A Question for Dr. Volkow

Drug warriors don’t answer phone calls or emails from the likes of us, so the only way to ask them questions is to show up when they’re speaking publicly and hope to get called on during Q&A. Sitting in the moderator’s line of sight helps, as does not looking like a balls-to-the-wall hippie drug-legalizer (not that there’s anything wrong with that).

And so this past Friday I attended the “African American Brain Trust on Eliminating Racial Disparities in Substance Abuse Policies” sponsored by the National African American Drug Policy Coalition, for the dual purposes of developing contacts for an unrelated project, and hopefully to get some answers from NIDA Director Dr. Nora Volkow who would be presenting. NAADPC assembled an impressive list of speakers, and though the event was neutral in tone, it’s probably safe to say that if NAADPC replaced ONDCP, there'd be less to blog about. The audience consisted primarily of criminal justice and medical professionals, but the full anti-prohibitionist viewpoint was represented by ubiquitous reformers Kymone Freeman and Howard Wooldridge of LEAP. True to form, both asked about legalization, which prompted squirmy but less-than-dismissive responses from panels of distinguished judges, prosecutors, and law-enforcement professionals.

A neutral, non-politicized discussion of the drug problem inevitably favors the compassionate activist over the status quo, but the final word of the day from Dr. Nora Volkow provided a startling reality check. Dr. Volkow’s power-point presentation titled “Using Science and Medicine to Effectively Treat Drug Addiction” conjured a distopian future in which “addicts” are administered government drugs by force in order to prevent them from enjoying the drugs they take voluntarily. But she didn’t phrase it that way.

Dr. Volkow argues that prolonged drug use alters the brain in ways that reduce the user’s control over drug-taking itself, thereby necessitating compulsory treatment in order to help the user regain the ability to make his/her own decisions. Addiction is a disease, yes, but drugs themselves cause the disease over time, according to Dr. Volkow. By this logic, intervention appears justified at any stage.

With time running short, I was fortunate to be one of three people chosen to ask questions. Mine came out something like this:

I hope that by looking at drug addiction as a disease, society will become less inclined to stigmatize people with drug problems. But there’s a flipside in that most people who use drugs are doing just fine. I know that most people in treatment for marijuana were coerced into it by the criminal justice system, for example. As your research progresses, will you still acknowledge that most drug users don’t fit into the addiction model you just described?

Dr. Volkow was answering before I was done asking, and her answer was clever. She admitted that many drug users don’t experience negative consequences. “We’ve always acknowledged that” she said, as if I was kind of stupid for asking. “But it’s important to realize,” she went on, “that even experimentation with drugs can have dire consequences.”

It’s pathetic that after a forty-five minute presentation on addiction science, she would resort to such an unscientific generalization. Yes, experimentation can have consequences, but as Jack Herer once said, “nobody’s ever died from marijuana that wasn’t shot by a cop.” Too often, the consequences of drug use take the form of government persecution justified by junk science from prohibitionists masquerading as public health experts.

Dr. Nora Volkow says we shouldn’t stigmatize drug-users, but then she goes around diagnosing them with a brain-rotting disease that most of them don’t actually have.