Book Review: Chasing the Scream
Mar. 13th, 2018 07:39 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
osprey_archerI did not expect Johann Hari’s Chasing the Scream: The First and Last Days of the War on Drugs to blow my tiny mind. I knew that the war on drugs grew out of a race panic in the early twentieth century. (“Black men/Mexican men/Chinese men seducing white women with cocaine/cannabis/opium! THIS SCOURGE MUST BE STOPPED.”) I’ve read about many of the experiments Hari cites, like Bruce Alexander’s Rat Park. I was already basically in accord with Hari’s view that the war on drugs has been a disaster.
But nonetheless the book did blow my tiny mind, because Hari not only shows that the war on drugs has only led to an increase in crime and increased power for organized crime without making any perceptible dent in the number of addicts - he also shows that almost everything that I thought I knew about drugs & addiction were wrong.
Case in point: Only 10% of drug users become addicts. This holds true even for drugs like crack cocaine or heroin, even though the general perception with these drugs that “if you try these once you’re probably going to die an addict.” (This is more or less the impression I got in health class.)
In fact it turns out that addiction itself often dies out naturally, even in the absence of any heavy-duty treatment: people drink alcohol or smoke pot or do heroin because the pain and stress in their life is unmanageable, and when they’re in a manageable situation again they either stop entirely or become recreational users again. (Hari cites heroin use statistics among US soldiers in Vietnam: people were terrified that hordes of hopelessly addicted soldiers would come back to the States and wreak havoc, but in fact 95% of the soldiers stopped once they got home. They no longer needed it.)
The reason for this discrepancy is that the War on Drugs narrative about drugs is all about the chemicals in drugs. It promotes the idea that addiction is a result of chemicals: drugs have chemical hooks that hijack your brain and force you to need more drugs forever.
But, Hari explains, although that chemical effect is real, it’s actually not the main factor that drives addiction. “With the most powerful and deadly drug in our culture [nicotine], the actual chemicals account for only 17.7 percent of the compulsion to use.” (183)
Side note. One of the bitter ironies of the drug war is that the two deadliest drugs - alcohol and tobacco - aren’t illegal. (They tried it briefly with alcohol during Prohibition, but that had such deleterious effects on white communities that - imagine - the government actually called that one off.)
Other side note, I suspect that 17.7% figure is a bit shakier than some of Hari’s other evidence, but fortunately he has other evidence to muster to support his argument that environment rather than the innate addictiveness of the chemicals is the main driving factor in addiction. This is where Bruce Alexander’s Rat Park experiments come into play.
Capsule summary: if you put rats in tiny bare cages with no other stimulus (which is basically hell on earth for a social animal like a rat - or a human), nine out of ten will use cocaine till they die. If you put rats in a giant cage with lots of toys and other rats to play with, they will use much less cocaine, and none of them will use it till they die.
Also, it turns out that if you take cocaine-addicted rats out of their tiny bare cages and put them in Rat Park, they will make friends with the other rats and soon break out of their addiction.
What the drug war does, instead, is make it harder for addicts to form meaningful connections with other human beings. It’s hard to get a job or find housing with a drug conviction.
Or, as Hari puts it, “the core of addiction doesn’t lie in what you swallow or inject - it’s in the pain you feel in your head. Yet we have built a system that thinks we will stop addicts by increasing their pain.” (166)
Addicts become addicts because the drugs are the only things that can stop their pain - they’ve bonded with drugs rather than with other human beings, often because their rotten childhood gave them no opportunity to form healthy human bonds.
“Professor Peter Cohen...writes that we should stop using the word ‘addiction’ altogether and shift to a new word: ‘bonding.’ Human beings need to bond. It is one of our most primal urges. So if we can’t bond with other people, we will find a behavior to bond with, whether it’s watching pornography or smoking crack or gambling.” (175)
Also, as Hari outlines later, addicts often find people to bond with through their addictions. Gamblers bond with fellow gamblers, alcoholics bond with the bartender, heroin addicts bond with other heroin addicts, etc. Humans need bonds so much that we will latch onto bonds that will kill us rather than go totally without.
(It occurs to me - this is just me spitballing, not something Hari talks about - that we may have to rethink Maslow’s hierarchy of needs. If people are willing to put emotional bonding above safety and even basic physiological needs like food and shelter, we may need to move it down closer to the bottom of the pyramid. Do psychologists actually use Maslow’s hierarchy of needs anymore anyway? It still has currency in pop psychology, at least.)
This doesn’t even close to summarize Hari’s whole book. He also talks a lot about the destruction the drug war has wrought in countries on major drug supply lines, where drug money allows gangs to become more powerful than the cash-strapped local government. He points out that the reason the drug war spread worldwide is because the US basically strong-armed everyone else into it.
But this has already gotten quite long. So the long and the short of it is that our current drug laws are pretty much the opposite of what you would design if you wanted to design a system that would actually limit the harm of addiction. In countries like Portugal, where drugs have been decriminalized, addiction goes down, because it’s easier for addicts to get help and stop being addicts.
And even the addicts who aren’t ready to quit yet become significantly more functional members of society once they no longer have to hustle to pay astronomical prices to pay criminals for drugs (which are often adulterated - and it’s the adulteration that causes a lot of the side effects we associate with drugs). They get a prescription for their drug from doctors, and they get jobs, start families, settle down, and then often stop using simply because there’s so much else going on in their lives that they no longer really need the drug.
It’s a lot cheaper to administer than a drug war, too. In fact, legalized drugs can be taxed, so they become a net revenue stream rather than a revenue drain. And then you’ve got all sorts of money to spend on other things, like child abuse prevention programs that might make a dent in addiction before the drug-using part even begins.
Win-win all around, really. Maybe someday we’ll put this into practice.
But nonetheless the book did blow my tiny mind, because Hari not only shows that the war on drugs has only led to an increase in crime and increased power for organized crime without making any perceptible dent in the number of addicts - he also shows that almost everything that I thought I knew about drugs & addiction were wrong.
Case in point: Only 10% of drug users become addicts. This holds true even for drugs like crack cocaine or heroin, even though the general perception with these drugs that “if you try these once you’re probably going to die an addict.” (This is more or less the impression I got in health class.)
In fact it turns out that addiction itself often dies out naturally, even in the absence of any heavy-duty treatment: people drink alcohol or smoke pot or do heroin because the pain and stress in their life is unmanageable, and when they’re in a manageable situation again they either stop entirely or become recreational users again. (Hari cites heroin use statistics among US soldiers in Vietnam: people were terrified that hordes of hopelessly addicted soldiers would come back to the States and wreak havoc, but in fact 95% of the soldiers stopped once they got home. They no longer needed it.)
The reason for this discrepancy is that the War on Drugs narrative about drugs is all about the chemicals in drugs. It promotes the idea that addiction is a result of chemicals: drugs have chemical hooks that hijack your brain and force you to need more drugs forever.
But, Hari explains, although that chemical effect is real, it’s actually not the main factor that drives addiction. “With the most powerful and deadly drug in our culture [nicotine], the actual chemicals account for only 17.7 percent of the compulsion to use.” (183)
Side note. One of the bitter ironies of the drug war is that the two deadliest drugs - alcohol and tobacco - aren’t illegal. (They tried it briefly with alcohol during Prohibition, but that had such deleterious effects on white communities that - imagine - the government actually called that one off.)
Other side note, I suspect that 17.7% figure is a bit shakier than some of Hari’s other evidence, but fortunately he has other evidence to muster to support his argument that environment rather than the innate addictiveness of the chemicals is the main driving factor in addiction. This is where Bruce Alexander’s Rat Park experiments come into play.
Capsule summary: if you put rats in tiny bare cages with no other stimulus (which is basically hell on earth for a social animal like a rat - or a human), nine out of ten will use cocaine till they die. If you put rats in a giant cage with lots of toys and other rats to play with, they will use much less cocaine, and none of them will use it till they die.
Also, it turns out that if you take cocaine-addicted rats out of their tiny bare cages and put them in Rat Park, they will make friends with the other rats and soon break out of their addiction.
What the drug war does, instead, is make it harder for addicts to form meaningful connections with other human beings. It’s hard to get a job or find housing with a drug conviction.
Or, as Hari puts it, “the core of addiction doesn’t lie in what you swallow or inject - it’s in the pain you feel in your head. Yet we have built a system that thinks we will stop addicts by increasing their pain.” (166)
Addicts become addicts because the drugs are the only things that can stop their pain - they’ve bonded with drugs rather than with other human beings, often because their rotten childhood gave them no opportunity to form healthy human bonds.
“Professor Peter Cohen...writes that we should stop using the word ‘addiction’ altogether and shift to a new word: ‘bonding.’ Human beings need to bond. It is one of our most primal urges. So if we can’t bond with other people, we will find a behavior to bond with, whether it’s watching pornography or smoking crack or gambling.” (175)
Also, as Hari outlines later, addicts often find people to bond with through their addictions. Gamblers bond with fellow gamblers, alcoholics bond with the bartender, heroin addicts bond with other heroin addicts, etc. Humans need bonds so much that we will latch onto bonds that will kill us rather than go totally without.
(It occurs to me - this is just me spitballing, not something Hari talks about - that we may have to rethink Maslow’s hierarchy of needs. If people are willing to put emotional bonding above safety and even basic physiological needs like food and shelter, we may need to move it down closer to the bottom of the pyramid. Do psychologists actually use Maslow’s hierarchy of needs anymore anyway? It still has currency in pop psychology, at least.)
This doesn’t even close to summarize Hari’s whole book. He also talks a lot about the destruction the drug war has wrought in countries on major drug supply lines, where drug money allows gangs to become more powerful than the cash-strapped local government. He points out that the reason the drug war spread worldwide is because the US basically strong-armed everyone else into it.
But this has already gotten quite long. So the long and the short of it is that our current drug laws are pretty much the opposite of what you would design if you wanted to design a system that would actually limit the harm of addiction. In countries like Portugal, where drugs have been decriminalized, addiction goes down, because it’s easier for addicts to get help and stop being addicts.
And even the addicts who aren’t ready to quit yet become significantly more functional members of society once they no longer have to hustle to pay astronomical prices to pay criminals for drugs (which are often adulterated - and it’s the adulteration that causes a lot of the side effects we associate with drugs). They get a prescription for their drug from doctors, and they get jobs, start families, settle down, and then often stop using simply because there’s so much else going on in their lives that they no longer really need the drug.
It’s a lot cheaper to administer than a drug war, too. In fact, legalized drugs can be taxed, so they become a net revenue stream rather than a revenue drain. And then you’ve got all sorts of money to spend on other things, like child abuse prevention programs that might make a dent in addiction before the drug-using part even begins.
Win-win all around, really. Maybe someday we’ll put this into practice.
no subject
Date: 2018-03-13 11:54 pm (UTC)(I dunno about legalizing crystal, tho. That shit is immensely vile.) But anyway, the whole "you take your VERY FIRST PUFF of marijuana and you are addicted for life and will also become a crack whore" propaganda is insane. But junkies have been saying that for a long time, only nobody really listened -- Burroughs wrote "Junk is a way of life." You don't wake up one day and go hey, I think I'll get addicted to heroin. It actually takes quite a while and a lot of determination and use. But once that happens, there are chemical changes in the brain that can fuck someone up. But IIRC if you abstain long enough, the brain kind of rights itself and people find other interests. (I always say that addicts who survive typically find some non-lethal activity to get addicted to instead -- music, exercise, work, art, whatever.) But it also takes a while to get that done, and people generally need peace and quiet and security and support to work through all that.
I do think both authors downplay genetic vulnerabilities that run in families, altho how to tease that out from stressful environment and learned behaviour....but I also remember seeing footage of the infamous LAPD "doorknocker," the crackhouse battering ram, and what the hell good did that do? Just about zero, as it turned out http://articles.latimes.com/1986-02-10/local/me-27297_1_steel-battering-ram
And then you’ve got all sorts of money to spend on other things, like child abuse prevention programs that might make a dent in addiction before the drug-using part even begins.
You know about the ACE studies re stress and trauma in environment, right? https://en.wikipedia.org/wiki/Adverse_Childhood_Experiences_Study
no subject
Date: 2018-03-14 12:55 am (UTC)I've been on morphine. It turns out to be the only chemical of my acquaintance (and my acquaintance includes two solid years of doctors throwing any medication indicated for pain at me, which is why I have a long list of side effects and some patchy memories) that cancels out the chronic pain from the nerve damage in the front of my face. It also interacts horrifically with my digestion and plays almost as badly with my ability to concentrate, so it's not a viable treatment. But I did not leave the hospital where I had been on a morphine drip and instantly seek out heroin from a street dealer. I was just sad, because for a tiny splinter of time I hadn't hurt, and because my body had forgotten what it was like not to hurt, the absence of pain was as huge and tangible as a presence and felt amazing, and then it went away again and I missed it.
no subject
Date: 2018-03-14 01:07 am (UTC)//rant rant
Butyeah, T, who drank more and for longer than I did, had Percocet or something after his dental surgery and just kind of left the pills in the medicine cabinet. "I'll just take them if I need them." I was like, HOW? HOW CAN YOU FEEL THIS WAY ABOUT HAPPY PILLS. Like having cookies in the kitchen. So it differs from person to person, even among addicts. Some people need abstinence, some need harm reduction, some can just quit. But instead of good options everyone gets this ridiculous Procrustean (sp) caricature.
That 'absence of pain' really is a great feeling. I wish you could have it.
no subject
Date: 2018-03-14 02:38 am (UTC)And I don't know about the medical community, but speaking for myself, Maslow's hierarchy of needs always struck me as bullshit. We need all things, always. The things don't exist in isolation. Sure we need food--but also friendship and people to talk to about stuff. As much as food! "Finer feelings" aren't just for when we've squared away the other needs--everything's all interwoven.
What you say about friendships is so key too. If all your friends are addicts, it's really lonely and counterintuitive to try to not be an addict. It's hard to try to build a whole different lifestyle and make a whole new set of friends! That's asking a LOT of people. And yet people do manage to do it--not everyone, but some people. Even with no help (or hardly any) from society and stigmatization to boot.
ETA: Oops, put this in the wrong place--sorry [personal profile] kore--I had meant this as a generalized reply - -;;
no subject
Date: 2018-03-14 02:41 am (UTC)no subject
Date: 2018-03-15 02:14 pm (UTC)It seems to me that a lot of twentieth-century psychology seems to be about separating psychological causes out from each other - humans are driven by the sex instinct, or learned behaviors, or a hierarchy or needs, or whatever - and twenty-first century psychology is stepping back and saying, "No, actually none of these things exist in isolation, and you can't separate them out to study them in isolation because that ends up distorting the picture."
no subject
Date: 2018-03-15 02:17 pm (UTC)no subject
Date: 2018-03-15 09:16 pm (UTC)Yeah, and one-size-fits-all treatment really doesn't work for people either. For both addiction and depression (and the delightful 'dual diagnosis' combo).
no subject
Date: 2018-03-15 09:15 pm (UTC)Oh yeah, I meant to say, LOL that was my mom. She started smoking in Italy in the fifties "because all my friends would in cafes, and they made fun of me if I didn't," but she never liked it. She would have a pack of cigarettes in her purse for MONTHS and smoke one and forget about it. And then she was like, "This smells terrible, I quit." And my dad and I would just stare at her, we both paid in blood to quit smoking.
no subject
Date: 2018-03-18 12:07 pm (UTC)I just can't get over how different people are, in every way. I feel like I spent the first part of my life marveling at how similar we are--and I mean, I still feel like on a basic level we're, y'know, all the same species and recognizably so--but jeez, whether it's what we're physically able to do or how we react to stimuli or what interests us... SO DIFFERENT.
no subject
Date: 2018-03-19 12:42 am (UTC)no subject
Date: 2018-03-19 12:51 am (UTC)no subject
Date: 2018-03-19 02:40 am (UTC)Some people go so far as to try to typify addicts based on substances, kind of an astrology of intoxicants, but that's pretty stupid. --Oh humans. We're SO into taxonomies. Like Japanese classifying people by their blood types.
no subject
Date: 2018-03-15 02:25 pm (UTC)no subject
Date: 2018-03-15 09:10 pm (UTC)(Nobody's going to replace Mate in my heart though.)
no subject
Date: 2018-03-14 12:34 am (UTC)Stuart McMillen drew a very beautiful comic about Rat Park.
[edit] In fact it turns out that addiction itself often dies out naturally, even in the absence of any heavy-duty treatment: people drink alcohol or smoke pot or do heroin because the pain and stress in their life is unmanageable, and when they’re in a manageable situation again they either stop entirely or become recreational users again.
I did not know that had been proven to the percentage point in people as well as in rats, but it does not surprise me.
no subject
Date: 2018-03-15 02:09 pm (UTC)no subject
Date: 2018-03-14 01:17 am (UTC)no subject
Date: 2018-03-15 02:04 pm (UTC)no subject
Date: 2018-03-14 06:38 am (UTC)no subject
Date: 2018-03-15 02:06 pm (UTC)Or at least this is what every war movie & cop show ever has led me to believe and if they were all lying to me, then I will be VERY put out.
no subject
Date: 2018-03-19 12:46 am (UTC)no subject
Date: 2018-03-15 05:11 pm (UTC)no subject
Date: 2018-03-15 05:20 pm (UTC)no subject
Date: 2018-03-15 09:12 pm (UTC)