I have worked really hard – alongside my editor, fact-checker, and lawyers in the US and UK – to make sure everything in the book is accurate. If there are any errors left in the text, I’d be grateful for your help in correcting them for future editions and for the record. If you spot any mistakes, please email me at the address above. I’ll post corrections on the same date, and give you a shout-out for spotting them.
If there was anything the book left you wondering, please do message me at chasingthescream@gmail.com and I’ll be happy to try to figure out the answer.
- Posted 10th January 2024In December 2023, I received an email from a conservative journalist writing for a website. He said he wanted my response to a series of accusations against my books. When I read the accusations, it was clear that he had taken them from Twitter, and they contained such basic errors about what the books say that they could only have been written by people who haven’t read my books. I sent a detailed reply to the journalist, and after looking at the facts, he has clearly decided not publish these untrue claims. Since these falsehoods are still there in the more obscure corners of the internet, I thought it might be useful to post the facts about them here too. 1. He claimed I had mistranslated quotes provided to me by interviewees to better fit my thesis, by recasting their agreement with points made by me as moments of their own personal revelations. He gave no examples of this claim, because there are none in any of my books. Where I interviewed people in a language I don’t speak, I had a fluent native speaker there to translate, and accurately relayed their translation. I quote everyone accurately. The only time the quotes in the book diverge from the audio - as I explain clearly in my writing - is in one scenario. When as part of my fact-checking process I sent the quotes in the book to the person I interviewed, occasionally they asked me to amend their spoken words to more precisely reflect their views, or because they made a factual error in what they said. I have an extensive paper trail of all the emails and audio recordings that prove this, and all the quotes I use are posted on this website. Wherever I present somebody as having a personal revelation, that is because they had a personal revelation. I have many hundreds of hours of audio of interviews, and I can demonstrate in each case that this is the case. 2. He claimed I had misrepresented the theories of Gabor Mate and others as an unknown, renegade position rather than fairly well-established scientific dissent within the scientific community, and that I had decided to ignore other reputable and non-dissenting work. I present clear evidence in Chasing The Scream that Gabor Mate and Bruce Alexander’s work has indeed taken a minority and renegade position. For example, I reported from Vancouver on Dr Mate and Professor Alexander’s passionate advocacy for supervised injection sites. Whilst arguments for SISs have a history going back decades amongst drug treatment specialists, they are illegal in the vast majority of the world and any suggestion that a city or state might introduce them is highly controversial. In the UK a recent attempt to introduce one in Scotland was unofficially sanctioned and lasted less than a year. See this academic analysis of the attempt). Gillian W Shorter, Magdalena Harris, Andrew McAuley, Kirsten MA Trayner, Alex Stevens (2022), ‘The United Kingdom's first unsanctioned overdose prevention site; A proof-of-concept evaluation’, International Journal of Drug Policy, 2022, Volume 104 It is accurate to say that advocating for a policy that is banned almost everywhere in the world is a marginal and renegade position. I do not say that their positions were “unknown”: this is a false claim. I name and reference their published books and scientific studies, which could hardly exist if they were unknown. To address the second point raised here: I present a broad range of views in all my books. It is true there are some views I don’t represent. That is also true of all books ever published. No book can or should represent all conceivable opinions on a topic. 3. He said I had been been criticised for the approach taken in respect of the citation of primary and secondary sources, namely the reliance on a handful of books again and again. In the endnotes and bibliography for Chasing The Scream, I cite 187 books and over fifty more written sources, in addition to over 200 interviews and original archival research that I conducted in more than a dozen countries. My books are based on a very broad range of sources, referenced throughout the text and endnotes. Nobody could make this criticism if they had read the book. 4. He said “you claimed that there are "slews of studies" to substantiate your assertion that "almost all" drug addicts naturally recover but failed to include any citations to corroborate this claim.” Again, nobody who has read the book and the sources readers are directed to could make this claim. Natural recovery is a well documented phenomenon, and my citations direct the reader towards extensive evidence for it. This phenomenon is where people who have an addiction problem recover without any medical intervention or going to a rehab centre. I explain in the book how this phenomenon was first identified, writing: “It was first spotted by a psychologist named Charles Winick, who set up a free clinic for addicted musicians in New York in the 1950s. Winick, like everyone else, used to believe that once you were a heroin addict, you were a heroin addict until you died, but what he found was something very different. “Heroin use was concentrated in the 25 to 39 group, after which it tapered to very little,” he wrote. Most addicts simply stopped of their own accord. They “mature out of addiction… possibly because the stresses and strains of life are becoming stabilized for them and because the major challenges of adulthood have passed.” This process—the fancy names for it are “maturing out” or “natural recovery”—is not the exception: it’s what happens to almost all of the addicts around you. This finding is so striking I had to read about it in slews of studies before I really took it on board: Most addicts will simply stop, whether they are given treatment or not, provided prohibition doesn’t kill them first. They usually do so after around ten years of use.” I have interviewed many leading experts on this question, including Professor Wayne Hall, Dr Sally Satel, Dr John Marks, and Dr Gabor Mate. In the endnotes I provide several references for this section of the book, including this one: “A good discussion of this subject is found in Harald Klingemann, “Natural Recovery from Alcohol Problems,” chapter 10 of The Essential Handbook of Treatment and Prevention of Alcohol Problems, edited by Nick Heather. See also Satel and Lilienfeld, Brainwashed, 54–56.” In that chapter, Professor Harald Klingemann explains how evidence for natural recovery can be established. It is primarily done by interviewing people about addiction problems or heavy drug and alcohol use they engaged in in the past, and then asking them about their current drug and alcohol use. Where they have stopped or significantly reduced their drug use to a non-addictive level, they are then asked if they received any medical intervention or rehab. To give one example, he explains: “Canadian population studies have suggested that about 78 percent of interviewees with alcohol problems have overcome them without professional treatment.” (I explain elsewhere in ‘Chasing The Scream’ that the largest drug of addiction in our societies is alcohol, and the next most prevalent is nicotine - see below for statistics on natural recovery and nicotine, for example). Professor Klingemann cites seven books and 57 studies in his endnotes, and I read many of them. They constitute the “slews of studies” I cite in the text, along with many other sources. For a further overview of the research, I recommend reading this paper about natural recovery from heroin: https://abuse-drug.com/lib/Opiates-heroin-methadone/natural-recovery-from-heroin-addiction-a-review-of-the-incidence-literature.html Some other studies I consulted include: Remission from drug abuse over a 25-year period: patterns of remission and treatment use, 2001. The authors explain: “Most drug abusers who had started using drugs by their early 20s appeared to gradually achieve remission. Spontaneous remission was the rule rather than the exception.” Even more evidence supporting natural recovery has emerged since the book was published, including: Is Recovery from Alcoholism without Treatment Possible? A Review of the Literature, 2017 “A growing body of evidence confirms successful remittance of alcoholism can be achieved and maintained over time, without formal treatment. Contrary to common lay and professional perceptions, a significant percentage of alcoholics appear to achieve sobriety without receiving formal treatment.” Why do smokers try to quit without medication or counselling? A qualitative study with ex-smokers, 2015. “When tobacco smokers quit, between half and two-thirds quit unassisted” Motivations to quit cannabis use in an adult non-treatment sample: Are they related to relapse?, 2013 “The majority of cannabis smokers who quit do so without formal treatment, suggesting that motivations to quit are an important part of cessation process.” “Other epidemiologic and longitudinal studies suggest that a majority of cannabis quit attempts occur without formal treatment (Cunningham, 1999, Cunningham, 2000, Price et al., 2001, Smart, 2007).” So in the book, I tell the story of the scientist who first discovered it and direct the reader to a range of reputable books which relay the science in more detail, including the slews of studies I read for research. Nobody who has read the book could claim I don’t provide evidence for it.
- CORRECTIONS XXI – Published December 16th 2020
I have three corrections to make. The first two were pointed out to me by Peter Cracknell, to whom I am grateful.In the afterword to the book, added in 2019, one passage says: "As I spoke to Kambiz, I thought about what one of the British women who was jailed, demonised, and tortured just for fighting for women to be granted their right to vote-Millicent Fawcett-said once: "Courage calls to courage everywhere.""Many campaigners to give the vote to women were jailed and tortured in Britain but Millicent Fawcett - while demonised - was not.The book also says: "In 2012, the Canadian Supreme Court ruled that addicts have a right to life, and that safe injecting rooms are an inherent part of that right and can never be legally shut down."This in fact happened a year earlier, in 2011.Both these errors will be fixed in future editions of the book. Thanks again to Peter for pointing them out.Also, Louise Morley pointed out an error in the afterword. I made a mistake in the publication process - I sent the wrong Word document - so the afterword was published without my fact-checks, and two errors got through.I referred to the painting Gin Lane, by William Hogarth, but I wrongly called him "Richard Hogarth", and I made an error in the description of what happens in the painting. I describe it as a baby falling while his mother downs a bottle of gin; in fact, the baby is falling while his mother - who is clearly drunk - is pinching some snuff.This will be corrected in future editions too. Thanks to Louise for pointing this out. - Corrections XX – posted 20th February 2019
I was emailed with a series of thoughtful and intelligent questions by Stephen who runs the YouTube channel Coffee Break, and in a series of email exchanges with him, a few areas came up that I thought it might be useful to clarify here for readers and to add as an additional footnote in the book.
Stephen emailed me about the material covered in pages 173 to 175, which is about heroin use by American soldiers in Vietnam during the war there.
In the text, I reference a study that was published in the Archives of General Psychiatry. Stephen pointed out that I should have also have put a full citation in the footnotes giving the full name of the study and where readers can find it, and he’s totally right, so I’ll be adding a footnote to the full study: it’s called ‘Narcotic Use in Southeast Asia and Afterwards: An interview study of 898 returnees’. The full reference is Arch Gen Psychiatry. 1975;32(8):955-961. doi:10.1001/archpsyc.1975.01760260019001
You can also read some of Professor Robin’s interesting later reflections on the study here.
Stephen read the study and wondered if I had misunderstood some of Professor Robin’s conclusions.
Professor Robin showed that most troops who used heroin in Vietnam came home and stopped rapidly and did not continue their use in the US itself. I interpret these findings primarily as one more piece of evidence contributing to the growing insight that there is a huge environmental component to addiction – that where the environment makes people distressed and disconnected, addiction will generally go up; and where the environment makes people feel secure and connected, addiction will generally go down.
It’s not the only factor, of course. There are significant biological and psychological components that exist alongside (and interact with) the environment. Chemical hooks, for example, are a real component in addiction, as is childhood trauma – along with other aspects I discuss more in my more recent book ‘Lost Connections.’
Stephen asked me several questions that I had considered when I was reading Robin’s study for the book years ago, but didn't include in the book itself. His questions made me realise it would be a good idea to expand on this in the footnotes (and here, on this site) because they are, I think, interesting and instructive.
He pointed out that Professor Robin interpreted her own data differently to my reading of it in Chasing The Scream. It’s normal for a scientist like Robin to gather data that are solid and undisputed, and then for others (like myself and Professor Bruce Alexander and Dr Gabor Mate) to interpret that data differently – but Stephen is right to suggest I should have made it clear in the text why I was doing this.
He points out the following areas of disagreement between Robin and me about what her findings mean - I'd like to go through one by one and explain why I read her findings differently:
DISAGREEMENT WITH ROBIN, ONE:
Robin did not think that avoiding distress was the key driver of this heroin use in Vietnam. As Stephen explained in his email, “it was asked why these people used heroin while at war, and the vast majority of them responded "to get high" rather than to "relieve depression" or "relieve boredom". This seems to fly in the face of the dislocation hypothesis, where you'd expect depression, boredom and fear to be the main drivers.”
40% said the goal of their heroin use was to “get high”, while 9% said to “relieve depression”, 9 percent said “to relieve boredom”, and 8 percent said “to relieve fear.”
MY REASON FOR DISAGREEING, ONE:
(a) As I explain in Chasing The Scream, today most drug use isn't addictive use (even with 'harder' drugs) - in fact, even according to the UNODC (the main drug war body in the world), 90 percent of all currently banned drug use is 'non-problematic' use. So it's natural that even in the extreme circumstances of Vietnam, there would be plenty of recreational use, and some people would describe themselves that way accurately because they were in fact recreational users and not addicted.
(b) Perhaps most importantly, I don't think the options Professor Robin presented them with cancel each other out. Almost everyone I know who has an addiction would tell you they used their heroin or crack or drug of choice to "get high" (or get drunk etc) - using a drug to get high doesn't preclude you having an addiction. "Getting high" is what takes away the pain for people with addiction problems. If you're reading from those figures that everyone who gave "getting high" as the goal of their drug use as a statement that they weren't addicted, that would rule out the vast majority of people who you and I would describe as addicted today.
(c) Even if you thought naming "getting high" as the primary reason for your use precluded you being addicted (and I think it's very hard to make such a case), it would be important to bear in mind: Addictive use is deeply stigmatised now. It was far, far more stigmatised when Professor Robins was writing - the fact that the vast majority of soldiers, given a tick-list of options, would say "getting high" as their goal rather than "avoiding pain" will be skewed by that stigma.
If you go now and ask the first homeless drug users you meet why they are using (as I have done many times), even with people who clearly have really problematic addictions, most of them will give you a similar answer. Addiction is a really painful condition that it's hard to talk about, especially in a context of deep stigma. Under-reporting of addiction is very common.
DISAGREEMENT WITH ROBIN, TWO:
She wrote: "The argument that addiction in Vietnam was a response to war stress, and therefore remitted on exit from the Vietnam war theatre, is still frequently cited as though it were self-evident, because it sounds so plausible. Yet accepting this argument is difficult in the face of the facts. Heroin was so readily available in Vietnam that more than 80% were offered it, and usually within the week following arrival. Those who became addicted had typically begun use early in their Vietnam tour, before they were exposed to combat."
MY REASON FOR DISAGREEING, TWO
Every soldier sent to Vietnam knew that it was a terrible and terrifying war where they could be killed and where they may have to kill – so I find it a bit strange that she implies that “war stress” only begins in the active combat-zone itself. If I was told that next month I was going to have to fight in Vietnam, and started taking heroin to calm myself today, I think it would be a peculiar interpretation to say “it is hard to say Johann used heroin to deal with the war stress. He started using before he was exposed to combat.”
The soldiers used the heroin knowing they were on their way into a combat-zone that would be horrific and where they could die and where they could be made to commit horrible crimes against civilians. Most were conscripts who didn’t want to be there at all. They were under intolerable pressure.
That’s why I think it’s reasonable to interpret this heroin use when they arrived in Vietnam in their first week of deployment as, in many (not all) instances, a response to war stress. (I stress not all, because some of it will simply have been recreational use.)
DISAGREEMENT WITH ROBIN, THREE:
She thought the main reasons people stopped using after they came home from Vietnam were because their family and friends disapproved, and because it was harder to get hold of the drug.
MY REASON FOR DISAGREEING, THREE:
I think we need to understand Robin’s data in terms of what we’ve learned since about the interaction between the environment and addiction.
We now have a lot of evidence demonstrating that there’s a very significant environmental component to human addiction. Ann Case and Angus Deaton’s studies, to name a great (and heart-breaking) recent example, have shown that the areas with the highest opiod addictions & deaths are the areas with the highest disconnection, interpreted broadly (which is not to say that it’s the only factor: it’s not, as they stress).
The most powerful human example is the transformation in the drug policies of Portugal and Switzerland in the past twenty years. They made drugs more easily accessible, yet at the same time, they dealt with many of the underlying disconnections that were driving the addiction epidemics in their countries – and they saw a significant and well-documented fall in problematic drug use and overdoses.
If Robin was right and it was both availability of the drug and disapproval from relatives and friends that were the main reasons why people broke opioid addictions, it would be really hard to account for the huge fall in addiction in Portugal and Switzerland since they (respectively) decriminalised or legalised. They made the drug more easily available; and there was a reduction in social stigma from friends and family, not an increase; yet addiction fell – largely because they dealt with the deeper dislocations. (I go through how in the book, in chapters sixteen and seventeen.) The vast majority of people who have studied the Swiss and Portuguese successes (and the people working in it on the ground, who I spent loads of time with) think problematic drug use has fallen because they dealt much more successfully with the environmental factors that cause addiction.
I’m grateful to Stephen for raising these questions and I’ll be adding the full details of the study and a link to these reflections to the footnotes of the book. - Corrections XIX – posted June 19th 2017
On page 19 of Chasing The Scream, I write, about Billie Holiday: "Billie brought herself up on the streets of Baltimore, alone, defiant. It was the last city without a sewer system in the United States, and she spent her childhood among clouds of stinking smoke from all the burning shit.”
I have been contacted by a reader called Debrah Sambuco explaining that the second sentence there can’t be right. She wrote: “I am writing to tell you of an error in your otherwise very good and interesting book Chasing the Scream… The sewer system in Baltimore was built before Billie Holiday was born. She never lived in the city before it had a sewer system. Baltimore's sewer system was begun after the Great Fire of 1904. By 1915, when Billie Holiday was born, it was already very extensive and nearing completion. Here is a pdf of a history of Baltimore's sewer system from Waterfront.com.
I also checked the historic newspaper database Baltimore Sun Historic, and found many articles, dated before Ms. Holiday's birth, about the work being done on the new sewage system. One article, dated January 6, 1912, was entitled "Sewers Rapidly Completed." Here is part of the text of that article: "The Sewerage Commission is preparing to notify the Health Department of the new completion of large sections of the new sanitary system of sewers in East, South, West, and Northwest Baltimore..... Letters from Moscow and Constantinople received yesterday by Sewage Engineer Hendrick show the extent of international advertising Baltimore is getting from the new sewage system. This was three years before Billie Holiday was born.”
I’ve checked this out and Debrah is right: I’ll have that second sentence cut from future editions of the book.
She also pointed out a related error in the publishing of the endnotes. On p311, I refer the reader to page 6 of Billie's memoir 'Lady Sings The Blues.' I had intended to refer the reader to this if they want further information relating to the first sentence I quote above - "Billie brought herself up on the streets of Baltimore, alone, defiant", which is the subject of that chapter of the memoir. By an editing mistake I should have spotted before publication, the endnotes make it seem like this is, in fact, the place to look for a reference for the second sentence – "It was the last city without a sewer system in the United States." That’s incorrect - the next endnote I give in the book gives the source for that claim, which turned out to be incorrect, or to be misunderstood by me. I'll also have this end-noting error corrected in future editions too.
Thanks to Debrah for pointing out these mistakes – I appreciate it. If you’ve read the book and spotted any errors please do drop me a line (click to email). I’ll look into it and if you’re right I’ll thank you on here.
- Corrections XVII – posted June 17th 2016
Captain Paul Vandenbos has emailed to point out an error on page 86. I refer to somebody being a 'Lieutenant Colonel' in the US Navy, which is in fact a rank in the US Army; the correct description of this position in the Navy is 'Commander.' Thanks to Captain Vandenbos for pointing this out - it will be corrected in future editions of the book. - Corrections XVI – posted June 6th 2016
On page 183 of Chasing The Scream, I write:
“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 were 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.”
This week, I received an email from Garret Merriam, who is an Associate Professor of Philosophy at the University of Southern Indiana, with an important correction to this passage. He wrote:
“Dear Mr. Hari,
I have just finished "Chasing the Scream" and I enjoyed it tremendously. I found it to be thorough, engaging, fair and thought-provoking. I think it is fair to say that you have persuaded me of your core theses (but then again, I was pretty sympathetic towards them going in.) I consider myself fairly knowledgeable about this topic, but I had never heard of Harry Anslinger before. I feel a large gap in my knowledge base has been filled. For that reason, among others, I have recommended the book to several colleagues and friends.
But I did want to address the one part where I felt there was a glaring logical error in your text. On page 183 of the paperback edition you note that "The Office of the Surgeon General has found that just 17.7 percent of nicotine patch wearers were able to stop smoking." I take no issue with that claim, but later on the same page you draw the following conclusion from this stat: "With the most powerful and deadly drug in our culture, the actual chemicals account for only 17.7 percent of the compulsion to use."
That conclusion simply does not follow from the Surgeon General's statistic. The figure of 17.7% refers to PEOPLE, not to amounts of their compulsion; when you draw your conclusion, you equivocate between those two very different things. It might be the case that the chemicals account for, say, 30% of the compulsion to use, BUT only 17.7% of users have the willpower to overcome the remaining 70% of the compulsion accounted for by other factors. (By the same token, the chemicals might account for more than 30%, or less than 17.7%, or somewhere in between.) We simply cannot draw conclusions about how much of the compulsion comes from the chemicals based solely on the success rates of people who can quit when the chemical is removed as a factor. All we can conclude is that 17.7% of people are capable of overcoming the non-chemical factors.
I hope that doesn't seem too nit-picky, but I catch logical fallacies for a living, so that kind of jumped out at me. Notwithstanding this fairly small error, I again wish to express my praise for your book, as well as my gratitude to you for writing it.
Sincerely yours,”
This is a really important correction. When I was explaining this point in an interview recently, I realized there was something wrong with what I was saying – but I couldn’t put my finger on what.
Thank you to Merriam for pointing this out, and I’ll be correcting this point in future editions of the book to reflect the point he makes.
(This is also proof I should have concentrated more in my philosophy classes when they talked about logical fallacies: more Bertrand Russell, less Nietzsche...)