The facts that heroin was illegal and strongly socially discouraged were pretty big factors. I don't think going "Most people stop doing heroin when the government puts lots of pressure to stop doing heroin, therefore the government can safely decriminalize heroin" makes sense.
There will still be strong social pressure against heroin use either way. The question (assuming you don't care about freedom per se) is whether legal prohibition does more good than harm. Clearly it helps some stay away from heroin. Also clearly it creates black markets, criminal gangs, drive-by shootings, adulterated drugs that kill, lives of users destroyed by incarceration, prison expenses, etc.
Just because we pass a law prohibiting something doesn't mean it goes away. It reduces it, but there are costs and consequences involved.
I agree that is the question. I don't think social pressure alone will be enough to keep heroin use at the optimal rate, which is pretty low imo. I think the costs of millions of people going on heroin, especially if it's totally legalized and pharma companies can really optimize for addictiveness beyond what gangs can do, will outweigh the current costs you listed.
Prior to 1924 heroin was completely legal in the US. It was sold in pharmacies without a prescription. When I think of the 19th century US, I don't think of a plague of millions of heroin addicts. Because there wasn't one.
We've made things worse instead of better. Heroin addiction is bad, but the "treatment" is worse.
Interesting study! I was unfamiliar with it. Could be though when they returned the price and search costs were higher. Doesn’t refute your point that use of drugs is a conscious choice, but just pointing out it also follows a downward sloping demand curve. See my papers with keith Finlay on methamphetamine which we found has an elasticity of -0.2 to -0.3 using two supply side shocks to the Input markets which caused huge increases in retail prices of meth. One was in economic inquiry and the other in health economics.
Not antibiotics. That is dangerous. Many drugs need to be regulated. We can probable legalize drugs such as heroin and cocaine, but many drugs are too dangerous to let wild.
Freedom, if it means anything, means the right to make choices society disapproves of and thinks unwise, provided those choices don't violate others' rights.
That is a load of BS. When I graduated from high school in 1996, surveys said that over 60% of high school students had used mamajuana in the pervious month. How do you double 60% Are you claiming 100% of Americans use marijuana? That is foolish. Here in Chicago, everyone I know that uses weed buys it on the street because the legalized shops charge and arm and a leg. Furthermore, who cares if they do? The country would probably be better off if more alcohol heavy users switched to weed. It would lead to lower medical bills.
I personally do not use marijuana, but those who demonize it are all so out of touch as to be comical. Keep in mind, anyone who wants opiates can easily find them. People who think the war on drugs is good are usually those who do not understand that world. I went to a high school loaded with hard drugs. I have classmates who swear there were no drugs there (despite students dying from heroin overdoses). The same issue happens with crime. There was a mall out there (called Woodfield Mall) where rapes were endemic. The town was called Schaumburg. To this day people claim that town is "safe." The rape rate there is like 100 times worse than Chicago, but Chicago is "dangerous." In reality, Chicago is dangerous for gangsters and safe for girls and young women. Schaumburg is the exact opposite, and I bet the average resident cannot be convinced otherwise.
The drug issue has no good solutions in a free society. The current cost of the drug war are unsustainable. We should try to find a good enough solution before we are forced to do otherwise. I would say the same for Federal public spending, but I know that will only come from a crisis. As a country, we need to start making intelligent policy decisions instead of waiting for busy bodies to over-react when properly manipulated by journalists an Hollywood.
To be fair to Critic (it's difficult given his uncharitable attitude and ignorance), maybe he meant that the number of marijuana users has doubled since CO legalized it (much more recently than 1996) - not the percentage. That's at least mathematically possible (if unlikely).
"The same issue happens with crime. There was a mall out there (called Woodfield Mall) where rapes were endemic. The town was called Schaumburg. To this day people claim that town is "safe.""
The lower link is broken. I do not see any crime stats for 1996. As far as rape stats go, Virgina's own stats back me up. You need to mix with population figures, but non-acquaintance rapes are overwhelmingly committed against girls (not women) in suburban and rural communities.
This has the summary of the data I used when doing my graduate school analysis at Georgetown (https://vsp.virginia.gov/wp-content/uploads/2021/08/Crime_in_Virginia_2000.pdf) but I cannot easily find that raw data (what I used). Unless one calls suburbs "urban," non-acquaintance rape is almost always targeting under-18 girls.
So what? (And how do you know - people routinely lie about the illegal things they do.) Marijuana use is harmless. I am quite sure marijuana-related crime has dropped to approximately zero.
Yes, moving opiate users from black-market drugs with all their adulteration and unpredictable potency (which are what kills) would be an improvement, even if it mean more users.
Moreover, isn't *freedom* worth anything at all to you?
Freedom in the Libertarian sense is why this country exists. We did not rebel against the British Empire for a good time. We did not fight the Civil War to create tourism in underdeveloped parts of the South. We fought for the Libertarian sense of freedom. We allowed those freedoms to be taken from us little by little over the last 100 years, and it was a mistake. All of our problems today come back to that gradual yet persistent erosion of American freedom.
Ah yes, because 100 years ago legal tolerance of sodomy was much more pervasive, there were no blasphemy or obscenity restrictions, mandated prayer in school, etc. Stop pretending that the Founders would have cheered on Pride parades and drug use.
Creating MORE freedom is good. Expanding freedom was the point. Yes, slavery and the SOCIAL repression of homosexuality were wrong. We are growing in freedom when we get more of it. That is good. The problem has never been expanding freedom to more people. The problem is taking it away.
So something like "intelligence" is largely at the whims of inheritance and genetics, but something like addiction or "other mental illnesses" are personal choice?
What the RHHW study didn't touch on is the boredom and and extra time available to drug users, particularly rear echelon troops. Both rear echelon and infantry were bored and all types were in a stand down mode by 1971 and looking to go home. This situation created a need for relief, hence the escape into drugs - Idle hands are the Evil's workshop. Those in the Rear had more time on their hands and the ability to safely get high. All drug users in Vietnam were doing so because of boredom and and as an escape from the normal daily harassment done by cadre over inconsequential and petty details. In the Rear Echelon, e.g. Long Binh Junction, there were two basic types that made morning formation., the "juicers" and the "heads". The former drank alcohol and the latter did drugs. The combat arms units, restricted to base camps, had similar experiences. Once a G.I. knew he was going home, he straightened-up and saw life as a starting over, hence dropping drugs by going cold turkey. Time to put all that behind once he got back to the "World", i.e. U.S.A.
1) Addiction is a brain disease that gets worse over time. Your brain is literally rewired with the shortcut that the way to protect yourself from overwhelming emotional pain is to depend on the dopamine dump that comes from your addiction. This long-term physical brain change addiction is different than the chemical dependency addiction in that it impacts the way your brain makes decisions, not how your endocrine system functions without the drug. But, it is a very real physical addiction.
2) Every person's brain biology is different, and some are more prone to brain addiction than others. The dopamine dump from your drug of choice could be much, much higher or much lower than average, and your brains response to the amount of neuroplasticity in response to the dopamine dump will vary from person to person. Some people become brain addicted much faster than others. But, for everyone, it does take some time.
3) The amount of decision making that take place in our subconscious has been underestimated for a very long time. Current research on the use of "stored procedures" in our brain that make the majority of our decisions is just now learning how important it is. It takes a lot of effort for our brain to decide to buck the habits. For some it can be unmanageable without outside help.
4) The universe of people here likely are different from your average Appalachia user in that: a) they likely had a fairly short time window to become brain addicted; b) the environment of their US life was significantly different than the environment of their deployed life, which likely made changing habits easier once returning from deployment; and c) US soldiers are likely more disciplined in just about everything than your average person.
I disagree with your premise that it is reasonable to expect all opioid addicts to be able to recover without outside help. Huberman Labs has a lot of great information about neuroplasticity and addiction. Jordon Peterson does too, from a phycological perspective. His interview with Dr. David Eagleman on the topic is interesting.
Trying to understand the behavior of individuals that are caught in these types of addictions without really digging into the brain biology will not get a person very far.
The best advice is probably not to play around with these powerful drugs at all due to the risks. Everyone that has a major addiction had a choice at some point to abuse for a significant length of time. It's just that, many people that abuse for extended time periods can avoid the brain addiction that plagues others with the exact same behavior. But, I believe that the idea that anyone can recover from an addiction brain addiction without outside help is not supported by the data, our understanding of brain biology, and the personal experience of anyone who has experienced that hell and come back from it.
Most misconceptions on substack (and everywhere else) come from the utter lack of math knowledge in most Americans. I used a lot of probability and statistics early in my career, and I never cease to be amazed at how bad our people are at math. I have had bosses who disputed calculus and others who thought financial discounting was "my opinion." I worked with CFO's were used a normal distribution to model a discrete variable. I have no idea how we can force students to waste time on so many irrelevant items, yet allow people to graduate from university completely ignorant of probability and statistics. The advice I give to every young person I ever meet is for them to study probability and statistics. It is like a secret intellectual power that allows one to function on a higher level. Calculus does the same when learning new subjects.
I agree but expecting people to learn math is expecting too much - few people have the basic intellectual ability. The larger problem I think is that people believe what they want to believe and aren't very interested in the truth.
This seems like a gross oversimplification of “addiction”.
Yes, part of it is chemical dependence. But the “reasons” why someone started their use is myriad and complex. I don’t think “choice” alone comes close to capturing that complexity.
From this study, I would instead ask “why did that 10% remain addicted?” Perhaps they were the ones who suffered PTSD from their tour of duty?
It’s easy for someone (who grew up in a stable home yada yada) to say “just say no”. But I think it’s idiotic to suggest that a “drug addict” “chooses” to be so, once you see what crap quality of life that “choice” entails. I would not to so quick to judge unless I’ve walked a mile in those shoes.
In experimental psychology, the heroin story led to studies in behavioral pharmacology showing that drug addiction was a form of Pavlovian (i.e., classical) conditioning. A drug is an unconditional stimulus that causes a bodily response, a UR (in Pavlov, food causes and unconditional response of salivation). The US is paired with a neutral stimulus, a CS (in Pavlov, a tone). The CS predicts delivery of the US, and the animal learns a CR to prepare for its arrival (in Pavlov, it salivates preparing to eat). In drug conditioning the drug is a US (e.g., heroin) causing a UR (the high). The US is usually delivered under similar conditions every time, collectively forming a CS that predicts delivery of the US. The person acquires an adaptive CR, preparing for arrival of the US. In this case, the high is abnormal and dangerous (highs can kill), and the body's CR is to throw itself into the opposite of a high, so when the UR arrives, normality is restored. If the drug is not forthcoming, cravings occur. Vets didn't experience cravings or addiction because they were no longer in the drug environment and so the URs did not occur. This pattern has been extensively demonstrated both in the lab and in real-life cases of deaths by drugs, caused when the US drug is delivered under novel circumstances not associated with drug delivery. The leading researcher is Stuart Siegel; a general discussion by him is: The heroin overdose mystery. Current Directions in Psychological Science, 25, 375-9; https://doi-org.proxy.library.vcu.edu/10.1177/0963721416664404 .
It's possible to use these findings to treat addiction, but it runs into a intuitive conclusion that follows from the idea that drug use is a choice. The therapy involves addicts coming in on a schedule and being tested for drug use. If no markers are found, the addict is paid. People resist this, thinking that people are being paid for voluntary behavior they should be doing anyway.The therapy works and has recently been approved in CA.
I put it in the larger context of learning research in Fundamentals of Cognitive Science.
So by your logic there are no gambling addicts? For people who do not become addicted to drugs, alcohol, gambling,..., there are no problems. For those who do, it is often a life-long struggle. It is common for those who experience one addiction to later in life have another. Of course they are responsible for their choices, but once they are addicted, the outcomes are no so easy to undo.
From your post, I assume you have little experience of how addiction changes people. It is a real problem, even if most people do not experience it. We should treat it using evidence-based medicine. The moral crusade BS is what got us to this state where tens of thousands of people die every year and a huge percentage of able-bodied men are neither working or in school. The over-flowing prisons are another unwelcome requirement of the War on Drugs.
We need to treat addiction as a disease, because it is. Calling it some lack of character is just like calling mental illness a problem of character. You may FEEL that way, but your feelings should not be the basis of public policy (if only our president could learn this). We should treat addiction in the ways that work. Right now we have decades of evidence that shows that "Drug Rehabilitation" businesses are uniquely ineffective. The best results appear to come from opioid maintenance (methadone, buprenorphine), but only for those addicted to opiates such as heroin.
Most hard drug users will never become addicted. Their experiences are not an issue. It is only once one becomes addicted that more formal interventions are necessary. I also want to note that the stereotype of the criminally-inclined minority male as the typical addict is not even close to reality. Methadone clinics are full of working people who became addicted, and found no other way to function. Buprenorphine users have included investment bankers, physicians, tenured professors, and many other professionals who picked up a habit through bad choices, then could not break free of the hold addiction had, according to a friend of mine who is a doctor on these issues (I cannot share his name because I did not ask him, but he is deeply involved in this world).
The idea of harm-reduction (legalization) basically comes from the fact that drugs are widely available everywhere in the lower 48 states. No one avoids drug addiction for lack of access to drugs. Legalization will not cure addiction, but it will keep people out of prison, making it easier for them to find work, and it will prevent most of the deaths for accidental overdose. It would also remove the primary funds of organized criminal groups.
The best solution is to prevent young people from trying drugs in the first place, which is the exact opposite of what our culture does. We romanticize drugs addiction. Outside of government control of movies, music and television, I do not see how we can remedy that. I would also make sure that people understand that drug legalization and local authorities not prosecuting quality of life crimes is not the same thing. We can legalize drugs AND prosecute criminals for shoplifting, trespassing, panhandling, public urination, sexual harassment, indecent exposure,..., and any other crime that makes life so unbearable in places like California and Portland. Too many people confuse a permissive attitude towards crime and drug legalization, when they are tow distinct policies. Not prosecuting shoplifting, vandalism and trespassing, then complaining about "disinvestment" is for political scam artists like Al Sharpton, who were big proponents of the drug war, so long as they were getting paid. Idiot progressives are bizarrely enslaved to such hustlers.
"The vast majority of U.S. soldiers who were using heroin during the Vietnam War quit cold turkey as soon as they came home. Upshot: Addiction — even to heroin — is a choice."
My takeaway from the study was that the Vietnam War was a highly stressful environment, as war zones sometimes tend to be, and once the stressor (being in a warzone) was gone, the need for an escape diminished along with the stress.
German soldiers during WWII were legendary for their use of amphetamines, but we don't see hordes of methheads descending upon the 1946 German countryside like a swarm of locusts.
Japan's war on methamphetamines is an interesting subject, if you ever care to research it. They also used a considerable amount of drugs during the war, but they did have problems with addiction. To this day it is illegal to bring cold medicine into the country (it can be processed into amphetamine). They had a social campaign and mass crackdown, and it mostly worked. Homogenous societies have many advantages.
The fact that most soldiers quit after returning doesn’t contradict the compulsive nature of addiction—only highlights how deeply the context shapes compulsion
I strongly agree. I can definitely see how a returning soldier could more easily overcome a heroin addiction than they might have believed because the habit is harder to justify in the radically different civilian context, particularly given the extreme physical costs. Someone who got addicted in an American urban context, though, will still feel the urge to medicate as long as they remain in that context even if they fully understand the negatives of long-term use.
I do however find it a bit of leap where you say addiction is a choice, when the study says that there are a set of pre-existing conditions that predispose a subset of people to re-addiction.
One imagines that the experimentation with heroin in Vietnam is in part due to the horrific conditions these men faced as late teens (imagine our college-aged kids were subjected to the same conditions).
I think Robert Sapolsky would have something to say about just how much choice these men had in their initial heroin use and subsequent re-addiction or lack thereof.
>but that most veterans no longer wanted to use.
The facts that heroin was illegal and strongly socially discouraged were pretty big factors. I don't think going "Most people stop doing heroin when the government puts lots of pressure to stop doing heroin, therefore the government can safely decriminalize heroin" makes sense.
There will still be strong social pressure against heroin use either way. The question (assuming you don't care about freedom per se) is whether legal prohibition does more good than harm. Clearly it helps some stay away from heroin. Also clearly it creates black markets, criminal gangs, drive-by shootings, adulterated drugs that kill, lives of users destroyed by incarceration, prison expenses, etc.
Just because we pass a law prohibiting something doesn't mean it goes away. It reduces it, but there are costs and consequences involved.
I agree that is the question. I don't think social pressure alone will be enough to keep heroin use at the optimal rate, which is pretty low imo. I think the costs of millions of people going on heroin, especially if it's totally legalized and pharma companies can really optimize for addictiveness beyond what gangs can do, will outweigh the current costs you listed.
Prior to 1924 heroin was completely legal in the US. It was sold in pharmacies without a prescription. When I think of the 19th century US, I don't think of a plague of millions of heroin addicts. Because there wasn't one.
We've made things worse instead of better. Heroin addiction is bad, but the "treatment" is worse.
The treatment in Singapore doesn't have any side effects. Crushing black markets and gangs is a solved problem, just need the will.
There was a group of people that were constantly high on heroin and other amphetamines back in the 20s and 30s...the Nazies.
Interesting study! I was unfamiliar with it. Could be though when they returned the price and search costs were higher. Doesn’t refute your point that use of drugs is a conscious choice, but just pointing out it also follows a downward sloping demand curve. See my papers with keith Finlay on methamphetamine which we found has an elasticity of -0.2 to -0.3 using two supply side shocks to the Input markets which caused huge increases in retail prices of meth. One was in economic inquiry and the other in health economics.
Good points.
The Drug War must be ended now. Totally. ALL drugs.
Not antibiotics. That is dangerous. Many drugs need to be regulated. We can probable legalize drugs such as heroin and cocaine, but many drugs are too dangerous to let wild.
Freedom, if it means anything, means the right to make choices society disapproves of and thinks unwise, provided those choices don't violate others' rights.
If it doesn't mean that, whatever does it mean?
That is a load of BS. When I graduated from high school in 1996, surveys said that over 60% of high school students had used mamajuana in the pervious month. How do you double 60% Are you claiming 100% of Americans use marijuana? That is foolish. Here in Chicago, everyone I know that uses weed buys it on the street because the legalized shops charge and arm and a leg. Furthermore, who cares if they do? The country would probably be better off if more alcohol heavy users switched to weed. It would lead to lower medical bills.
I personally do not use marijuana, but those who demonize it are all so out of touch as to be comical. Keep in mind, anyone who wants opiates can easily find them. People who think the war on drugs is good are usually those who do not understand that world. I went to a high school loaded with hard drugs. I have classmates who swear there were no drugs there (despite students dying from heroin overdoses). The same issue happens with crime. There was a mall out there (called Woodfield Mall) where rapes were endemic. The town was called Schaumburg. To this day people claim that town is "safe." The rape rate there is like 100 times worse than Chicago, but Chicago is "dangerous." In reality, Chicago is dangerous for gangsters and safe for girls and young women. Schaumburg is the exact opposite, and I bet the average resident cannot be convinced otherwise.
The drug issue has no good solutions in a free society. The current cost of the drug war are unsustainable. We should try to find a good enough solution before we are forced to do otherwise. I would say the same for Federal public spending, but I know that will only come from a crisis. As a country, we need to start making intelligent policy decisions instead of waiting for busy bodies to over-react when properly manipulated by journalists an Hollywood.
To be fair to Critic (it's difficult given his uncharitable attitude and ignorance), maybe he meant that the number of marijuana users has doubled since CO legalized it (much more recently than 1996) - not the percentage. That's at least mathematically possible (if unlikely).
His comment says "marijuana use"; that can easily double without any increase in the number of users.
"When I graduated from high school in 1996, surveys said that over 60% of high school students had used mamajuana in the pervious month."
That's a flat out lie: https://link.springer.com/article/10.1007/s11121-019-0989-7/figures/2
" The country would probably be better off if more alcohol heavy users switched to weed."
Perhaps, yet marijuana seems to at best have a slight reduction in drinking:https://pmc.ncbi.nlm.nih.gov/articles/PMC8286984/#:~:text=Individuals%20who%20reported%20frequent%20and,compared%20to%20non%2Duse%20days.
"The same issue happens with crime. There was a mall out there (called Woodfield Mall) where rapes were endemic. The town was called Schaumburg. To this day people claim that town is "safe.""
Schaumburg is safer than Illinois at large and the US: https://www.macrotrends.net/global-metrics/cities/us/il/schaumburg/crime-rate-statistics. You're just a liar. This bullshit might have worked in 2014, but since the UVA debacle no one believes that there's a secret epidemic of rape in rich white communities.
The lower link is broken. I do not see any crime stats for 1996. As far as rape stats go, Virgina's own stats back me up. You need to mix with population figures, but non-acquaintance rapes are overwhelmingly committed against girls (not women) in suburban and rural communities.
This has the summary of the data I used when doing my graduate school analysis at Georgetown (https://vsp.virginia.gov/wp-content/uploads/2021/08/Crime_in_Virginia_2000.pdf) but I cannot easily find that raw data (what I used). Unless one calls suburbs "urban," non-acquaintance rape is almost always targeting under-18 girls.
VA Population:
https://va.beyond2020.com/va_public/Browse/browsetables.aspx
So what? (And how do you know - people routinely lie about the illegal things they do.) Marijuana use is harmless. I am quite sure marijuana-related crime has dropped to approximately zero.
Yes, moving opiate users from black-market drugs with all their adulteration and unpredictable potency (which are what kills) would be an improvement, even if it mean more users.
Moreover, isn't *freedom* worth anything at all to you?
Freedom in the Libertarian sense is why this country exists. We did not rebel against the British Empire for a good time. We did not fight the Civil War to create tourism in underdeveloped parts of the South. We fought for the Libertarian sense of freedom. We allowed those freedoms to be taken from us little by little over the last 100 years, and it was a mistake. All of our problems today come back to that gradual yet persistent erosion of American freedom.
Ah yes, because 100 years ago legal tolerance of sodomy was much more pervasive, there were no blasphemy or obscenity restrictions, mandated prayer in school, etc. Stop pretending that the Founders would have cheered on Pride parades and drug use.
Creating MORE freedom is good. Expanding freedom was the point. Yes, slavery and the SOCIAL repression of homosexuality were wrong. We are growing in freedom when we get more of it. That is good. The problem has never been expanding freedom to more people. The problem is taking it away.
So something like "intelligence" is largely at the whims of inheritance and genetics, but something like addiction or "other mental illnesses" are personal choice?
What the RHHW study didn't touch on is the boredom and and extra time available to drug users, particularly rear echelon troops. Both rear echelon and infantry were bored and all types were in a stand down mode by 1971 and looking to go home. This situation created a need for relief, hence the escape into drugs - Idle hands are the Evil's workshop. Those in the Rear had more time on their hands and the ability to safely get high. All drug users in Vietnam were doing so because of boredom and and as an escape from the normal daily harassment done by cadre over inconsequential and petty details. In the Rear Echelon, e.g. Long Binh Junction, there were two basic types that made morning formation., the "juicers" and the "heads". The former drank alcohol and the latter did drugs. The combat arms units, restricted to base camps, had similar experiences. Once a G.I. knew he was going home, he straightened-up and saw life as a starting over, hence dropping drugs by going cold turkey. Time to put all that behind once he got back to the "World", i.e. U.S.A.
Lots of boredom, mixed with moments of stress.
A few things:
1) Addiction is a brain disease that gets worse over time. Your brain is literally rewired with the shortcut that the way to protect yourself from overwhelming emotional pain is to depend on the dopamine dump that comes from your addiction. This long-term physical brain change addiction is different than the chemical dependency addiction in that it impacts the way your brain makes decisions, not how your endocrine system functions without the drug. But, it is a very real physical addiction.
2) Every person's brain biology is different, and some are more prone to brain addiction than others. The dopamine dump from your drug of choice could be much, much higher or much lower than average, and your brains response to the amount of neuroplasticity in response to the dopamine dump will vary from person to person. Some people become brain addicted much faster than others. But, for everyone, it does take some time.
3) The amount of decision making that take place in our subconscious has been underestimated for a very long time. Current research on the use of "stored procedures" in our brain that make the majority of our decisions is just now learning how important it is. It takes a lot of effort for our brain to decide to buck the habits. For some it can be unmanageable without outside help.
4) The universe of people here likely are different from your average Appalachia user in that: a) they likely had a fairly short time window to become brain addicted; b) the environment of their US life was significantly different than the environment of their deployed life, which likely made changing habits easier once returning from deployment; and c) US soldiers are likely more disciplined in just about everything than your average person.
I disagree with your premise that it is reasonable to expect all opioid addicts to be able to recover without outside help. Huberman Labs has a lot of great information about neuroplasticity and addiction. Jordon Peterson does too, from a phycological perspective. His interview with Dr. David Eagleman on the topic is interesting.
Trying to understand the behavior of individuals that are caught in these types of addictions without really digging into the brain biology will not get a person very far.
The best advice is probably not to play around with these powerful drugs at all due to the risks. Everyone that has a major addiction had a choice at some point to abuse for a significant length of time. It's just that, many people that abuse for extended time periods can avoid the brain addiction that plagues others with the exact same behavior. But, I believe that the idea that anyone can recover from an addiction brain addiction without outside help is not supported by the data, our understanding of brain biology, and the personal experience of anyone who has experienced that hell and come back from it.
Did he say "all"? I wouldn't say "all" about any large group of people, about anything. Law of large numbers and all that...
Most misconceptions on substack (and everywhere else) come from the utter lack of math knowledge in most Americans. I used a lot of probability and statistics early in my career, and I never cease to be amazed at how bad our people are at math. I have had bosses who disputed calculus and others who thought financial discounting was "my opinion." I worked with CFO's were used a normal distribution to model a discrete variable. I have no idea how we can force students to waste time on so many irrelevant items, yet allow people to graduate from university completely ignorant of probability and statistics. The advice I give to every young person I ever meet is for them to study probability and statistics. It is like a secret intellectual power that allows one to function on a higher level. Calculus does the same when learning new subjects.
I agree but expecting people to learn math is expecting too much - few people have the basic intellectual ability. The larger problem I think is that people believe what they want to believe and aren't very interested in the truth.
I hope you are wrong. If you are not, then most liberal ideas of democracy fall apart. Otherwise, thank for your insight.
What about the price of heroin in the US versus Vietnam?
I think “addictions” are vastly overstated but “habits” are very real and can be powerful. Sounds like the return to the USA broke the habit.
This seems like a gross oversimplification of “addiction”.
Yes, part of it is chemical dependence. But the “reasons” why someone started their use is myriad and complex. I don’t think “choice” alone comes close to capturing that complexity.
From this study, I would instead ask “why did that 10% remain addicted?” Perhaps they were the ones who suffered PTSD from their tour of duty?
It’s easy for someone (who grew up in a stable home yada yada) to say “just say no”. But I think it’s idiotic to suggest that a “drug addict” “chooses” to be so, once you see what crap quality of life that “choice” entails. I would not to so quick to judge unless I’ve walked a mile in those shoes.
In experimental psychology, the heroin story led to studies in behavioral pharmacology showing that drug addiction was a form of Pavlovian (i.e., classical) conditioning. A drug is an unconditional stimulus that causes a bodily response, a UR (in Pavlov, food causes and unconditional response of salivation). The US is paired with a neutral stimulus, a CS (in Pavlov, a tone). The CS predicts delivery of the US, and the animal learns a CR to prepare for its arrival (in Pavlov, it salivates preparing to eat). In drug conditioning the drug is a US (e.g., heroin) causing a UR (the high). The US is usually delivered under similar conditions every time, collectively forming a CS that predicts delivery of the US. The person acquires an adaptive CR, preparing for arrival of the US. In this case, the high is abnormal and dangerous (highs can kill), and the body's CR is to throw itself into the opposite of a high, so when the UR arrives, normality is restored. If the drug is not forthcoming, cravings occur. Vets didn't experience cravings or addiction because they were no longer in the drug environment and so the URs did not occur. This pattern has been extensively demonstrated both in the lab and in real-life cases of deaths by drugs, caused when the US drug is delivered under novel circumstances not associated with drug delivery. The leading researcher is Stuart Siegel; a general discussion by him is: The heroin overdose mystery. Current Directions in Psychological Science, 25, 375-9; https://doi-org.proxy.library.vcu.edu/10.1177/0963721416664404 .
It's possible to use these findings to treat addiction, but it runs into a intuitive conclusion that follows from the idea that drug use is a choice. The therapy involves addicts coming in on a schedule and being tested for drug use. If no markers are found, the addict is paid. People resist this, thinking that people are being paid for voluntary behavior they should be doing anyway.The therapy works and has recently been approved in CA.
I put it in the larger context of learning research in Fundamentals of Cognitive Science.
So by your logic there are no gambling addicts? For people who do not become addicted to drugs, alcohol, gambling,..., there are no problems. For those who do, it is often a life-long struggle. It is common for those who experience one addiction to later in life have another. Of course they are responsible for their choices, but once they are addicted, the outcomes are no so easy to undo.
From your post, I assume you have little experience of how addiction changes people. It is a real problem, even if most people do not experience it. We should treat it using evidence-based medicine. The moral crusade BS is what got us to this state where tens of thousands of people die every year and a huge percentage of able-bodied men are neither working or in school. The over-flowing prisons are another unwelcome requirement of the War on Drugs.
We need to treat addiction as a disease, because it is. Calling it some lack of character is just like calling mental illness a problem of character. You may FEEL that way, but your feelings should not be the basis of public policy (if only our president could learn this). We should treat addiction in the ways that work. Right now we have decades of evidence that shows that "Drug Rehabilitation" businesses are uniquely ineffective. The best results appear to come from opioid maintenance (methadone, buprenorphine), but only for those addicted to opiates such as heroin.
Most hard drug users will never become addicted. Their experiences are not an issue. It is only once one becomes addicted that more formal interventions are necessary. I also want to note that the stereotype of the criminally-inclined minority male as the typical addict is not even close to reality. Methadone clinics are full of working people who became addicted, and found no other way to function. Buprenorphine users have included investment bankers, physicians, tenured professors, and many other professionals who picked up a habit through bad choices, then could not break free of the hold addiction had, according to a friend of mine who is a doctor on these issues (I cannot share his name because I did not ask him, but he is deeply involved in this world).
The idea of harm-reduction (legalization) basically comes from the fact that drugs are widely available everywhere in the lower 48 states. No one avoids drug addiction for lack of access to drugs. Legalization will not cure addiction, but it will keep people out of prison, making it easier for them to find work, and it will prevent most of the deaths for accidental overdose. It would also remove the primary funds of organized criminal groups.
The best solution is to prevent young people from trying drugs in the first place, which is the exact opposite of what our culture does. We romanticize drugs addiction. Outside of government control of movies, music and television, I do not see how we can remedy that. I would also make sure that people understand that drug legalization and local authorities not prosecuting quality of life crimes is not the same thing. We can legalize drugs AND prosecute criminals for shoplifting, trespassing, panhandling, public urination, sexual harassment, indecent exposure,..., and any other crime that makes life so unbearable in places like California and Portland. Too many people confuse a permissive attitude towards crime and drug legalization, when they are tow distinct policies. Not prosecuting shoplifting, vandalism and trespassing, then complaining about "disinvestment" is for political scam artists like Al Sharpton, who were big proponents of the drug war, so long as they were getting paid. Idiot progressives are bizarrely enslaved to such hustlers.
"The vast majority of U.S. soldiers who were using heroin during the Vietnam War quit cold turkey as soon as they came home. Upshot: Addiction — even to heroin — is a choice."
My takeaway from the study was that the Vietnam War was a highly stressful environment, as war zones sometimes tend to be, and once the stressor (being in a warzone) was gone, the need for an escape diminished along with the stress.
German soldiers during WWII were legendary for their use of amphetamines, but we don't see hordes of methheads descending upon the 1946 German countryside like a swarm of locusts.
Japan's war on methamphetamines is an interesting subject, if you ever care to research it. They also used a considerable amount of drugs during the war, but they did have problems with addiction. To this day it is illegal to bring cold medicine into the country (it can be processed into amphetamine). They had a social campaign and mass crackdown, and it mostly worked. Homogenous societies have many advantages.
Reminds me of Junky by William Burroughs. He describes kicking heroin as no worse than getting over a cold, even though he returned to it often.
“You become a narcotics addict because you do not have strong motivations in any other direction. Junk wins by default”
The fact that most soldiers quit after returning doesn’t contradict the compulsive nature of addiction—only highlights how deeply the context shapes compulsion
I strongly agree. I can definitely see how a returning soldier could more easily overcome a heroin addiction than they might have believed because the habit is harder to justify in the radically different civilian context, particularly given the extreme physical costs. Someone who got addicted in an American urban context, though, will still feel the urge to medicate as long as they remain in that context even if they fully understand the negatives of long-term use.
Super interesting study.
I do however find it a bit of leap where you say addiction is a choice, when the study says that there are a set of pre-existing conditions that predispose a subset of people to re-addiction.
One imagines that the experimentation with heroin in Vietnam is in part due to the horrific conditions these men faced as late teens (imagine our college-aged kids were subjected to the same conditions).
I think Robert Sapolsky would have something to say about just how much choice these men had in their initial heroin use and subsequent re-addiction or lack thereof.