Wednesday, September 18, 2013

Everything is Social (Scary, Scary Drugs Edition)

Happened to come across two unrelated articles making the same point this morning: drug use, and specifically addiction, is much less about the physiological science of neural pathways and connectors that we've been told. Instead, as warms this sociologist's heart, it's far more about the social conditions in which that drug use takes place.

First there's this follow-up to the classic "rats will drug themselves to death given the option" study. The short version is that there was a classic old study in which rats in a cage had a lever they could push to get a dose of heroin. Once the rats started, they never stopped; they would keep pushing that lever until the OD'd or died from doing nothing but taking the drug, slowly wasting away as they ignored food and other stimuli.

This study has long been a cornerstone of conservative, bootstraps-based anti-drug zealotry. For instance, here's the conclusion of Professor Avram Goldstein, the man who conducted the study: "A rat addicted to heroin is not rebelling against society, is not a victim of socioeconomic circumstances, is not a product of a dysfunctional family, and is not a criminal. The rat's behavior is simply controlled by the action of heroin (actually morphine, to which heroin is converted in the body) on its brain."

You can just hear Rush Limbaugh cackling in delight while reading that -- "see, you god damned hippies! It's all about people making bad choices because they're stupid, not anything to do with the fact that they're living in crushing poverty while people who call them stupid deny them basic rights."

But in the follow-up linked above, they found a very simple way to avoid the rats getting addicted to the point of death: they built a bigger cage. That's it. It turns out that when the rats actually have other options besides sitting in a tiny cage all day getting high, they very much chose those other options. In a cage with other rats, large enough to have room to exercise, move about freely, raise a litter, etc. the rats didn't become addicts. In fact, they had been forced into addiction prior to being put in the large cage, and then ceased using the drug even though they were already addicted.

So it turns out giving the support to make choices in life other than drug use has a profound effect on drug use. Who could have guessed? (Answer: any sociologist. Any sociologist alive could have guessed that).

But that's rats, you say. That proves nothing (side note: it's funny how when rats prove what you want them to, it's a definitive study, but when they disprove what you want, then they're just rats). Well, enter Dr. Carl Hart. In an amazing pioneering study, he's providing free drugs (crack or methamphetamine) to people who are already addicted. These folks come to stay in a hospital for several weeks, and every morning Dr. Hart's assistants give them an unspecified amount of their drug of choice.

Then, throughout each day, they're given the option of another free dose or some sort of economic reward instead (usually some nominal amount of cash) which they would not be able to receive until the end of the study (thus proving the ability to favor delayed rewards over immediate gratification). And it turns out, the vast majority of these drug users would chose the economic incentive, demonstrating the fact that even scary, scary addicts can make logical choices (here you might point out how amazing it is that in the year 2013 we still need to prove that point, but such is the world).

You see, it turns out that just like rats, when humans have an option besides drug dependency, they'll generally chose it.

This is a classic example of confusing cause and effect, and not surprisingly, that confusion being strongly influenced by a desire to push an ideology that has little to no connection to reality. For there is a fairly strong connection between economic destitution and drug abuse (of course it's important to remember it's not ironclad, and plenty of economically comfortable people abuse all sorts of drugs). For drug warriors and conservatives, this meant stupid poor people can't understand drugs are bad for them, and thus they should be punished because they're too stupid to take care of themselves.

But what this evidence (and a lot more like it) demonstrates is that the cause and effect is backwards -- people don't do drugs and become destitute, they start using because they're destitute. And when you have nothing, it's hopefully not too hard to see why getting high and forgetting that fact for a little while would look appealing. Even in the absence of physical dependence, there's not really much of a reason to not use drugs, so why not?

So not to get too radical here, but it turns out that just maybe helping people is more effective in combating drug use than is punishing people. Though, of course, that assumes drug warriors are actually concerned about drug use and not about finding yet another excuse for shitting on the poor, but that's another post for another day...

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