Ideology and Science
To reiterate the content of my last post, in 1984 I was expecting to field-test some theories about drug/ human interaction. My theories (hypotheses) grew firstly from the records of prehistoric drug use I had collated in the previous years. The advances of neurosciences in the decades of the 1960, 1970s and 1980s also educated and inspired my curiosity; particularly in the question of whether drug seeking is biologically derived or whether individual or societal pathologies drive it.
However, when I began shaping my hypotheses, I could find no references in popular culture of the 1980’s to the neuroscience concept that drug addiction is a ‘relapsing’ brain disease like schizophrenia or diabetes; that without formal medical treatment compulsive drug craving, seeking, and consuming take over individual lives and leads to their wreckage. No information seemed to exist either about the growing certainty that genetic factors play a part in the variability in susceptibility of each individual to becoming addicted.
I was not surprised by this omission. Through time and across regions, religions, politics, professional ethics and/or other socio-economic conditions have frequently controlled what individuals can consume, grow, learn, and manipulate with psychoactive substances, even those their society endorses. See for example, in the history of the Australia Aboriginal drug pituri (Duboisia Hopwoodii) the number of existing controls that ensured only respected elders chewed the drug.
To ensure my readers belief in the authenticity and reliability of my hypotheses, I jump ahead here to the period between 1990s -2014. Would this time span contain an explanation as to why no public knowledge or discussion appeared to exist in the early 1980s of drug use as a brain disease? Fortunately the period does oblige, at least partially.
Below, I quote from a journal article by Dr Al. Leshner, a neuroscientist fin the USA. Leshner holds a significant role in drug research, policy and administration. At least two of his papers discuss the question of why ‘drug use is a brain disease’ has been slow to enter the public discourse. Here is Al. Lashner’s profile. It comes from The American Association for the Advancement of Science.
Alan I. Leshner has been Chief Executive Officer of the American Association for the Advancement of Science and Executive Publisher of the journal Science since December 2001. Before coming to AAAS, Leshner was Director of the National Institute on Drug Abuse. He also has served asDeputy Director and Acting Director of the National Institute of Mental Health, held a variety of senior positions at the National Science Foundation, and served as a professor of Psychology at Bucknell University. Leshner received an undergraduate degree in psychology from Franklin and Marshall College, and M.S. and Ph.D. degrees in physiological psychology from Rutgers University.
These are extracts from his paper, Addiction is a Brain Disease and it Matters, in Science:
Dramatic advances over the past two decades in both the neurosciences and the behavioral sciences have revolutionized our understanding of drug abuse and addiction. Scientists have identified neural circuits that subsume the actions of every known drug of abuse, and they have specified common pathways that are affected by almost all such drugs. Researchers have also identified and cloned the major receptors for virtually every abusable drug, as well as the natural ligands for most of those receptors.
In addition, they have elaborated many of the biochemical cascades within the cell that follow receptor activation by drugs. Research has also begun to reveal major differences between the brains of addicted and nonaddicted individuals and to indicate some common elements of addiction, regardless of the substance.
That is the good news. The bad news is the dramatic lag between these advances in science and their appreciation by the general public or their application in either practice or public policy settings. There is a wide gap between the scientific facts and public perceptions about drug abuse and addiction. For example, many, perhaps most, people see drug abuse and addiction as social problems, to be handled only with social solutions, particularly through the criminal justice system. On the other hand, science has taught that drug abuse and addiction are as much health problems as they are social problems. The consequence of this gap is a significant delay in gaining control over the drug abuse problem.
Part of the lag and resultant disconnection comes from the normal delay in transferring any scientific knowledge into practice and policy. However, there are other factors unique to the drug abuse arena that compound the problem. One major barrier is the tremendous stigma attached to being a drug user or, worse, an addict. The most beneficent public view of drug addicts is as victims of their societal situation.
However, the more common view is that drug addicts are weak or bad people, unwilling to lead moral lives and to control their behavior and gratifications. To the contrary, addiction is actually a chronic, relapsing illness, characterized by compulsive drug seeking and use. The gulf in implications between the “bad person” view and the “chronic illness sufferer” view is tremendous. As just one example, there are many people who believe that addicted individuals do not even deserve treatment. This stigma, and the underlying moralistic tone, is a significant overlay on all decisions that relate to drug use and drug users.
These difficulties notwithstanding, I believe that we can and must bridge this informational disconnection if we are going to make any real progress in controlling drug abuse and addiction. It is time to replace ideology with science.
This is a shocking indictment. Blaming drug abuse on pathological social or personal conditions goes back at least to the 1950s over 62 years ago. It was not evidence based then. As a theory it did not help addicts then nor does it help now. It interferes with our legal and justice system, it sabotages our relationships with other countries, and costs immense sums of money.
Thinking solely as an anthropologist at the moment I ask myself what does the AngloSphere gain by maintaining this belief? It creates a group of scapegoats; without the weak and perverse drug users, we could not acknowledge a better class of people. At the same time, it manifests and reiterates the beliefs of revealed religions like Christianity, Islam and Judaism that mankind is full of sin.
Leshner, A.I. (1997). Addiction is a brain disease, Science, 278, pp.45–47.