The real driver behind most drug use is pleasure, not dependence

Surprisingly good article, thanks for posting.

 

David Nutt
The Guardian

In the future, harm reduction approaches must explicitly incorporate the maintenance, and possibly even the enhancement, of pleasure, if we really want people who use drugs to see that harm-reduction advice is balanced and truly non-judgmental.

Harm minimisation, harm reduction, drug-related harm, drug overdose, addiction: these are the dominant narratives that are used when we talk about drugs. As doctors we diagnose those seeking treatment for many drug-use problems as having an illness.

And government policies are driven by the drug use consequences of the minority of users who develop drug dependence. Don't get us wrong: drugs – legal, illegal and prescribed – can ruin lives. Governments must provide treatment services and information. But the discourse almost always fails to explicitly and openly discuss drug-related harms in the context of the real driver behind most drug use, which is not dependence, but drug-related pleasure.

Last year's Global Drug Survey decided to explore the obvious fact that drug use, like other decisions, is one of balance. We wanted specifically to look at how the commonly used drugs in our society were rated not by scientific committees or "drug experts" but by people who actually use these drugs. Global Drug Survey did this by developing a new (and as yet unvalidated scale) called the Net Pleasure Index. It was developed after lots of feedback from our 2012 survey and discussion with many people – experts, users and expert users.

It consists of 10 items exploring the positive aspects of their drugs experience, effects and function over the last year and 10 items exploring matching negative aspects for nine drugs including tobacco and alcohol. The NPI was completed by more than 20,000 people worldwide who had used those drugs in the last year. The mean score for each drug was determined by subtracting one from another.

The results from the 7,000-strong UK sample closely match those seen in the full 22,000. It shows that when taking the good, the bad and the ugly side of drugs into consideration MDMA (ecstasy), magic mushrooms, and LSD come out top, with alcohol and especially tobacco languishing in last place.

Alcohol is rated as the most harmful drug. This may come as a surprise to many but what's striking is how closely these rankings of everyday users matched those of 29 experts who sat in a room in 2010 and generated the data for a Lancet paper calling for a review of drugs classification.

It matches the data from the World Health Organisation showing the greatest burden of drug-related disease comes from alcohol and tobacco.

The three drugs that came out top share the capacity to broaden one's inner world and scope for emotional and spiritual attachment. LSD and magic mushrooms have no recorded drug-related deaths to their name, are used sparingly by most users, and virtually no one becomes dependent.

In the case of MDMA, there are some drug deaths each year, but some of the risk and harms are associated with uncertain dosing due to variable purity and pills containing other stimulants, multiple drug use and limited implementation of common sense safer-use strategies.

Mephedrone (also known as M-cat and meow meow), once considered as a drug with a positive low-risk profile, now tops the negative rankings for after-effects and unwanted effects on mental health.

The government should not fear drug law reform. The results from this year's survey of the potential impact on drug use by current and non-users clearly shows that reducing drug penalties for small amounts of illegal drugs would, for the overwhelming majority, reduce stigma, improve discussion with families, who are the best placed to help and support individuals, and access help for their use.

Once again our work suggests that most people who use drugs do so without encountering significant harm and make sensible decisions around their use of drugs. Many more might do so if provided with information in a way that was personally meaningful and did not get in the way of them using and enjoying their drugs.

continued: http://www.guardian.co.uk/commentisfree/2013/apr/18/driver-drug-pleasure-dependence

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Good article, but too bad that this is "news" to some people.

 

What's the counterargument for people who say that alcohol is worse only because it is more widely used?

 

^ I might start here.

 

Thanks.

 

In the future, harm reduction approaches must explicitly incorporate the maintenance, and possibly even the enhancement, of pleasure, if we really want people who use drugs to see that harm-reduction advice is balanced and truly non-judgmental.

This is an extremely bold statement, even in the HR community.

 

^ I don't even know how I feel about that.

...I suppose that's what we're saying when we tell people to be careful "not to lose the magic".

 

A member posted this on the comments section

Yes, 60,000 have died in Mexico because criminals continue to put their selfish hedonism before the safety and welfare of the people who suffer as a result of them funding drugs cartels, which is a powerful illustration of how self-obsessed drug users are and the damage that their sense of entitlement is capable of inflicting on their fellow human beings.
I'm not a big fan of caffeine as it happens,or any of the crutches people use because they haven't developed mature coping mechanisms. There's nothing fake about sunshine. Dosing up with various forms of happy pill is simply faking your way through life.

I find this to be completely absurd. Faking our way through life for using drugs, yeah because life's so easy. Drugs dont make my life easier. When sensibly used they're just a way I like to experience life, we all do the same. People use drugs for different reasons, and yeah, sometimes it's because life's really hard for them, but stop pointing fingers and demeaning people for their decisions. Fuck. Posts like this get me mad. People who think they're on some higher level because they've found "the way" and they sure know what's good for us. Welcome to the internet :/

 

Yes, 60,000 have died in Mexico because criminals continue to put their selfish hedonism before the safety and welfare of the people who suffer as a result of them funding drugs cartels, which is a powerful illustration of how self-obsessed drug users are and the damage that their sense of entitlement is capable of inflicting on their fellow human beings.

Did drug use ever take place without bloodshed? Yes. Through most of human history, people have gotten high in the absence of carnage. What caused this to change? Prohibition.

Drug taking was ours before they tried to take it away from us. The blood is on their hands, not on ours.

 

Good article, but too bad that this is "news" to some people.

Indeed. I am a member on a quit smoking forum since I quit 6 months ago. Man would I get shat on by the nosmo nazis if I posted that 8)

So many of them found that the only way to quit was to believe that there was absolutely nothing positive about smoking, and that is was 100% to relieve withdrawal..... The idea that they got anything good from smoking doesn't exactly sit well with them and "threatens" their quit.....

Of course I got clean from IV heroin and cocaine years ago, so the idea that quitting a drug is only possible if I got no pleasure from it is absurd, and I'd probably be dead by now if I believed that.

Great article tho!

 

It's amazing how much scientific research has to go into showing some things that are so obvious and true to many people who are intimate with the subject. I really liked the article though. A+

 

That's the point of scientific research though isn't it: to check the many views expressed against the reality to see which view is closest to being right.

 

Yup. It's not the people who are already intimate with the subject that need it proven to them. It's everyone else! Science has to demonstrate things in ways that are equally true to everyone, regardless of biases or pre-existing beliefs - totally objective. That really is a lot of work, even for apparently obvious things.

 

Finaly a well balanced media article. Great work !

 

i'd like to stick my face in that tupperware full of boomers.

 

Can't really see how this is possitive
A)david nut said mcat shouldn't be band and this report majes it sound terible so it discredits him
B)saying its just pleasure seeking not addiction removes any rights to special treatment

 

^do you want special treatment?

 

I have no higher level science qualification so I wouldn't count myself as an authority on the subject but this is precisely how I've began to think of addiction in the past 18 months or so, as I have behaved so as to render all the terms interchangeable: habitual, dependent, addicted. I was uncomfortable with these labels - which had been used on me by others - and realised it was not because I was harbouring deep guilt over my inescapable and devastating addiction, not because I was in denial, but because I really wasn't worthy of the term. I'm not suffering the kind of addictions others are, i would say. They are real addicts with genuinely compelling addictions; using it on myself is a weak and cowardly way to absolve blame for what I'm doing to myself


And then it sort of dawned on me: addiction is not a compulsion of the mind or body to satisfy the particular need the addictive habit creates. All addictions are driven by the the desire for pleasure and happiness; they merely all operate as different systems of delivery to the brain. With drugs this is very simple as they are literally the pathway to the pleasure centre in the brain. Here's how I see it, from a post I made earlier:

I would say like a moth to the flame but that is to denigrate the many, many people who - once they break the 'barrier' - go on to have a manageable and healthy relationship with drugs. But there will always be a relationship with them once you break the barrier. That relationship will be binding. You may not take drugs all the name, you may not think about them all the time, they may not be the most important thing in your life, they may not feel like they matter at all, when you think about them they may not even be hugely - let alone compulsively - appealing, but you will think about them. At stages, when triggered, your mind will drift to the thought of them. The frequency of that drifting and the triggers for it may determine much about how your 'relationship' proceeds.


The barrier I'm talking about is that first great drug experience. I have only taken a narrow scope of drugs but I imagine the experience is universal, and can apply to any drug: that breakthrough moment, that defining experience. The truth is - that not many people, I imagine, are willing to admit for how addictive this statement alone sounds - is that once experienced, your perspective on the world changes. Nothing you have ever experienced in your life, no matter how meaningful, will come close. It will be the best thing you have ever done, the greatest feeling you have ever felt. The memories - foggy, hazy, nondescript, malformed as they may be, it doesn't matter, even the memory of having a memory of the experience is enough - will become crystallised in whatever part of your brain controls pleasures and drives. The association will be insidious

For me, personally, drug usage is just personal hedonism: pleasure for pleasure's sake. Herein lies the addiction, and the only thing crack addicts lack is willpower. ,

 

I think the study misses the mark a little. I do agree that there is some issue around the pleasure factor, and an ingrained societal belief system that admonishes euphoria as somehow hondistic or unbecoming; but the greater reason that the least harmful drugs are illegal is that they cause the user to re-examine the human structure of living. Alcohol and tobacco are the most harmful, but they do not pose any threat to the established and accepted thought patterns.

If you look at which drugs pose the greatest threat to the status quo and which drugs don't, the scheduling of substances will make a lot more sense. It's not about pleasure vs. dependence but acceptable thoughtspeak vs. unacceptable ideology. People whose point of view is shifted dramatically may refuse to participate in, or even begin rebelling against the structures they grew up unconsciously accepting.

If the laws were genuinely about harm reduction then alcohol and tobacco would be schedule I. That's not to say that there is no harm to the other substances, but in terms of loss of life, and socioeconomic impacts, alcohol and tobacco take the cake.