Reconsidering addiction: a film about Bruce Alexander's remarkable 'rat park' experiment

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Seven minute trailer for an upcoming documentary by Jennifer DiCresce on Bruce Alexander's Rat Park experiment:

 

The Following discussion on Rat Park by Mike Jay (reviewing Alexander'sbook the 'Globalisation of Addiction') was originally posted on this blog in January 2009:

Bruce Alexander is best known - though deserves to be much better known - for the 'Rat Park' experiments he conducted in 1981. As an addiction psychologist, much of the data with which he worked was drawn from laboratory trials with rats and monkeys: the 'addictiveness' of drugs such as opiates and cocaine was established by observing how frequently caged animals would push levers to obtain doses. But Alexander's observations of addicts at the clinic where he worked in Vancouver suggested powerfully to him that the root cause of addiction was not so much the pharmacology of these particular drugs as the environmental stressors with which his addicts were trying to cope.

To test his hunch he designed Rat Park, an alternative laboratory environment constructed around the need of the subjects rather than the experimenters. A colony of rats, who are naturally gregarious, were allowed to roam together in a large vivarium enriched with wheels, balls and other playthings, on a deep bed of aromatic cedar shavings and with plenty of space for breeding and private interactions. Pleasant woodland vistas were even painted on the surrounding walls. In this situation, the rats' responses to drugs such as opiates were transformed. They no longer showed interest in pressing levers for rewards of morphine: even if forcibly addicted, they would suffer withdrawals rather than maintaining their dependence. Even a sugar solution could not tempt them to the morphine water (though they would choose this if naloxone was added to block the opiate effects). It seemed that the standard experiments were measuring not the addictiveness of opiates but the cruelty of the stresses inflicted on lab rats caged in solitary confinement, shaved, catheterised and with probes inserted into their median forebrain bundles.

Yet despite (or perhaps because of) their radical implications for the data that underpin addiction psychology, the Rat Park experiments attracted little attention. Alexander's paper was rejected by major journals including Science and Nature, and eventually published only in the respectable but minor Pharmacology, Biochemistry and Behavior. Although the experiments have subsequently been replicated and extended, they still inform the science of addiction only at its margins. The Globalisation of Addiction is Alexander's attempt to draw out their full implications for our understanding of addiction, and to chart a course towards forms of treatment that can transform their findings into practice.

His analysis begins with a radical reconception of addiction itself. Throughout the 20th century, as the science and treatment of addiction have developed into vast academic and professional industries, its underlying nature has stubbornly refused to coalesce into any sort of consensus. Is it a physiological condition marked by metabolic responses such as tolerance and withdrawal, a condition produced simply by exposure to 'addictive' drugs? Or is it a psychological affliction, the product of an 'addictive personality' - or, alternatively, a moral weakness, a failure of willpower and abrogation of social responsibilities? And how do these clinical views of addiction relate to the ever-expanding meanings of the term in the wider culture?

For Alexander, all these seemingly disparate accounts are united by their focus on the individual addict; but even a cursory historical and cultural survey reveals that the incidence of addiction is essentially a social phenomenon. Many historical and indigenous cultures have lacked even the concept of addiction - but many of these same cultures, once their traditional structures have been disrupted by conquest or colonisation, have been destroyed by it. All across the Americas, the Pacific and Australia, hundreds of 'demoralised' cultures have descended into vicious spirals of addiction, usually to alcohol, in many tragic cases wiping themselves out entirely. The root causes of addiction, then, must run deeper than any individual pathology: they must be sought in a larger story of cultural malaise and 'poverty of the spirit' that forces individuals, often en masse, into desperate and dysfunctional coping strategies.

Once addiction is recognised as a consequence of broader social currents, it becomes clear that the problem is far more widespread than the professional focus on drugs allows. Uncontrolled and chaotic appetites are extensively diagnosed across our culture not merely for illicit drugs, alcohol and nicotine but for other substances (food), other consumer activities (shopping, gambling), and other sources of emotional support such as romantic love. 'Addictive' is a slogan of enticement used to sell online gaming, exercise programmes and women's magazines. Even successful and high-functioning individuals can often be accurately described as addicted to money, power or status. Throughout the 20th century, these extensions of the concept of addiction were typically marginalised on the grounds that, unlike illicit drugs, these were mainstream activities that generated dysfunctional behaviour only in a minority of subjects. But alcohol has always been both mainstream and addictive, and it is increasingly clear that illicit drugs are used widely without necessarily generating addiction. Any attempt to get to the root of the problem must recognise that addiction is rampant not merely among a subculture of problem drug users but across society at large.

Alexander's search for the drivers behind the modern explosion in addiction leads him to consider the parallel spread of free market societies. Along with their obvious economic benefits, free markets also bring a widespread increase in what he terms cultural 'dislocation'. What were once elaborately reciprocated cultural transactions are reduced to simple commercial exchanges, and 'the competitive marketplace becomes the matrix of human existence'. Social fabrics are loosened as economic winners and losers polarise into their respective ghettoes, and traditional networks of trust are replaced by often brutal demarcations between neighbourhoods and social classes. It is our now endemic culture of competitive, zero-sum individualism that has, in the phrase of Alexander's title, globalised addiction over the last 50 years.

It is, he acknowledges, too simplistic to blame capitalism itself: the fundamental problem, dislocation, can equally be generated by feudalism , communism or any other political system. Nevertheless, a consumer society systemically erodes the sovereign remedy against addiction which, following Erik Erikson, Alexander terms 'psychosocial integration'. This has long been recognised as a necessity for social functioning: even Charles Darwin, whose theory is typically used to support competitive free market ideology, insisted that generating 'social and moral qualities' was a crucial factor in human evolutionary success. Psychosocial integration eliminates the hyperfocused pursuit of individual gratification that manifests as addictive behaviour, and balances individual autonomy with social belonging. Dislocation, though its effects are concentrated among the poor and socially excluded, has pervasive effects on society as a whole, which is why levels of happiness and wellbeing stubbornly refuse to rise in proportion with purchasing power. The greatest modern triumph over drug addiction, in China during Mao's Great Leap Forward from 1949-1955, took place against a background of material poverty but intense social cooperation in rebuilding a shattered society.

This analysis has helped Alexander to understand the successes and failures of treatment programmes in his professional world in Vancouver, where alcoholism and violence remain an intractable problem among many native Canadian Indians. Dislocation, rather than poverty, is their ultimate cause: communities resettled on unfamiliar land can be subsidised to the point where a 4x4 sits in every drive and a satellite dish on every roof, but still manifest higher levels of addiction than those which are allowed to remain in their homelands and follow their traditional subsistence strategies. In the arresting motto adopted by British Columbia's successful aboriginal community projects, 'Culture is Treatment'.

Once addiction is reconceived as a symptom of the dislocation embedded in modern cultures, the practical measures required to manage it become vast in scope. Treatment of addicts needs to become more holistic, and interwoven into a far wider spectrum of social programmes. Education and treatment need to lose their narrow focus on illicit drugs and alcohol, and to encompass addiction in all its forms. Although the prohibition of drugs is a major contributor to social dislocation, legalisation is far from a panacea: the majority of addictions, after all, are to legally available products. (The greatest benefit of legalisation, perhaps, would be to allow communities to determine their own drug policies, thereby providing a crucial lever for increasing psychosocial integration.) Faith-based treatments, whether Christian or more broadly spiritual, have an important role to play: St. Augustine's Confessions remains a powerful template for the addiction recovery narrative, and membership of faith groups can provide an effective antidote to dislocation. Political activism, both global and local, is a tool of social empowerment that can benefit addicts and addiction professionals alike.

All these strategies are eminently sensible, but remain hard to patch into the treatment of addiction as currently constituted. We may accept Alexander's persuasive case that drug addiction, properly understood, is a scapegoat for broader social dysfunction, but it is by no means obvious how to respond effectively. Like it or not, treatment remains focused on individuals, for whom his analysis holds limited explanatory power. Alexander does not deny the existence of personal tendencies to addiction, which may include genetics and neurochemistry, but maintains that they are often marginal factors and poor predictors of individual risk: overall, interventions are more effective at the social level than the personal. But these underlying causes are far easier to identify than to address. Our societies are profoundly structured around the need for individual autonomy; and personal freedom must, on some levels, always include the freedom to become addicted.

The Globalisation of Addiction is a considerable work, highly ambitious in its scope, impressive in its multidisciplinary scholarship, clear in its structure and generous in its references. It is both its strength and its weakness that it integrates addiction so convincingly into broader issues of social and political reform. Like Rat Park, it offers a fundamental critique of the 20th century view of addiction, but also demonstrates how dominant are the processes and structures that drive it.

Published with permission from Mike Jay. Mike is a writer and historian (See Mikejay.net ) and a trustee of Transform Drug Policy Foundation.

Originally published on www.nthposition.com
Article copyright 2009 Mike Jay

The Globalisation of Addiction is available on Amazon with a readable excerpt.

The heroin and cocaine trade: clear on the problem - unclear on the solution

Foreign Policy magazine have produced an excellent graphic/schematic , by Beau Kilmer and Peter Reuter, showing the inflationary price effects of the illicit market as heroin and cocaine transit through the criminal chain from producers to users in the West (the first page is below - the full article with references is here).

What is lacking, however, is any comment or analysis of the fact that it is very specifically prohibitionist policies (combined with high, and growing, demand) that fuel this extraordinary price inflation. There is also no mention of the fact that there are parallel legal markets in both coca/cocaine and opium/heroin (for medical and other legal uses) that do not demonstrate this same dynamic, and do not feature any criminal activity whatsoever, at any point in the production and supply chain. These existing legal markets are described in some detail in Transform's latest publication 'After the War on Drugs; Blueprint for Regulation'

Unlike the analysis in the Foreign Policy piece that argues, rather lamely, that 'Answers are hard to come by in the quest to fight drugs' , the existing and functioning legal markets for heroin and cocaine, combined with the regulatory models for opiates and coca products discussed in Blueprint, do offer a basis for serioous discussions on ways to effectively combat the illicit trade and its associated problems - and also provide a sound foundation for addressing the longer term public health challenges of problematic use.

Russian Drug Czar calls for fumigation of poppies in Afghanistan

On September 24, during his visit to the US, Victor Ivanov, Director of Russia’s Federal Service for the Control of Narcotics (Russia's Drug Czar), gave a talk at The Nixon Center on "Drug Production in Afghanistan: A Threat to International Peace and Security." Ivanov discussed the effects of drug trafficking on Russia and the world and called for U.S.-Russian cooperation in eradicating the trade. His remarks can be read in their entirety here; a short summary of the event is also available.

Following the extracts from his speech below, is a press briefing from the White House showing that the US administration gave Ivanov short shrift.

In a speech that repeatedly calls for the liquidation and elimination of the Afghan poppy crop, Ivanov extolls the virtues of aerial fumigation. A plan which, to their credit, the Americans have opposed.

The speech is as revealing for what Ivanov doesn't say, as for what he does. Pointedly blaming the Afghans and Americans for the heroin being used in Russia, Ivanov refuses to acknowledge that the demand for heroin in Russia could have anything to do with Russia's domestic and foreign policy, either now, with regard to creating social conditions that drive their citizens into problematic drug use, or their previous interventions in Afghanistan itself.

History apparently began when the US went into Afghanistan in 2001 in order to achieve "Enduring Freedom"!

Well worth a read of the entire speech, Ivanov repeatedly refers to opium/heroin as a security threat. Failing to understand or publicly acknowledge that it is the prohibition that creates the threat, not the drug.

I have pulled out some quotes I think are worthy of specific comment:

Ivanov fails to see any irony in this statement:

"Along with that, being here, at the Nixon Center, is good reason to recall that the “War on Drugs” was declared exactly 40 years ago by President Richard Nixon. And that decision was certainly no coincidence."

Clearly Russia has had only peaceful and benign intent toward its neighbour over the millenia:

"Unfortunately, we have to acknowledge that the instability and military confrontation of the last eight years created in the long-suffering Afghanistan perfect conditions for the rise of a global Narco-State which alone is producing more opiates than the whole world did ten years ago."

Afghanistan takes the full blame for Russia's dreadful habit:

"For Russia the task of liquidation of Afghan drug production is an unrivaled priority as it is Russia that has today become the main victim of this phenomenon.
More than 90 per cent of drug-addicts in our country are consumers of Afghan opiates. Up to 30 thousand people die of heroin annually."

The drug, not the regime of prohibition gets the blame here:

"It must be admitted that heroin ruins young statehoods and kills democracy.
This situation can be rightfully considered a unique global historical phenomenon and qualified according to the UN Charter as a threat to international peace and security."

Some sense here:

"However, what lies behind the global Afghan drug production?
Its main cause is the ongoing geopolitical tension in Afghanistan, induced by the growing resentment of the population, especially Pashto peoples, against foreign military troops which inevitably creates numerous centers of resistance and micro-conflicts."

And the solution to this geopolitical problem?:

"But the clue to solving the problem of Afghanistan lies in the hands of the United States."

"Refusal to eliminate drug crops, declared by Mr. Richard Holbrooke in Trieste as the basis of the new strategy to fight Afghan drugs, is misguiding [misguided ed].
In this connection, the Afghan drug issue should be made one of the main topics and tracks of Russian-American relations."

Be great if it was.

But first some more history:

"Next year, the whole world will commemorate the 65th anniversary of the great Victory over Nazi Germany. The creation of a Russian-American Anti-Drug Coalition by that time would have not only pragmatic, but also a deep symbolical meaning.
After all, it was by virtue of the prompt creation of an anti-Hitler coalition in 1941, immediately after Nazi Germany’s aggression against the USSR, that the defeat of Nazism and militarism became possible in 1945."

Because drugs are like Nazis...but more evil. What would be really interesting would be a Russian-American Drug Coalition, set up by next year that took a global lead toward a peaceful resolution of the war on drugs; not anti-drug, but anti-war...

And again, wrong analysis leads Ivanov to assess opium/heroin as the threat to international peace and security, rather than the war on drugs:

"Our analysis shows that in order to achieve this objective it is necessary to raise the issue of Afghan drug-production to the level of a threat to international peace and security. This would make it possible to turn the campaign against Afghan drug-production into priority for the international community and put the instruments provided by the international law to full use."

However, despite Russian pressure, US resolve to maintain its opposition remains strong. Here is an excerpt from the White House press briefing for 23 September:

Ian Kelly
Department Spokesman
Daily Press Briefing
Washington, DC
September 23, 2009

QUESTION: Russia, and particularly its drug czar, is urging the U.S. to go back to poppy eradication by air. What's your response to that?

MR. KELLY: Yeah. We did take note of that. Of course, Russia is one of the major destination countries for Afghan heroin, and of course, because of that, has been long concerned about international counternarcotic efforts in Afghanistan. They've been active in the Paris pact, a consortium of nations committed to assist Afghanistan combat illicit drug production and trafficking.

As you note, Viktor Ivanov, who is the director of their anti-drug agency, is in Washington, and tomorrow will have meetings with the White House Office of National Drug Control Policy, with Director Kerlikowske, and here at State with David Johnson, who's our Assistant Secretary for International Narcotics and Law Enforcement Affairs.

In general, I think just to sort of lay out what our general policy has been, we believe that large-scale eradication efforts have not worked to reduce the funding to the Taliban. And we believe that it's also worked as a kind of a recruiting tool by driving farmers who have lost their livelihood into the hands of the insurgency. So we're supporting the Afghan Government's efforts to provide farmers with alternative means of supporting themselves.

And because of this new policy, we're reducing support for eradication. We do provide some targeted support for Afghan-led efforts where we think they will work on a case-by-case basis. But our assistance will focus on increased efforts for alternative crop development, and this is part of our overall strategy in Afghanistan of supporting the people and Government of Afghanistan to stand on their own.

Heroin trials welcome - but the wait has cost lives

Transform yesterday wholeheartedly welcomed the results of the heroin prescribing trials (as reported by the BBC), and the understanding that these pilots would be rolled out further still – perhaps to four or five new locations.

However, as the RIOTT Trials are published to much celebration, what have we really discovered?

That problematic heroin users do better on legally regulated pharmaceutically pure diamorphine, than street junk - they steal less and their health improves

That should not be news to anyone. I realised during my third or fourth interview yesterday, that the feigned shock from radio presenters that the Great British Public would be funding heroin users ‘addiction’, should be as nothing compared to their real shock that we are all funding the prohibition that leads users to steal and compromises their health in the first place.

Whilst the presumed roll out is to be welcomed, one has to ask why it has taken so long to come to this conclusion. Evidence has existed for years that, for those assessed as having a clinical need, heroin prescribing will keep them alive, improve their health and wellbeing and reduce the collateral damage of their use to wider society. Indeed there has been a barely concealed sense of inevitability about these trials; the strong impression being that they were needed to provide political cover for a roll out, rather than to provide yet more evidence of the blatantly obvious.

Of course supervised use of legally regulated supplies of heroin significantly improve the lives of users, who otherwise have commit crime to raise money to score dirty drugs from gangsters, for consumption using dirty paraphernalia in marginalised and unsafe environments. The lesson here is that moves to take users out of the illegal market and into a regulated supply where drugs are quality controlled will produce the kind of outcomes we all want to see.

The fact is that thousands of long term dependent heroin users have died, or contracted serious diseases in the last three decades because of the failure of Government to maintain or develop heroin prescribing services. And, with the Department of Health playing badly strung second fiddle to the Home Office, much of the medical establishment has been complicit in this tragedy by maintaining a deafening silence.

But NHS heroin isn't the only way forward here; access to cheap smokeable opium from licenced outlets would also achieve significant decreases in crime and improvements in health, as it would also promote transition towards safer products, using behaviours, and using environments. We would hope too, that the next round of trials includes provision of oral morphine (and possibly other pill form synthetic and semi-synthetic opiates), which will be effective for many, and is also dramatically cheaper, and safer, than injectable dry ampules.

The substantially increased cost of prescribing injectable heroin, compared with oral methadone, must also be seen in the context of the Macfarlane Smith monopoly on the UK opiates market that the Department of Health buys from. That means that the UK pays well over the odds for our diamorphine (£12,000 a year per user), compared to the Dutch (£2000 a year for the same product). This artificial cost barrier has been a major political obstacle.

Finally, let us hope that these trials pave the way to more discussion of how best to control and regulate drug supply and use, beyond the limited numbers able to avail themselves of medicalised heroin. And that those members of the medical establishment who have held this initiative back, feel their consciences pricked and support a scheme that could save the lives of hundreds more in the future.

UNODC mugged by reality

Sanho Tree, writing below for the Transform blog, responds to the Guardian report last week that 'UN wants 'flood of drugs' in Afghanistan to devalue opium':

United Nations officials in Afghanistan are attempting to create a "flood of drugs" in the country intended to destroy the value of opium and force poppy farmers to switch to legal crops such as wheat.

After the failure to destroy fields of the scarlet flowers in Afghanistan's volatile south, the United Nations Office on Drugs and Crime says the answer is to stop the drugs from leaving the country in the first place.

"Manual eradication is incompetent and inefficient," UNODC chief Antonio Maria Costa said during a visit to the western Afghan province of Herat. "So we want to see more efforts to stop the flow of drugs across Afghanistan's borders and the hitting of high-value targets to create a market disruption.

"We want to create a flood of drugs within Afghanistan. There will be so much opium inside Afghanistan unable to go out that the price will go down."

It looks like Costa has finally been mugged by reality.

When the Taliban allowed anyone to grow poppies in the late 1990s, the price of a kilo of opium fell to $30 on the streets of Kandahar because of the resulting glut. When Mullah Omar decreed it was no longer consistent with Islamic values to grow poppies in 2000, the prohibitionist price of opium shot up to $740/kilo just before the Sept. 11 attacks.

For the first time that I can recall, a prominent drug warrior has allowed the inconvenient truth of prohibition economics to intrude on his crusade.

Alas, Costa still clings to the idea that opium can still be stopped from leaking across the borders of Afghanistan. Still, the idea of allowing the natural devaluing of illicit crops by stopping eradication is more than a baby step -- it's a sea change in drug war thinking and it stops the counterproductive and inhuman "war" against peasant farmers. Now that he has admitted the futility of shoveling water, we can only hope he will abandon the idea of building a metaphorical wall around the country.

While I truly applaud Costa's belated arrival to the real world, it is still a fairly simplistic solution he has outlined. Since the days of the Silk Road Afghanistan has been been famous for trading by merchants, plundering by bandits, and smuggling by tax evaders. The latter two groups know the terrain better than any Westerner or Google map and I doubt NATO can seal the borders from these people any more than they can keep the Taliban from walking back and forth
to Pakistan. It's also one of the most corrupt countries in the world so a little cash can facilitate a lot of smuggling.

While the addiction rates in Afghanistan are still relatively low and rising, the neighboring countries have a huge addiction and HIV problem as a result of cheap Afghan heroin. The situation is dire and demands real solutions.

Still, I think his policy switch is important for five main reasons:

1) It's the first time a top drug warrior has allowed the law of supply and demand to rear its inconvenient head into policymaking. Will wonders never cease? Once they have acknowledged
this, it's hard to go back and pretend they can still make illicit crops disappear by making them astronomically more valuable in a world where HALF of the human race "subsists" on less than $2/day.

2) It's hard to eradicate in a region where illicit crops have taken root and the trade networks have been established. It's a lot easier to prevent a region from converting to illicit crops in the first place. If farmers transition back to legal crops, those networks could recede and then they might have a chance of preventing their return if there is sufficient aid for infrastructure and credit.

3) Adam Smith's "invisible hand" will be the culprit that motivates farmers to switch crops on their own. It doesn't make NATO forces and the UN into the hated "bad guys" who eradicated the fields of peasant farmers and drove them into the arms of the Taliban. The Taliban's fatal mistake in 2000 was in imposing total prohibition of poppy cultivation. While it made some Taliban commanders fabulously wealthy because they had cornered the market on warehoused opium at pre-prohibition prices, it turned farmers against them because they starved and suffered as a result so they were happy to help NATO forces.

4) When the opium prices fall, the Taliban will have a harder time funding their war and fewer lives should be lost. This could hasten the withdrawal of combat troops and the decreased violence should allow for more effective development assistance -- assuming Congress doesn't repeat the mistakes of the last Afghan war against the Soviets. To recall, we wiped our asses and left as soon as the Soviets retreated thus leaving a perfect vacuum for civil war and eventual Taliban victory.

5) They can now stop punishing the weakest of the weak and the poorest of the poor. Forced eradication without providing viable alternative livelihoods is not only counterproductive, but it is also monstrously cruel.

See previous blogs:

• Afghan Opium and the Empor0r's New Clothes

• Unintended consequences - side effects and contra indications of Global prohibition
  
  

Transform publishes comparative cost-effectiveness study of prohibition / regulation

Transform's latest report is published today:

A Comparison of the Cost-effectiveness of the Prohibition and Regulation of Drugs

media coverage listing below

Summary

‘The benefits of… [legalisation/regulation] – such as taxation, quality control and a reduction in the pressures on the criminal justice system – are far outweighed by the costs and for this reason, it is one that this Government will not pursue either domestically or internationally.”

Home Office Briefing, 2008

• Despite the billions spent each year on proactive and reactive drug law enforcement, the punitive prohibitionist approach has consistently delivered the opposite of its stated goals. The Government’s own data clearly demonstrates drug supply and availability increasing; use of drugs that cause the most harm increasing; health harms increasing; massive levels of crime created at all scales leading to a crisis in the criminal justice system; and illicit drug profits enriching criminals, fuelling conflict and destabilising producer and transit countries from Mexico to Afghanistan. This is an expensive policy that, in the words of the UN Office on Drugs and Crime, has also created a raft of negative ‘unintended consequences’.
  
  
• The UK Government specifically claims the benefits of any move away from prohibition towards legal regulation of drug markets would be outweighed by the costs. No such cost-benefit analysis, or even a proper Impact Assessment of existing enforcement policy and legislation has ever been carried out here or anywhere else in the world. Yet there are clear Government guidelines that an Impact Assessment should be triggered by amongst other things, a policy going out to public consultation or when ‘unintended consequences’ are identified, both of which have happened with drug policy in recent years.
  
  
• Alternative approaches - involving established regulatory models of controlling drug production, supply and use - have not been considered or costed. The limited cost effectiveness analysis of current policy that has been undertaken has frequently been suppressed. In terms of scrutinizing major public policy and spending initiatives, current drug policy is unique in this regard.
  
  
• The generalisations being used to defend continuation of an expensive and systematically failing policy of drugs prohibition, and close down a mature and rational exploration of alternative approaches, are demonstrably based on un-evidenced assumptions.
  
  
• This paper is an attempt to begin to redress these failings by comparing the costs and benefits of the current policy of drug prohibition, with those of a proposed model for the legal regulation of drugs in the UK. We also identify areas of further research, and steps to ensure future drugs policy is genuinely based on evidence of what works.
  
  
• This initial analysis demonstrates that a move to legally regulated drug supply would deliver substantial benefits to the Treasury and wider community, even in the highly unlikely event of a substantial increase in use.

Media Coverage:

BBC radio 4: The Today Programme:

• Home affairs correspondent Mark Easton Could we save money by legalising drugs? ( 0.53-0.57)
• Transform's Steve Rolles Drug policy "not cost-effective"

BBC Mark Easton's Blog: Could we save billions by legalising drugs?

BBC R4 'More or Less': the price of prohibition (podcast or listen again)

Guardian news: Legalisation of drugs could save UK £14bn, says study

Guardian Comment piece by Danny Kushlick: Immunised from scrutiny

Telegraph: Illegal drugs cost the country £16bn a year, says charity Transform

Financial Times: Call to review drugs legalisation

Mirror: Legalise drugs to halve crime

Metro: Halve drug deaths by making heroin and cocaine legal (Plus the Metro Poll)

The London Paper: legalising heroin and cocaine could halve drug deaths report says

The Herald: Call for heroin and cocaine to be legalised in bid to halve deaths

ePolitix: Legalising heroin and cocaine could save £10 bn

BMJ medical ethics blog: Drug Policy Transformed

The Register: Legalising drugs would save UK plc a packet. Common sense doomed by Guardian/Daily mail axis

New Statesman: Limping Along on the Left

Politics.co.uk: the cost of drug wars: £16 billion

Hungarian news portal:no translation available


not all the print coverage was positive / straight reportage:

South Wales Evening Post: legalising drugs would lead to chaos

Daily Mail: Peter Hitchens: Eliot Ness couldn't stop booze, but he would win today's war on drugs ("Another parcel of garbage from the pro-drug lobby")


Other broadcast interviews included :

Radio:

• BBC Five Live drive-time
  
• BBC radio Wales
  
• BBC radio London
• Talk Sport radio
  
• LBC radio
  
• Liverpool city talk radio
• SFM (South Africa national radio station)
  

TV

• South Africa Broadcasting corporation TV news
  
• BBC news channel
  
• Channel five - The Wright Stuff (discussion of report not featuring Transform staff)
  

Ministry of Defence propaganda and the Afghan drug war

The media today is full of reports about a massive military operation in the Helmand province of Afghanistan, codenamed DIESEL. Closer examination reveals reporting of the operation to have been dramatically propagandized by the Ministry of Defense, with the media acting as their willing - if somewhat confused - accomplices. Somehow a story about less than a £100,000 worth of raw opium has been transformed into a story about £50,000,000 worth of 'deadly heroin'.

Reports of the story in different media are strangely contradictory:

The Sun told us that

“Enough raw materials to produce heroin with a street value of £50million was seized from a sprawling network of compounds.”

The Press Association reported that:

“A daring military operation in Afghanistan has seized heroin and drug-making chemicals with an estimated final street value of more than £50 million”.

The headline in the usually reliable Guardian was

“British troops seize £50m of Taliban narcotics”

with the coverage noting that:

“Troops recovered more than 400kg of raw opium in one drug factory and nearly 800kg of heroin in another.”

From the Telegraph we learnt that:

“British forces have seized £50 million of heroin and killed at least 20 Taliban fighters in a daring raid that dealt a significant blow to the insurgents in Afghanistan."

the Independent told us that:

“Troops seize £50m of Afghan opium”

Whilst the for the BBC it was

“Raids seize £50m of Afghan heroin”

One of the MOD issued action shots: In the Daily Mail this image is subtitled with:

"Operation Diesel: British troops have taken £50million worth of heroin during an attack on a remote Taliban stronghold in Afghanistan"

These are just 7 out of the 100s of reports (600+ listed on Google news), each of the above with a different version of events. They cant all be right, so which one is? Bizarrely enough, a cursory check of the Ministry of Defence's online account reveals they are all wrong.

The MOD website account describes three separate drug finds: one of ‘over 60kg of wet opium’, another of ‘over 400kg of raw opium’ and a third, ‘the largest find of opium on the operation, nearly 800kg’. Along with this opium a “massive supply of the essential chemicals required to make heroin were discovered; sacks of Ammonium Chloride, barrels of Acetic Anhydride and other chemicals that were piled up ready for use”.

So operation DIESEL, in reality, resulted in the finding and destruction of somewhere in the region of 1300kg of unprocessed opium and an a quantity of the chemicals required to process opium into heroin. A few quick sums: According to the UNODC the 'farm-gate' price for opium in Afghanistan in 2008 was $85 a kilo, and these DIESEL stockpiles were presumably not far from the Helmand farms on which they were produced. 1300 x 85 = $110,500, in other words, opium worth approximately £78,000 to the Taliban, at this point in the supply chain.

Were this 1300kg of opium to have been turned into low grade heroin (and we can reasonably suspect that this was what was going to happen), on the basis that it takes around 10kg of opium to produce 1 kg of heroin, it would have produced around 130kg. If the ‘street price’ of a kilo of heroin in the UK is estimated to be around £50- 75,000, then 130 kilos would earn you somewhere between £6.5 and £9.7 million. A very large sum of money certainly, albeit nowhere near £50 million.

The UK street price of a kilo of heroin is, however, vastly inflated above what a kilo of heroin in Afghanistan is worth to the Taliban – the only ‘farm-gate’ price estimate I can find is £450*. But that seems low so lets be generous and put it at a nice round £1000; you are still looking at a Taliban heroin haul worth only £130,000 (and even if the Taliban sold it on the next link in the supply chain at some point in the future for ten times this, the figure only reaches £1,300,000). According to the Independent report the following were found: 5,000kg of ammonium chloride, 1,025 litres of acetic anhydride, 1,000kg of salt and 300kg of calcium hydroxide, which the MOD tells us is exactly enough chemicals to process a conveniently media friendly total of £50million pounds (UK street value) worth of heroin, but this would only be the case if there had been another 5-10 tons of opium seized, which there wasn't. The chemicals themselves are not especially hard to get hold of, or expensive (relative to the profits being made anyway), and processing opium into low grade morphine/heroin for transport is not especially difficult.

None the less, through the prism of MOD drug war propaganda and lazy journalism a story about £78,000 worth of opium has miraculously transmuted into a story about £50,000,000 worth of ‘deadly heroin’.

Defense secretary John Hutton plays this willful misunderstanding for all its worth, quoted extensively (from the MOD report) saying that:

“The seizure of £50 million worth of narcotics will starve the Taliban of crucial funding preventing the proliferation of drugs and terror on the UK's streets.”

So lets be clear; Hutton claims '£50million worth of narcotics' was seized, a ‘fact’ which is demonstrably shown to be untrue by the very same report he is quoted in. Numerous media outlets in the UK and around the world then ran the story that '£50m of heroin' was seized (Daily Mail, Telegraph, BBC etc) – even though no heroin was seized and the 50million figure is pure fiction (one that goes some way beyond the tired old 'make the seizure sound as big as possible by quoting the street price’ trick). The MOD report even opens with the (slightly different) claim that they captured ‘drugs, chemicals and equipment with a UK street value of £50m’ – which is also multi-tiered nonsense.

Worse still, and even if you want to argue the toss over the street value figures, the Hutton quote appears to deliberately imply that the Taliban have somehow been deprived of £50million in funds by this action – when in fact the reality is probably nearer £130,000, and this is assuming that these were indeed establishments entirely in the control of, and serving the profits of the Taliban, which again we have to take on trust from the MOD, and assuming they had a way of establishing it as fact. The Taliban and network of opium farmers also have stockpiles of opium, estimated by the UNODC to run to several 1000's of tons, so it is unlikely this raid will have any serious impact on supply. Moreover, evidence clearly suggests (and indeed the UNODC have argued) that restricting supply serves to increase prices - so the the net impact on profits of sporadic interdiction successes will be even less - potentially even boosting the value of remaining stockpiles.

According to the UNODC’s most recent Afghanistan report the Taliban are making between $250 and $470 million (or £175 - £330 million) a year from the Afghan drug economy (both in taxing poppy farmers and direct involvement in production and export) based on production of between 7 and 8 thousand tons of opium. This rather puts some of the ministers’ grand claims into perspective; this mission prevented maybe £100k in Taliban profits, and destroyed just over one ton of opium (and 20 dead Taliban).

To achieve this triumphant success took 700 troops and veritable fleet of high tech armoury and helicopter gunships (“including RAF Chinooks, Royal Navy Sea Kings and Lynx, joined by US CH53 Sea Stallions”). It will all have doubtless been fantastically expensive, and whilst we are in no position to estimate exactly what the operation did cost (PQ anyone?) we can be sure it would have been many many millions.

This is nothing less than a classic example of war time propaganda – and the madness of the drug war requires more propaganda to support it than most. Reading the MOD report makes this all the more clear. The media were provided with action photos, and action video footage as well as an account that reads like a Boys own war story. The targets are variously described as ‘labs’, ‘drug factories’ and ‘processing plants’ discovered in a ‘chain of compounds’, all sounding rather more like a Bond-villain’s high-tech lair than the mud huts full of dirty plastic bags and rusty barrels we see in the video footage.

The standard issue 'kicking the door down' drug-bust action shot

It has been a quite brilliant propaganda coup for the MOD, with the media uncritically reporting their account, ludicrously inflated statistics and all (and still almost all of them getting even that completely wrong, including the broadsheets). Some of the reporting is extraordinary; The BBC even ran the ‘Raids seize £50m of Afghan heroin’ headline, despite in the body of its report noting that ‘Troops destroyed 1,295kg of wet opium, estimated to have a street value of more than £6m as heroin’.

The need for such propaganda is not surprising. The Afghan conflict is a disaster; despite many billions being spent by the UK, the country is falling apart. The Taliban are resurgent, there is no evidence that the attack on the drug economy is achieving anything positive in the UK or Afghanistan, and the UK soldier casualty list has grown to 145 (one more announced today), not to mention the US and Afghan casualties. The MOD obviously need stories of success like this more desperately than ever, to give the impression they are 'winning' even when the opposite is true. That the operation was 'brilliant', 'daring', 'brave' and 'skillful' is not the point - it does not mean that it wasn't also ultimately futile or even counterproductive. The last thing the Government wants is for people to be told the truth; not just that the Afghanistan drug war is a disaster, but that it is the Government’s complicity in global drug prohibition that gifts control of the completely unregulated opium market to the Taliban insurgents and War lords in the first instance. Half of the worlds opium production is entirely legal and regulated for the medical opiates market (a small proportion of which is prescribed to addicts as heroin) and this legal production is not funding any paramilitary groups, mafiosi, or terrorists. We do have a choice.

More surprising perhaps is that the media, even what we like to think of as the quality end of the market, were so happy to uncritically regurgitate it all. Questioning the Government's account of foreign wars in not a betrayal of our troops – quite the opposite. It is what the media should be doing, and we have been badly let down.

Update 19.02.09:

I have now spoken briefly to the MOD press office. They maintain that the UK street price calculations are based on the heroin being sold at 40% purity. The calculations above are based on the UK street price of a kilo of heroin being sold at £75K. This translates into £75 a gram which is around double the usual street price anyway - so this would not substantially alter the analysis. Even if we do double the UK street price valuation - this still only takes it to a range of £12-20million.

See also:

• Afghan opium and the Emperor's new clothes
  
  
• The opium war's front line: Afghanistan, Iran and Hampshire
  
  
• Drug War remembrance
  

*The £450 figure comes from this report: Matrix Knowledge Group (2007). The illicit drug trade in the United Kingdom. Home Office Online Report 20/07. London: Home Office. It is a bit confusing - it seems too high to be referring to opium (unless you go back to 2001-2003) but does define farm-gate price of 'heroin' as the price received by the farmer before any subsequent processing’ - any clarification of this or alternative data would be appreciated.

Addicts’ adventures in wonderland

The following editorial by Danny Kushlick was published in the the journal; Addiction Research and Theory (15(2): 123–126) in April 2007*, and is reproduced here as much of it seems relevant to current debates, both on this blog and in the wider drugs field.

Addicts’ adventures in wonderland

Viewed from a public health and wellbeing perspective, you could be forgiven for thinking that drug policy is developed at the Mad Hatter’s tea party. Huge numbers of legal drug users are effectively ignored, whilst relatively tiny numbers of illegal users have enormous time and resources spent on stopping them using.

I am going to suggest that policy is not rationally based upon sound public health or harm reduction principles, but rather that it is skewed to the point of ridiculousness by the Government’s denial of the counter-productive effects of drug prohibition.

What is the drug problem?

The drugs in the UK that contribute overwhelmingly to public ill health are tobacco and alcohol. Both are legal, with tobacco sales oddly, legally sold to those over the age of 16, as opposed to 18 for alcohol. There are over 10 million regular tobacco users and 40 million alcohol users. Alcohol is implicated in about 40,000 deaths per year, with 120,000 for tobacco. Tobacco products carry a health warning but no ingredients list, whilst alcohol products carry neither.

Cocaine and heroin also contribute to public ill health but at much lower levels of use. Both are illegal and consequently there are no controls on their production, sale or use, apart from the blanket prohibition that aims, fantastically, to eliminate them from society. There are an estimated 340,000 problematic heroin and crack cocaine users in the UK and much of the ill health associated with their use is directly related to their illegality.

Within the national ‘drug’ strategy there is no discussion of the needs of our 10 million plus tobacco users, four million problem drinkers or our one million prescribed tranquilliser users. The reason: our commitment to drug prohibition (and the orchestrated demonisation of illegal drugs that has gone with it) has blinded us to the fact tobacco, alcohol and tranquillisers are drugs. And more importantly, that the use of licit drugs constitutes by far the bigger public health problem.

Messages on ‘Addiction’

What does the Government’s Talk to Frank website say about cocaine and alcohol ‘addiction?’ Under the heading ‘Chances of getting hooked’ it says: ‘Coke is very addictive. It can be difficult to resist the craving and strong psychological dependence due to changes in the brain. Recent evidence suggests possible long-term changes to the nervous system’. And under the same heading for alcohol: ‘For most people, if you drink within the sensible limits for regular drinking, that’s OK. But for some people drinking gradually gets out of control and results either in regular binge-drinking, heavy harmful drinking or alcoholism (alcohol dependence)’. But, note not ‘addiction’ and no long-term changes to the nervous system.

So, different messages for each drug. But what about the response to those who do develop a ‘drug problem?’

Treatment – voluntary and coerced

As a result of our long-standing ‘war’ on illegal drugs, an enormous amount of resources are skewed toward ‘treating’ people who commit acquisitive crime in order to support their habits. One of the consequences of the prohibition of heroin and cocaine is that the price of a daily habit is hugely inflated. Consequently low income dependent users resort to crime to earn money and collectively commit anything up to half of all property crime. A Government that is keen to be seen to be ‘doing something about the drugs problem’ must try to ‘get addicts off ’ their drugs. Because if they don’t, ‘addicts’ will continue stealing things and prostituting themselves in public and generally proving how counterproductive prohibition is. The problem is that we have an apparent crime problem, that appears to be a drug problem, for which ‘treatment’ would appear to be the solution. When in fact, it is a self created prohibition problem (an attempt to eradicate a symptom of lack of wellbeing),underlying which are unaddressed wellbeing problems.

A Drug Rehabilitation Requirement (DRR) is a court-ordered treatment condition handed out for those who are convicted of offences related to their illegal drug use, usually acquisitive crime. But, remember it is our commitment to the global prohibition of drugs that create the high prices, that cause the offending to support a habit in the first instance. Interestingly, there are very few orders given for those whose violent offending is related to their alcohol use. You might wonder if the Government is more committed to addressing problematic drug use that creates property crime than that which creates horrible violence against other people.

Within a prohibitionist paradigm it makes perfect sense for Home Office-led interventions to force heroin ‘addicts’ to overcome their ‘addiction’. Whereas for the Department of Health: ‘Alcohol drunk in moderate amounts in appropriate circumstances is not a danger to health’. Perhaps we need a Drug Policy Rehabilitation Requirement for politicians in denial of the unintended consequences of enforcing prohibition.

Imagine someone walking into his or her local drug project seeking help to get into residential rehab for tobacco ‘addiction’. Why does this seem odd, funny even? The fact is that it even if it were to be possible for them to get funding for rehab, most centres allow residents to smoke tobacco.

Think about the number of smokers you know who are in ‘recovery’ from ‘addiction’, having assiduously gone through a twelve-step programme. (Both the co-founders of AA died of smoking-related disease.)

Our anomalous attitude to drug ‘treatment’ is not unlike the Caucus Race that the Dodo organised in Wonderland:

‘What I was going to say’, said the Dodo in an offended tone, ‘was, that the best thing to do to get us dry would be a Caucus-race’.

‘What is a Caucus-race?’ said Alice . . .

‘Why’, said the Dodo, ‘the best way to explain it is to do it’ .. . .

First it marked out a racecourse, in a sort of a circle, (‘the exact shape doesn’t matter’, it said,) and then all the party were placed along the course, here and there. There was no ‘One two three and away’, but they began running when they liked, and left off when they liked, so that it was not easy to know when the race was over. However, when they had been running half an hour or so, and were quite dry again, the Dodo suddenly called out ‘The race is over!’ and they all crowded round it, panting, and asking, ‘But who has won?’

This question the Dodo could not answer without a great deal of thought, and it sat for a long time with one finger pressed upon its forehead . . . . At last the Dodo said, ‘Everybody has won, and all must have prizes’.

Except that those illegal drug users who are not ‘dry’ after half an hour might well find the Queen shouting at them, ‘Off with his head!’

A public health and wellbeing approach

The recent report from UNICEF put the UK at the bottom of the table of 21 countries for child wellbeing in industrialised countries, with the United States 20th. The UK and US also have some of the highest levels of drug use and misuse in developed countries and both also enforce some of the harshest drug laws on earth. The UK has the highest prison population in Europe, the US the highest in the world. Perhaps this is what is meant by the ‘special relationship?’

These laws conform to neither legislative nor public health norms when compared to other social issues (imagine criminalising tobacco use, gambling or teenage pregnancy). The criminal justice system should be used as a last resort, not a starting point in dealing with public health problems.

A drug policy based on a public health and wellbeing paradigm would be truly comprehensive, cross-departmental and tick all the right boxes with regard to social determinants of health and wellbeing. It might look something like the text below, adapted from Tony Blair’s forward to the Alcohol Harm Reduction Strategy of 2004. I have swapped the words ‘drugs’ and ‘drug use’ for ‘alcohol’ and ‘drinking’. It speaks for itself:

‘Millions of us enjoy drug use with few, if any, ill effects. Indeed moderate drug use can bring some health benefits. But, increasingly, drugs misuse by a small minority is causing two major, and largely distinct, problems: on the one hand crime and anti-social behaviour in town and city centres, and on the other harm to health as a result of binge- and chronic drug use.

The Strategy Unit’s analysis last year showed that drugs-related harm is costing around £20 bn a year,and that some of the harms associated with drugs are getting worse.

This is why the Government has been looking at how best to tackle the problems of drug misuse. The aim has been to target drug-related harm and its causes without interfering with the pleasure enjoyed by the millions of people who use drugs responsibly.

This report sets out the way forward. Alongside the interim report published last year it describes in detail the current patterns of drug use – and the specific harms associated with drugs. And it clearly shows that the best way to minimise the harms is through partnership between government, local authorities, police, industry and the public themselves.

For government, the priority is to work with the police and local authorities so that existing laws to reduce drug-related crime and disorder are properly enforced, including powers to shut down any premises where there is a serious problem of disorder arising from it. Treatment services need to be able to meet demand. And the public needs access to clear information setting out the full and serious effects of heavy drug use. For the drugs industry, the priority is to end irresponsible promotions and advertising; to better ensure the safety of their staff and customers; and to limit the nuisance caused to local communities.

Ultimately, however, it is vital that individuals can make informed and responsible decisions about their own levels of drug consumption. Everyone needs to be able to balance their right to enjoy using drugs with the potential risks to their own – and others’ – health and wellbeing. Young people in particular need to better understand the risks involved in harmful patterns of drug use. I strongly welcome this report and the Government has accepted all its conclusions. These will now be implemented as government policy and will, in time, bring benefits to us all in the form of a healthier and happier relationship with drugs’.

The health and wellbeing approach will become reality within a decade, but for now unfortunately, Mr Blair and his colleagues prefer Wonderland.

References

• UNICEF report on BBC
  
  
• ‘Talk to Frank’ web site
  
  
• ‘Alice’s Adventures in Wonderland’, Lewis Carroll, 1865
  
  
• Tony Blair’s Foreword to the Alcohol Harm Reduction Strategy, 2004 (from an idea by Steve Rolles) See here

Danny Kushlick is Director of Transform Drug Policy Foundation**

* note that some of the content is out of date
** Danny Kushlick is now head of policy and commincations

When rats were placed in an environment ideally suited to their needs, they no longer showed interest in puhsing levers for rewards of morphine.

'The globalisation of addiction' by Bruce Alexander

review by Mike Jay

Bruce Alexander is best known - though deserves to be much better known - for the 'Rat Park' experiments he conducted in 1981. As an addiction psychologist, much of the data with which he worked was drawn from laboratory trials with rats and monkeys: the 'addictiveness' of drugs such as opiates and cocaine was established by observing how frequently caged animals would push levers to obtain doses. But Alexander's observations of addicts at the clinic where he worked in Vancouver suggested powerfully to him that the root cause of addiction was not so much the pharmacology of these particular drugs as the environmental stressors with which his addicts were trying to cope.

To test his hunch he designed Rat Park, an alternative laboratory environment constructed around the need of the subjects rather than the experimenters. A colony of rats, who are naturally gregarious, were allowed to roam together in a large vivarium enriched with wheels, balls and other playthings, on a deep bed of aromatic cedar shavings and with plenty of space for breeding and private interactions. Pleasant woodland vistas were even painted on the surrounding walls. In this situation, the rats' responses to drugs such as opiates were transformed. They no longer showed interest in pressing levers for rewards of morphine: even if forcibly addicted, they would suffer withdrawals rather than maintaining their dependence. Even a sugar solution could not tempt them to the morphine water (though they would choose this if naloxone was added to block the opiate effects). It seemed that the standard experiments were measuring not the addictiveness of opiates but the cruelty of the stresses inflicted on lab rats caged in solitary confinement, shaved, catheterised and with probes inserted into their median forebrain bundles.

Yet despite (or perhaps because of) their radical implications for the data that underpin addiction psychology, the Rat Park experiments attracted little attention. Alexander's paper was rejected by major journals including Science and Nature, and eventually published only in the respectable but minor Pharmacology, Biochemistry and Behavior. Although the experiments have subsequently been replicated and extended, they still inform the science of addiction only at its margins. The Globalisation of Addiction is Alexander's attempt to draw out their full implications for our understanding of addiction, and to chart a course towards forms of treatment that can transform their findings into practice.

His analysis begins with a radical reconception of addiction itself. Throughout the 20th century, as the science and treatment of addiction have developed into vast academic and professional industries, its underlying nature has stubbornly refused to coalesce into any sort of consensus. Is it a physiological condition marked by metabolic responses such as tolerance and withdrawal, a condition produced simply by exposure to 'addictive' drugs? Or is it a psychological affliction, the product of an 'addictive personality' - or, alternatively, a moral weakness, a failure of willpower and abrogation of social responsibilities? And how do these clinical views of addiction relate to the ever-expanding meanings of the term in the wider culture?

For Alexander, all these seemingly disparate accounts are united by their focus on the individual addict; but even a cursory historical and cultural survey reveals that the incidence of addiction is essentially a social phenomenon. Many historical and indigenous cultures have lacked even the concept of addiction - but many of these same cultures, once their traditional structures have been disrupted by conquest or colonisation, have been destroyed by it. All across the Americas, the Pacific and Australia, hundreds of 'demoralised' cultures have descended into vicious spirals of addiction, usually to alcohol, in many tragic cases wiping themselves out entirely. The root causes of addiction, then, must run deeper than any individual pathology: they must be sought in a larger story of cultural malaise and 'poverty of the spirit' that forces individuals, often en masse, into desperate and dysfunctional coping strategies.

Once addiction is recognised as a consequence of broader social currents, it becomes clear that the problem is far more widespread than the professional focus on drugs allows. Uncontrolled and chaotic appetites are extensively diagnosed across our culture not merely for illicit drugs, alcohol and nicotine but for other substances (food), other consumer activities (shopping, gambling), and other sources of emotional support such as romantic love. 'Addictive' is a slogan of enticement used to sell online gaming, exercise programmes and women's magazines. Even successful and high-functioning individuals can often be accurately described as addicted to money, power or status. Throughout the 20th century, these extensions of the concept of addiction were typically marginalised on the grounds that, unlike illicit drugs, these were mainstream activities that generated dysfunctional behaviour only in a minority of subjects. But alcohol has always been both mainstream and addictive, and it is increasingly clear that illicit drugs are used widely without necessarily generating addiction. Any attempt to get to the root of the problem must recognise that addiction is rampant not merely among a subculture of problem drug users but across society at large.

Alexander's search for the drivers behind the modern explosion in addiction leads him to consider the parallel spread of free market societies. Along with their obvious economic benefits, free markets also bring a widespread increase in what he terms cultural 'dislocation'. What were once elaborately reciprocated cultural transactions are reduced to simple commercial exchanges, and 'the competitive marketplace becomes the matrix of human existence'. Social fabrics are loosened as economic winners and losers polarise into their respective ghettoes, and traditional networks of trust are replaced by often brutal demarcations between neighbourhoods and social classes. It is our now endemic culture of competitive, zero-sum individualism that has, in the phrase of Alexander's title, globalised addiction over the last 50 years.

It is, he acknowledges, too simplistic to blame capitalism itself: the fundamental problem, dislocation, can equally be generated by feudalism , communism or any other political system. Nevertheless, a consumer society systemically erodes the sovereign remedy against addiction which, following Erik Erikson, Alexander terms 'psychosocial integration'. This has long been recognised as a necessity for social functioning: even Charles Darwin, whose theory is typically used to support competitive free market ideology, insisted that generating 'social and moral qualities' was a crucial factor in human evolutionary success. Psychosocial integration eliminates the hyperfocused pursuit of individual gratification that manifests as addictive behaviour, and balances individual autonomy with social belonging. Dislocation, though its effects are concentrated among the poor and socially excluded, has pervasive effects on society as a whole, which is why levels of happiness and wellbeing stubbornly refuse to rise in proportion with purchasing power. The greatest modern triumph over drug addiction, in China during Mao's Great Leap Forward from 1949-1955, took place against a background of material poverty but intense social cooperation in rebuilding a shattered society.

This analysis has helped Alexander to understand the successes and failures of treatment programmes in his professional world in Vancouver, where alcoholism and violence remain an intractable problem among many native Canadian Indians. Dislocation, rather than poverty, is their ultimate cause: communities resettled on unfamiliar land can be subsidised to the point where a 4x4 sits in every drive and a satellite dish on every roof, but still manifest higher levels of addiction than those which are allowed to remain in their homelands and follow their traditional subsistence strategies. In the arresting motto adopted by British Columbia's successful aboriginal community projects, 'Culture is Treatment'.

Once addiction is reconceived as a symptom of the dislocation embedded in modern cultures, the practical measures required to manage it become vast in scope. Treatment of addicts needs to become more holistic, and interwoven into a far wider spectrum of social programmes. Education and treatment need to lose their narrow focus on illicit drugs and alcohol, and to encompass addiction in all its forms. Although the prohibition of drugs is a major contributor to social dislocation, legalisation is far from a panacea: the majority of addictions, after all, are to legally available products. (The greatest benefit of legalisation, perhaps, would be to allow communities to determine their own drug policies, thereby providing a crucial lever for increasing psychosocial integration.) Faith-based treatments, whether Christian or more broadly spiritual, have an important role to play: St. Augustine's Confessions remains a powerful template for the addiction recovery narrative, and membership of faith groups can provide an effective antidote to dislocation. Political activism, both global and local, is a tool of social empowerment that can benefit addicts and addiction professionals alike.

All these strategies are eminently sensible, but remain hard to patch into the treatment of addiction as currently constituted. We may accept Alexander's persuasive case that drug addiction, properly understood, is a scapegoat for broader social dysfunction, but it is by no means obvious how to respond effectively. Like it or not, treatment remains focused on individuals, for whom his analysis holds limited explanatory power. Alexander does not deny the existence of personal tendencies to addiction, which may include genetics and neurochemistry, but maintains that they are often marginal factors and poor predictors of individual risk: overall, interventions are more effective at the social level than the personal. But these underlying causes are far easier to identify than to address. Our societies are profoundly structured around the need for individual autonomy; and personal freedom must, on some levels, always include the freedom to become addicted.

The Globalisation of Addiction is a considerable work, highly ambitious in its scope, impressive in its multidisciplinary scholarship, clear in its structure and generous in its references. It is both its strength and its weakness that it integrates addiction so convincingly into broader issues of social and political reform. Like Rat Park, it offers a fundamental critique of the 20th century view of addiction, but also demonstrates how dominant are the processes and structures that drive it.

Published with permission from Mike Jay. Mike is a writer and historian (See Mikejay.net ) and a trustee of Transform Drug Policy Foundation.

Originally published on www.nthposition.com
Article copyright 2009 Mike Jay

The Globalisation of Addiction is available on Amazon with a readable excerpt.

Afghan Opium and the Emperor’s New Clothes

Last week the UNODC launched its latest report on opium production in Afghanistan. Steve Rolles and I attended the presentation of the report at Chatham House by Antonio Maria Costa Executive Director UNODC and Bill Rammell, Minister of State Foreign and Commonwealth Office.

• UNODC's press release
  
  
• Rammell's comments
  
  
• Costa's comments

Their headline was the 20% reduction in opium cultivation which they welcomed (albeit cautiously) as evidence of new found success of their respective interventions in the region. Opium production, by the way is only down 6% (as yields per acre cultivated have risen).

The statistical annex on world drug prices and purity from the World Drug Report 2008, shows precisely how badly they are really doing - even by their own standards. It is now eight years after the Allied troops overthrew the Taleban and effectively took control of the country with one of the key aims being the eradication of the opium crop, and things really aren't going well given the billions thrown at the sprawling military-led anti-opium enterprise since 2001.



As they each informed the audience of the positive story coming out of Afghanistan, I was reminded of the story of the Emperor’s New Clothes. Explaining how opium production had declined in the north of the country, I began to feel like the boy in the fairytale who, not having any investment in admiring the Emperor’s new clothes, points out to the assembled crowd that he is in fact naked. The 'we're turning the corner' fantasy they present ignores the brutal realities of supply and demand economics: not only are they palpably not winning the war on opium in Afghanistan, but crop eradication, interdiction, and enforcement more generally are actually the prime cause of much of Afghanistan’s ‘drug problem’.

Prohibition is what makes an intrinsically low value commodity like opium more profitable than any other agricultural option for Afghanistan's mostly impoverished farmers. It is economic alchemy, whereby plants are transmuted into commodities worth literally more than their weight in gold. Even if supply side interdiction was more effective (and you try and eradicate 1500+ square kilometers of poppy fields scattered over an area the size of Western Europe, every year, forever) the effect would be be to push up the price, that in turn inevitably incentivises new entrants to the market, and new cultivation. It is an economist's dream; the completely unregulated interplay of supply and demand, and whilst the demand driven economic imperative exists (and there's no sign of significant change on that front) the best that can be achieved is temporary, marginal and localised supply side 'success'. The problem may move around a bit - but it doesn't go away.

An image of opium and wheat cultivation from the UNODC report

It is the war on drugs that makes Afghanistan’s more fundamental problems intractable; a point made very clearly by none other than Lord Adair Turner, head of the Financial Services Authority.

As you would expect, anyone who asked a challenging question, received a response, not a reply, with the ‘successes’ merely repeated. When I suggested to Rammell that a responsible government would expose the costs of the policy to a more thoroughgoing analysis (along the lines of the PM’s Strategy Unit Report 2003), he informed me that he did not agree with the critique (failing to say why) and, in time honoured sound bite fashion, that legalisation was a “counsel of despair”. When I interjected that I had not suggested legalisation and that I had merely called for them to include a scrutiny of the costs, he used the 101 Media Training line: “if you’ll let me finish…” with that studied pained look that media trainers the world over have taught to politicians to enable them to persist in not answering difficult questions. Steve similarly asked a question along the lines of the economic analysis above. Aren't supply interventions futile in the current context, especially given the long history of interdiction failure in the region and elsewhere? Again the answer was more of the same; repeating cherry picked successes, process achievements (that evidently have no bearing on 'outcomes'), and more 'turning the corner' type rhetoric. To quote Paul Flynn MP, we have now turned the corner so many times we have gone around the block several times - but not actually got anywhere.

Other stand out analysis from the presentation included:

• The fact that the report showed that production in the longstanding poppy growing area of Helmand, had actually increased slightly and that Afghan production still significantly exceeds demand.
  

• Costa admitted that insurgents (The Taleban) were stockpiling opium. His reasoning was that it must be insurgents, (because traffickers would not stockpile opium when the price was dropping). Why insurgents would wait until the price rose but traffickers would not, was not made clear…

At this point the economic analyst (something Costa has some claim to being, given his background) might look at the over-production of the last few years (global demand is only around 4000 tonnes Costa informed us, and we have no reason to doubt this estimate) and how it coincides with falling prices and conclude that stockpiling was a rational economic response for almost anyone in the Afghan supply chain. It is not only an insurance policy against poor harvests or any eradication and interdiction efforts they might fall foul of, but also, crucially, by restricting supply stockpiling will help boost the price again. Look at the graph below. This is exactly what happened in 2001. The Telaban banning production had nothing to do with religion. It was, in retrospect, a rather effective ploy to boost prices; they rose tenfold, and stockpiles from the bumper harvests of the two previous years meant that supply to the West was largely uninterrupted.


Again, this is raw economics writ large. Interdiction can only make the problem worse; even when it succeeds, it fails. Opium prices are still well above pre-2001 levels and the new report notably also estimated that the Taleban are now making $500 million a year from the trade.

• Part of the plan detailed at the presentation was to stop opium getting out of Afghanistan in order to keep prices low and thus dissuade production. As well as being similarly in denial of economic realities, this plan appears to ignore the fact that controls are all-but non existent on the lengthy border between Afghanistan and Pakistan, some of the worlds remotest and poorly policed territories. This is just next season's emperor's new clothes range.
  

• One final point made is worth flagging up. The switch in demand patterns from heroin to cocaine might be good for Afghanistan. Not only an extraordinary take on the balloon effect but also begging the question of how well this scenario works for Colombia.

The next time Rammell and Costa turn up for a double act to spin the latest 'successes' I expect more of the audience to point out the messengers' nakedness.

See also:

• The BBC's Mark Easton on the 'Missing Opium'
  
  
• Lord Malloch-Brown's comments on the report
  
  
• Costa being given a light grilling by Zaena Badawi on BBC's Hard Talk
  
  
• Exec Summary of the Report

• Medical use of Afghanistan's opium wont solve the problem