Drug War: Understanding Addiction and Substitution Needed For Better Policies

The “war on drugs” has accomplished little in the eyes of detractors, except for criminalizing those in need of help and fostering violence at the hands of criminals.  After more than four decades of the drug war, the globe faces a crisis of prescription drug abuse, a meth epidemic, a growing number of increasingly dangerous synthetic street drugs, a brutal war between terroristic drug cartels, the criminalization of addicts, and the further entrenchment of socioeconomic disparities along racial lines.  With traditionally conservative Pennsylvania becoming the twenty-fourth State to legalize the use of marijuana in the US for medical purposes and over 1,000 world leaders declaring the war on drugs a failure, change is certain, but what changes are made will determine whether or not it is for the better. 
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 Although proponents of the drug war might argue efforts have helped save the lives of countless by curbing the use and availability of drugs, the failings of the war on drugs cannot be denied.  Compared to the harmful nature of prescription drugs, marijuana is probably a far more sensible alternative when it comes to managing chronic pain.  Like alcohol, however, the last thing anyone needs is a bunch of people under the influence of marijuana or any drug when driving, working, or walking around public areas while children certainly do not need added peer pressure to try drugs.  Where many critics of the war on drugs are pushing to outright legalize the “recreational” use of marijuana, as well as other drugs, national and global leaders must take the lead to ensure the best policies are adopted.

The legalization of marijuana across the United States at the state level stems from an improved understanding about this particular drug.  Cocaine, heroin, PCP and other narcotics are devastating the lives of those who use these drugs and their families.  Like caffeine, sugar, sex, and video games, marijuana can be harmful and addictive; however, it does not belong in the same class as heroin.  More importantly, it is certainly a better alternative to highly addictive narcotics like oxycodone, Vicodin, and morphine.  By embracing the limited use of marijuana to alleviate the suffering of those with certain medical conditions, policy makers are recalibrating their efforts to address healthcare and the threat of addiction.  By further understanding the nature of addiction, even better policies can be devised. 

Clearly, addiction has a physiological-psychological component.  Although this hints at how to medically treat those whose biology makes them more susceptible to the reinforcing nature of addictive substances, we truly do not understand how to treat addiction as a society.   There are numerous treatment options available to addicts, but drug addiction is viewed as a choice rooted in a character flaw that can be discouraged with legal penalties.  Criminalizing drugs gives authorities the ability to arrest drug users and drug dealers.  Unfortunately, our culture often embraces perverse incentives while those in positions of authority too often forget they are given their power to serve, not to discriminate.  Instead of arresting drug addicts to help them, we cruelly inflict ineffective punishments on them.

This writer remembers a childhood field trip to a local police station where the holding cells lacked mattresses.  An officer explained, “if people want to act like animals, we’re going to treat them like animals.”  Viewing drug addicts as animals demonstrates a thorough failure to understand the impacts of drugs on certain people.   A disease of this nature is difficult to treat, because it is rooted in our basic psychological response to appetitive stimuli.  Drugs affect the natural response that all humans have to any given chemical that makes us “feel good,” thus addiction is not a disease that can be cured by fixing something in the body.  Some addicts may be retrained to find certain drugs too aversive for consumption, but too often the best option available is to try to deprive addicts of their drugs. 

Furthermore, drug addicts will often substitute one drug for another. In many respects, the same is true for almost all people, whether they are reasonably healthy or dysfunctional.  Looking specifically at people who battle with severe dysfunctions, i.e. psychological and behavioral disorders that prevent such individuals from properly functioning in their communities without assistance, there is a pattern of avoiding necessary decisions and tasks that healthy people engaged in on a regular basis.  The fundamental reason why dysfunctional people avoid critical decisions, or make outright self-destructive choices, stems from how the dysfunctions of these individuals' skew their ability to tolerate potentially uncomfortable situations.
 
Because all people exhibit some dysfunctional behavior from time to time, understanding how our tolerance levels for necessary discomforts affects what we do, can help reasonably healthy and unhealthy people alike identify, as well as understand, their dysfunctional traits.  Substitution involves an attempt to avoid the consequences of one choice by embracing the less uncomfortable consequences of another choice. A drug addict, for example, will often substitute food, cigarettes, cutting, suicide, and/or sex for narcotics.  Ignoring the impulse to use drugs is extremely uncomfortable to these people, thus substitutes, which might be healthy or unhealthy, help ease that discomfort.  Similarly, someone with OCD will use excessive cleaning to overcompensate for insecurities while the mother of a deceased child might seek to distract herself from the emotional deficit by "mothering" other children or adults.
 
In reality, these substitutes are being used to avoid something far more uncomfortable, such as emotional pain; therefore, treatment for those using substitutes hinges upon the ability of such individuals, with the proper assistance of a support network, to move beyond the substitutes in order to address their underlying issues.  Given that the most fundamental mechanism behind all self-destructive behaviors is the avoidance of discomfort, substitution does not necessarily have to be harmful. Only when a substitute prevents an individual from addressing underlying issues does a substitute inhibit the healing process.
 
Someone suffering from depression, who uses a string of superficial relationships to avoid the emotional pain of past intimacy, is engaging in a form of unhealthy substitution, because the sex is simply another means of avoiding the need to confront past feelings and the potential pain of real intimacy.  Conversely, a smoker drinking a glass of water when in need of a cigarette is healthy as the act allows the smoker a chance to avoid the intense discomfort of not smoking until that discomfort is minimized. Consequently, healthy substitution affords damaged individuals the ability to function and live functional lives as they heal. Understanding the difference between healthy and unhealthy substitutes can empower individuals to overcome emotional and psychological roadblocks.
 
Although it is essential to avoid over intellectualizing emotional issues, i.e. emotions cannot be reasoned away, this is especially important for people in crisis.  Life altering changes, such as prolonged unemployment, i.e. financial insecurity, or heartbreak, i.e. emotional insecurity, can lead to the need for individuals to adapt; however, that change sometimes requires too much discomfort. Suddenly, once functional individuals are unable to function in their new circumstances.  Instead of dealing with the necessary discomfort of addressing unmanageable situations, people in crisis will seek to occupy their time with seemingly nonsensical activities. Such individuals will either become locked into old routines or seek substitutes to avoid the discomfort of dwelling on distressing circumstances.

In reality, all people tend to avoid what they find uncomfortable, yet most individuals find little to no significant discomfort in what must be done to establish and/or maintain a healthy lifestyle. When people cannot tolerate the discomfort of doing what they must, or cannot do what they need to do because of exasperating factors such as financial insecurities, substitution allows these individuals some comfort. In more dire circumstances, thoughtful, well-tailored interventions from family, friends, community, and/or trained professionals, can be used to funnel and harness the untapped potential of someone in need of a healthy substitute.

When substitution leads to the resolution of underlying issues, such as the creation of a new job or improved relationships, it can be healthy. When substitution distracts individuals from dealing with their issues, it is unhealthy. As such, substitution can be a healthy or unhealthy mechanism, but understanding its role in our decision-making process affords us a powerful tool in our efforts to overcome everything from minor quirks to disabling mental health issues.  For drug addicts, it is particularly easy for their aversion to discomfort and the distressing circumstances their addiction creates to overwhelm their ability to cope.  Criminalizing drug addiction only adds a greater burden to the hopelessness that drug addicts often face, thereby encouraging them to seek relief from their discomfort with drugs.
 
Instead of addressing the underlying social need to help drug addicts overcome their self-destructive behavior, our authorities too often treat addicts as inferiors in need of authoritative correction, thus they mistreat addicts.  Certainly, society cannot tolerate the misconduct of addicts, but we must also remember they are in need of help.  Quite frankly, taking a punitive approach to drug use does nothing to prevent drug abuse; it only marginalizes drug addicts and somewhat lessens the negative impact of drug abuse on our communities.  Instead of self-righteously condemning our drug addicts and finding ways of throwing them away, we need to find ways of serving them, so they overcome their addiction and our society can reap the benefits of a society safe from drug abuse.