đAIP 118 Everything You Know About Addiction Is (Probably) Wrong
A few months ago, I was hosting a party at my apartment when, as one does, I got into a conversation about the dreaded D word: Drugs.
At the mere mention of weed, the guy sitting across the couch from me gasped as if I'd just stolen his appendix. "I would never use marijuana," he proudly proclaimed putting his hands on his hips.
"Why not?" I asked, genuinely curious.
He took a sip of his 5% Twisted Tea. "It's addicting, dangerous, illegal, and turns you into a zombie. I know someone who smokes all day and hasn't gone to a lecture in weeks."
There was a time when I would've agreed with him. Hell, I probably sounded just like him. I used to see all drugs aside from prescriptions and alcohol as bad. Period. Until two years ago, I had only underage drank during my high school graduation party.
But after my first experience with âmushroomsâ and reading more into Johan Harri's book, âChasing The Screamâ, I felt there was something deeply flawed in public perception of addiction, in the world at large, but more specifically in the United States. From my research, I discovered three great misconceptions about addiction fueling this misperception. As strange as it sounds, these three beliefs are driving a drug war which is causing more violence, hurting addicts' ability to reintegrate into society, and feeding a fear of drugs that, in many cases, is unwarranted.
If you, like me, have been wary about drugs, I ask you to put on your skepticism hat. Not just for your perceptions but for everything in this article. This is simply the findings of my research as a flawed human being.
In addition, this article will focus primarily on drugs in the U.S. While that does hone it's focus down, I find a lot of the insights on the drug war in the U.S. are useful toward drug wars in other countries as well.
Don't worry, I'm not pitching a world in which everyone dances on their rooftops, taking magic mushrooms and heroin while singing Kumbayah. I'm pitching for compassion, for nuance, and for reality-based policy. We all know someone who has been influenced by drugs. We all have been fed beliefs about addiction by our parents, friends, and society. It's time to put those beliefs under a magnifying glass.
I hope this journey will be as illuminating for you as it was for me writing it.
The Three Great Misconceptions About Addiction
The First Great Misconception Is All Illegal Drugs Are Bad
The guy in the opening story lumped drugs into two categories: the legal and good, and the illegal and bad. But it's not just him: tons of people see drugs this way.
And I can't blame you. Drugs, especially in the U.S., are fogged in a culture of fear. There are many historical events that shaped this perception, from prohibition to when Harry Anslinger became commissioner of the Federal Bureau of Narcotics and proclaimed marijuana was turning people to insanity, violence, and, worst of all, interracial jazz. Yup.
But after Ansligner, the most major stepping stone in our perception of drugs came in 1971. The air smelled of protest signs and polyester as The Vietnam War raged on. Helicopters thwacked overhead like mechanical vultures, circling rice paddies slicked with blood and napalm. Children ran screaming through the smoke, their skin melting like wax under the chemical sun of Agent Orange.
Thankfully, there were dissidents in the U.S. who protested the needless war. Enter: Richard Nixon. Nixon like many politicians of old, wanted power. And war is the crown jewel which sits in powers crown. War fuels industry. War fuels fear and want for a strong leader. War fuels control.
The problem for Nixon was those dissidents. Mainly the antiwar left, the hippies, and black people who in the midst of the Civil Rights movement were stirring up his main voting base, white middle class Americans.
But he couldn't just outlaw being liberal or black. That would be too obvious. So, he took a different strategy. He discovered many of these antiwar leftists were using marijuana and psychedelics, and many of the black people were using heroin. So, at a press conference, he declared drug abuse to be "public enemy number one."
Behind closed doors, Nixon's men weren't vague about this. John Ehrlichman, one of his top advisors, admitted years later:
"The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and Black people⊠We knew we couldn't make it illegal to be either against the war or Black. But by getting the public to associate the hippies with marijuana and Blacks with heroin, and then criminalizing both heavily, we could disrupt those communities."
Let that sink in.
They didn't ban drugs because of their danger. They banned drugs to make it legal to raid homes, arrest leaders, break up protests, and fill prisons. The drug war wasn't furthered with a concern for public health. It was launched with a concern for political power.
This is why cannabis, psychedelics, heroin, and more were all placed as Schedule I substancesâthe most dangerous category. Meanwhile, Twisted Tea remained legal.
By painting all illegal drugs with the same dirty brush, Nixon created a cultural boogeyman and, in so doing, the one thing we all want most in a time of uncertainty: a scapegoat. Suddenly, people didn't need to engage in critical thinking's boring crawl; they could lie inside radicalization's calming bedside.
To this day, many people still smear all illegal drugs with the same shade of fear. But when you peel back the paint, contradictions bleed through the canvas.
For example, there's tons of "illegal drugs" we use legally all the time.
Methamphetamine (aka Meth) is sold as prescription desoxyn. Yes, meth. The infamous face-eating, tooth-melting drug of public service announcements. Except when it's FDA-approved and called Desoxyn, prescribed for ADHD and severe obesity.
Same chemical structure. Different name. Stamp of approval.
Heroin is a Schedule I substance. But its chemical cousinsâoxycodone, hydrocodone, fentanylâare given by doctors and dentists. They're often used clinically for short-term, high-intensity pain, as well as more chronic forms. And no, people who get these drugs administered to them clinically, rarely get addicted.
I'm not saying you should go outside and start doing every illegal drug you can find. There's good evidence showing many drugs like marijuana, especially if used regularly during childhood, can have permanent brain damage. I'm simply trying to point out that black-and-white drug thinking makes you miss the color called nuance.
Consider this nuance: what drug am I talking about below?
48% of homicide convicts were taking this before the murder. Among victims of domestic violence, this drug played a role in 55% of the cases, while other drugs played a role in only 9%. I'll make it easier for you: around 10,511 people die per year driving while taking this drug[1], and the WHO estimates around 3 million deaths annually are due to this drug[2].
That's right, I'm talking about alcohol.
Don't get me wrong, I love a drink every now and then at a party. But when the second most popular drug on the planet is arguably the worst, it makes one reconsider if all illegal drugs are as bad as people think.
But we're forgetting one substance. It's not generally considered a drug, but if addiction and health risks were considered, there's a strong argument for itâin its added formâbeing made Schedule 1, right alongside its friends marijuana, heroin, and psychedelics.
I'm talking about sugar.
Have you ever read a nutrition label? Sugar is the ninja of modern food. There are the things you expect would have it, and then there are the things you don't. Tomato Sauce. Bread. Salad dressing. And so much more.
Look at global health outcomes, and you will find a direct link between added sugar and obesity rates, heart disease, and so much more. In 2022, 1 in 8 people are obese[5] and excessive sugar intake, particularly from processed foods and beverages, plays a substantial role in early-onset obesity.
Companies are free to inject it into every cereal box, snack pack, and so-called health bar they can get their factory-frosted hands onâas long as they list it on the nutrition label, where it hides under fifteen different names like a con artist on the run. Why do they do it? Because it's incredibly addicting. Adding even a small bit of sugar into your food dramatically increases the chance you'll get that food item again, even if you didn't know there was sugar in it in the first place.
I've just spent a few paragraphs rambling on about the addictiveness and physical danger of consuming sugar, which do exist. And you probably nodded along with me. Yet, I'm about to contradict myself with the next misconception. Because as strange as it sounds, the physiological addictiveness of the drug isn't the most significant danger. It's not realizing this that has created a massive amount of our bad relationship with addiction.
The Second Great Misconception Is Addiction Is Primarily Driven Through Physiology
You likely were taught the same lecture regarding drugs as I was in school. Drugs act on chemical receptors in the brain. The more we use a drug, the more receptors our brain makes for it. This leads to tolerance, so we use more of the drug. Over time, we develop a physiological dependence on the drug, creating cravings and, eventually, the dreaded word: addiction. And if we stop, withdrawal, at worst death.
This isn't wrong. Physiological effects are involved in addiction. The misconception comes with believing it's the primary factor. That's the lie we've been told.
To see the problem, we must look at a fascinating study. Stead LF et al. (2012) took a group of cigarette smokers and gave them nicotine patches.[3] If you ascribe to the primarily physiological view of addiction, this should solve the majority of smoking. After all, they're still getting their nicotine just through patch form.
Only 1 in 15 people were able to successfully quit.
Let that sink in. What's going on here? Johan Harri in his book Chasing The Scream, has a few answers. What he says we need to realize is addiction is primarily a psychosocial problem, not a physiological one.
Think about the above study. People don't just smoke cigarettes for the nicotine. There's the feeling of smoke in one's mouth. The coolness of being a cigarette smoker. The shared bonding with other cigarette smokers. The association of cigarettes with the feeling you get after using them. Taking nicotine patches takes away all of that, even though they're both giving nicotine.
Then, consider this. A growing body of Adverse Childhood Experiences (ACEs) studies reveal that 64% of people have at least one ACE, which doubles or quadruples their likelihood of using drugs or alcohol, particularly at a young age. An ACE score of four nearly doubles the risk of heart disease and lung cancer, with your likelihood of becoming an alcoholic increasing by 700%. An Adverse Childhood Experience can be anything from divorced parents to emotional neglect. Notice this has nothing to do with the physiological effects of drugs.
Then, consider loneliness. One study highlighted that the feeling of loneliness is stronger in drug abusers compared to non-drug abusers, suggesting that loneliness could increase the probability of engaging in high-risk behaviors and substance abuse[4] (Hosseinbor M et al., 2014).
Consider drug relapses. In the physiological view of addiction, relapses shouldn't be prominent. Why would they be? If the substance hasn't been used in years, the addiction is gone. And yet, we all know one person who has been off a drug for years only to relapse into taking it heavily again.
Finally, consider non-drug addictions. Video games, gambling, social media. These are all things we can become addicted to which don't have primarily physiological causes. Yet, for some reason, we treat drugs entirely differently.
The evidence is clear: psychosocial factors are more prominant than physiological ones in addiction. Once you think about it, it makes sense.
Why would people become addicted to a substance? To put it simply, because it makes them feel good.
Imagine carrying childhood grief like wet sand in your pockets. You drift into a party, half-present, the air buzzing with laughter that doesn't quite reach you. Then someone offers you heroin, and you say yes, not because you're reckless, but because you're tired.
And when it hits? It's like someone opened a window in a room you didn't know was sealed. Warmth floods in. For a moment, you remember what it felt like to feelâwithout armor, without numbness. Not joy exactly, a remembering through forgetting.
You begin to associate heroin not just with escapeâbut with connection. Not the kind you read about in self-help books, but the gritty communion of shared detachment. People around you aren't just usersâthey're mirrors, cracked in all the right places. You're not running from the police so much as dancing with them, high on adrenaline and the illusion of purpose. It's not happiness. But it's not nothing. It's sensation. And for now, that's enough.
One day, you're caught. The police arrive not with compassion but with cuffs. Suddenly, you're in a cell, cut off from your drug, your community, and whatever fragile lifeline was keeping you afloat. Because beneath the surface of our perception of addiction lies one final, festering illusion: that punishment cures pain. It's the third great misconceptionâand the most damningâlaid brick by rotten brick atop the others.
The Third Great Misconception Is Illegalization Is The Solution To Solving Addiction
The logic behind this misconception is so powerful because it's deliciously intuitive. Drugs are bad because they cause physiological addiction that turns you into a zombie creature. If we illegalize these drugs, we will disincentivize people from using them, help the addicts in prison become unaddicted, and stop whatever harm they would have caused out on the streets, particularly to our children.
Once you break through the two misconceptions above you start seeing the issues.
Firstly, not all illegal drugs are bad.
Alcohol and arguably sugar, in particular, are two substances that we consume without a second glance, even though there are many illegal drugs that you could have good arguments for not being nearly as bad. The idea of a stoned person, or someone on ecstasy or magic mushrooms, doing some of the things people do on alcohol is about as absurd as a monkey that doesn't eat bananas.
Secondly, and more importantly illegalization doesn't help addicts, it hurts them.
Addiction isn't a criminal justice problem, it's a public health problem and illegalization only makes things worse. Outside of prison, addicts' days become a cursed game of scrambling together enough money to pay for their next drug while constantly on the run from the police who should be helping them. If they do get their drug, there at terrible risk of overdose from unregulated contaminated black market drugs with dirty needles. Drug buyers don't know if there's 1mg or 100 mg, and often the drug is loaded with concrete, bleach, and other shit.
If they do get imprisoned, it only exacerbates the issues fueling one's addiction. Isolated in a cell, addicts will be more lonely, destroy their job prospects, and without the one drug that made life bearable for them outside bars.
This isn't even mentioning drug laws are extremely classist and racist. When a ton of people are breaking the drug laws, police are incentivized (not their fault) to go for the weakest link. So even though the vast majority of people who do drugs are middle class and aren't addicted, the one's who get targeted by drug laws are the most poor marginalized people in society.
And yet, there's one more problem with illegalization, which puts the nail in the coffin: When drugs are criminalized, it opens up an incredibly lucrative, violent black market drug trade for gangs willing to risk it.
Of course, in order to control this trade, you must at every point in the process avoid getting caught by police, or overtaken by another gang. The best way to do this is by developing a terrifying reputation.
A rival gang takes your friendâs hand. You take one of their heads. They mount another friend's head on a spike. Every act of violence births the nextâbecause if your name doesnât inspire fear, it doesnât move product. And once fear fades, so does your grip on the business. Youâre not just selling drugs. Youâre selling dominance.
People think it's the addicts on drugs which cause the violence in the drug war. Nope. The majority of violence from the drug way is between the police and gangs, most of which aren't under the influence of drugs.
Police in many countries try and stop the drug war, but often, the gangs are too powerful. If you remove one criminal under lord, it causes a series of infighting to find another. Friends on both sides are killed, sparking hatred towards the other even though everyone is human. Other times the police in particularly corrupt countries are paid off and blatantly ignore the black market operating under their feet. They can't do anything, or it would be there head on a spike next.
The black market counterintuitively also makes drugs more addictive because of the iron law of drug illegalization. The law states if drug transport is risky because of being caught, it's much more lucrative to smuggle the hardest versions of a substance than the lighter ones to save space and be able to sell to more people. So, while many addicts would prefer to use a lighter version of heroin for similar effects and less addiction, heroin is often less expensive than its lighter counterparts in the black market.
Criminalization can even spread drugs. Why? Because when you criminalize addiction, you force addicts underground. Underground, they need money. To get money, they become dealers. And to make a profit, they buy some drugs, use what they need, contaminate the rest so they can sell more, then sell them to other people. So to feed one addiction, they may create five more. That's exponential growthânot from usage, but from desperation.
So the drug war hurts addicts, it hurts police, and it hurts the gangs caught up in the violent black market trade. The drug war is a war against sensibility. Thankfully, there is a way out of this mess. A way that has already been explored by a variety of countries that helps addicts builds back trust in the police and dissolves the violent black market over drugs.
What's The Alternative?
Let me paint you a picture.
Imagine walking into a clean, safe clinic. You're greeted by name. No back alley deals, no needle sharing, no bleach-laced heroin. Just a nurse, a sterile room, and a therapeutic plan. You get a regulated dose of the drug you're addicted toâyes, even heroinâbut alongside it, counseling, housing support, connection.
You don't rob or sell and you aren't a criminal; you're a patient.
That's not utopia. That's Portugal.
In 2001, Portugal decriminalized all drugs. Not just weed. Heroin. Cocaine. MDMA. LSD. If you were caught, you weren't thrown in prisonâyou were sent to a panel of social workers, psychologists, and doctors, all aimed at getting to the root of why you were using. Was it loneliness? Trauma? Desperation?
Police, friends, family, and the community as a whole stopped seeing addicts as evil zombies and began seeing them with the empathy we all deserve. And once those relationships started strengthening, addicts realized it was much more addicting than their drugs.
As Hari puts it, the opposite of addiction isn't sobrietyâit's connection.
Before, 70% of reported crime was associated with drugs. Now, 15% is. Before, Portugal had 50% of total HIV transmission in the EU. Now, that's dropped to 1.68%. Before, overdose rates in Portugal were similar to that across the EU. Now, Overdose rates fell by 80% between 1999 and 2016.
Let me be crystal clear: this wasn't because Portugal made drugs free and fun and flung them off rooftops at music festivals. Almost no countries in the world have experimented with full-found drug legalization. They only decriminalized it.
But in the process, they made drugs boring, clinical, regulated and weakened the black market by removing its customer base. They shifted away from abstinence based just say no programs, and towards genuine conversations with kids about what they would do if someone offer them drugs and why they might say no. They made it a conversation that could be talked about rather than something to hide from.
Portugal isn't the only country who's moved toward this. The Netherlands, Vancouver, Norway, and so so many more have gone in this direction. But there is an essential counterargument we must talk about:
"Wouldn't legalizing drugs make more people use them, especially those most susceptible, our kids?"
On the surface, it makes sense. Make something legal, easier to access, and more people will want it.
And in Portugal this as well as some other countries which have moved in this direction, this does seem to be the case. Lifetime drug use among adults rose from 7.8% in 2001 to 12.8% in 2022. In the first five years after drug policy reform, use of illegal drugs rose slightly among the general population. But it fell again in the following five years, and use among 15-24 year olds fell throughout the decade. Drug use in schoolchildren has been consistently below the European average for the past twenty years. And this increase is still below European averages.
Why might this be? Well, we all know people who might be willing to go out and use drugs but don't want to disobey the law. Some changes may be attributed to reduced stigma, leading to more honest reporting, rather than an actual surge in usage. Or adults might actually be using more drugs.
It's too early in drug reform to tell for sure, but the caveat must be said. Here's the question I want you to sit with: is it drugs we're scared of or the effects they're associated with?
We aren't scared of heroin, we're scared of addiction, zombifying, the police, gangs, and more. But with decriminalization and perhaps legalization, those issues become much less prevalent. The fact is even ending the drug war, most people don't want heroin, don't want their friends to use it, and aren't susceptible to addiction.
Drug de-criminalization or legalization doesn't mean getting rid of drug stigmatization. Cigarettes are legal in the U.S. But most of us can't even imagine using one because of how much the negative effects of smoking have been shown through public health announcements, embedded in social norms, laws against smoking in certain areas, and more. Why can't it be the same for other drugs? The forbidden fruit effect disappears when the fruit is labeled, barcoded, and handed to you by a nurse named Deborah in a room that smells like hand sanitizer.
As we explored earlier, addiction is most prevalent when you have negative psychology you're avoiding, particularly from ACEs and loneliness. So even the hardest drug like heroin isn't as dangerous to become addicting to a normal middle-class adult as you might expect. And if they do end up using it more than once in a decriminalized or legal system, what would you rather have: they go to a clinic to get a clean, regulated, version of the drug alongside clinical support, or they try to get it through a black market drug gang? A street dealer will sell a drug to anyone, including your child. A regulated government institution will not.
Maybe the scariest drug isnât heroin, cocaine, or meth. Maybe itâs certainty. The certainty that "drugs are bad," that "addicts are criminals," that "prison will fix them." Those stories might feel safe, but theyâre killing people. And the only antidote is curiosity. What if everything weâve been taught about addiction is wrong? And what if the truthâhowever messyâis our only shot at something better?
References
- https://drugabusestatistics.org/drug-related-crime-statistics/?utm â©ïž
- https://www.who.int/news/item/25-06-2024-over-3-million-annual-deaths-due-to-alcohol-and-drug-use-majority-among-men?utm
- Stead LF, Perera R, Bullen C,Mant D, Hartmann-Boyce J, Cahill K, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD000146. http://www.ncbi.nlm.nih.gov/pubmed/23152200 â©ïž
- Hosseinbor M, Yassini Ardekani SM, Bakhshani S, Bakhshani S. Emotional and social loneliness in individuals with and without substance dependence disorder. Int J High Risk Behav Addict. 2014 Aug 25;3(3):e22688. doi: 10.5812/ijhrba.22688. PMID: 25632385; PMCID: PMC4295122. â©ïž
- https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight?utm_source=chatgpt.com â©ïž