Tag: Addiction

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.
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.
An Addiction to Consumerism

An Addiction to Consumerism

Posted on by jabittan
Johann Hari doesn’t believe that the answer to solving our nation’s drug problems lies in locking up drug users and dealers. He doesn’t believe that those who develop addictions are some type of moral failure. He doesn’t think that what we need is better enforcement of laws, more policing, and better deterrence through the criminal legal process. What Hari believes is necessary is that we focus on reducing the harms of illicit drug use, and start asking larger questions about what motivates all of us, and how we interact and connect with one another.

 

There is a larger addiction than drug addiction that Hari is concerned about, addiction to consumption in general. As a culture, the United States has spent years believing that we could be content and happy in our own homes, as long as we can buy lots of things to fill our homes. We moved to suburbs where we could drive to and from work, park our cars in our garages, hire people to do our yard work, and never have to see or interact with people we don’t know. We watch TV, scroll through social media, and stay inside where it is safe and where we can be around our possessions.

 

“We all know deep down it doesn’t make us happy,” Hari Writes, “to be endlessly working to buy shiny consumer objects we have seen in advertisements. But we keep doing it, day after day. It in fact occupies most of our time on earth. We could slow down. We could work less and buy less. It would prevent the environment – our habitat – from being systematically destroyed. But we don’t do it, because we are isolated in our individual cages. In that environment, the idea of consuming less, in fact, fills us with panic.”

 

Across the United States we have developed an addiction to consumerism. We have lost the sense of community that has held together human beings for our evolutionary history, and we have limited our interactions with people in the outside world to meaningless transactions. We then criticize those who cannot find meaning in our consumerism and turn to drugs. We failed to provide them with a community and real relationships with other humans, and as a result people turned to drugs and we further outcasted them. Our consumerism has many negative externalities, and Hari would argue that isolation and addiction are consequences of our consumer culture. To solve drug addiction, he believes, requires that we re-think our ideas of consumerism, and start to look more toward re-engagement with community over individual purchases of things.
Addiction and Loneliness

Addiction and Loneliness

Posted on by jabittan
A little while back I wrote about the connection between isolation and addiction that Sam Quinones described in his book Dreamland. I wrote about the Former Surgeon General of the United States, Vivek Mirthy, who has also recently published a book about loneliness in the United States, arguing that we have a loneliness epidemic that is causing a number of health issues for people across the country. Mirthy was interviewed on Ezra Klein’s podcast, and the idea of loneliness has been one that Klein has returned to over and over in his show, with small comments or questions to many of his guests during conversations about a wide range of problems in American life.

 

The connection between addiction and loneliness is also something addressed by Johann Hari in his book Chasing the Scream. Hari focuses on the importance of community in helping people avoid drug misuse and addiction, and in helping people recover from addiction. On loneliness he writes, “One recovering heroin and crack addict on the Downtown Eastside [of Vancouver, CA], Dean Wilson, put it to me simply. addiction he said is a disease of loneliness.”

 

Addiction is not limited to people who live on the streets or who have no friends and find themselves in an apartment, isolated from any friends or family. However, isolation in that manner does make illicit drug use, prescription drug abuse, and addiction more likely. Addiction is also not limited to chemical substances. Hari argues that when we feel isolated, when we lack meaning, when we have no community to participate with as part of a broader mission than buying shiny consumer products, we are more likely to form bonds with chemicals, with sex, or with behaviors such as gambling. A sense of loneliness leaves us wanting something more and something different, and often, we can find ourselves addicted to something to distract from our loneliness.

 

Punishing people with addiction challenges, making it harder for them to be part of society, limiting the opportunities for them to have a meaningful job and work toward a social goal makes it harder for them to overcome their addiction and loneliness. Hari writes, “The heroin helps users deal with the pain of being unable to form normal bonds with other humans. The heroin subculture gives them bonds with other human beings.”

 

If we try to fight the addiction and the drug itself, we create a subculture of other lonely humans, who bond together through  their shared addiction and isolation. We almost guarantee that people struggling with addiction will be trapped, unable to find meaning in their life, stuck in isolation, and miserable. The answer from Hari is to instead focus on redeveloping our communities and social infrastructure. To fight loneliness and not addiction, to give people more meaning in their lives by developing more connections between us, and to reinvest in our communal spaces. By building institutions and cultures that push back against loneliness we address the upstream causes of addiction, and help cut away from the pressures that drive toward addiction. This is the ultimate message of Hari’s book, and it is not just a way to fight addiction, but a way to help us all have more meaningful lives.
Addiction Can't be Fought with Pain

Addiction Can’t be Fought With Pain

Posted on by jabittan
With the exception of the copious amounts of caffeine I consume thanks to a high coffee intake, I don’t use any drugs and don’t really have any personal direct experience with the world of recreational drug use or drug addiction.  Nevertheless, our nation’s opioid crisis has always stood out to me as an important and intriguing policy issue. Despite not having first hand knowledge of drug culture in the United States, I have been able to recognize the changing landscape as more states provided legal avenues to obtaining marijuana, as policy discussions popped into my orbit about racial disparities in drug sentencing, and as prominent American figures opened up about drug addiction in their family. To better understand the issue I selected a handful of books to read to better understand drug use and addiction in America. One of the books I read was Johann Hari’s book, Chasing the Scream.

 

Before my mini dive into drug policy and drug use literature, I didn’t have fully formed thoughts about our nation’s response to drugs. The idea that we would lock up drug addicts and those who tampered with or misused prescription medications seemed normal. I figured that putting people in prison where they would be away from drugs and monitored as they went through withdrawals made sense, and I had no reason to question the system and approaches we used to curb drug abuse and addiction. However, as the opioid crisis spread, I recognized how incomplete my understanding was, and sought out new information to better understand why our county has faced such serious drug problems. Across the books I read, what I learned was that drug policy has been racially biased throughout American history, and that drug use and addiction is often deeply tied to pain and trauma, and worsened by the loss of community.

 

These themes ran throughout the books I read and made me re-think the way we approach drug addiction and how we are so quick to punish drug abuse. My sense is that most Americans think along the same lines that I previously thought along – unaware of the deep social factors that run through so much of the drug abuse and addiction in our country.

 

Johann Hari writes, “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.”

 

So many of the people who fall into drug addiction originally turn to drug use and misuse as a way to ease some sort of pain stemming from a deep trauma. America’s suburbs have reduced our sense of community, and furthered isolation in our country. People with pain and trauma have minimal support for mental and emotional challenges, and as a result, often turn to drugs to attempt to manage the psychological or physical pain they live with.

 

Our response has been punishment, not support. People with deep pain and trauma cannot be healed by making their lives more painful, more traumatic, and by putting more barriers in front of a successful and healthy life. We assume drug addicts need to face more severe consequences to scare them away from drug use, but that is because we fail to see the common threads I have been writing about over the last several weeks. The result has been disastrous for those who find themselves misusing drugs and facing a road to addiction. Punishing the thing we are afraid of in an attempt to stamp it out only entrenches it further, and makes it worse for all of society. We have to recognize the reality of pain and trauma combined with a decimation of our sense of community in regard to addiction. We have to solve those problems first before we can ask people to work with us to fight through drug abuse and addiction.
Punishment Versus Compassion

Punishment Versus Compassion

Posted on by jabittan
An idea that Johann Hari explores in his book Chasing The Scream is that people with drug addiction need family and community support to get through their addiction, not punishment and castigation. Throughout the book Hari asks why people develop addictions, what do people do when they successfully get past an addiction, and what structures and systems work against recovery?

 

Early in the book Hari references a conversation he had with pastor and civil rights activist Eugene Callender about singer Billie Holliday. Hari writes, “Callender had built a clinic for heroin addicts in his church, and he pleaded for Billie to be allowed to go there to be nursed back to health. His reasoning was simple, he told me in 2013: addicts, he said, are human beings, just like you and me. Punishment makes them sicker; compassion can make them well.”

 

Hari argues that community is the cure for drug addiction. He sees drug addiction as a consequence of trauma, pain, depression, adverse experiences, and a loss of a sense of togetherness. When people are isolated and don’t truly feel as though they are part of a larger community where they belong and where their lives and actions matter, then people can’t take personal responsibility, they can’t work for more, and they often turn to drugs to blunt the pain and fill the empty voids. What this means, is that addiction is a consequence of everyone’s selfish actions, it is not just a moral failing of the individual. Consequently, we all have a role to play in the recovery of those in our communities dealing with addiction.

 

What Reverend Callender noticed, as highlighted in the quote above, is that people dealing with substance addictions need support and guidance to get through their struggles. People turn to drugs in times of pain when they feel something lacking in their lives. Taking more away from them, limiting their ability to interact with a community, and pushing more challenges at them only worsens the underlying psychological stress and trauma that drove them to addiction in the first place. Punishment is harmful, whereas compassion and forgiveness is what gives people a second chance and encourages them to improve their lives. If we don’t treat people facing addiction with dignity and respect, can we ever expect them to treat themselves with the dignity and respect needed to overcome addiction?
Jobs and Addiction

More Than The Chemical: Jobs and Addiction

Posted on by jabittan
A simple view of addiction is that people become hooked on a powerful chemical and their entire life becomes focused on nothing but the drug. The chemical sinks into the brain of the addicted person, and their desire for the neurological high from the chemical drives them beyond everything else. If only we could stop the person from ever being exposed to the chemical, even once, we would prevent them from ever developing their drug addiction and chemical dependence.

 

This view, however, is incomplete. A lot of what I try to do with this blog is show that the world is more complex than we often realize. It is easy to sit at home, listen to a news story on TV, and call everyone an idiot while offering an obvious solution from the couch. In reality however, our first impressions of the world and its problems are woefully inadequate, and drug addiction is a good example.

 

I recognize that chemical hooks, neurotransmitters, and brain chemistry are major parts of addiction, whether to a chemical substance, to a behavior like gambling, or other forms of addiction, but research that Dave Chase’s book The Opioid Crisis Wake-Up Call presents is a good indication that there is more going on than just a drive to fill the brain with a chemical. Chase writes, “For every one percent rise in unemployment, there’s a four percent rise in addiction and a seven percent increase in emergency department visits.“

 

Our economy, it appears, is deeply connected with addiction. It is not hard to think of a causal model between economic performance and addiction. Having a meaningful job gives people a chance to feel valued, gives people a chance to contribute to society, and gives people an increase in their social status (in political science we might think of Social Construction Theory: working people are Advantaged or at least Dependents whereas the unemployed are simply Deviants).

 

When people lose their job, they feel a loss of social status, they may feel helpless if they cannot find another job of equal status, and they lose their feeling of importance. They become more vulnerable, and it appears are more likely to turn to substances to blunt the pain they feel, either physically, mentally, or emotionally. This sets people up for addiction.

 

In this model, addiction is not just a moral failure. It is a failure at more levels than just the individual and their ability to work and resist chemicals. Our society has isolated people and made it hard to maintain strong family connections. When jobs disappear and people don’t have close people and community connections and organizations to turn to for meaning, purpose, and participation, they will struggle, and in their empty void potentially turn to drug use. Economic data makes this clear, and the solution is not just to provide someone with a bleak call-center job, but to really develop community connections, meaningful work, and opportunities to improve social status while deepening relationships and opportunities to contribute to society. Drug use is not a simple issue, it is tied to larger economic and social forces, and we have to recognize that reality to solve our nation’s problems.
Addiction and Community

A Final Thought on Addiction and Community

Posted on by jabittan
In the afterword of his book Dreamland, author Sam Quinones includes a quote from an obituary written for a 24-year-old man who lived in Avon Lake, a town of about 24,000 people just west of Cleveland. The parents of the young man who died from addiction wrote in their son’s obituary, “They say it takes a community to raise a child. It takes a community to battle addiction.”

 

Everyone, including those of us who are not parents, know that it is true when we say it takes a community to raise a child. Historically, new parents have been in their early to mid twenties (this is changing now – possibly for these communal reasons), and with lower incomes in early stages of their careers and fewer immediate resources, new parents have relied on family members and friends to help with child rearing. As kids get older, they enter public schools, where everyone, parents and non-parents, contribute financially, typically through local property taxes. We know that it is hard to raise a kid on your own, and that it makes a big difference to live near family, to have close friends who are raising kids at the same time, and to have supports from work for the times when our kids are sick and need extra love and attention.

 

The quote from the parents in their son’s obituary, and all of Dreamland demonstrate that the same is true for how we should approach addiction. Asking someone to overcome addiction on their own is like asking a child to raise themselves. It can happen, but it doesn’t often turn out well. People battling addiction need supportive relationships in their lives. The family members and friends of people with addiction need help, because it can be challenging and taxing to help someone else stay sober and find meaning in life beyond addiction. We need communities where we can help each other, watch out for one-another, and provide support in times of need. Many of us have lost this along our way, as our culture has pushed us toward staying inside, watching TV in our own homes, and filling our lives with stuff rather than with the people we love and care about.

 

This is a tough time to find new connections and community as we work to prevent the rapid spread of a new virus, but we should be thinking forward nonetheless to a time where we can better connect with those around us and find new ways to live in community with those who matter. It might just save the life of someone we know whose struggle with addiction has been hidden from us.
More on Isolation and Addiction

More on Isolation and Addiction

Posted on by jabittan
I previously wrote about pain medicine ideas that Sam Quinones presents in his book Dreamland. He is critical of the idea that we can take a pill to alleviate chronic pain without making substantial changes in our lives to address the root cause of our pain. Even if we can’t completely stop chronic pain by changing our habits, our environment, and our lifestyles, Quinones shares information which suggests that our experience of pain is connected to many parts of our lives, and that we can change how we think about and relate to pain, even if we cannot eliminate it completely. This is a holistic approach to pain and pain management that Quinones thinks is a crucial piece for understanding our nation’s current opioid epidemic.

 

Chronic pain and its mismanagement is a common route to opioid addiction. Quinones views opioid addictions similarly to how he views chronic pain. In his book he writes, “Chronic pain was probably best treated not by one pill but holistically. In the same way, the antidote to heroin wasn’t so much Naloxone; it was community.”

 

Naloxone is a drug that helps prevent opioid overdoses by binding to opioid receptors in the body to block the effect of opioids like heroin. This drug has helped save thousands of lives, but on its own it won’t stop addiction. Quinones argues that a big problem with addiction is the way in which we hide it from others, whether it is addiction to drugs, gambling, or something else, we don’t allow anyone to know about our addiction. Without talking about addiction, without acknowledging that it has had impacts on our families and lives, and without having meaningful connections with others, we languish in our isolation and addiction.

 

The argument that Quinones makes in his book is that we need more community. We need more things in our lives where we interact meaningfully with others. We need to find more ways to be in service to other people, to work together for meaningful causes, and to have greater social connections with the people around us. By developing meaningful relationships with others, we provide community for everyone, and that helps push back against the forces that drive toward isolation and drive many of us toward substance addiction. Community provides us the space to discuss our challenges, our addictions, and our discontents, and hopefully gives us the chance to build constructive spaces in which we can connect and find solutions to problems that we cannot find in isolation.
Isolation and Addiction

Isolation and Addiction

Posted on by jabittan
American’s are isolated, and it’s not just because we have all been asked to work from home, stay inside, and intentionally distance ourselves from others to prevent the exponential transmission of COVID-19. We have been isolated for a while, so much so that former Surgeon General of the United States, Vivek Murthy, recently published a book about loneliness and the importance of human connection. Loneliness and isolation are new problems that we are starting to look at in new ways. In his book Dreamland, Sam Quinones connects isolation and addiction in ways that change the discussion we have about addiction and our values as Americans.

 

Quinones is critical of how our society interacts today, or rather how our society doesn’t interact. He writes, “the most selfish drug [opioids] fed on atomized communities. Isolation was now as endemic to wealthy suburbs as to the Rust Belt, and had been building for years. It was true about much of a country where the streets were barren on summer evenings and kids no longer played Kick the Can as parents watched from porches. That dreamland has been lost and replaced, all too often, finally, by empty streets of bigger, nicer houses hiding addiction that each family kept secret.”

 

To atomize means to convert into very fine particles or droplets, and is used by Quinones to show that we have separated our communities into individual, isolated nuclear units. We hide inside our houses, rarely venturing outside to just be outside. We drive to our suburbs, stop at the mailbox from our car, park in our garages, and rarely spend any time outside. If we do get out, we are in our private backyard where we cannot be seen. We have cut out everyone else, leaving us with just ourselves in our ever larger houses filled with ever more things for our individual enjoyment.

 

Quinones argues that this lifestyle has been brought on by our own selfishness. We want our own stuff, we want to show it off, and it holds more value today than it did in the past. Consequently, we are also more jealous of those who have more than us, and more guarded of our things. We lock out other to protect our stuff, but in the process we locked out a crucial part of our humanity: our connections and community.

 

Community shows us that there is more to life than just our desires. Isolation and addiction are linked because when we withdraw from community, when we focus only inward on what we want, our purpose of helping others and interacting with others disappears. Quinones believes that a lack of interaction with others fueled the opioid crisis. We hid addiction in our homes, withdrew from community, and and took away the joys and connections that made us human. We left ourselves vulnerable to pain killing addictions, and took away the best tools to cure the epidemic we now face.