Everything You Think You Know About Addiction and the War on Drugs Is Wrong
What if everything about the way we thought about drug addiction was backwards? What if the war on drugs was the purest distillation of this backward thinking?
Those are the questions that animate Chasing the Scream: The First and Last Days of the War on Drugs, a new book by journalist Johann Hari that's brimming with shocking findings about the origins and misadventures of America's century-long war on drugs.
Hari, whose own family members dealt with serious drug addiction during his youth, recently embarked on a three-year journey through nine countries to establish why drug addiction is so misunderstood throughout the world — and what can be done to correct that misunderstanding.
He recently wrote about the ideas in his book for the Huffington Post in a widely read piece titled "The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think." Hari discussed how he thinks that the roots of addiction aren't moral failure or physiological compulsion, but rather an existential thirst for connection.
Mic sat down with Hari to hear more about the implications of his findings.
Mic: Tell us about your research on the likely causes of drug addiction and why popular attitudes toward it are misguided.
Johann Hari: If you asked me four years ago, "What causes heroin addiction?" I would have looked at you as if you were simple-minded. I would have said, "Well, heroin causes heroin addiction." It's obvious. We've been told this story about addiction for a century now that's so deeply ingrained in our consciousness it seems like common sense.
We think that if you and me and the next 20 people to walk past this cafe all used heroin together, on day 21 we'd all be heroin addicts, because there are chemical hooks in heroin and our body would physically need those chemical hooks by the end of it, and that's what addiction is. It turns out that's not really the case.
A doctor in Vancouver explained it to me like this: If you and I step out into the street and you get hit by a car and break your hip, when you're taken to a hospital, it's very likely you'll be given a lot of diamorphine. Diamorphine is heroin. It's much better heroin than you'll ever score on the streets — it's medically pure. They've been giving it for quite a long period of time; it's happening in every hospital all over America.
If what we believe about addiction is right, what should happen? Those people should leave the hospital as addicts, right? That virtually never happens. That alerted me to the fact that something is not right about the story we've been told, but I couldn't quite figure it out — until I met an incredible professor named Bruce Alexander. He explained to me that our idea of addiction comes from a series of experiments conducted early in the 20th century.
"It's not your morality. It's not your brain. It's your cage. Addiction is an adaptation to your environment. "
They were really simple experiments. A rat would be placed in a cage and given two water bottles: one containing only water and one containing water that was laced with heroin or cocaine. The rat almost always preferred the drug water and almost always killed itself within a few hours. So there you go — that's our theory of addiction.
Bruce came along in the 1970s and said, Hang on a minute, we're putting the rat in an empty cage. He's got nothing to do, except use the drug water. Let's do this differently.
So Bruce built Rat Park. Rat Park was heaven for rats. Anything a rat could want, it got in Rat Park. It had lovely food, colored walls, tunnels to scamper down, other rats to have sex with. And they had access to both water bottles — the drug water and the normal water.
What's fascinating is that in Rat Park, they didn't like the drug water. They hardly ever used it. They only used it in low doses, none of them ever overdose and none used it in a way that looked compulsive or addictive.
What Bruce says is that this shows us that both the right-wing and left-wing theories of addiction are wrong. The right-wing theory of addiction is that it's a moral failing and hedonist. The left-wing theory is that you get taken over, your brain is hijacked. Bruce says, It's not your morality, it's not your brain — it's your cage. Addiction is an adaptation to your environment. Human beings need to connect, and when we can't connect with each other, because we're traumatized or beaten down or cut off, we will connect with something that will give us some sense of relief or pleasure. If you can't bond with people, you will obsessively bond with something that gives you some sense of purpose.
Mic: What are the implications of the Rat Park experiment for addiction and the war on drugs?
JH: The war on drugs is built on the idea that the chemicals are the problem. Once you realize that disconnection and isolation are the drivers of addiction, you suddenly realize that what we do actually makes addiction worse. We take addicts who are addicted because they're isolated and suffering, isolate them in prison cells and make it impossible for them to get jobs when they leave, and inflict more pain and suffering on them. As the doctor from Vancouver said to me, if you wanted to create a system that would make addiction worse, you would create the system that we have.
I went in Arizona to a prison called Tent City, where I went out with women who were forced to go out on a chain gang wearing t-shirts saying "I was a drug addict." When I went to the isolation unit where they're kept, they're literally put in a cell that that makes you think, "This the closest you could get to a human reenactment of the rat cage that guaranteed addiction — the one in the first set of experiments."
Mic: Many Americans think of the war on drugs as something that began under the Nixon administration and escalated under Reagan, whose presidency marked the beginning of a massive expansion of the prison population. But your book describes how that war began far earlier.
JH: Two global wars begin in 1914. One lasted four years, and one is still going. The one that's still going is obviously the drug war. Drugs were banned in the U.S. in 1914, which means they were transferred from being controlled by doctors and pharmacists, which worked pretty well, to being controlled by armed criminal gangs, a model that isn't working out so well.
"There was a belief that African-Americans and Chinese-Americans were taking drugs, forgetting their place and attacking white people."
If you ask, "Why were drugs banned?" I would guess that most people would say that they were banned for the same reasons we give them for banning them now. We don't want people to become addicted, we don't want kids to use them. That kind of thing.
But those barely come up if you study the time period. Drugs were banned in the United States in the middle of a race panic. There was a belief — which was obviously wrong — that African-Americans and Chinese-Americans were taking drugs, forgetting their place and attacking white people.
The way I tell this in the book primarily is through the story of Billie Holiday, and how she was stalked and killed by the man who launched the war on drugs. In 1939, not that far from where we are right now, Billie Holiday climbed onstage and sang the song "Strange Fruit," a song against lynching. It was incredibly shocking at the time.
That night, she was told by the Federal Bureau of Narcotics to stop singing that song. The bureau was run by a crazed racist named Harry Anslinger, a man who was regarded as a crazed racist even by other crazed racists of the 1930s. He used the N-word so often that his own senator said in an official memo that he should have to resign.
Holiday grew up in segregated Baltimore, and she promised herself that she would never bow her head to any white man. She effectively said, Screw you, I'm going to carry on singing my song. And that's when Anslinger decides to have agents stalk her. He has her sent in prison in 1947, and when she gets out, he makes it almost impossible for her to sing anywhere, because she needs a license to perform anywhere alcohol was served, and that was denied to her.
When she collapsed with liver cancer in her early 40s in 1959 and was taken to the hospital, the agents handcuffed her to the bed. They didn't let people see her, they took away her flowers and candies and she went into withdrawal. One of her friends insisted she be given methadone, and she started to recover. But 10 days later, they cut off her methadone and she died. One of her friends told the BBC that she looked like she'd been violently wrenched from life.
Mic: For many, the notion of drug abuse as a moral deficiency that must be fought in absolutist terms is quintessentially American. But in fact, before drugs were banned in 1914, and even in the immediate aftermath of the ban, Americans had a far more measured response to addiction.
JH: Drugs were not banned without a massive fight, and without huge numbers of people pointing out accurately what the drug war would mean for people. The ban was fiercely resisted by some of the most popular and prestigious people in the United States.
Until 1914, drugs were legal everywhere in the world. You could go to your local store and buy opiates, mostly in liquid form, and cocaine-based products. Coca-Cola really did contain the same extracts as cocaine, albeit a small amount. The vast majority of addicts prior to criminalization were somewhat depleted but they had jobs, they had lives and they were no more likely to be poor than other Americans.
There was a deliberately written loophole in the law banning drugs in 1914, very deliberately written, which said this basically doesn't apply to addicts. Addicts should be able to get their drugs from their doctors. A number of doctors used this loophole to continue giving heroin to addicts after the ban, because they thought it was better that they get the drug from them than from criminal gangs who mark up the prices enormously and sell unregulated product.
But under Anslinger, the Federal Bureau of Narcotics led a massive round-up of doctors across the U.S., arresting something like 17,000 in a huge sweep. Doctors really resisted this, as did some politicians. The mayor of Los Angeles came out saying, in effect, You will not shut down this clinic. It's good for L.A.
Mic: If the war on drugs is futile, what are the alternatives?
JH: It's important to understand this is not an abstract or a theoretical question. There are societies that have moved beyond the war on drugs.
In the year 2000, Portugal had one of the worst drug populations in Europe. One percent of the population was addicted to heroin, which is mind-blowing. Every year they tried the American way, and every year the problem got worse. One day the prime minister and the leader of the opposition got together and realized they couldn't go on like this. So they set up a scientific panel of doctors, scientists and judges, and they agreed in advance that they would try whatever that panel recommended they would do, and just took it out of politics.
The panel said: Decriminalize everything, from cannabis to crack. Take all the money we currently spend on arresting, trying and imprisoning drug addicts and spend it on really good drug treatment. It's not drug treatment the way we normally think of it — some of it is, but not most of it. It's drug treatment that learns the lesson of Rat Park. Portugal's system is predominantly about reconnecting addicts to society.
Portuguese decriminalization was an effort to make sure that every addict in Portugal had a reason to wake up in the morning. The biggest part of the program included subsidized jobs or micro-loans for addicts. Say you used to be a mechanic, and became a smack addict. The government, when you're ready, will go to a garage and say, If you employ this guy for a year, we'll pay half his wages. They made it really easy to give addicts jobs — the exact opposite of what we do, which is make it extremely hard for addicts to get jobs.
It's been nearly 15 years in Portugal, and the results are in. Injecting drug use is down by 50%. Every study shows broader addiction is down. Overdoses are massively down. HIV transmission is massively down. And one of the ways you know it's been successful is that almost nobody wants to go back.
This interview has been condensed and edited for clarity. You can learn more about Johann Hari's book Chasing the Scream here.