of.
None of this is to suggest that these people wouldn’t be better off heroin-free. But as the paper concludes: “If debate about drugs is to be rational, it is important that this fact is recognised, and that constructive lessons are drawn.”
Chapters 3 and 4 are particularly recommended if you’re in a rush.
Jordan // Jan 29, 2010 at 11:05 am
I think it’s a lot like the idea that there is a certain segment of the population that has a high risk of becoming alcoholic but most people will be able to drink without too much risk. However these things don’t get reported because a) we don’t yet have reliable ways of determining who is and who isn’t at risk and b) a general sense that it’s never good to tell people things like that.
That last bit seems to stem from the fact that people just aren’t very good at analyzing risk. We become terrified by things like Mad Cow disease, which carry a more or less negligible risk, but don’t think twice about how often people are killed by driving their cars. Some of that just comes down to wiring. We naturally seem to assume that the risk of something happening is directly correlated to how gruesome the effects are. We’d definitely all benefits if statistics were pushed a bit harder in primary and secondary school math classes.
As a side note, I wonder how much the level of societal harm due to opiate usage could be reduced if studies into ibogaine would finally become legal in the U.S.
Brendan I. Koerner // Jan 29, 2010 at 11:55 am
The point you raise re: alcohol is something I’ve been thinking about a lot. The abstinence model offered by most 12-step programs turns a lot of people off, for precisely this reason–they don’t like having to admit they’re entirely powerless. On the other hand, some addicts do need to abstain, because the 12-step theory of “if you have one, you’ll have 20” holds true for them. As you note, we really need to develop a better way–or some way!–of determining who can benefit from which approach.
Think I might’ve mentioned this before, but I wrote a piece about ibogaine back in 1999 or thereabouts. Def. works for some people, but it sounds like an absolutely terrifying experience. Not for the faint of heart, that’s for sure.
Captured Shadow // Jan 29, 2010 at 6:00 pm
I am looking forward to the future posts. Addiction is kind of a strange phenomenon. I imagine it is like other chronic (as opposed to contagious) diseases in that is due to a combination of genetics and environment. But the challenge is identifying what those factors might be.
I bet there are some interesting studies of twins out there that might shed some light.
Jordan // Jan 29, 2010 at 10:48 pm
@Captured Shadow
Here’s the NIDA report on drug addition twin-studies:
http://www.drugabuse.gov/NIDA_notes/NNVol14N4/Twins.html
The Questionable Power of Horse // Feb 18, 2010 at 10:13 am
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