CHANGING OUR ATTITUDE TOWARDS ADDICTS AND ADDICTION - CHASING THE SCREAM

 

Everything I knew about addiction was wrong and so was my attitude towards addicts. Then I came across a book ‘Chasing the Scream’ by Johann Hari and that made me sit up and re-think. Of late, particularly after the untimely demise of a successful actor because of alleged drug abuse, our Narcotics Control Bureau has taken upon itself the task of cleansing the Bollywood of the dreaded drug habit. We are told that the drug cartels and the terror organizations go hand in glove and so fighting the drug war is a national emergency lest we become drug heavens like Colombia, Mexico and Venezuela and lose a generation to drugs. Films like Hare Rama Hare Krishna, Charas, Dum Maro Dum, Pankh, Fashion and Udta Punjab have tried to talk about the effects of drugs on our society but the addict never gets the sympathy.

 

Being a Plastic Surgeon, with more than 3 decades of experience in trauma surgery, I have prescribed morphine and morphine like drugs called opioids to countless patients for pain relief. Did all of them become opium addicts? No, it doesn’t happen that way. Almost every adolescent attempts to behave like an adult by puffing an occasional cigarette. Do all of them become tobacco addicts?  Addiction is a primary, chronic disease of brain involving reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. There is a reason why the world calls them recreational drug. Recreation is harmless if practiced in moderation. Why have we criminalized recreation?

 

Do you know that psychiatrists today classify addiction into two broad groups - Substance Related Disorders and Non-Substance-Related Disorders? Yes, for addiction you do not need alcohol, cocaine, or hash or LSD or Ecstasy every time.   Gambling Disorders, particularly internet gambling is turning out to be a bigger menace. Then we have the Internet games, excessive use of social media, such as Facebook, viewing pornography online, all these comprise the Non-Substance Related Disorders. With them also certain pathways in their brains are triggered in the same direct and intense way that a drug addict’s brain is affected by a particular substance. The gaming prompts a neurological response that influences feelings of pleasure and reward, and the result, in the extreme, is manifested as addictive behavior. It is now evident that various behaviors, which are repeatedly reinforcing the reward, motivation and memory circuitry are all part of the disease of addiction, whether they are substance related or non-substance related. So why are we going hammer and tongs after those using recreational drugs only and treating them as criminals?

 

In an interesting experiment one Prof. Alexander put two water bottles in a rat cage, one with normal water and one with opium water and invariably the rat in the cage would go for the opium water, drink it again and again till it died. But when he converted the empty cage into a rat heaven with lots of cheese and burrows and tunnels and many more rats, the animals ignored the opium water! They fed on cheese, had sex, produced babies and lived happily. So substance of abuse was their companion of boredom and solitude, and when they had better alternatives they didn’t fall for addiction. Why are we humans failing to understand this interpretation?

 

During the Vietnam War many American soldiers became addicted to various substances and this became a serious health concern. But once they returned to their loving families most of them were able to lead a normal life! Solitude of an alien country was now replaced by the love and affection of friends and family. They did not need the company of drugs anymore.

 

When we give in to our anger towards addicts, or drugs – and there’s some of it in all of us – the problem only gets worse; and when we choose a deep kind of love, the results can be amazing. But two things can be seen everywhere in the world. The first is how similar the debate is across the world. Drug prohibition is a global war, and it has predictable effects everywhere it is tried. The second is how hungry people are to hear about the alternatives. There is a deep awareness that what we’ve been doing isn’t working – but societies and governments are not trying an alternative course. What happened when Portugal decriminalized all drugs, and transferred the money they used to spend on making addicts’ lives worse to making their lives better? They actually reduced injecting drug use by 50%! When Switzerland legalized heroin, they reduced deaths on legal heroin to zero! How? We should contemplate about these questions with an open mind and urgently mend our ways.

 

One of the ways the “war on drugs” works is that it makes the people it is destroying feel that it is all their fault. It does this to drug users, drug addicts, drug sellers and the people who live in the supply route countries. It makes them feel they are dirty and defective, and soaks them in shame when actually they shouldn’t feel this way. On the contrary: they should be loved. The world owed them an apology – for inflicting this war on them. They had always been made to feel the opposite – that they owed the world an apology. In Chasing the Scream the author rightly says ‘the opposite of addiction isn’t sobriety; it is connection.’

 

What is expected from the government? They should do course correction by ending the drug war and choosing a legal, regulated market for drugs instead. The one thing the cartels fear – more than anything else – is a regulated, legal market. Decriminalize certain common drugs like ganja and charas but sell them openly through licensed outlets. Prohibition of alcohol only results in death by consumption of illegal hooch, as we have seen time and again in Bihar. Over 3.46 lakh people have been arrested in the last five years and close to 150 lakh litres of country-made and Indian Made Foreign Liquor seized from April 2016 to February 2021! Prohibition has created a parallel bootlegger economy that has in turn lead to an increase in violent crime. Does this not demand a course correction?

 

Often very good books do not get the viewership they deserve. When you write a book, it’s like writing a message in a bottle and tossing it into the ocean – you know the likelihood is that nobody will ever find it, and it’s hard to picture the people who might. I’ve known plenty of people who spent years writing important books, only for virtually nobody to ever read them. Fortunately, this book, 'Chasing the Scream' has turned out to be a best seller and after reading an online review I read it and my entire outlook about treating drug addicts changed. ‘Chasing the Scream: The First and Last Days of the War on Drugs’ is a book by Johann Hari. It examines the history and impact of drug criminalization, collectively known as "the War on Drugs". Chasing the Scream is published by Bloomsbury and has 400 pages. In Kindle Store you can get it for Rs. 280 and the paperback costs Rs.1,352.