Do We Export Addiction?

Do you know that Richard Nixon announced victory on the importation of such “hard” drugs as cocaine and heroin in 1973? Of course, we are observing the 100th anniversary of the Harrison Narcotics Act, which made heroin, cocaine, and marijuana illegal in the United States in the first place, a policy we eventually spread throughout the world.

In 1914, use of such drugs was negligible across the American social spectrum. Other than that, how is it going for our drug policy, as drug use is now a normal part of contemporary American life?

In The Meaning of Addiction I (Stanton Peele) review the headlines announcing how we had cut off the drug supplies from Mexico, South America, and Asia—year after year—as well as new announcements of heroin epidemics through the decades. Of course, all such announcements were whistling in the dark, despite our constant, best efforts.

Now comes this recent New York Times headline: “Afghanistan’s Unending Addiction.” In the article, the editorial board states: “Over the last dozen years, the United States has poured $7.6 billion into combating Afghanistan’s opium production, and the results are now clear: The program failed.”

I want to highlight one spectacular part of this failure. John Sopko, the inspector general in charge of assessing American programs in Afghanistan, said:

By every conceivable metric, we’ve failed. Production and cultivation are up, interdiction and eradication are down, financial support to the insurgency is up, and addiction and abuse are at unprecedented levels…-JOHN SOPKO, THE NEW YORK TIMES

Why would addiction and drug abuse be “at unprecedented levels” in Afghanistan…a country that has cultivated poppies and smoked opium indigenously for centuries? Here are the top three reasons. But, really, there is only one reason.

• Economic. That old demand curve. People will supply what masses of people will pay for. This is obvious – so obvious that to rely on it as the sole explanation for our failures to curtail the drug trade is simplistic.

• Drug composition. When a drug is exported, it will be transformed into its most concentrated form – heroin replaces morphine replaces opium. (The same occurred in Colombia where native people consumed cocaine as tea or by chewing coca leaf for centuries, but started consuming it in powdered form when it appeared locally in massive quantities.) The drug is essentially the same, so this is not a biochemical phenomenon. It is experiential: a more concentrated experience of the drug.

• Social learning. This is the real explanation. We in the United States have become convinced that everything about addiction is due to drugs’ biochemical effects. In reality, the reverse is true; everything about addiction is due to social learning. Thus, in Meaning, I explain that what we view as the physical effects of drugs are as much subject to cultural and social learning as what are called drugs’ psychological effects.

Flash forward to the World Health Organization’s Cross-Cultural Applicability study of dependence. The investigators found that, contrary to the primary hypothesis of this study designed by American/Northern European researchers, “descriptions of physical dependence criteria appeared to vary across sites as much as the more subjective symptoms of psychological dependence.”

In line with the social learning explanations for addiction, people need to learn what addiction is. We have invented the idea that if you take a lot of a substance you become wedded to it so that you cannot cease using it without traumatic withdrawal. Despite our insistence that addiction is embedded in our bodies, Afghanis and Colombians, who had used poppies and coca leaf traditionally for all of their recorded history, had to be taught to be addicted to these drugs.

Our sophisticated campaigns against these drugs in Colombia, Bolivia, Afghanistan, Laos, and Thailand have bombarded people with the idea that opiates and cocaine entrap them—that drug use cannot be escaped. Then, voila–masses of people in these countries abuse these drugs in ways that have never appeared before, just as occurred historically in the United States and Europe at the turn of the last century when we medicalized addiction.

And we redouble our efforts with every failure.