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The Myth of Drug Addiction
(Bruce K. Alexander, Simon Fraser University)
Most Canadians believe that certain drugs cause catastrophic addictions in people who use them. This conventional belief is reflected in such familiar phrases as "crack cocaine is instantly addictive" or "heroin is so good, don't even try it once". It is also implied in the professional literature which routinely describes certain drugs as "addictive", "dependency producing", or "habit forming". The belief that drugs can induce addiction has shaped drug policy for more than a century. . . . However, the only actual evidence for the belief in drug-induced addiction comes 1) from the testimonials of some addicted people who believe that exposure to a drug caused them to "lose control" and 2) from some highly technical research on laboratory animals. These bits of evidence have been embellished in the news media to the point where the belief in drug-induced addiction has acquired the status of an obvious truth that requires no further testing. But the widespread acceptance of this belief is a better demonstration of the power of repetition than of the influence of empirical research, because the great bulk of empirical evidence runs against it. . . . Belief in drug-induced addiction may have deep cultural roots as well, since it is a pharmacological version of the belief in "demon possession" that has entranced western culture for centuries. . . . This is more than an academic issue. Canadian policy decisions frequently are constrained by the public’s strongly-held belief in drug-induced addiction. Draconian laws, sentencing, and even police violence have been justified by the need to keep addicting drugs out of the hands of the nation’s youth at all costs. As well, it is almost impossible to experiment with medical administration of heroin or cocaine to addicts for fear that the medical profession would be seen as dispensing an addicting drug that could find its way to the public. . . . Analysing the vast and complex literature that relates to this topic becomes simpler if the general belief that heroin and cocaine cause addiction is resolved into two more specific claims, and each is evaluated separately. The two claims are: Claim A: All or most people who use heroin or cocaine beyond a certain minimum amount become addicted. ... Claim B: No matter what proportion of the users of heroin and cocaine become addicted, their addiction is caused by exposure to the drug. . . . The two claims are rarely stated this explicitly. Usually, they are either assumed, stated in a vague way, or combined. However, every professor who teaches a course in drug addiction knows that the majority of students firmly believe both of them at the beginning of the semester. . . . Claim A is usually asserted less strongly now than it has been in the past, when claims of "instant addiction" were often made for both heroin and cocaine and, earlier, for alcohol, marijuana, and numerous other drugs. More cautious contemporary statements of Claim A state that addiction only occurs after several exposures to the drug, although the minimum amount required to produce addiction is left unspecified. . . . Here it is important to consider the meaning of the term "addiction". Some (not all) of the non-addicted users of heroin studied by Blackwell and by Zinberg were regular users of heroin. However, they did not feel out of control, the heroin habit did not consume their lives, they did not steal to obtain it, and they were not criminalized. Therefore, by all normal definitions of "addiction" and equivalent terms, these people were not addicted (for example, see definitions in Jaffe (1990) or the most recent Diagnostic and Statistical Manual of the American Psychiatric Association). If the term "addiction" is applied to mere occasional use or innocuous regular use the term becomes trivial--most people regularly and stubbornly use things that carry some substantial risk of harmful side effects, like automobiles, skis, computers, and birth control pills. . . . Taken together, the American and Canadian population surveys indicate that merely having used cocaine is associated with less than a 10% chance of having it as often as 100 times. Virtually all addicts use it far more than 100 times. . . . I hope that this short review is sufficient to show that the conventional belief that heroin and cocaine cause addiction is very far from an empirically supported fact. By the normal, skeptical standards of science, Claim A is false and Claim B is an unsubstantiated hypothesis. . . . Moreover, the conventional belief in drug-induced addiction appears to persist because it serves personal, social, professional, commercial, and political needs.

[NOTE: This is only a short excerpt from a very long paper containing much detail and many references. Please click the link above to read the entire paper.

posted by Lorenzo 4:20 PM