99: Why You Can't Punish Addiction

In this episode I talk about the biological, social and cultural consequences of punishing addiction, a counterproductive habit that's become so normalized in the US that many of us can't imagine doing things any other way. But as the data make clear, the best way to get people to stop using drugs is to get them to want to stop using drugs. And the best way to get them to want to stop is to just give them their drugs and stick around until (or if) they want to reduce or halt their use. Addiction rates in people who make less than $20k per year are three times those of people who make more than $50k per year (Centers for Disease Control, “Today’s Heroin Epidemic,” updated regularly https://www.cdc.gov/vitalsigns/heroin/index.html )For info about 12-step programs, success rates and huge failure rates, see the Atlantic article, "The Surprising Failures of 12 Steps"Drug use rates in US versus other countries: see the UN Drug Report (I used the 2014 version here, but they all have the same info). For information about how prison makes criminality worse (in 11 out of 23 studies in this meta-analysis), check out Martin Killias and Patrice Villetaz, “The Effects of Custodial vs Non-Custodial Sanctions on Reoffending: Lessons from a Systematic Review,” Psicothema 10, no. 1 (2008).For the study in Baltimore with a group of 1300 addicted people, authors found that one out of five IV drug users stopped using between 1988 and 2000, and that those who spent time in jail during that time were half as likely to be in the group who stopped using: N. Galai, et al., “Longitudinal Patterns of Drug Injection Behavior in the ALIVE Study Cohort, 1988-2000: Description and Determinants,” American Journal of Epidemiology 158, no. 7 (2003).Another study found the same thing in Canada from 1996-2005: recent incarceration made it half as likely for an addicted person to have stopped using drugs post-release: K DeBeck et al., “Incarceration and Drug Use Patterns across a Cohort of Injection Drug Users,” Addiction 104 (2009).For more about kids who were given custodial sentences, like jail or juvenile hall, and were three times more likely to be arrested as adults then those who were charged with the same crimes as kids, but given non-custodial sentences, like probation or house arrest, see A. Aizer and J. J. Doyle, “Juvenile Incarceration & Adult Outcomes: Evidence from Randomly-Assigned Judges,” National Bureau of Economic Research, (February, 2011). For more about 2/3 of people in drug studies valuing reward over punishment, see Sarah Bechara, Sara Dolan, And Andrea Hindes, “Decision-Making and Addiction (Part II): Myopia for the Future or Hypersensitivity to Reward?” Neuropsychology 40, no. 10 (2002): 1690-1705.For more about the Learning Disorder model of addiction, see Maia Szalavitz's work, or my book, Dr. Junkie: One Man's Story of Addiction and Crime that will Challenge Everything you know about the War on Drugs. Addiction rates across the US from current CDC numbers and from D. A. Regier, et al., “Comorbidity of Mental Disorders with Alcohol and Other Drug Abuse: Results from the Epidemiological Catchment Area (ECA) Study,” JAMA 264, no. 19 (1990).  Support the show