Many people use drugs – but here’s why most don’t become addicts | January 6, 2015 |Paul Hayes, Hon. Professor Drug Policy, London School of Hygiene & Tropical Medicine
This article refers to the UK, but I feel like I could have written this myself, his views and thinking so closely match my own.
Drug use is common, drug addiction is rare. About one adult in three will use an illegal drug in their lifetime and just under 3m people will do so this year in England and Wales alone.
Most will suffer no long-term harm.
There are immediate risks from overdose and intoxication, and longer-term health risks associated with heavy or prolonged use… However most people will either pass unscathed through a short period of experimentation or learn to accommodate their drug use into their lifestyle, adjusting patterns of use to their social and domestic circumstances, as they do with alcohol.
Compared to the 3m currently using illegal drugs there are around 300,000 heroin and/or crack addicts while around 30,000 were successfully treated for dependency on drugs in England in 2011-12, typically cannabis, or powder cocaine
A powerful cultural narrative focusing on the power of illegal drugs to disrupt otherwise stable, happy lives dominates our media and political discourse, and shapes policy responses.
Drug use is deemed to “spiral out of control”, destroying an individual’s ability to earn their living or care for their children, transforming honest productive citizens into welfare dependent, criminal “families from hell”.
However, the narrative has resonance far beyond the political arena and underpins most media coverage of drug addiction and the drug storylines of popular culture.
Most drug users are ..?
In reality the likelihood of individuals without pre-existing vulnerabilities succumbing to long-term addiction is slim. Heroin and crack addicts are not a random sub set of England’s 3m current drug users
Addiction, unlike use, is heavily concentrated in our poorest communities – and within those communities it is the individuals who struggle most with life who will succumb.
Problem cannabis use is less concentrated among the poor, but is closely associated with indicators of social stress and a vulnerability to developing mental health conditions.
Most drug users are intelligent resourceful people with good life skills, supportive networks and loving families.
These assets enable them to manage the risks associated with their drug use, avoiding the most dangerous drugs and managing their frequency and scale of use to reduce harm and maximise pleasure.
Crucially they will have access to support from family and friends should they begin to develop problems, and a realistic prospect of a job, a house and a stake in society to focus and sustain their motivation to get back on track.
In contrast the most vulnerable individuals in our poorest communities lack life skills and have networks that entrench their problems rather than offering solutions
In short what determines whether or not drug use escalates into addiction, and the prognosis once it has, is less to do with the power of the drug and more to do with the social, personal and economic circumstances of the user.
It’s much easier for politicians to gather support (and money) by demonizing some “outside influence” (drugs) for social damages than try to repair those social damages. This would expose how many are being caused by their own policies of criminalizing drug use.
Shortly after I wrote the above, I found another article by Paul Hayes, which echoed my suspicions:
For ideologues of a traditionalist conservative bent, drug use is part of a broader liberal folly, a social program that has trashed the morals.
It would also invite a less politically convenient explanation for poverty, one that emphasises structural inequality rather than the individual failings of the poor.
Faced with this prospect, the easier option for ideologues is to ignore the facts, thereby sustaining the integrity of their analysis and the power of their polemic.
Heads in the sand
Unfortunately the strong relationship between social distress and addiction is ignored by politicians and media commentators in favour of an assumption that addiction is a random risk driven by the power of the drug.
Until we re-frame our understanding of drug addiction as more often the consequence of social evils than their root cause, then we are doomed to misdirect our energy and resources towards blaming the outcasts and the vulnerable for their plight rather than recasting our economic and social structures to give them access to the sources of resilience that protect the rest of us.