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October 10, 2003

What a rush

Rush Limbaugh is a junky and has checked into drug rehab. No link necessary-that's the declarative fact. That's the most valuable public service he has ever performed. Mark this date as commencing the United States' treatment of drug addiction as a genetic/medical issue rather than a matter for the criminal justice system.

Posted by martin at 09:41 PM

If we legalize recreational drugs rates of addiction will rise and the medical problem with addiction will become greater.

We certainly need advances in vaccines and other treatments for addictions. But I don't see how excoriating those who are in favor of keeping recreational drug use illegal is helping matters any. Humans are not evolutionarily adapted to handle recreational drugs.

Posted by: Randall Parker at October 10, 2003 11:15 PM

The fact is that most Americans are junkies who are addicted to one or more drugs that may be either legal or illegal. And if they don't do drugs, they go on sugar and fat binges on a regular basis. Even the most ardent anti-drug conservatives tend to be addicted to alcohol, caffiene, nicotine, various pills of questional legality, and crap food. None of this is going to change in the near future, regardless of the prevailing drug policies.

Posted by: Chris W at October 11, 2003 01:58 AM

Chris W - agreed. Most research suggests that drug addicts are basically self-medicators and are taking drugs to make up for chemical imbalances in their brains. Randall who is usually concerned about the effects of legislating against human nature, doesn't see the irony in being a hard line prohibitionist. I don't see legalisation as a solution but it's certainly a damned sight better than the opposite. When you add up the policing costs, property crime created, the fact that prohibition indirectly led to the development of crack cocaine (because of the incentives and profits provided to create a bigger bang for your buck) then even in a welfare state, a medical approach may be a lot less expensive.

Posted by: Jason Soon at October 11, 2003 04:11 AM

This definitely could be a Nixon-goes-to-China moment. Limbaugh has been at the forefront of those demagoguing this issue. My guess is that he'll be issued himself a one-time exception.

Posted by: Zizka at October 11, 2003 07:04 AM

As I've said I find little of merit in Limbaugh. I wouldn't wish drug addiction on anyone though. I hope he can get clean. But I was reading in the paper this morning that this has been going on for years and he has been in treatment before. That doesn't bode well at all for him.

In fact its available without prescription (today only) and here's a link:


In part:

"Limbaugh, 52, said he had twice checked into rehabilitation clinics over the last half-dozen years in an effort to break his addiction and would do so again immediately."


"Limbaugh, perhaps the most prominent conservative commentator on the air, said on his program that he began taking painkillers five or six years ago after unsuccessful spine surgery, which caused lingering pain in his back and neck."

So obviously it wasn't about his hearing problem that came up a year or so ago.

Posted by: Katy at October 11, 2003 07:19 AM

Most research suggests that drug addicts are basically self-medicators and are taking drugs to make up for chemical imbalances in their brains.

This is true, but the other side of the story is also that taking drugs that stimulate the reward centers of your brain can alter those pathways -- and that these physiological changes underlie much of what we call "psychological addiction," the strong craving/desire for the drug that persists even years after physical withdrawal symptoms have disappeared. This appears to be why most people relapse, not because of physical withdrawal. They can get through detox and rehab, but the cravings remain overwhelming, and they eventually give in.

I have to dig to get my sources on this, they're collected in a pharmacology textbook I just reviewed. But the point is that, although many addicts have a genetic/psychological predisposition to drug abuse (leading to self-medication for what's often theorized to be a "reward deficit," or chronic anxiety, depression, etc.), the process appears to be able to go both ways. Drugs may cause long-term changes in the brains of otherwise normal people, and may tip them into drug-seeking behavior.

Posted by: Claudia at October 11, 2003 08:25 AM

Sorry for the tags. Guess HTML doesn't work.

Posted by: Claudia at October 11, 2003 08:26 AM

It wasn't an operation for his hearing loss, it was something else before that -- gastric, no doubt!!

He hasn't excused himself thus far. He issued a very frank statement of what the problem was and what he was doing about it. He explicitly did not excuse himself for the addiction, said that it was wrong and that he alone was responsible for it. He further discouraged any talk of him being a role model in the "drug survivor" sense, as many celebrities are treated when their addictions hit the news. His attitude seems to be "this is a stupid f'd up state I've gotten myself into, and now I've got to get myself out. Don't feel sorry for me".

He's handling it with way more dignity than most.

Posted by: Twn at October 11, 2003 09:24 AM

According to Limbaugh's pronouncements to date, he should do time rather than go into rehab. I don't think that he's going to remain consistent on that point. He has been unmistakably clear about this on cases basically identical to his own.

Posted by: Zizka at October 11, 2003 10:55 AM

Megadittoes( in Rushspeak)Jason Soon. My antipathy for those advocating incarceration for people who use(certain) drugs knows no bounds. Our present day drug warriors are the witch burners of the 23rd century.
You're exactly right Zizka-this is a Nixon goes to China moment. I'm laughing in cold contempt at the rationalizations going on at FreeRepublic to excuse Mr. Limbaugh. I'll never underestimate the human capacity for hypocrisy-but if Limbaugh does not go to jail, I see it as a huge blow to the repressive bureaucracy that is the War on Drugs.

Posted by: martin at October 11, 2003 11:16 AM

HTML does work, but just conventional tags. they will work ;)

Posted by: razib at October 11, 2003 11:50 AM

Jason says (italics mine):

Randall who is usually concerned about the effects of legislating against human nature, doesn't see the irony in being a hard line prohibitionist.

Jason, the law against murder is legislation against human nature. Look at the Yanamamo. They are acting out human nature. I do support laws against murder in spite of this. You keep misrepresenting my views. Much of the rest of the law operates against human nature. We need a state to make people honor contracts and respect the rights of others because lots of them naturally do not want to do so.

We can't have civilization without placing some blocks in the way of human nature. It is a matter of degrees. I realize that idealists have a hard time with this notion. But where things go way wrong is when the gap between human nature and the rules of society becomes either too large or too small. There is optimal middle ground between anarchy and excess in the law where the worst of human nature is curbed and protected against while at the same time various urges and desires from human nature have outlets of expression that minimize the damage caused.

The problem with the issue in question is that human nature is not compatible with recreational drugs. We didn't evolve to handle them. Drugs hijack pleasure centers designed to reward learning and adaptive behavior. As a consequence lots of people become walking disasters when exposed. Similarly, human nature is not compatible with the widespread private ownership of thermonuclear weapons.

Martin, you are misusing the word hypocrisy. This is, unfortunately, extremely common to do in politics against people who one disagrees with who do not live up to their own standards. If a person does a thing they sincerely do not approve of doing (and, yes, it may be hard to get your mind around this but people do exactly that every day) then they are not being hypocrites. Look it up in a dictionary if you don't believe me.

Posted by: Randall Parker at October 11, 2003 10:00 PM

GC, Recreational drug use was not a significant selective force in human evolution. In some (though obviously not all) groups there were selective pressures to develop a better ability to handle alcohol analogous to the ability to make lactase enzyme to consume milk past infancy. But there was just not much selective pressure for the vast bulk of the human population to handle drugs.

Maybe there was some mild selective pressure with coca in parts of South America. But I doubt there was much else anywhere else. Just because there were signs of occasional use in ancient history these anecdotes do not add up to convincing evidence of widespread use on a scale large enough to become selective pressures before modern times.

I think legalization will increase the incidence of addiction for most recreational drugs. I think the costs of that increased addiction in combination with the costs of worse behavior by those who will use the drugs more even without becoming addicted will be greater than the costs we are incurring from the current laws on drugs.

I don't think the Prohibition analogy works for a number of reasons. The trade-offs are not the same for all drugs. I get the arguments for legalization. What I think those making those arguments haven't done is rigorously added up all the costs from drug abuse. I've read a lot of libertarian articles on legalization and I don't see in them any estimates that have firm empirical foundations on what they expect will happen with addiction rates if, for instance, heroin was legalized. If animal models are a reliable indication then increased drug abuse in the early teen years will especially lead to more addiction in the longer term.

Didn't Rush have an auto-immune disorder of his inner ear cochlea? He was on pain killers due to back problems and shoulder problems. He's had surgery for those problems. Apparently he still has had a lot of pain even with surgery.

Posted by: Randall Parker at October 12, 2003 01:13 AM

Randall-as far as I know Limbaugh has advocated sending people to jail for drug law violations use-if he has violated drugs laws and doesn't check himself into jail after checking out of rehab-he's a hypocrite. Period. Similarly, many people are in jail right now for prescription drug violations. So if Limbaugh has violated those statutes and the Drug War does not pursue Limbaugh as he's too rich, famous, whatever, the Drug War is a hypocrite. Period.

Posted by: martin at October 12, 2003 08:07 AM

Martin, Every single day cops and prosecutors decide someone shouldn't be charged for some crime they have committed and this is routinely done for a very large variety of crimes. Since these same cops and prosecutors charge others for those same crimes does that make them hypocrites?

Posted by: Randall Parker at October 12, 2003 12:21 PM

Randall- if the cop and the prosecutors charge people with crimes they themselves routinely break-then they ARE hypocrites. E.g. a high class brothel was recently busted by the FBI in New Orleans. (the FBI thought international drug gangs were involved-but to their embarrassment it was just a brothel) Many of the johns were the cream of New Orleans legal society-judges, lawyers, and maybe even a police chief. The client list was never made public (surprise).
Now plenty of low rent prostitutes and johns are being busted every day in this fair city. So (true story) if a certain judge sentences a low rent downtown streetwalking prostitute to jail for ten days and that very afternoon consorts with a $600/hr. prostitute in a discreet and tastefully decorated uptown mansion-YES said judge is a flaming hypocrite.
So as Rush Limbaugh was advocating incarcerating drug users on the air, and after the show apparently going to a Denny's parking lot to engage in routine street drug deals-YES he is a flaming hypocrite-UNLESS he confesses and goes to jail, exactly where he has advocated others in his situation belong.
I guess you are fond of Limbaugh. I did find him a necessary corrective to a pathetically liberal media, but on the drug issue he's worthless. Personally I think anyone who smokes tobacco and wants to jail potheads is a prima facie hypocrite, but an Oxycontin addiction takes it to a whole new level of vicious meta-hypocrisy.
You know the whole "life, liberty, and the pursuit of the happiness" is not footnoted with a list of exceptions in the original.
I thought about it-I can honestly say there is nothing I personally do that I advocate other go to jail for doing. It's really not that demanding of a moral ethic if you ask me.

Posted by: martin at October 12, 2003 12:56 PM

Martin, I have no fondness for Limbaugh. I never watch or listen to him. He holds no appeal.

Rush is not a prosecutor. It is not up to him to prosecute himself. At this point the cops could make a case against him pretty easily even without his help. They could, if reports are to be believed, offer his housekeeper immunity in exchange for testimony.

But the vast bulk of those who become addicted to prescription drugs who start taking them because of physical pain are not prosecuted for it. You can find exceptions. But they are the exceptions, not the rule. Why is that? It is pretty simple really: most people who become addicted to prescription drugs started taking them for a medical reason and at the instruction of a doctor. Unfortunately the most powerful painkillers are addictive opiates. Some people get addicted to them. The medical profession expects this to happen. But the need for these drugs for medical purposes is so great that the risk is run. We need better non-addictive painkillers.

You insist upon using the word hypocrite in a way that doesn't match its dictionary definition. It is most likely that he really does disapprove of illegal drug use. You seem to be discounting the power of an addiction. In light of your views about drug laws in the first place I guess I don't find that surprising.

Posted by: Randall Parker at October 12, 2003 03:02 PM

Randall you are missing the point. He may not be a hypocrite for speaking out against drugs and then using them IF (as you speculate) he still disapproves of his own drug use (yeah right). However-because he has advocated jailing people who violate drug laws-he IS a hypocrite if he tries to fight going to jail IF he has violated a drug law.
Dictionary.Com defines hypocrisy:
"The practice of professing beliefs, feelings, or virtues that one does not hold or possess; falseness."
We have both violated drug laws. Jail for you-but not jail for me. That's hypocrisy.

P.S. I know plenty of people with addictions-the vast practical difficulties in their life come from the illegality of their addictions not the addictions themselves. Look at Limbaugh-a functioning and highly successful opiate addict for at least six years-now in trouble only because he was caught up in a police investigation.

Posted by: martin at October 12, 2003 03:43 PM

Martin, Has he started trying to plead not guilty to a drug charge? I must have missed that part. You want to call him a hypocrite and so you judge him for something he hasn't even done yet.

Regards your contemptuous "yeah right": Yes, lots of people disapprove of their own drug use and their own alcohol use. Why is that so hard to believe? I know addicts who wish they could quit. A late alcoholic uncle referred to his addiction as "a monkey on my back". I know lots of cigarette smokers who wish they could quit who try to stop and end up starting up again. I know a vicodin addict (started as Rush did, chronic pain) who wants to quit and has a very dim view of addiction. You think that if you took a poll of, say, heroin addicts a majority of them would say that they morally approve of their own addicted state? I seriously doubt it.

Yeah, I looked up the dictionary definition well before you did. So far you have offered no evidence that Rush doesn't privately morally disapprove of drug addiction. If reports are to be believed that he's tried to break the habit twice already that suggests that he doesn't want to be addicted. When he first tried to stop pain meds and found he craved them my guess is that he was not happy about it. Use common sense. Most people wouldn't be.

Posted by: Randall Parker at October 12, 2003 04:13 PM

Well Randall he could do worse than to have you as his defense lawyer. Once again, though, his personal thoughts as to his own addiction are irrelevant to me-it's the fact that he wants to jail other people with addictions that galls me.

Posted by: martin at October 12, 2003 08:27 PM

Martin, Do we even know that Rush has consistently come out against legalization? No we do not. I did 2 whole minutes of Google searching and came across this transcript from 1998 where, if this is an accurate transcript, Rush advocates legalization.

* RUSH: OK let me ask you a question because this came up yesterday and I gave an answer that many would call a flippant answer. I will give you the same answer you tell me if it's flippant.

** Based on the reality of how we're going after cigarette smokers, The thing that we cannot do in the drug fight right now is regulate because it's illegal. Drugs are against the law and so the manufacturers are illegal. They're not even on shore they're down there in Columbia and the Calli Cartel and they're working to poison the brains and minds of the future of America. And so what we do is to try to keep those drugs from getting in. And I agree with you that it's a half baked effort.

** But what are we doing with cigarettes. Well we are punishing the manufacturers We're suing them left and right we're going to cause them to settle out of court for $368 billion. We're gonna let them keep making them but then we're going to have the price go way way up so that we ostensibly say by virtue of that we don't want anybody to smoke cigarettes anymore and we're going to try to price it out of most peoples existence but we're going to raise those prices and most of that money will be taxes and we're going to use that money for health care programs for our kids and so forth.

*** It seems to me that what is missing in the drug fight is legalization. If we want to go after drugs with the same fervor and intensity with which we go after cigarettes let's legalize drugs. Legalize the manufacture of drugs. Licence the Calli Cartel make them tax payers and then sue them. Sue them left and right and then get control of the price and generate tax revenue from it. Raise the price sky high and fund all sorts of other wonderful social programs.

**** Because it seems to me, flippant as though it may sound to you, that what gives us the power to do what we're doing, what gives the government the _power_ to do what it is doing, state and federal, in cigarettes is that it's a legal substance regulated by uh the federal government. And they don't have any such power and control over drugs because it's illegal.

**** So let's legalize them and then go after them the same way.

I'm skeptical of character attacks that are being made from people on one side against someone on an opposing side. It is just so easy to go digging thru the entire record of what a person has said and pick up on those times they took one position and ignore the times when they took a more nuanced position or an entirely opposing position. Rush obviously has an active mind and has talked for thousands of hours on all sorts of subjects. What else has he said about drug use? Probably all kinds of stuff that is all over the map as he thought about the problem in different ways.

Posted by: Randall Parker at October 12, 2003 11:00 PM

Sorry Randall-he's a hypocrite. I won't bother posting his multitude of ridiculous statements. If you want to continue this debate I'll see you in Godless's fpp (conveniently entitled "Limbaugh is a big,fat hypocrite").
If you'll revisit my own fpp above though-you'll see attacking limbaugh for hypocrisy is nowhere mentioned. I'm only asserted that this is the beginning of the end of the present paradigm for The War on Drugs. Megadittoes, Rush.

Posted by: martin at October 13, 2003 06:14 AM

"I know plenty of people with addictions-the vast practical difficulties in their life come from the illegality of their addictions not the addictions themselves."

I do understand you point, Martin. At the same time, alcoholics tend to express a different viewpoint.

In pharmacology generally, some medications are felt to be safe to sell over the counter. These are rarely entirely harmless -- aspirin and tylenol can kill you, but they're so commonly used, and so widely beneficial, that the cost/benefit analysis favors letting them be sold without a prescription. Other medications must be sold with a prescription, because the ordinary consumer is not in a position to make an informed choice about when it's appropriate to use them.

Recreational drugs can easily fit within this same framework. Sometimes the legalization/criminalization discussion ends up in an all-or-nothing impasse. But there's plenty of precedent for different kinds of regulation for different kinds of biologically active substances, depending on their potential for harm, and potential for benefit - or at least harmless use.

Criminalizing marijuana makes no more sense to me than criminalizing alcohol. But I wouldn't legalize heroin any more than I'd want digoxin, insulin, or chemotherapy meds sold without a prescription.

Although we could get into a whole discussion about prescribing narcotic drugs for registered addicts -- this subject is being turned on its head by the use of buprenorphine, or "bupe," as a better substitute for methadone.

Posted by: Claudia at October 13, 2003 06:40 AM

Just to add that I do understand the distinction between making a substance illegal for all uses, vs. a subtance that is legal, but tightly regulated. There's a reasonable discussion that can be had about making heroin available by prescription to registered addicts (to be injected on-site, to prevent black market reselling). I'm not saying right or wrong, but reasonable.

My point is that this case may not need to be made, if we have developed better alternate medications (i.e., buprenorphine) for long-term maintenance of addicts.

But when there's a tightly regulated market, there will always be a black market. So unless you're prepared to make now-illegal drugs as freely available and widely advertised as aspirin or Bud Lite, some legal enforcement is necessary to maintain the boundaries of regulation. It's hard to defend this kind of free availability for drugs that are potentially lethal (cocaine, heroin), without essentially saying there should also be no regulation of poisons or prescription medications.

I think a more reasonable goal is to shrink the size of that black market demand by creating some form of reasonable regulation for marijuana, and siphoning off hard-core heroin addicts into medical maintenance programs that actually do what addicts need them to do -- manage cravings as well as physical withdrawal.

Posted by: Claudia at October 13, 2003 08:39 AM

Claudia-those are exactly the reasonable and measured points I hope our society will soon begin discussing. Our current drug policy is akin to trephination-it's time to update the protocol.

Posted by: martin at October 13, 2003 08:47 AM

I favor drug legalization (including hard drugs) - but while you can make a strong utilitarian case for legalizing marijuana and some other 'soft' drugs, it's not at all clear that society is 'better off' with cheap, legal heroin. Good thing I'm closer to a natural-rights libertarian :-).
The book 'Opium' has some good information on how damaging opiate addiction can be. Ten percent of China's population was addicted to opium before the Communists ended the trade (and yes, you can win the WoD, if you're willing to go to the lengths the Maoists did...). There's also a section that mentions the widespread use of opium by the English lower classes as a cheap way of calming crying babies in day care (those kids didn't turn out well).
I often see libertarians foolishly asserting that dirt-cheap drugs will not result in significant increases in use, as if the laws of economics (normally so familiar to us libertarians) were suspended for this one special case. It seems obvious that use would increase a great deal if drugs were legalized. But imprisonment just for taking drugs (of whatever kind) appears to me so profoundly unjust that I can't support it, regardless of the consequences.

Posted by: bbartlog at October 13, 2003 09:52 AM

But imprisonment just for taking drugs (of whatever kind) appears to me so profoundly unjust that I can't support it, regardless of the consequences.

It sounds like our arguments have a great deal of overlap, and one of the main areas of discussion has to do with who gets punished for which actions (users, sellers, neither, or both). Not a trivial issue by any means, but just trying to isolate the point of controversy.

Posted by: Claudia at October 13, 2003 10:12 AM

Martin, Just so we are clear here: Rush's past arguments in favor of legalization are, in your mind, irrelevant to the question of whether he is a hypocrite. Okay, got it. No point in debating it further.

The whole problem with the libertarian legalization argument on drugs is that the libertarians basically downplay the damage that drugs cause to brains. They ignore the fact that greater availability will lead to much greater usage. Human nature is not compatible with recreational drugs.

Imprisonment is a horrible thing. But a baby born to a crackhead mother or a heroin addict mother is also a horrible thing. So is a car accident caused by PCP, coke, methamphetamine, or heroin usage or child abuse caused by people being too high to deal with their kids properly. The effects of drugs on humans are tragic no matter how they are handled. There is no policy for handling drugs (short of the development of vaccines and other new forms of medical treatment to reduce usage) that will lead to a less than tragic outcome.

As for treatment programs and a more medicalized approach: how successful are treatment programs if, say, a heroin or cocaine addict is ordered by a court to go into treatment? What is the recidivism rate within 1 year or 5 years? If we are going to to take a more medicalized approach then where is the evidence that such an approach will work?

Posted by: Randall Parker at October 13, 2003 10:24 AM

Randall: would you support the recriminilization of alcohol?
To justify imprisoning e.g. crackheads you say: "But a baby born to a crackhead mother or a heroin addict mother is also a horrible thing."
Yet the National Organization on Fetal Alcohol Syndrome states Fetal Alcohol Syndrome is the leading known cause of mental retardation and birth defects.
Car accidents: According to MADD
"Drinking and driving killed about 17,000 people last year alone, and injured half a million more."
Child abuse: Children of alcoholics suffer more injuries and poisonings than children in the general population. (West, M., and R Prinz. 1987. Parental alcoholism and childhood psychopathology. Psychological Bulletin 102(2):204-218.)
Treatment: here's the seminal
Rand Study which states "Given the high cost of "supply control" programs, this report concludes that treatment of heavy users may be a more cost-effective way of dealing with drug interventions."

Finally, back to Mr. Limbaugh. A wealthy presumably well medically-advised drug addict.
Apparently he decided to check himself into a private rehab facility rather than have his addiction treated at the Dade County jail. At least he's not hypocritical about saving taxpayer money. What do Rush and his doctors know that we don't?

Posted by: martin at October 13, 2003 10:52 AM

If we are going to to take a more medicalized approach then where is the evidence that such an approach will work?

This is an excellent question, and the research is being done -- some preliminary results already out there, some coming in. If any addictions researchers are out there and have this info at your fingertips, drop a note.

Part of the reason for failure of rehab programs in the past is the problem of treating not just the physical withdrawal, but also the cravings -- which have a biological reality in the brain, but have been relatively resistant to pharmacological treatment. But this is an area of intense investigation and drug development.

Posted by: Claudia at October 13, 2003 10:57 AM

GC, Impressions are not science. I've gone Google searching on this question occasionally looking for a rigorous treatment of this question since the libertarians, being unempirical utopians, can't be bothered. But I haven't come up with anything firm.

I'd like to see drug use as a function of time for the Netherlands, Belgium, and Denmark to compare them with info about when they changed informal enforcement practices as well as formal laws. Keep in mind that if you want to do such comparisons that since enforcement isn't always done even when the laws remain on the books and so to compare different enforcement regimes one has to know a great deal about legal practices of each country that is to be compared longitudinally.

All that longitudinal comparison is hard work though. Idealists who think they can create utopias don't need to concern themselves with rigorous longitudinal comparisons or research on recividism rates of drug addicts who seek treatment or research on how drug exposure changes adolescent brains. An argument that comes in the form of a pose of moral superiority that is based supposedly on high principle (which is really based on false myths about human nature) which includes a morally indignant posture toward those who disagree with you is not an argument that is going to change my mind. But it is so much easier to make, isn't it?.

I'm up for being convinced with empirical data on how any particular proposal to change our drug laws and enforcement practices will help reduce total injustice (including the injustice to a baby of having mom spend her pregnancy on drugs or booze) and social pathology and crime. But arguments about supposed hypocrites or appeals to a mythological view of free will and human rights are not going to convince me to support a reckless social experiment.

Posted by: Randall Parker at October 13, 2003 01:30 PM

Martin, I am quite aware of the cost of legalized alcohol use. Will adding legalized cocaine, vicodin, heroin, PCP, and ecstasy increase or decrease the total costs to the rest of us?

I don't see the Rand study as an argument for legalization. After all, if drugs were legalized then we would have to spend more money on treatment of addicts because there would be more addicts.

The Rand study has one statement that shows just how poorly cocaine treatment programs work.

An estimated 13 percent of heavy users treated do not return to heavy use after treatment."

Oh wow, a 13 percent success rate. This is a substitute for other means of restricting usage?

That study was from 1994. What is the percentage today? What is the percentage for heroin and other drugs?

Posted by: Randall Parker at October 13, 2003 01:38 PM

Just to reference my note above, here's the most recent New England Journal article on buprenorphine:

Office-based treatment of opiate addiction with a sublingual-tablet formulation of buprenorphine and naloxone.

There was an excellent article about this in the New York Times a while back:

New Drug Promises Shift in Treatment For Heroin Addicts
(registration required)

This is not meant to answer the fundamental question about the efficacy of the medical model, but simply to document info.

Another well-accepted treatment for addiction is for cigarette cessation -- the use of the nicotine patch/gum, often in combo with drugs like Zyban, which tend to reduce nicotine cravings. Not perfect, but shown to reduce rates of relapse when compared to no treatment.

Posted by: Claudia at October 13, 2003 03:39 PM

A 13% success rate. So it CAN work. Interesting. Considering you can purchase illegal drugs virtually anywhere in the US, including inside maximum security prisons, and at ever decreasing real prices-I hardly think interdiction is a sparkling success either.

Leave aside the fact we are a presumably "free" people-just look at it pragmatically-if we took the $13 billion spent in useless interdiction attempts in 1994 alone and funded Claudia and her colleagues with those amounts-we could certainly increase the successful treatment rate.

I want to avoid another pro/con legalization debate as I'm sure we can't persuade one another to change sides. So let me ask me one (maybe two) question(s):

1. are you content with our current drug policies?

2. if not, what would you change?

P.S. drugs weren't always illegal in this country. Perhaps drug criminilization was the original "reckless social experiment"?

Posted by: martin at October 13, 2003 03:51 PM


The 13% success rate: what is the rate of addicts getting themselves off drugs because they don't like living in alleyways or because they are imprisoned and can't get drugs as easily since they lack the money to buy them?

What would be the success rate of just putting drug addicts on extremely isolated island communities (I'm thinking of perhaps using some Aleutian Islands for this purpose) where they are tested periodically and where it is hard to bring in drugs because of the physical isolation and because of ways that supplies get shipped in? Force people to live drug-free for n months and stick them back in society and see what the recividism rate is for various periods of isolation.

No, I'm not content with current policies.

I'd up the level of medical research into vaccines and drugs for breaking dependence. I'd also fund more longitudinal studies into the effects of drug exposure beginning at various points in life.

I'd also up the interdiction efforts.

I'd also up research into nanotech sensors that could allow parents to get continual feeds on whether their adolescents have drugs in their bodies.

I'd also provide government funding for free birth control implants (e.g. Norplant) and tubal ligation for drug addict females.

I'd make it easy for cops to get warrants to do blood tests on pregnant women who appear to be under the influence of alcohol or drugs. I'd allow pregnant women to be imprisoned for the length of their pregnancies (or placed in a remote place or required to submit to daily or weekly tests under a form of parole) once they have been shown to be users while pregnant.

I have other ideas but this is enough to get across the point that libertarian legalization is not the only imaginable policy response to the problem. These other responses might work better. They have the advantage of not being based on a libertarian fantasy about human nature.

P.S. Why do you suppose so many governments have opted to criminalize drugs? Could it be that drugs became a problem for society in many different countries?

Posted by: Randall Parker at October 13, 2003 04:09 PM

Well Randall I do applaud you for setting forth some specific and imaginative alternatives. We'll definitely be voting for different candidates in the years ahead though. If your candidate wins wins, well, I always did want to visit the Aleutian islands...

Posted by: martin at October 13, 2003 08:26 PM