Chasing the Scream: The Search for the Truth About Addiction

by Johann Hari

rat with a good life almost never will, no matter how many drugs you make available to him. As Bruce put it: he was realizing that addiction isn’t a disease. Addiction is an adaptation. It’s not you—it’s the cage you live in.

Smoking tobacco kills 650 out of every hundred thousand people who use it, while using cocaine kills four.

The Office of the Surgeon General has found that just 17.7 percent of nicotine patch wearers were able to stop smoking. How can this be? There’s only one explanation: something is going on that is more significant than the chemicals in the drug itself. If solving the craving for the chemical ends 17.7 percent of the addictions in smokers, the other 82.3 percent has to be explained some other way.

The first time he heard about black holes in space, Bud felt he intuitively understood them. “They absorb any light coming near them and crush it. I felt like that in here,” he says, jabbing at his insides. “When I first read about a black hole in space I thought—that’s how I’ve always felt. That’s exactly

Imagine you are a street heroin addict. You have to raise a large sum of money every day for your habit: £100 a day for heroin at that time in the Wirral. How are you going to get it? You can rob. You can prostitute. But there is another way, and it’s a lot less unpleasant than either of them. You can buy your drugs, take what you need, and then cut the rest with talcum powder and sell it to other people. But to do that, you need to persuade somebody else to take the drugs too. You need to become a salesman, promoting the experience. So heroin under prohibition becomes, in effect, a pyramid selling scheme. “Insurance companies would love to have salesmen like drug addicts,” with that level of motivation, John remarked.

Most addicts here, he says, come with an empty glass inside them; when they take heroin, the glass becomes full, but only for a few hours, and then it drains down to nothing again. The purpose of this program is to gradually build a life for the addict so they can put something else into that empty glass: a social network, a job, some daily pleasures. If you can do that, it will mean that even as the heroin drains, you are not left totally empty. Over time, as your life has more in it, the glass will contain more and more, so it will take less and less heroin to fill it up. And

Users can stay on this program for as long as they want, but the average patient will come here for three years, and at the end of that time, only 15 percent are still using every day.

In 1985, some 68 percent of new HIV infections in Switzerland were caused by injection drug use, but by 2009, it was down to approximately 5 percent.

number of addicts dying every year fell dramatically, the proportion with permanent jobs tripled, and every single one had a home. A third of all addicts who had been on welfare came off it altogether. And just as in Liverpool, the pyramid selling by addicts crumbled to sand: people on the heroin prescription program for a sustained period were 94.7 percent less likely to sell drugs than before their treatment.

program costs thirty-five Swiss francs per patient per day, but it spares the taxpayer from having to spend forty-four francs a day arresting, trying, and convicting the drug user.

in Brownsville, Brooklyn, the state spends one million dollars for every five people it arrests and convicts of midlevel drug offenses: that’s what it took to get the Souls of Mischief off the streets for a while.

In the United States alone, legalizing drugs would save $41 billion a year currently spent on arresting, trying, and jailing users and sellers, according to a detailed study by the Cato Institute. If the drugs were then taxed at a similar rate to alcohol and tobacco, they would raise an additional $46.7 billion a year, according to calculations by Professor Jeffrey Miron of the Department of Economics at Harvard University. That’s $87.8 billion next year, and every year.

don’t count alcohol as drug use, then drug use would go up. But if you do count alcohol as drug use, then there is some evidence suggesting overall drug use will not go up after legalization. Why? What seems to happen when you legalize marijuana is that a significant number of people looking to chill out transfer from getting drunk to getting stoned.

quixotic

“Alcohol is a poison,” he tells me. “It is a toxic substance that can result in overdose deaths. Its use alone—not including accidents and injuries—is responsible for [about] forty thousand deaths in the United States each year. No deaths are attributed to marijuana use.

going through every recreational drug, and calculating how likely it was to harm you, and to cause you to harm other people. He found that one drug was quite far ahead of all the others. It had a harm score of 72. The next most harmful drug was heroin—and it had a harm score of 55, just ahead of crack at 54 and methamphetamine at 32. It wasn’t even close. The most harmful drug was alcohol.

The desire to judge him—and my relative, and myself—seemed to have bled away. The old noisy voices of judgment and repression were only whispers now. I told him to call me anytime. I told him I’d go to Narcotics Anonymous meetings with him. I told him that if he was tempted to relapse I’d sit with him, however long it took, until his urge to use passed. I didn’t threaten to sever the connection: I promised to deepen it.

One in 130 prescriptions for an opiate such as Oxycontin or Percocet results in addiction, according to the National Survey on Drug Use and Health. (Th at makes up around 10 to 15 percent of users over time—the same ratio as for other drugs, including alcohol.) If the chemical hooks alone were the driving factor, we would expect to see those addictions spread evenly throughout the country—as high in Beverley Hills as in the Appalachian Mountains. They are not. The addictions cluster in specific areas,