Slashing the Cost of Addiction

The War on Drugs costs us $500 per second. We have spent a trillion dollars over 40 years, and it has made virtually no difference. That’s because we’re trying to cut the supply of drugs by dealing with people highly motivated by lotsa money, as opposed to showing young people what could happen to their own bodies and lives.

The NIH has published studies of teens that show decreased drug usage among those who have been taught the probable consequences of drug use. Personally, I don’t understand how anyone who has any personal experience of such consequences, even photographs, could for even a moment think drug use might be a cool thing to try.

The War on Drugs costs us $500 per second.

Afghan teens on the freely available opium there look totally blitzed, barely capable of standing up, and dirty. With my own eyes I’ve seen face-down filthy alcoholics on the sidewalk, soaking in their own urine and vomit. Photos of dead addicts sprawled in stairwells, covered in vomit. The “meth mouth” of methamphetamine users, with rotted teeth, gums, and jawbone, their face caving in on itself. The ER case whose cocaine use has led to another heart attack… Take a look at the brain of an addicted mouse, missing billions of brain cells.

These things are shocking, even to someone like me, who worked for years in a hospital setting. It’s hard to imagine why anyone who has seen these consequences or learned the facts could even think of experimenting with drugs.

Photos of addiction are shocking.

But of course there’s a problem with that, and mostly it’s the government. Drug control efforts have a long history of propaganda that was simply false, and often stupid, driven by the false beliefs of right-wing purists. (Anyone remember “pot needles”?) Most of it was aimed at marijuana, which is used by many millions of people with none of the dire effects the government lectured about. (Not that I believe there are no possible dangers from pot use. There are some, but what the government used to tell us was simply wrong.)

So the first thing is to quit lying, because everyone can see right through it, especially in the era of the internet. We certainly don’t need false ideological beliefs. The facts are quite impressive enough, and don’t need untruthful exaggeration.

The second thing is to recognize addiction as an illness. At least a quarter of incarcerated inmates are there because of drug convictions—at an annual cost for each of them equal to the average family income, or a couple years of college education. Prison does almost nothing to help them become productive citizens.

We must treat addiction as an illness.

No addict expected to become addicted, and no one takes drugs in order to become addicted. What’s more, many who try illegal drugs do not become addicted. But some who try legal alcohol and cigarettes do, and any kind of addiction ruins lives. There are several factors that determine whether or not you are likely to become addicted, including your DNA and the social setting where you grew up. But you can’t know if you will succumb until it’s too late. Alcohol was perfectly acceptable in the circles I grew up in, but I had no way of knowing whether I might become alcoholic. (I didn’t.)

A third thing is to adopt some level of decriminalization of drugs and their users. Most of the 25% or more of those in prison because of drugs would be much better off out of jail and locked in to a treatment program. We spend $39B per year on prison costs. Many of these inmates could be treated at a fraction of the cost. Just 1% of that cost would give us $390,000,000 per year to work with.

Just 1% of the annual prison cost
would give us $390,000,000 to work with,
and that doesn’t even count savings
if we quit the War on Drugs.

Unfortunately, one of the main reasons we haven’t already taken a more realistic and productive approach to addiction is the false belief that addiction is always caused by weak character, racial flaws, or moral laxity. You could easily conclude just that, if the only evidence you had were addicts at their nadir, when they have lost all control over their lives, and have ruined everything to satisfy their addiction. But it’s a false belief.

Being from a “better class” of people does not protect you from addiction. Physicians, lawyers, teachers, politicians, actors, and many other accomplished persons are well represented in the ranks of the addicted. Read Abraham Vergese’s book The Tennis Partner for an intimate look at what meth addiction did to a brilliant young doctor who could not escape.

Physicians, lawyers, teachers,
politicians, actors, and many others
become addicted.

Moral judgments have no legitimate place here, and the result of all this judgment, plus the $500 per second cost of the War on Drugs, has wasted many hundreds of billions and accomplished very little. It’s rather like the “Tough on Crime” nonsense that has given us the largest population of incarcerated citizens in all of human history—and done absolutely nothing to control crime. It simply hasn’t worked.

When a course of action doesn’t work, it is time to change direction and try something more promising. Treatment, not imprisonment. Enlightenment, not battles with drug lords.

Show the kids what can happen to those who become users. Get the addicts out of prison and into treatment. Put the drug dealers out of business by giving addicts free government-supplied drugs during their treatment. There is plenty of money to spend on this, and the payoff is guaranteed to be better than the trillion dollars we wasted on the War on Drugs.

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