F.A.Q. on Drugs

Why is it “wrong” to use recreational drugs (or to use prescription drugs for recreational purposes)? (This one’s often asked by teenagers.)

First, four practical reasons:

1) They’re toxic (hence the term “intoxicant”) – sometimes instantly, and certainly over time, they damage the brain, interfering with cognition, processing speed, mood, motivation, even basic life-support functions like breathing and heartbeat, and they cause peripheral tissue damage throughout the body, which in turn causes all kinds of physical, interpersonal, and professional dysfunction, up to and including death. 2) They’re addictive – whether you think recreational drug use is a choice (as I do) or a “disease,” if you’re among those whose brains are genetically wired to experience such pleasure from a recreational drug that you’d squander everything you ever worked for, die young, and leave everyone you ever cared about behind, then it’s smartest to never find out, because you can’t get addicted to something that you never try. While family history of addiction is a clear risk factor, the absence of any such history should give you zero confidence that you lack addiction potential, and addiction is one of my four “bullet trains to poverty” (the others are quitting school, committing crime, and making a baby when you’re not married to the person with whom you make the baby). 3) Their use often follows a pattern of escalation – not only is the “gateway” phenomenon real, but in my clinical experience, I don’t think I’ve ever assessed a crack, meth, or heroin addict who didn’t start out with marijuana, generally followed by hallucinogenic mushrooms, ecstasy, acid, … . So again, if you’re among those whose brains are genetically wired to crave an ever-more-powerful high after experiencing marijuana for a while, then it’s smartest to never find out, because a usage pattern can’t escalate if it never starts. And 4) They’re illegal – even a marijuana possession conviction is no laughing matter if you want to keep all possible educational and employment options open.

Second, four intellectual reasons:

1) Intoxication impairs your intellect, and your intellect is what separates you – a human being – from the rest of the animal kingdom, so, when you become intoxicated, you reject your very humanity by functionally reducing yourself from a human being to an animal. 2) Whenever you “shut off” your intellect, you further devalue yourself by putting yourself at unnecessary risk of serious harm (because you render yourself unable to think clearly in the face of various predictable dangers). 3) If you can’t fully enjoy yourself while you’re fully conscious, then you have serious issues that you need address with your intellect fully intact. And 4) Other people get hurt – those who love and care about you, those to whom you owe responsibilities and obligations (including spouses, children, and strangers, e.g. other drivers on the road), and the victims of all of the crimes (usually up to and including murder) that occur along the supply chain from the original grower/manufacturer to the end user (you may never know anyone in the latter group, but if your demand helps create that supply chain, then you’ll be helping to create motives for murders, robberies, and scores of other crimes).

Note: With respect to religious individuals and individuals who have certain physical or mental health problems or take certain medications, additional faith-based or health-based reasons may apply specifically to them, but the reasons stated above apply generally to everyone.

What’s the difference, then, between alcohol and other intoxicants? (Also often asked by teens.)

In addition to being a crime, the only purpose of recreational drug use is intoxication, while alcohol can be enjoyed, by adults, legally, without the goal of intoxication.

What about “medical” marijuana? 

The pain-relieving compound in marijuana has been isolated and can be administered in a prescription drug (dronabinal, marketed as Marinol) that delivers a therapeutic dose of the pain reliever (which is extremely difficult to measure in smoke form) without getting you high, so anyone who insists that he/she needs to smoke marijuana for pain relief probably really is seeking the intoxicating effect.

Will my kids even listen to me if I tell them not to experiment?

In my clinical experience, many kids do. They typically don’t thank their parents for their wisdom, at least until much later in life, but they often do listen. And whether they do or don’t, it’s your job as a parent to at least be that voice that can reverberate through their minds at that critical decision point if/when they’re grasping for a reason to do the right thing.

Should I tell my kids about my own past drug use? 

In my opinion, that’s likely to be counterproductive. Learning from others’ mistakes requires a mature mind, focused on acquiring information about what’s most likely to be in its best interests in the long term. The typical teenage mind, however, is focused on the short term and will screen your words carefully for anything that can be twisted into permission or justification to do what it wants to do. (And no, I wouldn’t worry at all about your kid being upset with you later in life if you lie, and the kid steers clear of drugs in high school and college, and he/she somehow learns the truth in 20 years.)

What’s wrong with labeling addiction a “disease”?

Three reasons: 1) It’s insulting to people with real diseases like breast cancer to equate them to addicts. 2) When you absolve addicts of personal responsibility for starting addictive behavior, you also disempower them to stop it. And 3) It doesn’t distinguish between desire and behavior — if you want to call the desire to keep doing something that’s destroying you a mental disease, fine, but unless someone literally forces a substance into you, if you actually pick it up and ingest it, that’s volition at work, not a disease. I understand why many addicts want to cling to the “disease” label — otherwise, they’d have to look in the mirror and see people who’ve voluntarily ruined or severely degraded their own lives and probably — selfishly — also the lives of others about whom they’re supposed to care. The truth may hurt, but I believe, as the saying goes, the truth (if anything) is what will set them free.

Don’t some people have a genetic predisposition to become addicted?

Apparently. So what? All that does is make a substance more pleasurable for a certain subset of people than it is for most people, who can take it or leave it. A genetic predisposition doesn’t force anyone to do anything, especially because it can’t possibly affect a person’s desire for a substance until that person has already experienced the substance at least once.

What about behavioral “addictions” like sex and gambling?

First of all, if you’re going to call those things “addictions,” then basically anything that anyone finds enjoyable enough to prioritize over loved ones or important responsibilities qualifies as an “addiction.” If you must use that label, then the primary difference between so-called behavioral “addictions” like sex and gambling and chemical addictions like drugs and alcohol is that chemically-addicted people need to quit with medical supervision so that quitting doesn’t kill them.

Why does traditional “rehab” have such a high failure rate?

Unless you’re going to literally put bars between a person and his/her addiction (which isn’t a bad idea for intractable addicts like, perhaps, actress Lindsay Lohan), you’re unlikely to talk someone into quitting something that he/she prefers over his/her career, his/her family, even his/her very life. And if/when the person chooses to value those other things/people over the addiction, he/she probably won’t need all that much talking/convincing (as evidenced by the huge numbers of people who’ve successfully quit and remained sober without traditional “rehab”) — what he/she will probably mostly need at that point is medical assistance with the physiological repercussions of quitting.

And finally, as Bill O’Reilly asked me on television last week, what’s our societal responsibility, if any, to addicted people?

First and foremost, our responsibility is to protect innocent people who could be damaged by addicts’ drug-seeking/using behaviors. And secondly, our responsibility is to make it hard to commit drug crimes (and increasingly hard to commit subsequent drug crimes). You don’t get less of something by making it easier to do (contrary to what Tony Bennett rather ignorantly suggested while eulogizing fellow singer Whitney Houston last week). And believe me, if you think we have an addiction problem in America now, and if you think we’re not collectively being productive enough to pay our national bills now, then for all of the reasons given above, you don’t ever want to live in a society wherein most people experiment substantially with recreational drugs early in life.

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