This article originally appeared in the May 2015 edition of the New Zealand Drug Foundation’s Journal “Matters of Substance”

Click here to see the original article…

Kyle MacDonald talks to author Johann Hari about his new book Chasing the Scream.

Addiction, for those who overcome it, is about adversity: of facing demons and persevering through overwhelming pain and multiple failures.

Johann Hari’s Chasing the Scream: The First and Last Days of the War on Drugs may be a strong, well argued polemic on the failure of using prohibition as the foremost weapon with drug problems in the War on Drugs, but it is also personal: from his admission of prescription stimulant use, to his drug addict partner and his childhood recollection of failing to wake an intoxicated relative.

Lurking in the background is also author and journalist Hari’s most infamous adversity: the 2011 revelations of plagiarism for his use of a pseudonym to change the Wikipedia entries of his critics. It may go unwritten in Chasing the Scream, but these are the words and opinions of a talented young journalist whose wrongdoings led him to return his 2008 Orwell Prize and lose his job at the UK broadsheet newspaper The Independent. As such, this book in itself is the story of perseverance.

Chasing the Scream was criticised by The Guardian’s John Harris as using “the gauche journalistic equivalent of the narrative voice found in Mills and Boon novels”. Certainly, his prose is colourful, but Harris’s comparison to romantic trash is unfair because it undermines Hari’s belief in the failure of the War on Drugs. He is not melodramatic; he is passionate and tells a rollicking good tale.

During our interview, he is also honest and generous, and I found it impossible to conjure up the cynicism displayed by other reviewers. Chasing the Scream is a popular book: it entered the New York Times best seller list at the start of the year and is still there at the time of writing because it is a character-driven tale. Hari shows genuine affection for his interviewees, describing how he is “oddly drawn” to them because “they feel like my tribe, my group, my people”.

Hari may be fervently against prohibition but points out the need to be apolitical – or at least argue to both ends of the political spectrum – over drug reform. “Left wing and right wing theories of addiction are wrong,” he tells me. “Addiction is an adaptation to your environment.”

His reasons and research are convincing. Hari cites evidence that the famous early studies of addiction on laboratory rats are simply wrong: “An isolated rat will almost always become a junkie. A rat with a good life almost never will, no matter how many drugs you make available to him.”

He explains that more recent studies reveal “addiction is a disease of connection”.

“Once you understand that addiction is to a large degree caused by pain and isolation, suddenly the idea of imposing more pain and isolation on addicts in the hope it will make them stop seems crazy.”

One of Hari’s most convincing examples of this more humane approach is Portugal, which decriminalised all drugs in 2001 and now differentiates between users and people dependent on drugs, helping the latter into employment and making a striking effect on their social wellbeing.

“The biggest and most successful part of the [Portugal] programme is to do the opposite of what we [in the UK and New Zealand] do and guarantee that addicts have jobs. It’s been nearly 15 years now and the results are in from this experiment: injecting drug use is down 50 – that’s five zero – percent.”

But surely – as with many of Hari’s examples throughout Chasing the Scream – this is too simplistic? Surely there must be opposition to the Portugal solution?

“There are individuals in Portugal who want to go back, but they’re a very small minority. None of the political parties want to go back, and when I was talking to people on the street, I literally couldn’t find anyone who wanted to go back.” Hari says plenty of countries are dealing with drug reform – including New Zealand, where the recent political U-turn caused the Psychoactive Substances Act to fail in Parliament.

“I know you’ve had a charged debate in New Zealand about the proposed legalisation and regulation model of legal highs, which I think was a really important model.”

But he explains how even politically conservative governments can adopt seemingly liberal drug reform laws – for example, in Switzerland, where legalisation helps treat people dependent on heroin.

“Libertarian arguments are really unpopular. What is popular is a conservative order-based argument. What they argued in Switzerland was essentially that the drug war means anarchy and legalisation is a way of extending order to this currently anarchic Wild West frontier.”

And this is the essence of why Hari says arguments for drug reform are beyond politics.

“When you talk to prohibitionists, they’re motivated by a few things. Basically, they don’t want kids to use drugs, they don’t want people to become addicted and they want less crime. Those things drive me as well – my only disagreement is that I think the policies they’re favouring actually don’t deliver those goals and in fact make these problems worse.”

Ultimately, though, this cause and this book are personal for Hari.

“My book is dedicated to my nephews who are all teenagers and who I really don’t want to use drugs. One of the main reasons why I’m in favour of drug reform is for this reason.”

But he says the misunderstanding of that personal reaction has led to failed policies.

“If we’re honest, for anyone who has addicts in their lives and addicts that they love, then there’s a large part of your time that you’re really angry with them. When I set off on this journey, there was a big part of me that was really angry with the addicts in my life. It’s very natural and human to look at an addict and think, ‘Jesus, someone should just stop you’. I’ve certainly thought it even though I knew intellectually it wasn’t right, but there was certainly a part of me that felt that way.”

The stories Hari tells in Chasing the Scream reinforce the ultimate failure of the battle plan behind the War on Drugs: the desire to control people using drugs constantly contrasts with the tragic stories of those affected and the campaigners who simply wish to treat those suffering with compassion.

When we see the emotional examples of addiction alongside the consistent failures of individuals driving the policies behind the War on Drugs, it is easier to understand how we got this so very wrong for so long. But it shouldn’t be surprising that kindness and generosity help treat people in pain.

“The only thing that is going to turn around the life of someone that is in terrible pain is love and compassion. The evidence for that is really clear.”

This then, is the book’s central lesson. We can’t control and punish people out of pain. Instead, we need to be open to connection and risk loving and becoming closer to everyone with a drug problem in our lives and in our communities.

Perhaps unsurprisingly, the three and a half years and 50,000 kilometres Hari clocked up to come to this revelation has also made an impact on his own view of dealing with adversity.

“The only real way out of it is to strengthen your bonds, not to threaten them. And that really helped me, I don’t think I knew that before.”

Kyle MacDonald is a psychotherapist and blogger from Auckland

RESOURCES

To hear audio of the whole interview with Johann Hari, see Kyle’s podcast The Confident Mind or on iTunes.

Find out more about the book, Chasing the Scream.

LSD (lysergic acid diethylamide) has long been associated with the idea that it can “make” people psychotic, and cause other severe mental health problems.  However recent research has questioned this long held idea, and Mark and I discussed it’s findings on Radio Live this Sunday morning.  (Click here to hear the interview)*Correction: In the interview I stated that the chemist who invented “LSD” was Austrian.  The late Albert Hoffman was, of course, Swiss.

The research looked at data from the population studies in the USA, and compared respondents that had used psychedelic drugs (LSD, psyclobin or “magic mushrooms” and mescaline or “peyote/ cactus”) and those who hadn’t.  What they found was about 14{1b812f7ed7a77644fff58caf46676f6948311bf403a3d395b7a7f87010507f87} of respondents had used psychedelic drugs, and

“… that individuals in this group were not at increased risk of developing 11 indicators of mental-health problems such as schizophrenia, psychosis, depression, anxiety disorders and suicide attempts.”  (Click here for the whole article)

While these results will come as a shock to some, we have to be clear about what they say and don’t say.  Firstly, they don’t say that psychedelics are harmless, far from it.  However they don’t lend any weight to the idea that psychedelic drugs “cause” psychosis, because if that was the case we would expect to see higher levels of mental health problems in the “psychedelic using” group.

The realistic view of these results is it highlights a confusion of causation and correlation: that people tend to first use psychedelic drugs in their late teens and early twenties, an age when mental health problems often first start to show up.  It’s also true that people often experience psychedelic drugs as extremely powerful and memorable, and as such a re more likely to attribute subsequent difficulties to its impact.  However this data suggests it’s much more likely that these drugs are a trigger for a small minority, but not the “cause.”

However, a further recent study shows an even more interesting result…

“The second of the new two studies, also published in the Journal of Psychopharmacology, looked at 190,000 NSDUH respondents from 2008 to 2012. It also found that the classic psychedelics were not associated with adverse mental-health outcomes. In addition, it found that people who had used LSD and psilocybin had lower lifetime rates of suicidal thoughts and attempts.”  (Click here for the whole article)

This finding makes more sense when we consider recent studies that show psychedelics, psilocybin in particular, has real promise as a treatment for existential distress in terminally ill cancer patients, and is also being trialed as a treatment for alcohol addiction.

“Cancer patients receiving just a single dose of psilocybin experienced immediate and dramatic reductions in anxiety and depression, improvements that were sustained for at least six months.  “I thought the first ten or twenty people were plants—that they must be faking it,” Ross told me. “They were saying things like ‘I understand love is the most powerful force on the planet,’ or ‘I had an encounter with my cancer, this black cloud of smoke.’ People who had been palpably scared of death—they lost their fear. The fact that a drug given once can have such an effect for so long is an unprecedented finding. We have never had anything like it in the psychiatric field.”  (Click here for an excellent and deatiled history of psychedelic therapy from “The New Yorker”).

What’s exciting is that this research is happening, after many decades of being shut down by the laws assocaited with the “drug war”.  Under the drug laws in the United States of America, which New Zealand and much of the Western World take it’s lead, LSD and other psychedelics are classified as “Schedule I” meaning:

• The drug or other substance has a high potential for abuse
• The drug or other substance has no currently accepted medical use in treatment in the United States
• There is a lack of accepted safety for use of the drug or other substance under medical supervision

When it comes to psychedelics, it is clearly not the case that there is no accepted medical use, and that while recreational abuse may have been controlled by these laws, valuable research has been shut down and a powerful palliative and transformational treatment has potentially been denied to many countless thousands.

The word psychedelic means “mind manifesting.”  Hopefully the powers that be can also keep their minds open because our ability as a species to ease peoples pain in the last stages of life is limited, but perhaps our ability to help people find meaning in their pain is in fact limitless.

“LSD is a psychedelic drug which occasionally causes psychotic behavior in people who have NOT taken it.”
― Timothy Leary

The war on drugs is not a war on “chemicals”: it is a war on the lives and souls of addicts, and not only has this approach failed, almost every idea that the war on drugs is based on is either wrong, or an outright lie.

This is the startlingly common sense, and revolutionary idea at the heart of the new book “Chasing the Scream: The first and last days of the war on drugs” by Johann Hari.  Mark Sainsbury and I talked about the book, and the research cited in it, on Radio Live this Sunday morning. (Click here to listen to the interview)*

*A small, but very important correction.  In the interview I stated Portugal has “legalised” all drugs.  This is not correct they have “decriminalised” all drugs.  Click here for more details.

Hari, a journalist, charts in the book his journey to understand both the war on drugs and how addictions work, and with his engaging narrative makes some very important and challenging facts easy to digest.

Anyone who has worked in the field of addiction treatment knows that there are many flaws with the idea that drugs are “bad” and that people simply become addicted to chemicals through exposure to them.  And anyone who has ever spent time using drugs recreationally, or around people that do, also know there are many people who seem to be able to take drugs, even quite regularly, and not get caught in the web of addiction.

But before I go on, let me be clear, this book is not “pro-drugs” as it is often possible to get caught in polarized thinking when discussing drugs this openly.  But the studies cited by Hari show the overwhelming majority (up to 90{1b812f7ed7a77644fff58caf46676f6948311bf403a3d395b7a7f87010507f87} in some studies) can use any addictive drug recreationally and not experience addiction.  And just to state the obvious, an absence of addiction doesn’t mean there is no harm, just that life remains manageable and the person can stop if they want, or need to.

So to put that another way, only about 10{1b812f7ed7a77644fff58caf46676f6948311bf403a3d395b7a7f87010507f87} of people who use drugs, develop an addiction.  So what is different about these people?

Well, addiction specialists have long known that trauma of many kinds (and especially in childhood) is highly prevalent in their clients, and the more severe the addiction, generally the more severe the trauma…

“Childhood violence and prostitution, abandonment and homelessness, all led their victims to the same remedy: a narcotic anaesthetic for pain and loneliness. “Human beings have an innate need to bond. Healthy, happy people bond with other humans. But if you can’t do that because you’re so traumatised by your childhood that you can’t trust people, you may well bond with a drug instead.” The scientific evidence of the correlation is so overwhelming, Hari writes, that “child abuse is as likely to cause drug addiction as obesity is to cause heart disease”.  (Click here for the rest of the article)

Is it really this simple?  No, of course not.  Because it is also true that not everyone who gets addicted has experienced childhood trauma.  There are other factors: but there are other factors at play with heart disease too and it doesn’t stop us from trying to prevent obesity.

In the book Hari however goes further and puts forth the hypothesis as to what the underlying factor in addiction is, and I must say it makes instinctive sense from my point of view as a psychotherapist.

More times than I can count I’ve heard people describe alcohol, or drugs as a “friend”, and the process of giving up being like losing, or saying goodbye to an “old friend”.  And so it seems that the process of addiction is satisfying a deep human need for connection, that those prone to addiction struggle to satisfy in other ways…

“Professor Peter Cohen argues that human beings have a deep need to bond and form connections. It’s how we get our satisfaction. If we can’t connect with each other, we will connect with anything we can find — the whirr of a roulette wheel or the prick of a syringe. He says we should stop talking about ‘addiction’ altogether, and instead call it ‘bonding.’ A heroin addict has bonded with heroin because she couldn’t bond as fully with anything else.

So the opposite of addiction is not sobriety. It is human connection.”  (Click here for the rest of the article)

Not only does this hypothesis make instinctive sense but it also offers a way to understand not just the high rates of addiction in survivors of child abuse, but also in ethnic minorities, those disenfranchised from their traditional land, the unemployed, those struggling with mental illness and people locked in poverty.

The underlying factor in all these situations is disconnection.

Hari also proposes that the growing disconnection evident in our capitalist, technologically connected but interpersonally isolated world is driving more and more of us to seek solace in the arms of an anaesthetic, rather than in true human connections with others.  Some critics have labelled his writing “melodramatic“, but there is little doubt Hari cares deeply about his topic, and as a call to arms its central message is hard to ignore.

Because via this hypothesis we are led to the uncomfortable and unavoidable truth: that in punishing, imprisoning and criminalising those addicted to drugs, we cause more isolation and disconnection.  The war on drugs actually makes ongoing addiciton more likely for those caught on its battlefields.

Ultimately as a society we must work harder to truly understand those who become addicted to drugs, not so we can better police them, but so we can treat addicts with compassion and generosity, because as a society when we fail those most in pain, ultimately we fail ourselves.