Category: Chasing the Scream – Johann Hari

An Epidemic of Disconnection

An Epidemic of Disconnection

Posted on by jabittan
Over the last few years I have become increasingly aware of the importance of developing real senses of community and connection between everyone in our societies. Johann Hari’s book Chasing the Scream was one of the books that kickstarted these ideas in my mind. We are social creatures, and we create the worlds we live in together, through shared efforts and visions. As we have lost our shared visions and isolated our efforts, our communities have suffered, and people have responded with drugs, addiction, and further isolation. We have created an epidemic of disconnection, and we have been facing the consequences for the last several years.

 

In his book, Hari writes, “The places with the biggest opioid crises are also the places with the highest suicide rates and the highest antidepressant prescriptions—which help us to see that what is really going on is an epidemic of deep disconnection.”

 

Drug abuse, addiction, and overdose are common across the country, but are not evenly distributed. There are parts of our country where deaths of despair are a major concern and are so prevalent that among some demographics overall life expectancy is decreasing. People are facing incredible challenges, and don’t have the support systems and communities that they need to help them through their challenges. Drugs are a way to blunt the pain, to numb the constant worry, and to try turn off the part of the mind that only sees life as downward spiral. The epidemic of disconnection that we see in our country is self-reinforcing and threatens lives and communities.

 

We need to find more ways for people to belong, for people to matter, and for people to be engaged in creative endeavors in their community. Isolating ourselves with Netflix, gating off our communities, and building walls between ourselves, our property and the outside world of trouble will only exacerbate the epidemic of disconnection and further the inequalities which lead to our societal problems. We have to find more ways to invest in our communities, to do things together (even in a pandemic), and help encourage people to be responsible to each other and society. We cannot only be responsible to our own homes, families, and bank accounts. In order to combat the opioid crisis, we have to reconnect with people who feel disconnected and isolated, and help fill their lives in ways that opioids never will.
Shifting Drug Use

Shifting Drug Use

Posted on by jabittan
In the United States we often fail to think about alcohol use when we think about drug use. Our country is comfortable with the idea of recreational drinking to take the edge off a tough day, to enjoy a party or social gathering, and to celebrate a holiday. Alcohol has a lot of downsides, especially when people drink in excess. Whether people have an addiction or just drink too much one night, consequences can include drunk driving car crashes, liver and stomach problems, and general poor decision-making. Alcohol is dangerous for the user and for other people within society. Nevertheless, we understand that it can be used responsibly, and unless you have a history of alcohol abuse, it is strange to not drink.

 

Other drugs don’t enjoy the same acceptance in society. Marijuana is becoming more accepted, but other drugs remain strictly prohibited and shrouded in fear and secrecy. When states consider increasing access to medical marijuana or marijuana legalization, legislatures and the public will debate for hours on end all the potential consequences of legalizing marijuana and the dangers which could stem from more marijuana use. But rarely will we have the same discussions of alcohol, and rarely will we consider the consequences of people shifting their drug use as policy changes.

 

However, research suggests that we should strongly consider shifting drug use when we think about drug policy. When I was completing an MPA at the University of Nevada, I looked at research on people switching from opioids to marijuana within states that legalized marijuana or expanded medical marijuana programs. There is good evidence to suggest that many people will shift away from opioids, which can be dangerously addicting, to marijuana when weed is more accessible. Marijuana seems to be less dangerous than opioids, with fewer risks for overdose. There are certainly consequences for using marijuana – I know of studies that look at negative health impacts of smoking weed studies that look at potential damage to intellectual functioning. However, opioids have been ruinous for many communities in the United States, with arguably worse health consequences than marijuana. The shifting drug use might not be the best outcome we could hope for, but it might be a step in a better public health direction.

 

In his book Chasing the Scream, Johann Hari looks at these ideas around shifting drug use. He writes, “After California made it much easier to get marijuana from your doctor … traffic accidents fell by 8 percent.” People were not driving under the influence of alcohol as much once they began using marijuana instead. As a result, the roads became more safe. Hari gives several examples of shifting drug use that might occur if more drugs (or all drugs) were legalized. The drugs used and settings for their use would change, which would have a lot of implications for public health and safety. He shows that in many instances, shifting drug use away from alcohol would make us safer and more healthy. We don’t always recognize this, and we don’t always think about shifting drug use appropriately because we fail to think of and count alcohol use as drug use.

 

Hari writes, “If you don’t count alcohol as drug use, then drug use would go up. But if you do count alcohol as drug use, then there is some evidence suggesting overall drug use will not go up after legalization.”  Patterns of drug use are complicated, and we don’t have a lot of evidence to help us anticipate shifting drug use in a world where access to drugs in a legal way was more available. However, if we want to express an opinion about shifting drug use, we should remember that alcohol is a drug, and we should think of it within the larger context of drug use, not as its own thing.

 

Ultimately, I (and I think Hari) would like to live in a world with minimal or almost non-existent drug use. However, our current approach to get there, drug prohibition, doesn’t seem to be working and seems to actually make our societies more dangerous. Shifting to a world where drugs were legalized and provided in a safe form by the state (or private entities) could lead to greater drug use, might lead to changes in what drugs people use, and would like change where, when, and how people use drugs. If we moved in this direction while simultaneously creating a strong system to help people stay healthy while using drugs and that encouraged them to find a lifestyle that didn’t include drugs, then our societies might become more healthy, and we might not actually see drug use increase in a dangerous way.
A True Democracy

A True Democracy

Posted on by jabittan
A while back I wrote about Cory Booker’s autobiography, and a quote he included from a housing advocate in Newark. Booker, learning from this advocate, talked about how important it is that everyone have access to housing. Both men believed that housing was a human right, just as we have rights to property, we have rights to stable, affordable, healthy housing. The reason housing must be a human right is because we cannot survive without it. We cannot flourish, we cannot store necessary medications, and we cannot live out our democratic responsibilities without a home. A true democracy helps its people do more than survive – it helps them participate, grow, and be valued members of society. A home is a necessary component of a true democracy.

 

A quote in Johann Hari’s book Chasing The Scream brought these ideas of a true democracy to my mind this morning. Housing is a first step toward solving many of the problems we see in society, but it also depends on how we think about our society and see our responsibilities within society. Right now we are too quick to cast out others and to see their lives as valueless.

 

Writing about drug users and people addicted to drugs, Hari writes, “In a true democracy, nobody gets written off. Nobody gets abandoned. Nobody’s life is declared to be not worth living.” We write off the lives of the homeless, of drug addicts, and of our nation’s poorest people all the time. If we were to be a true democracy, however, we would have to think more critically of our shared stories, futures, and connections, and work to lift up those who we have pushed down. A true democracy doesn’t limit you to your worst quality or mistake, it helps pull you up beyond your lowest point.

 

The quote makes me think about how important housing is for a democracy. You can’t participate in local politics without a local home. You can’t engage meaningfully with your society if you don’t have a place within society that you can call your own. You also, I think Hari would agree, can’t triumph over drug addiction without a home where you can be safe and have the necessary protection from the terrors and pressures which may push you back toward drug use. If we want to be a true democracy, we need to think about the ways in which homelessness leaves people behind, and we have to decide that their lives matter, and that they can’t be written off, even if they have used drugs or committed crimes in the past. Writing them off and shutting them out of our democracy doesn’t help them and doesn’t solve any problems, it only further entrenches the problems that already exist.
Downward Spirals of Drug Addiction

The Downward Spirals of Drug Prohibition

Posted on by jabittan
In his book Chasing the Scream, Johann Hari describes the ways in which drug prohibition leads to downward spirals for those dealing with drug addiction. From what he has seen first hand, the drug war doesn’t stop people from using drugs and doesn’t help the planet get closer to a point where no one uses or abuses drugs, but instead creates more drug users. It forces drug addicts to the lowest possible rung on our social ladder and ensures they can never improve their lives.

 

Hari writes, “Prohibition—this policy I have traced across continents and across a century—consists of endlessly spreading downward spirals. People get addicted so we humiliate and shame them until they become more addicted. They then have to feed their habit by persuading more people to buy the drugs from them and become addicted in turn. Then those people need to be humiliated and shamed. And so it goes, on and on.”

 

People who abuse drugs and develop drug addictions are pushed out of our homes, out of public spaces, and out of the work force. We force them into dangerous situations where they can be taken advantage of, abused, and harmed by tainted drugs and needles. When people become so isolated and have no connections to help improve their lives, the only thing they can turn to is more drugs. To finance their habit they begin dealing drugs, often mixing the drug with other substances to have more to sell. They pressure the few people they have connections with to become drug users, so they can have some income to then further their habit.

 

The drug war doesn’t help rehabilitate these people, doesn’t show them that we care about them and want them to get better. It tells them they are worthless, and discourages and degrades them. The entire system creates negative downward spirals in peoples lives, in communities, and in our economy. It propels itself, creating the evil that it lives to fight against.
Shifting Away From The Drug War

Shifting Away from the Drug War

Posted on by jabittan
In the context of supporting the war on drugs, Johann Hari, in his book Chasing the Scream, describes most people as, “admirable people who have a series of understandable worries about the alternative. They support the drug war out of compassion for all the people they fear might become victims if we relaxed the laws. They are good people. They are acting out of decency.”

 

However, Hari believes that support for the drug war is actually more costly in the long run, and damages the lives of those who use drugs to an unreasonable extent. In the book, Hari looks at recreational drug users who don’t develop addictions and don’t generally cause a lot of harms through drug use. He compares these individuals to those who do develop addictions, and who contribute to crime and public health problems as a result of their drug dependencies. A key difference between the groups is that many of the people who develop addictions also have severe trauma in their lives. They are often isolated, have had adverse childhood experiences, and are suffering from physical or psychological pain without a supportive community to aid them. Not all harmless recreational drug users are free from pain and trauma, and not all addicts have a traumatic past, but the frequency of past trauma and ongoing psychological pain is a substantial difference between the two groups. Punishment and making life harder for drug addicts who have experienced pain hurts them and makes it more likely they will feel stuck and isolated, with no alternatives to alleviate their suffering besides the temporary relief of continued drug use.

 

The idea of punishment for drug use makes sense when we think about recreational drug users who we want to prevent from causing problems as a result of drug use. But those individuals, aside from contributing to an illicit economy, are not  contributing to the major drug use problems that we see. We can see this in our alcohol policy. Responsible recreational drinkers are not problems, but people who either have trouble consuming alcohol responsibly or simply chose not to consumer responsibly (perhaps college binge drinkers fit in both categories) do create problems for the rest of us. Helping an alcoholic is often understood as helping them develop a safe social setting where they can avoid alcohol or use it responsibly with people who understand their addiction and/or other alcohol challenges.

 

At another point, Hari writes, “We all want to protect children from drugs. We all want to keep people from dying as a result of drug use. We all want to reduce addiction. And now the evidence strongly suggests that when we move beyond the drug war, we will be able to achieve those shared goals with much greater success.” Moving beyond the drug war means that we will develop real, meaningful treatments and supports for drug addicts. It means we can have safe, legal drugs that people can use in supervised settings. It means that people with a history of drug use won’t be barred from ever finding even the most menial of jobs, and will be able to reintegrate back into society, rather than being forced out into situations where continued drug use is almost inevitable. Our approach to drug policy via the drug war has had disastrous consequences, and Hari encourages us to reconsider the path we are on.
Help Them Build a Better Life

Help Them Build a Better Life

Posted on by jabittan
It is an unavoidable reality that we are more motivated by what is in our immediate self-interest than we would like to admit. This idea is at the heart of Kevin Simler and Robin Hanson’s book The Elephant in the Brain and can be seen everywhere if you open your eyes to recognize it. I’m currently doing a dive into reading about homelessness, and I’m working through Elliot Liebow’s book Tell Them Who I am. Liebow writes about American society’s belief that people will become dependent on aid if it is offered unconditionally. In a passage from his book where he reflects on the barriers that homeless women face in obtaining services and aid, and how those barriers can often become abuse, Liebow writes:

 

“One important source of abuse lies much deeper, in a widespread theory about human behavior that gets expressed in various forms: as public policy, as a theoretical statement about rehabilitation, or simply as common sense. Whatever the form, it boils down to something like this: We mustn’t make things too easy for them (mental patients in state hospitals, welfare clients, homeless people, the dependent poor generally). That just encourages their dependency”

 

What is incredible with the sentiment in the paragraph above is how well it seems to justify what is in the immediate self-interest of the people with the resources to help those in need. It excuses inaction, it justifies the withholding of aid, and it places people with material resources on a moral high ground over those who need help. Helping others, the idea posits, actually hurts them. If I give up some of my hard earned money to help another person, I don’t just lose money, that person loses motivation and loses part of their humanity as they become dependent on the state. They ultimately drag us all down if I give them unconditional financial aid. What is in my best interest (not sharing my money) just also happens to be the economic, moral, and personal best thing to do for another person in less fortunate circumstances.

 

This idea assumes that people have only one singular motivation for ever working, making money to have nice things. It ignores ideas of feeling respected and valued by others. It ignores the human desire to be engaged in meaningful pursuits. And it denies our needs as humans for love, recognition, and basic necessities before we can pull ourselves up by our boot straps.

 

Johann Hari’s book Chasing the Scream is an excellent example of how wrong this mindset is and of the horrors that people can face when the rest of society thinks this way and won’t offer them sufficient help to reach a better place in life. Regarding drug addicts and addiction, Hari quotes the ideas of a Portugese official, “addiction is an expression of despair, and the best way to deal with despair is to offer a better life, where the addict doesn’t feel the need to anesthetize herself anymore. Giving rewards, rather than making threats, is the path out. Congratulate them. Give them options. Help them build a life.”

 

Helping someone build a life requires a financial investment in the other person, a time and attention investment, and also requires that we recognize that we have a responsibility to others, and that we might even be part of the problem by not engaging with those in need. It is in our selfish interest to blame others for the plight of society or the failures of other people. From that standpoint punishment and outcasting is justified, but as Hari, Liebow, and the Portugese official suggest, real relationships and getting beyond fears of dependency are necessary if we are truly to help people reach better places and get beyond the evils we want to see eliminated from the world. We can’t go out of our way to find all the ways in which things that are in our self-interest are good for the rest of the world. We have to acknowledge the damages that our self-interests can cause, and find ways to be responsible to the whole, and help other people build their lives in meaningful ways.
The Cost of the Status Quo in Policing

The Cost of the Status Quo in Policing

Posted on by jabittan
It is not always clear exactly what the cost is of the status quo. Policing is an area that is getting more attention now, and hopefully calls to defund the police are met with serious consideration as to how much money our police forces really need. The status quo in policing is that we spend a lot of money to lock up people we determine to be criminals, but not a lot of money on things that help rehabilitate criminals or prevent crime in the first place. We argue that tight state and federal budgets don’t leave us with enough money for anything other than incarceration, but when we consider just how costly policing really is, we can see that changing the status quo would open a lot of funding for other avenues.

 

Johann Hari addresses this reality in his book Chasing the Scream from 2015. At the time Hari wrote the following about a block in Brooklyn, NY, “In Brownsville, Brooklyn, the state spends one million dollars for every five people it arrests and convicts of midlevel drug offenses.” Our priority for our police has been to go after drug criminals and place steep penalties against them. The harsh costs, society thinks, should go to drug dealers and addicts, but the reality is that the costs fall on society itself. The current movement of defund the police is as much about how we prioritize our resources as it is about stripping the police from their ability to cause physical harm to those they encounter.

 

“In the United States,” Hari writes, “90 percent of the money spent on drug policy goes to policing and punishment, with 10 percent going to treatment and prevention.”

 

We complain about limited resources and being unable to introduce policy to truly make the lives of our fellow citizens better. But we spend huge amounts of money ($5 million dollars on five people) in the costs of arrests, trials, and incarceration. We are willing to pay huge amounts of money to round up the problem and remove it from our sights, but we are not willing to pay money to work with people and help address the problems that spiraled into the even worse problems that we arrest people for having. There are other ways to address crime, drug use, and the dereliction of the lives of the people we incarcerate. Shifting away from an arrest first and police first mindset can open up new resources to better address these problems and challenges.
Ignoring Larger Causes

Ignoring Larger Causes

Posted on by jabittan
“Focusing only on this smaller aspect and ignoring the much larger causes is one of the reasons why our responses to this crisis are failing so badly,” writes Johann Hari in his book Chasing the Scream. The smaller aspect he refers to is the chemical hook of drugs. The story we tell ourselves is that drugs are addictive because they have powerful chemicals hooks that grab onto receptors in our brain and leave us continually craving more and more of the drug, and nothing else. He presents information, mostly from tobacco cessation studies, which suggest that chemical hooks are really only a small explanation of drug addiction, and that much larger and more powerful social factors are at play. If we truly want to address addiction, Hari argues, we have to think big and address the larger causes.

 

It is very tempting to take a small aspect of a problem and make that the entire focus of our solutions. For drug addiction, the chemical hook of a drug is an excellent scapegoat. It removes the moral failure argument, making the addict a victim of a dangerous chemical that can’t defend itself. It may allow us to vilify the pharmaceutical company that made the drug, and it allows us to rail against the rich whose pursuit of wealth causes harms to the rest of us. Finding a narrow scapegoat allows us to pick our wrong doers, and to make sure that we are not part of the group responsible for the problem.

 

I think this is why we so often fail to truly address problems at the level that is necessary. We want to signal our concern and stand up against a wrong, but only if we are not implicated in the action against the problem. In the example of drug addiction that Hari highlights, a big problem is the structure of American society. Jobs have been changing for decades, but we never did enough to truly invest in our communities to make them resilient in the face of changing work in a new technological society. We have punished drug abusers and addicts for years, because  providing them the support they need, truly caring for them and allowing safe places for them to overcome the challenges that lead to their drug use in the first place, would be costly. To solve addiction requires that all of us, including those of us who have never used drugs and think of ourselves as good people, acknowledge that we have fallen short in many ways and that we might be part of the problem.

 

It is comfortable to focus on a small aspect of the problem, especially when it places blame on others. But it is inadequate, and will never give us the outcomes we want to see. We will always be making insufficient investments, and we will fail to help those who we claim to actually care about and claim to want to help.
The Importance of Respect

The Importance of Respect

Posted on by jabittan
In my life, many family members, friends, and elders have warned me against drug use by belittling those who are addicted to drugs. Words like junkie, derelict, waste, and zombie are commonly accepted words that are used to denigrate drug addicts (and that’s the tame end of drug user insults). The common stance, from what I always saw growing up, was disrespect and disgust toward people addicted to drugs. The importance of respect for these individuals, always seemed to be lost.

 

I studied public policy at the University of Nevada, and one of my favorite frameworks for understanding the legislative process is Ingram and Schneider’s Social Construction Framework. By looking at the social constructions, that is the framings and structures through which we understand target populations, of those who will receive the cost or benefit of a policy, we can understand how society thinks about who is deserving and who is undeserving of aid. The framework helps us think about power in politics, and whether we like or dislike specific people or characteristics of people.

 

Drug addicts, in almost all examples of the Social Construction Framework, are viewed as deviants. They have no political power, and are not seen as deserving. Consequently, it is politically popular to put more punishments on drug addicts. Policies which aid drug addicts and provide some type of benefit to them are politically costly.

 

Unfortunately, as Johan Hari explains in Chasing the Scream, this framing can lead to isolation among drug addicts, making it harder for them to ever recover. Hari quotes Ruth Dreifuss as saying, “Prevention begins with respect.”

 

To help people recover from drug addiction, and indeed to stop people who use drugs from developing addictions, we have to show them respect. We have to acknowledge their humanity, and we have to be willing to work with them, rather than to only punish them further. When describing Dreifuss’s views, Hari writes, “She had always believed that everyone – no matter how seemingly lost – can be empowered if you do it right.”

 

We may never be able to help everyone completely overcome addiction. We may never be able to stomp out addiction and drug abuse entirely, but we can work with people and show them respect, even if they have made mistakes and even if they do something we don’t want to see, such as abuse drugs and develop drug addictions. We can work with everyone to help them become better and more well adjusted versions of themselves, but it requires respect and a recognition of their humanity. We can’t just see people as deviants and heap piles of punishment on them, and then wonder why they never rise up. Not everyone is going to be a perfect success and some will still fail, but they will always deserve respect and to be treated as fully human. If we can’t provide those two pieces, then we will certainly fail to reduce drug use and addiction, and we will continue living with people we classify as outcasts and deviants.
Race and Public Policy in the United States

Race and Public Policy in the United States

Posted on by jabittan
I was an undergrad at the University of Nevada when the Black Lives Matter movement first began to take shape. I didn’t have a deep understanding of race in the United States. I generally thought that since we didn’t use racial slurs directly toward minorities in public and since there were not any visibly active anti-minority groups and movements in the town where I grew up, that racism was over in the country, and no longer contributed to the inequalities between racial groups in America. Of course, I was very wrong.

 

At a certain point, our country stopped addressing race head on. Policies meant to specifically keep black people out of political power, separate from white spaces, and intended to limit black economic advancement were removed from the books across the country. What we refer to as Jim Crow laws were struck down, however they were never replaced with laws that would explicitly help the black people who had previously been harmed by public policy. What is more, our nation seemed to decide that if we couldn’t have laws directly targeting a racial minority in a negative manner, then we couldn’t have laws explicitly targeting race in any way, even if the laws sought to undue previous injustice and help advance real equality and equity.

 

The result was not a race neutral utopia where public policy was equal for everyone. The result has been a steady march of laws that appear to be race neutral, but clearly have disparate racial impacts. There may not be a single measure that anyone could point to in order to say, “That right there, is racism in action via public policy,” but the effects and intents of legislation often are not hidden very deeply.

 

In 2019 I did a mini dive into drug policy in the United States, and author Johann Hari in his book Chasing the Scream shows how drug policy was designed with explicit racial prejudices, even though drug policy was race neutral at face value. Hari describes the efforts of a man named John Marks, a psychiatrist in the UK, to provide drugs legally to drug addicts. The legally provided drugs were safer than drugs on the street, and when provided free to drug addicts, it prevented harm to the user, and reduced theft as people no longer needed to break into stores or mug people to obtain money for drugs. From this point, Marks could begin to work with the addicts to address their drug use and help them move forward in a more healthy way.

 

Many people hated his approach to drug addiction, and in the United States, whenever he traveled to discuss his radical approach to addiction, he was blocked by red tape and pressure from a congressman. Hari writes, “Everywhere they [Marks and his colleagues] went, at the end of the meeting, they were told the same thing – that the Republican congressman Jesse Helms had been pressuring the organizers to shut them down and shut them up. Helms didn’t want anybody to interfere with the war on drugs. A few years later, on a CNN phone-in show, a caller thanked him for everything you’ve done to help keep down the niggers, and he replied by saluting the camera and saying: well, thank you, I think.”

 

More on that call and on Helms can be found here. What I want to highlight from this quote is how race neutral drug policy was understood by people to be explicitly designed to hurt racial minorities. The caller understood that public policy that negatively targeted drug users and people with low socioeconomic status disproportionately affected non-white people, contributing to racial inequalities that presumably advanced the caller while limiting opportunities for people of color. It was not just an unfortunate consequence of drug policy that black people suffered, it was the goal.

 

Today we need to accept the realities that so many of our public policies have had. We need to accept that race neutral policy can have different impacts on different racial groups, and that such policies are not really race neutral. We need to address the realities that some groups have been politically favored and advantaged over others through out nation’s history, and we need to start implementing policies which will help racial minorities at disproportionate rates. It is important that we be honest about that reality when moving those policies forward. This requires a change in the way we think about race in this country. We have to move beyond the dismissive idea that all lives matter, and specifically address the harms that have been done to racial minorities by recognizing that black lives matter, and that all lives won’t matter until we recognize that black lives do matter. We must use the energy of the present moment to change the ways we think about race and public policy in the United States, and redesign programs that have historically contributed to racial inequality.