Every year, governments spend billions fighting the so-called “war on drugs,” which accounts for over half the American prison population. Either they were caught buying drugs, selling them or committing burglaries and assaults to fund their habit. In other words, we seem to be making little progress. And that is because we do not focus enough on why people start.
First, people use drugs to self-medicate. They suffer some kind of physical or mental illness, cannot afford treatment (or perhaps reject it out of hand) and then use illegal drugs to help them cope. In the short-term these work. Gradually, however, tolerance builds and addiction sets in. Then it falls to the taxpayer to fund the hospital admissions, emergency call outs, police arrests, and so on. And yet, though society demonizes them, they are behaving in a perfectly rational way. They experience pain, they want it to go away, and so they turn to a substance that does make it go away. In other words, they heal themselves the only way they know.
Misdiagnosis also plays its part. For example, a drunk driver smashes into a car and kills a young girl’s mother. She is on the back seat and escapes without a scratch. At first, she doesn’t want to talk about it and seems to cope. Life goes on. In her late teens she develops insomnia, depression and anger issues. She visits her doctor, lists the symptoms and leaves with tranquilizers and sleeping pills. They do not work. Eventually, to deal with her pain she tries opioids, later progressing to heroin. After years of homelessness and crime, a prison psychiatrist finally diagnoses post-traumatic stress, tracing it back to the accident. Had she received therapy at the time, all those years of addiction and crime might have been avoided.
Others never visit their doctor in the first place. Instead, they escape their depression by drinking vodka, or they use cannabis to help them sleep. Those who make their money from crime may not trust doctors and therapists, regarding them as dangerous authority figures. Many cannot express themselves when they do visit a doctor, making misdiagnosis even more likely.
People also use drugs to escape the demons in their head. Childhood sexual abuse, for example, is common among heroin addicts. Heroin is an obvious choice since it numbs pain. Drugs also blot out the demons of memory. And many are tormented by these on a daily basis: someone loses a child to leukemia, another cannot recover from their divorce, a third is haunted by their violent and loveless childhood. The list is endless.
Drugs may also be used to treat chronic shyness or low self-esteem. Cocaine, for example, boosts confidence. And people use alcohol for the same reasons. Party-goers don’t drink or use drugs solely to increase their fun. Many do of course, but many more use them to cope with social discomfort. Alcohol and drugs not only boost self-esteem they also reduce awkwardness and embarrassment. Rather than commit to months, even years, of cognitive behavioral therapy, it is quicker (and often cheaper) to snort a line of cocaine, smoke a cannabis joint or down a few shots of whisky.
Escape From Modern Life
Drugs also provide a quick and easy escape from the pressures of 21st-century life. Loneliness is a particular problem. Record numbers of people now live alone. In 2011, for example, 20% of German adults were living alone (in the city of Hannover it was nearly one in three). By 2020, it is estimated that nearly 40% of homes and apartments in the UK will consist of just one person. In 1950, 80% of American households comprised the traditional man, wife and child. Today, that has fallen to 49%. In other words, we increasingly live without the support and comfort of a family.
Not only do more people now live alone, they frequently do so in large, bustling towns and cities. We have managed to cram more people together while simultaneously leaving them more isolated! According to a 2010 issue of The Atlantic, in 1985 10% of Americans surveyed said they had no one with whom to discuss important problems; by 2004 that had risen to 25%. A 2010 AARP survey found that 35% of people over 45 felt “chronically lonely.” In 2000, the same survey put it at 20%.
And yet we need good, supportive friends more than ever. When asked to describe the 21st-century in three words, one futurologist chose “hot,” “overcrowded” and “overwhelming.” Twenty-four-hour news pumps us full of fear and Facebook torments us with the highlights of other people’s lives. Again, what better, quicker escape than a bottle of vodka or a few opioids?
To understand drug use, one must consider the wider cultural context. Addicts do not live in a vacuum; they are a product of their society. In some cultures, certain drugs are taboo while others are accepted and encouraged. An obvious example is alcohol use in northern Europe, where even today drunkenness is often considered funny rather than tragic. And among working-class men, being able to “hold your drink,” or drink a certain amount without vomiting, etc., is still a sign of macho toughness.
The difference between countries like England or Germany and Italy and Spain are striking. When young Italians move to England to study, for example, they are often shocked by the drinking culture – as are many Americans.
And these sorts of differences do not just exist between nations. Politics, education and even race also affect attitudes. Among well-educated liberals in San Francisco, LSD and psilocybin are often thought of as “mind expanders.” To refuse them is to side with the conservative mainstream. Among steel workers in Pennsylvania, however, or working-class men in England and Sweden, you’d be considered a “druggie” or an addict.
Then of course there is the individual personality. Psychiatrists recognize ten personality disorders. For example, those with an “avoidant” or “dependent” personality disorder are generally fearful and anxious. They also tend to be wary and suspicious. As a consequence, they may fear and avoid drugs. Someone with a paranoid personality, on the other hand, may assume that the drug is contaminated, or that the person offering it plans to hook them.
Other personality disorders make drug use more likely. The anti-social personality, for example, is characterized by impulsiveness, recklessness and difficulty foreseeing the consequences of one’s actions. Another, the “histrionic personality,” is a dramatic attention-seeker. To such a person, drug use may appear cool or edgy.
Of course, one does not need to develop a personality disorder. Even the blandest individual still has particular traits. Some are naturally cautious, others not. Some fear losing control, others enjoy it. And some of us are more curious. Indeed, curiosity often plays a big part in drug addiction. The young hear so much about them, both good and bad, that they want to experience it for themselves.
Just because a drug is legal and can be prescribed by a doctor, that does not mean it is safe. Many people begin with something legal. Right now, for example, the United States is experiencing an epidemic of opioid addiction, with people abusing prescription painkillers. When the doctor then cuts off their supply, they often turn to heroin.
But opioids are not the only drugs to fall into this category. Heroin addicts are often given methadone to help them reduce their intake. Friends may then try this under the impression that it is a medicine rather than a drug. After all, their heroin addicted friend has been given it by a doctor, so it must be safe!
Another problem is the mixed message young people receive. Even drugs as dangerous as heroin were made to look cool by artists like Lou Reed and Amy Winehouse. Others, like LSD or psilocybin, were popularized by serious writers and intellectuals like Aldous Huxley and R. D. Laing. This is especially problematic when the individual appears to suffer no consequences. A teenage music-lover may read the autobiography of someone like Boy George, David Bowie, Paul McCartney, etc., and think “each describes serious drug abuse when young – and yet they survived! Maybe parents and teachers exaggerate the dangers to discourage us.”
Another problem is that people confuse levels of harm with harmlessness. For example, in 2010 the British psychiatrist, Professor David Nutt ranked drugs from most to least harmful. He also made a series of provocative statements in the British press, claiming, for example, that ecstasy was less dangerous than horse riding. Unfortunately, people tend to hear what they want to hear: Professor Nutt says alcohol is more dangerous than cannabis, and drug users assume that means cannabis is harmless.
Sometimes drug addicts are everything the press makes them out to be: selfish, feckless and irresponsible. More often, they are sad, broken and in need of help. And, as with so many problems in life, the earlier you intervene the more successful you will be.