Everything we know about drug addiction is wrong

The only manner of tackling addiction as based on best practice, research and human rights, is through harm reduction policies | Cyrus Engerer

No one walks into the hospital with a broken leg, and walks out with an addiction to painkillers. This is because people do not become automatically addicted to drugs. In the same way, no one takes their first sip of alcohol or coffee or binges their first Netflix series and instantly turns into an addict. And it is no different with street drugs. It is in this context that during the past week I organised a conference together with the Platform for Better Preventive Healthcare.

While yes elements of physical addiction can occur after prolonged use of any addiction, addiction is not rooted in a physical dependence. It is rooted in a socio-psychological one. If you are running away from a past full of trauma and unresolved, deeply rooted issues, drugs are the perfect place to hide. And without a system that addresses this, then we are not addressing addiction from a scientific and human rights perspective and ultimately failing all those who need the system to help them.

In the 1970s, Bruce K. Alexander infamously created the first rat park experiment. In the experiment Alexander placed singular rats alone in a cage and offered two water bottles to the rats. One bottle was filled with water and the other was laced with either heroin or cocaine. In his experiment Alexander found that the rats would repetitively drink from the drug-laced bottles until they eventually all overdosed and died. This experiment led Alexander to believe that drug addiction was rooted in physical dependence, and once he issued his findings to the Government in the United States- the so called “war on drugs” began.

However the American and world wide “war on drugs” failed so spectacularly at achieving its goals that Alexander himself started to question his own findings. The world-renowned psychiatrist re-evaluated his original experiment and found that it was flawed and did not take into consideration other factors which surround the human psyche. In his re-analysis, Alexander realised that he had lacked to take into account the reality that human beings are surrounded by other humans, by communities, families and friends. And that this plays a huge part in “why and how” people turn to psychoactive substances or run away from them.

In a rehashed experiment Alexander put rats in “rat parks” where they were among others free to roam and play, to socialise and also have sex. The rats were given the same access to the same two types of drinking bottles.  What he found was that when surrounded with entertainment and most importantly, company, the rats inhabiting the “rat park” remarkably preferred the plain water. The few times that they did consume water from the laced water bottles, they did so infrequently, at irregular intervals and never overdosed.

In short, the fact that the rats were surrounded by other rats, and a social community, the power of drugs was beaten.

It is this that must be at the forefront of our addiction policies as a society.

Being a child of the 80s, I am part of a generation which was bombarded with the “just say no” campaign. But the reality of today has shown us that this campaign has seriously failed.  Because while we can all say no to drugs if we are offered them, it’s not as easy to say no to loneliness and depression when it comes knocking on our door, especially in the midst of a pandemic which requires social distance. This year, the National Report on the Drug Situation in Malta showed that the rate at which people use Cocaine and Heroin is on the rise. Given the socio-psychological element of drug use, this can be analysed through the loneliness that the Covid19 Pandemic has brought upon all of our society.

For all those who are unfamiliar, the “Just say no” campaign was an international anti-drugs campaign started by the Regan administration in the USA in the 80s.

It was an abstinence marketing campaign which grouped everything from alcohol to heroin to marijuana into one big bogeyman that should be avoided at all costs. And while the initial idea was a good one, studies from the 2000s clearly show that not only were these campaigns and policies ineffective in achieving the goals they set out to achieve, but they were also counter-productive.

So what does work? Here the science is clear.

The only manner of tackling addiction in individuals and society as a whole in a way which is based on best practice, throughout research and human rights, is through harm reduction policies. Harm reduction policies are rooted in justice and human rights by focusing on positive change and by working with people without judgement, discrimination or coercion. Harm reduction has no preconditions for support, and seeks to work with the person seeking assistance, not against them. It puts people at the centre of policy, and ensures that the addiction the person faces is looked at from a deeper, more empathetic and humanistic level- and this is what we need.

For as long as humanity has been around, humans have turned to various substances, actions or vices to escape their realities. And for the longest time, we have tried to deter humanity from doing this and this is the right approach indeed. Everyone deserves to be able to live a fulfilling and happy life sober. But we have been doing it wrong. For the longest time, we have been having the wrong conversation, with the wrong people and in the wrong setting- but finally, this is changing.

Slowly, more and more governments are moving away from these regressive policies around addiction, and are adopting a more human rights based approach to the conversation revolving addiction. Harm reduction is now arriving in the forefront of our policies and yes, we must all be ready to embrace this change our societies so desperately need.  I believe that the European Union stands at the perfect place to be the leader in this change in treating addictions.  It is with this in mind that I’m working in the European Parliament to be part of this change.