Newsflash! Despite Our Drug-Related Problems, Non-Problematic Drug Use Is the Norm

eureka
Feb 22 2016

Newsflash! Despite Our Drug-Related Problems, Non-Problematic Drug Use Is the Norm

Have you noticed a theme among a number of early articles on The Influence?

They point out a phenomenon that will be alien to many: Illicit drug use is always popularly reported in the most lurid terms, with drug users portrayed as self-destructive, violent addicts—but this does not present a fair overall picture.

Johann Hari’s piece noted how the government’s most famous anti-drug crusader, Harry Anslinger, hoked-up evidence that an axe murderer was high on marijuana, while ignoring harmless use of pot, in order to have weed legally banned.

Meanwhile, Carl Hart discovered in his own research (and experience) that Adderall, comprised of d-amphetamine and amphetamine, was virtually the same drug as methamphetamine, and even experienced users couldn’t distinguish the two. Yet kids are given Adderall for ADHD!

In one study of experimental amphetamine use at a college campus, Chris Johanson* found that subjects reported (like Carl Hart) finding the effects of d-amphetamine to be highly mood-enhancing. Yet, on successive sessions in which subjects were given the drug, although they continued to find the d-amphetamine pleasurable, these students and college employees became less and less willing to take the drug again and to savor its positive effects.

Why would you guess that was?  The simple explanation is a key to understanding the causes, prevention and treatment of addiction, on the one hand, and the myopic nature of our zero-tolerance, drug-focused policies on the other. The obvious explanation is that purposeful people concerned about functioning successfully at the university assigned the powerful drug a secondary place in their hierarchy of values and life choices.

Surely, this possibility of ordinary use can’t apply to heroin? In fact, as my article showed, our current heroin and painkiller epidemics greatly overlap. People who are addicted to painkillers are 40 times more likely to be addicted to heroin. And, remember, the narcotics addict that Chris Christie described on the political stump to such acclaim never took heroin—the drug responsible for his addiction and death was Percocet, a standard painkiller many of us have taken.

So opioid painkillers are addictive in the same way as heroin. Yet, many ordinary people take them without problems. Consider the great Super Bowl ad mystery—you know, the one depicting opioid constipation. Who knew so many regular Americans have this problem?

An estimated eight million Americans are constipated due to prescribed narcotic painkillers. Compared with this huge number, relatively few become addicted.

Consider that whereas fewer than two out of a thousand Americans over age 26 use heroin, more than 20 times that rate, 5% of middle age Americans, are using prescription painkillers. At some point in our lives, most of us will use such a painkiller. What keeps most of us from becoming addicted to “addictive” drugs?

None of us seeks to deny the real harms that are associated with drugs and addiction. But any realistic, proportional assessment of these subjects must acknowledge that most use is not problematic—as demonstrated, for example, by figures from the UN Office on Drugs and Crime, and many other sources.

So why do you think we are bombarded with negative stories about illicit “addictive” drug use, while we are protected from learning that most such drug use (Carl Hart estimates 80-90%) is normal and non-problematic? And how does this bias affect how we think about and deal with drugs?

These are critical questions—and ones that future articles on The Influence will address.

* Johanson, C.E., and Uhlenhuth, E.H. 1981. Drug preference and mood in humans: Repeated assessment of d-amphetamine.Pharmacology Biochemistry and Behavior 14:159-163.


Stanton Peele is a columnist for The Influence. He has been at the cutting-edge of addiction theory and practice since writing, with Archie Brodsky, Love and Addiction in 1975. He has since written numerous other books and developed the online Life Process Program. His latest book, with Ilse Thompson, is Recover!: An Empowering Program to Help You Stop Thinking Like an Addict and Reclaim Your Life. His website is Peele.net. Dr. Peele has won career achievement awards from the Rutgers Center of Alcohol Studies and the Drug Policy Alliance. You can follow him on Twitter: @speele5

  • The impulse to take decisive action with regards to drug use among our children is understandable. Not having an informed and reasoned game plan can most certainly lead to harsh knee-jerk reactions that often backfire and worsen the problem. As you point out though, the good news for parents everywhere is that the vast majority of young people who try alcohol and other drugs continue to do well in life without further incident. My question for you is, that yes, while most young people do not develop problematic relationships with substances, some do — how do we help them, their parents and educators to better know what they can do if youthful experimentation goes awry? Thanks in advance!
    Jerry Otero – Youth Policy Manager, Drug Policy Alliance

    • Joe Minella

      As a grandparent, I think there is no substitute for parental involvement in a child’s life. In fact, a lack of involvement may be a contributing factor to the problem in the first place. By the time the problem becomes apparent, it is very difficult for the child to accept the parental “input”. My grown son has had a long-time love affair with alcohol. Serious drinker, multiple treatment attempts, hated AA and meetings, desperate search for alternatives etc. The he got a serious medical wake-up call. Cue attitude adjustment. So, a couple of weeks ago, he decided to visit his brother out-of-state. Well, so far, he’s clean and happy. He’s got a p.t. job, looking for a second, and seems to be doing well! Maybe it won’t last, but I haven’t been this optimistic for him in a long time. The medical shock was the effective thing, but the “geographical” helped. He was not in a supportive environment. He is now.

  • Andrew_C_Bairnsfather

    “So why do you think we are bombarded with negative stories about illicit ‘addictive’ drug use, while we are protected from learning that most such drug use is normal and non-problematic? And how does this bias affect how we think about and deal with drugs?”

    One reason which doesn’t get much attention, I think, was made more apparent to me while I watched a recent PBS FRONTLINE investigation into supplements. Someone was shocked there had been no clinical trials on supplements. However, giving it a little thought takes away the shock; think about what one finds in health food stores, lots of herbal remedies which are not exactly new. The 5,000 year old iceman dug up in the Alps was carrying a fungus with antibacterial properties. What company is going to spend millions, hundreds of millions, perhaps around a billion dollars to definitively prove that chamomile does ___, etc… ? Or that specific sea shells are a great source of calcium carbonate? No company seeking a profit is going to try to prove a plant can have beneficial health effects. a plant which anyone who wants to, can grow and benefit from—including their competition which didn’t just blow big bucks—unless the company somehow has a monopoly interest (genetically modified & patented). Rick Doblin touches on this when discussing MDMA.

    Scanning the Boston Globe for a few years and it’s obvious how ga ga they are for biotech firms, drug labs, and patented drugs.

    NBC news also embodies this. During the few minutes they are on, it’s all horror stories about illicit drugs, but during the remaining time of the show we see advertisement after advertisement for pharmaceutical drugs.

  • Dougie

    Interesting take as always. It occurred to me reading this that there is also another consideration. The US DOJ conducted research into Drinking In America, in 2002, they found that about 75% of alcohol sold in the US was consumed by less than 30% of drinkers. The same results were included in a piece in the NYT last year but I’ve misplaced the reference. Meanwhile recent Australian studies have shown a very similar situation, as have studies in the UK. The idea continues that maybe Big Alcohol is aware of this from their own research. The advertising billions are therefore “invested” to assure a relatively small drinking (excessively) population that their behaviour is normal, when according to the latest UK Govt advice there is no “safe” amount of alcohol consumption. The other legal over the counter drug, nicotine, is making a comeback in a new delivery system, vapour. As yet it is probably too early to tell whether this is safer. The number of people damaged by conventional tobacco products are the “heavy” users.
    So, the question is, if the patterns of alcohol and nicotine are researched in the (currently) illicit drug users will similar patterns emerge?
    Personally, right now, as no prohibitionist – I lean toward decriminalisation of illicit drugs, however, the only way that is likely to happen is if big companies take over a legalised “business”, and if that happens will 75% of say, all heroin, be consumed by less than 30% of users?
    What might that look like?

    • Andrew_C_Bairnsfather

      Hi Dougie, It’s already that way; it’s my belief this is a fairly universal pattern; with adjustments in percentages depending on the activity or product.

      This is why I am a “legalizer” vs. a decrim guy; I’m convinced the biggest (and vast majority of) problems come from forcing drugs into the underground market and stigma campaigns.

      Check out this audit done by the Swedes many years ago regarding amphetamines.
      http://druglibrary.org/schaffer/Library/studies/cu/CU39.html

      Yes there are some categories/percentages of people who become super-consumers of massive quantities relative to other people, and yes the quantity consumed doesn’t perfectly equate to problematic use.

      However, I disagree with the logic that somehow advertising keeps the super-consumers consuming.

      And based on my recollection of campaigns to address alcohol in particular, all of them have promoted absolute abstinence, none of them have steered the reader towards what Dr. Peele and others have shown to be what most people do anyway! Namely self-chosen and self-guided moderation. Talk about irresponsible behavior from those who are supposedly trying to promote responsibility!

      Take a look at this graph which P. Armentano of NORML linked to.
      http://archpsyc.jamanetwork.com/article.aspx?articleid=2491353

      Peace.

      • Dougie

        Thanks for that, I’m taking a look at your links. The idea around the advertising though, I’m not sure it is logical to be honest, but, it is an avenue of investigation that I’m going to follow for a while, purely from interest. As a lifelong smoker I know all about irresponsibility, but I’m also aware that advertising had a big effect on normalising use for me, it’s absence makes it clear it’s not, normal that is!
        I may have mentioned Australia before where apparently 1 in 5 drinkers are so irresponsible they consume more than 75% of all alcohol sold, something must make them believe they are ok.
        Likewise, peace, and if you care to you can see other of my (misguided) thoughts on recovery from addiction at http://www.onlinerecoveryacademy.com

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  • African RockFish

    Wonderful take. The war on drugs convinced me to retire from practicing medicine. I don’t need the government headaches from doing one of the most important parts of my job: treating pain.

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