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Will We Ever Learn to Think in Moderation?

The media is all black or all white about brain drugs like Oxy and Adderall.

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And so, the early ‘70s fears that heroin was the worst drug imaginable made cocaine, by comparison, seem benign to those who used it in the ‘80s. But while the coke generation tended to avoid heroin, it had also missed the nation’s ‘60s bout with stimulants, which had informed the succeeding heroin-preferring group.

Every 10 years, the nation shifts from a "stimulant" decade to a "depressant" one: the speed-loving ‘60s, the ‘70s heroin wave, the coke-snorting ‘80s, the Kurt Cobain junky ‘90s, the methamphetamine ‘00s.

Although a crude metric, this pattern suggests that every 10 years, the nation shifts from a stimulant-dominated decade to a depressant drug-of-choice one: the speed-loving ‘60s, the ‘70s heroin wave, the coke-snorting ‘80s, the Kurt Cobain junky ‘90s, with some prescription opioids on the side. By the ‘00s, it was on to methamphetamine.

Because our attention span seems limited to one demon drug at a time, we create easy rationalizations for new generations of addicts who are not, after all, using the evil substance highlighted by the media during their childhood. We start by focusing on the fashionable drug’s benefits—an emphasis often encouraged by the drug company's marketing—and then turn on it, seeing only the risks. (When first marketed in 1895, heroin was advertised by Bayer as less addictive than morphine.) As a result, we are unable to break out of these cycles. 

Through all of this, we miss the realities of addiction, which depend less on particular drugs than on people’s need for relief, and the particular relief available when they are young and most prone to start using. Addicts do follow trends, but they also find the drugs that most suit them: Use of multiple substances is more the rule than the exception.

In the end, we damage both the addicts, when we are promoting the drugs and ignoring the risks, and the people who benefit—ADHD patients using stimulants, say, and pain patients using opioids—when we focus on the harms. We continually speak past each other: the people who see addiction as the worst fate while ignoring the suffering of those who benefit from medications vs. those who value the benefits dismissing the risks of addiction.

None of this is helped, either, by the demonization of addiction and addicts. Panic promotes harsh treatment of drug addiction; in fact, it is often sowed and spread by people with a political agenda that is implicitly or explicitly racist and involves fears of “contamination” of mainstream (read: white) America by minorities or “aliens” who use drugs.

The nation’s history of drug criminalization illustrates this point: Cocaine was made illegal due to fears related to black men using it; opium was banned because of its association with Chinese railroad workers; reefer madness was spurred by its connection to Mexicans and blacks. We continue to lock up black and brown people for their involvement with drugs, while whites are more likely to get “treatment, not punishment.”

Moreover, the vast majority of scare stories also involve the spread of the drug into the middle class. So, for example, in the Times piece we get a doctor saying, “Drug addicts don’t look like they used to,” as an explanation for why a nice white college kid can successfully lie about ADHD to feed his addiction. Addicts are never “people who look like us.”

If we’re ever to break out of these cycles and deal effectively with addiction as a health issue, we have to learn to live with complexity and contradiction. The same drug that is a lifesaver for me can kill you—and addiction is a perennial problem, not just one that surfaces with the popularity of specific drugs. To appropriately treat addiction, we need to recognize the racism that has marred our drug policy—and also see that while addiction does hit the poor the hardest, the middle class isn’t exactly immune.

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