corrections

Corrections – XV, posted April 14th 2016

I was asked by a few people on the book’s Facebook page to respond to an article on the excellent addiction and recovery website ‘The Fix’ that was entitled ‘Four Things Hari Gets Wrong,’ by an activist called Andrew Dobbs.

I’m happy to correct any mistakes in the book or anything I said – on this site I’ve corrected over twenty errors, and thanked the people who pointed them out in the latest edition of the book. In this case, after looking into this carefully, I could find no factual errors that were pointed out. There are some philosophical disagreements, which I’m happy to engage with, and to clarify my position here, so others can make up their own minds.

First of all I’d like to congratulate Andrew Dobbs on his recovery, and engage in the limited disagreements I have with him in a tone of love and compassion. We are on the same side in seeking to end the war on drugs, and to make sure people with addiction problems receive love and compassion, instead of shame and stigma. Our minor disagreements are a small shadow compared to what unites us.

I’d also clarify that Andrew is obviously responding to my TED talk and not to my book, since he claims I do not make arguments that I in fact do make in detail in the book.

Andrew’s criticisms are as follows:

(1) The title of my TED talk, ‘Everything You Think You Know About Addiction’, is condescending, since in fact most people with addiction problems know these things.

But the “you” in this title, the people who I am addressing, are not just people with addiction problems, but everyone. Most of the people who have viewed this talk, just like most of the people who’ve read the book, don’t have addiction problems. I agree that most people who’ve been through addiction know the points I’m making intuitively. But we have to address a much wider audience if we are going to end this war – that’s why I’m talking to far more people than just people with addictions. And of that “you”, most of them didn’t know this stuff. I was speaking to a TED audience, of whom – I’d guess – fewer than 10% had addiction problems.

This is a crucial point. I’m gay. I get to live as an equal citizen because gay people spoke to a much broader audience than just other gay people. That’s how we won our freedom. If we are going to win an end to the war on people with addictions, we can’t just talk to people with addictions.

It would be condescending to tell people with addiction problems that what they know is wrong. But the “you” I’m talking to in the speech very clearly – when you watch it – isn’t people with addiction problems; it’s largely everyone else.

If, in 1955, I had given a speech saying “Everything you think you know about homosexuality is wrong,” explaining that gay people are not paedophiles etc, you can imagine some gay people might misunderstand and say: “I already knew that. How condescending.” But most would have known that this wasn’t a speech for them – it was a speech for everyone else, to get them to stop persecuting gay people.

(2) He argues I have no training and I am not an addict myself, so my arguments do not have validity, or are diminished.

In fact, my insights into addiction come from closely studying the evidence from the social sciences. I was trained in depth in the social sciences at Cambridge University, where I got a double first, the highest qualification you can get; so I have been given the best training in the world at how to assess this evidence. It’s true I don’t have addiction problems. Some of the best advocates for equality for gay people were not gay – whenever a heterosexual person joins the fight for equality for gay people, I welcome them with open arms. Every successful struggle to defend a minority welcomes people from other groups who join their fight for dignity.

(3) He argues that I fail to see that “addiction has a physical component.” He comments: “This should be obvious to everyone familiar with one of the world’s most addictive drugs – nicotine”

In fact, my book lays out the evidence that addiction has a physical component very clearly. Indeed, I use nicotine as a key example.

Here’s what it says:

“It would be absurd to say the chemicals play no role at all in, say, cigarette or crack addiction. So how much really is due to the chemicals, and how much is due to the social factors? What’s the ratio?

As I read more, I stumbled across—in the work of an amazing scientist called Richard DeGrandpre—an experiment that gives us a quite precise answer, in percentage terms. You may well be taking part in it right now.

When nicotine patches where invented in the early 1990s, public health officials were thrilled. They believed in the theory of addiction that almost everyone believes in: addiction is caused by chemical hooks that are hidden in the drug. You use a drug for a while, and your body starts to crave and need the chemical in a physical way. This isn’t hard to grasp. Anybody who has tried to quit caffeine knows that chemical hooks are real: I am trying it as I type this, and my hands are very slightly shaking, my head is aching, and I just snapped at the guy sitting opposite me in the library.

Everyone agrees that cigarette smoking is one of the strongest addictions: it is ranked on pharmaceutical addictiveness scales alongside heroin and cocaine. It is also the deadliest. Smoking tobacco kills 650 out of every hundred thousand people who use it, while using cocaine kills four. And we know for sure what the chemical hook in tobacco is—it’s nicotine.

The wonder of nicotine patches, then, is that they can meet a smoker’s physical need—the real in-your-gut craving—while bypassing some of the really dangerous effects of smoking tobacco. So if the idea of addiction we all have in our heads is right, nicotine patches will have a very high success rate. Your body is hooked on the chemical; it gets the chemical from the nicotine patch; therefore, you won’t need to smoke anymore.

The pharmacology of nicotine patches works just fine—you really are giving smokers the drug they are addicted to. The level of nicotine in your bloodstream doesn’t drop if you use them, so that chemical craving is gone. There is just one problem: even with a nicotine patch on, you still want to smoke. The Office of the Surgeon General has found that just 17.7 percent of nicotine patch wearers were able to stop smoking.

How can this be? There’s only one explanation: something is going on that is more significant than the chemicals in the drug itself. If solving the craving for the chemical ends 17.7 percent of the addictions in smokers, the other 82.3 percent has to be explained some other way.

Now, 17.7 percent certainly isn’t a trivial amount. That’s a large number of people with improved lives. It would be foolish and wrong to say the drug has no effect—tobacco cigarettes are considerably more addictive than menthol cigarettes, to give just one example. But it would be equally foolish to say what we have been saying for a century—that the chemicals themselves are the main cause of drug addiction. That assertion doesn’t match the evidence.

This point is worth underscoring. With the most powerful and deadly drug in our culture, the actual chemicals account for only 17.7 percent of the compulsion to use. The rest can only be explained by the factors Gabor and Bruce have discovered.”

So I in fact make the very argument he accuses me of not making. I had also made this argument in many interviews by the time he wrote this article.

(4) He argues that I say loneliness is the only cause of addiction, and that this is not the case.

Here, Andrew is arguing against a case I have never made. When I talk about disconnection being a cause of addiction, I am not just talking about disconnection from the people around you – I am also, as I lay out at length in the book, talking about disconnection from meaning and purpose and other deeper forms of disconnection. Loneliness is a significant component; but I have never said it is the only one. If I had, Andrew would be right to criticize it.

(5) He says with addiction, “the determining factor is almost certainly physical and/or genetic.”

He asserts this without evidence. While there are physical and genetic components, I go through the evidence in the book that suggests this view that it is the “determining factor” is incorrect. I would urge Andrew to read the work of Professor Marc Lewis, Professor Carl Hart, Stanton Peele, and others who have engaged with this in depth. The claims he says is “almost certain” is in fact massively contested, and there is no evidence for it. (These factors are real, but they are not “the determining factor”, above all else.)

(6) He says I fail to acknowledge that “enabling is a real threat to addicts,” and then explores the problems that can emerge if somebody facilitates destructive behavior by addicts.

Andrew is again arguing against a position I don’t hold. I have always made clear that it is possible to develop destructive relationships with people who have addiction problems, and that this can be bad for both the addicted person, and the person who believes they are helping them.

All I said is that I’m against cutting off people with addiction problems, or threatening them, as a first resort, or as anything other than an absolute last resort. That doesn’t mean I’m in favor of giving every person with an addiction anything they ask for, or tolerating anything they try to do. I’ve never said that, and I’ve never done that. It would be right to criticize anyone who said that; but that person isn’t me.

(7) He says it is “irresponsible” of me to speak to people about the need for them to strengthen their relationships with addicts, without at the same time warning that people with addiction may not respect boundaries.

In a short twelve minute talk, I couldn’t say everything. There is nobody in Western culture who doesn’t know that addicts can be chaotic, ask for too much, or behave destructively. They don’t need me to spell it out. When I sit with people who are trying to love someone with addiction, I do discuss this topic, and how I’ve tried to deal with it in my life. But if you give me twelve minutes to talk to a large audience, I won’t focus on reiterating points literally everyone knows.

(8) He says I fail to acknowledge that “sobriety is connection.”

He makes the case that for many people, they discover connection precisely through discovering communities of other sober people who are recovering from addiction problems.

I agree with Andrew that sobriety, for many people, can be a route to connection. It’s one I have urged for some of the people I most love.

But I do not believe that sobriety is always connection. I know lots of sober people who are profoundly disconnected, and it manifests as depression or anxiety. So I don’t think it is true to say “sobriety is connection”, as an invariable rule.

(9) He then argues that I have never apologized since 2011 for some serious errors I made many years ago in some of my journalism. In fact I explored these questions in depth, four months before Andrew wrote this piece, in an interview in the Guardian with Decca Aitkenhead, and apologized in depth. If he had googled my name, it would have been one of the top results, so I am puzzled about why he made this claim.

I am sure Andrew will, if he looks at this evidence, correct the factual errors in his piece.

 

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