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. TO: President Clinton, The White House, fax 202-456-2461
Phil Boyce, Program Director, ABC-News NYC, fax 212-947-1340
Jim Gallant, Program Director, WMAL-AM-630, fax 202-537-0009
FROM: _______________, fax 202-___-____
DATE: March 13, 1997
RE: ABC News Special at the White House, 11am-noon, 3/12/97 (yesterday)
2 attachments
Hello. Yesterday morning I listened to the broadcast from the White House, with a group of teenagers, President Clinton, and Peter Jennings, in the East Room. I'm sending these remarks by fax to the White House, ABC Radio News NYC, and WMAL-AM, the ABC affiliate in Washington DC, to which I listened. My concerns have to do with effective public education about drug abuse, which I choose to call psychoactive mismanagement, for reasons explained below.
This coming together of the media, young people, and the Executive Office, was a terrific idea, and I applaud the effort. Yet, as a retired alcohol and other drug counselor, with 18 years in the field before retirement, and still actively concerned, to me the program exemplified a lot of things that are wrong with drug education. Briefly, it fostered denial, many myths, an inconsistent vocabulary, scare tactics, and confusion over the word "drug". In my opinion, it probably did more harm than good. Ironically, some of the faults of the broadcast were articulated by the teenagers, albeit in other contexts. For example, they decried scare tactics and exaggeration in public messages, yet this broadcast used both strategies. I am sorry to be making negative remarks (and later, some specific suggestions for improvements), because I'm sure the people working on the show went to a lot of effort and worked hard to make it effective. And it certainly was thought provoking!
One thing I came to believe strongly in my 18 years as a public educator, part of the time as a community leader and part of the time in charge of public education at a 4-county mental health program combining residential, outpatient, educational, and court-ordered programs for problems with alcohol and other drugs, is that modeling behavior is far more effective than exhorting or threatening. Modeling of consistent, responsible attitudes toward psychoactive management was not done during the broadcast. Another irony about the broadcast was that an item in the noon news, following the White House event, was about a prominent advocate of strict laws against drunk driving (a New York State Assemblywoman) being arrested for drunk driving. Surely this person's message against drunk driving has been impaired by her inconsistency, not practicing the cautious driving she recommends, although one has to grant her a point for consistency, in that she said she would plead guilty and not fight the charge. During the broadcast, one of the students said it was hard to believe that drugs were dangerous, because his parents used them. In other words, his parents' modeling illegal psychoactive use, ran counter to messages he heard against drug abuse.
Another time in the show, the President used a point about one student's use of downers (muscle relaxants) at a party, to highlight a comment made by a student about marijuana. The remark was inappropriate because of the irrelevance of the facts between the two chemicals, yet the President's aim was well intentioned-- He saw the two drugs as similar because they are "drugs". Yet, tobacco, which is 80 times worse than illegal use (* footnote 1), and the most obviously used drug in any household where anti-drug messages are promoted, when used at the same time as delivering anti drug messages, is going to weaken the impact of the anti drug message.
My point here is that, when a person speaks against drug use, then uses a drug, the speaking-against loses its impact. The modeling-in-favor counters the speaking-against. Worse, something else is being modeled, when this goes on: denial. Denial of the seriousness of chemical abuse, is at the root of problems in changing personal behavior, and in changing public behavior, in the psychoactive abuse area. Denial of drug seriousness, being modeled, not only hurts drug education because of its inconsistency, it gives users a *way* to *actively* resist that education-- By lying to themselves. In other words, I am not just decrying the inconsistency and hypocrisy of mass use of alcohol and tobacco as drugs, at the same time trying to exhort illegal consumers not to use drugs. Worse than that, the *modeling of denial itself*, is hurting such efforts-- And, I believe, having a negative effect. Public education in the drug abuse area almost uniformly gets a point across, that tobacco and alcohol are *not* drugs, because they are legal. Actually, this is explicitly stated by the Tobacco Institute when they argue against restrictions on tobacco use. "It isn't illegal, so it is all right," is their view.
In this broadcast, alcohol and tobacco, and problems with their use -- AS "drug problems" -- were conspicuous by their absence. Alcohol was mentioned, yes, and tobacco mentioned once-- But sadly, the *drug* aspects of alcohol were glossed over. As usually happens in such forums, downer pills, which the President kept calling "muscle relaxants", were not compared with alcohol, when in fact the effects on a person using them recreationally are the same. In fact, one problem many alcohol users have, which is the time lag between swallowing and the sedative effects, was mentioned by the boy who used pills at a party. "Nothing happened at first, so we took more," he said. The President, or Peter Jennings, missed a good chance to say, "Just like alcohol," highlighting the *drug* effect of the two substances. Tobacco? The only mention I remember was one student's remark-- "Smoking only hurts you, not other people."
Baloney! Golden opportunities were missed, to make mention of sidestream smoke (* footnote 2), reduced weight of newborn children from smoking mothers, jaundice and stillborn problems from smoking mothers, attention deficit disorder from smoking mothers (I am referring to pregnant smoking mothers, here.) No mention of intoxication from carbon monoxide and nicotine, definite dangers to drivers, nor mention of attention problems owing to drivers constantly looking for the ashtray, or for the fire which dropped in his or her lap. These things are supported by statistics, and have been known for decades. Heroin was described as reaching the brain quickly when injected. Nicotine gets there equally quickly, from inhalation, as does pot smoke.
In short, opportunities were missed right and left, to show that the various substances discussed are *drugs* because they *drug*. Instead, different problems for different drugs. Different horror stories. "Don't get caught" was a frequent message, "or you'll have to go to jail or be forced into treatment." Regardless of the beneficial results of such measures, the message was loud and clear, to me, and I believe to others, because I've talked with thousands of people about scores of programs like this-- Alcohol and tobacco are "safe" drugs, illegal drugs are dangerous now and then, and it's really horrible to get caught using. How sad.
Peter Jennings' behavior astonished me. At a time when it would have been wonderful to affirm the students' viewpoints and comments, twice he scorned their vote on the subject as to whether they would accept an unknown drug at a party, and once he minimized and deprecated another vote, on whether they thought President Clinton's stance on international trafficking was sound. Good grief! The point of having one student describe his negative experience, taking an unknown substance, was to discourage others from doing that. Yet when they said they wouldn't (or wouldn't have done it) Mr. Jennings scoffed. This was uncharacteristic of him, in my opinion. I say this as a fan of Mr. Jennings, and an admirer of his objective, clearheaded reporting. It made me wince. Again, later, he repeated this slur, and demeaned their vote on the President's ideas about international trafficking. "You did better this time," he said. What a backhanded compliment! How condescending! (* footnote 3)
I was very glad for one thing that happened-- The kids slammed the over- zealous public advertising, almost wholly spawned by the Partnership for a Drug Free America, which I think has done a lot of harm by widening the gap in understanding between legal and illegal substances. One student spoke against "This is your brain on drugs.... I didn't think drugs would fry my brain," he said. I have a visor-cap in my closet, comparing Chevrolets and Fords "on drugs", and there's a t-shirt comparing IBM and Apple computers, etc. That one ad is a tremendous joke-- Yet it still airs, from time to time. Again, another kid poked a hole in the "peer pressure" idea, politely saying, "Maybe other kids use drugs because of pressure, but not me." Let's face it, the biggest peer group in the world, and one which no one avoids getting into, is adults-- And among nearly all adults, dependent drug use is universal. I refer to alcohol, tobacco, and caffeine. And what is the most common response to kids who want to smoke or drink? "You're not old enough." Translation: When you get into our peer group of adults per se, some of your identity will come from the drugs we adults use. Then we tell kids, "Don't use drugs." Majorly confusing! We think it is inappropriate for marijuana smoking parents to tell their children not to smoke marijuana. Wouldn't it be worse, if the parents were using even "worse" drugs? Instead of this insight, a teen on the broadcasts says, "Tobacco use doesn't hurt anyone but the user." Irony! Addictive, automatic tobacco use, which is what is modeled by every regular user, is showing kids "This is how to use a drug addictively: Don't pay attention to what you're doing, and lie to yourself about the negative effects." (* footnote 8)
If we don't manage our psychoactives, they will manage us.
Why do we have our heads in the sand? Easy answers-- Economic dependency, from tens of billions of dollars a year spent on alcohol and tobacco. Chemical dependency, from personal use. Political dependency, from monied interests. Yet these dependencies are never mentioned, with these substances, number one and number two in importance. And we keep pretending that young people abusing psychoactives, is the major problem. In truth, it's the modeling by adults, into whose peer group kids are headed, that keeps the engine going. It's as though we had a health campaign against "juvenile flu", ignoring ill grownups. It's as though we had a driver safety campaign, implying only drivers of Fords, or only teenagers, had accidents, and arresting only teenage drivers of Fords. It's as though we had laws against contaminating baby food, but not grown up food products. That's the surface-level problem, with the inconsistency. The surface level problem is that our teachings and exhortations about psychoactives are ludicrous, in that they ignore the vast majority of chemical use problems -- our own, not just among kids.
But worse, as I said above, is the modeling of denial itself. In the area of psychoactive dependency, modeling denial, which is a core factor, is especially counterproductive and ironic.
I think it's a mistake to have public meetings featuring experts pointing a finger down at kids. That's one of the reasons I was happy to see this one, focusing on the teens-- the consumers-- and their candid criticisms of current policy. I smiled every time I heard President Clinton ask their opinions, just as I winced when I heard Mr. Jennings belittle their opinions. At the end, when Mr. Jennings gave Mr. Clinton a chance to wrap things up, I cheered to hear him give his time to the kids. What a great listener he is!
What specific suggestions do I have?
1- Stop having medical and law enforcement authorities deliver messages about psychoactive abuse. They present a misimpression that immediate effects of poisoning, and breaking the law, are the main dangers. The second one is especially wrong-headed. The laws are, presumably, based on personal dangers; yet the worst substances are legal. Any policeman, or DARE representative focusing on illegality, and jail time, and forced counseling (a travesty; * footnote 4), is doing tremendous harm, in modeling denial. (Perhaps having a coroner present some facts would be effective-- Facts about the ravages of alcohol and tobacco on the body.)
2- When giving "facts" about problems, present the statistical realities. 10% of cocaine and heroin users get addicted. 85% of tobacco users get addicted. The relapse rate for people trying to quit heroin is about the same as for tobacco. Many more people-years are lost to tobacco than to all other illegal drugs combined. (* footnote 1). These are loose figures; I'm quoting Consumer Reports' Licit and Illicit Drugs. Kids, and people generally, are more impressed by "10% will get addicted" than "Everyone will get addicted." A small, real risk is more credible than a large, unlikely one. "You probably won't die from tobacco induced emphysema; far more people are killed by heart disease" is more credible than "Emphysema is horrible, so stop smoking."
3- Have public discussions about frequently used terms, in the vocabulary of drug abuse. I once described eighteen different uses of "addiction." It is impossible to conceive of effective solutions emerging from public, or even private (governmental) discussions of "drug problems", without common concepts. And without agreement on word meanings, we can't discuss common concepts. This is the current situation-- Lack of common concepts, although it seems like there are words in common. Constructing public policies on drug abuse is like building a Tower of Babel. It's like the situation described in Orwell's 1984-- Impoverished and non-congruent vocabularies were fostered by the government, to keep people from discovering new ideas, or challenging the status quo. I'm not saying anyone is conspiring to keep our psychoactive vocabularies impoverished-- But there are economic, political, and other reasons why this situation exists. A Task Force is needed to examine this problem.
4- Talk more about the consumer aspects of consuming psychoactives recreationally. What effects are consumers looking for? How can we get the most effect for the least expenditure? Surprisingly, the popular wisdom on how to use chemicals responsibly, is exactly opposite to this interest. I refer to the idea that you should "Know your limit". In the State of Pennsylvania at one time, and perhaps still, a little card was circulated by the Department of Motor Vehicles, showing the "safe" amount of drinking one could get away with, before driving was impaired. What an awful thing to hand out. The message was, "Drink as much as you want, before bad effects happen." But this sort of advice promotes addiction! Why? Because if one drinks toward an upper limit, one becomes tolerant to the effects, and more and more of the substance is needed. The result of such widespread advice, and public education campaigns about "know your limit", is increased use! Better would be, "Drink as little as you need to get the effect you want." As one learned what that effect was, one would be consuming less and less-- And saving more and more money, by using one's substance economically. In the long run, consumption would reduce toward zero.
5- Stop targeting youth, stop targeting target populations generally. instead, target ourselves. A "drug educator" would then be pointing a finger, not at his/her audience, but at him/herself. "I used to do this with tobacco, now I do this," etc. Rad! But this is the idea of modeling, contrasted with exhortation. And the person need not be a celebrity, or an expert at anything-- But he/she ought to be accomplished in self-description. And how do we train people to do that? By showing them, ourselves. This sort of thing can spread of its own accord. A good start with this process would be to have governmental officials and prominent people in the news media, publicly discuss their own psychoactive consumption-- Of legal substances, of course, and have them acknowledge briefly that illegals are the same, re. the psychoactive realities being discussed. How to model situations with regard to contraband market dynamics (see 8C, page 6)? Simply talk about problems one has encountered as a result of poor quality control, generally, and acknowledge similarities with the contraband market.
6- Talk about attitudes toward recreational consumption, that all users have in common. For example, overcoming side effects. On the broadcast, much was made of the negative effects of various chemicals on users. What was overlooked was the fact that these effects are considered a challenge, not a warning or a wakeup call, by users, or they are considered humorous. We hear people say, "I must have had a great time at that party last night- I can't remember a thing I did!" Coughing, from smoking tobacco or pot; erratic walking, from downers or narcotics; erratic driving; the ability to act normal, under the influence, is a challenge. Using in order to act normal, is another feature, as contrasted with "getting high". Going back to a point in the previous paragraph, I recall one of the students saying he had "overdosed on alcohol." This idea of an "overdose" misses the point, because it is rooted in the concept of using as much as you can handle; a better idea is using as little as you need (Rule Two of Psychoactive Management)(below).
7- Communicate proper ways of using psychoactives, as contrasted with trying to scare people away from them altogether. We don't teach driver training by relentlessly showing pictures of horrible highway accidents; we inculcate smart driving behaviors. When I turn the steering wheel to go around a corner, my mind is full of images of twisted wreckage and people screaming from accident-induced wounds, from going off the road. I simply stay on the road because that's the way to drive.
8- Talk about psychoactives as psychoactives; stop focusing on individual problems with individual drugs. Here are some things in common among ALL types of recreational psychoactive consumption. By promoting such understandings, members of the public can become sensitized to "drug realities" in their recreational psychoactives, instead of having to remember little details, like "huffing causes brain damage, heroin causes slower breathing, alcohol causes worse driving, marijuana causes memory problems (President Clinton really goofed here, stressing "We now KNOW that marijuana causes memory problems" -- Good grief, that's been known for decades! Pot users call other users with long term memory problems "burnout" cases. And alcoholics have similar problems. An opportunity was missed to relate those.
A- People use recreational psychoactives to alter experience. Like making things harder to remember, with pot and alcohol. Like making things hurt less, with alcohol and downers. Like making things seem less of a challenge, with speed or coffee or tea. Like making things more fun, with marijuana or hallucinogens. Like making things more interesting, with hallucinogens or nitrous oxide. Like becoming less tense, with alcohol or tobacco. (Using the latter for such reasons is a serious mistake- And this should be pointed out-- IN TERMS OF CONSUMER INTEREST. In other words, we are getting ripped off by tobacco companies who want us to think tobacco use relaxes us. It only relaxes withdrawal symptoms. (* footnote 5). Any of those pairs could have more types of drugs added. In fact, there are people who use downers to pep them up, and coffee to get to sleep at night. One of my friends drinks a lot of coffee in the afternoon, and the psychoactive rebound from the upper effect, calms him at night when he wants to sleep. A client of mine swallowed "muscle relaxants" at night, so that the psychoactive rebound of pepping-up, would be present in the morning. In other words, what the stuff does, has a lot to do with how one uses it. The consumer is partly responsible for the specific effects of the substance.
B- Psychoactive rebound effects are present with all recreational psycho- active use. Uppers, later on, produce a downer effect. Downers, later on, produce an upper effect. Siders (what I call pot and acid), which produce effects on attention span, in a curve showing attention over one's personal length of time, that shrink the curve sideways. Rebounds from pot and acid predictably expand that curve, simultaneously shrinking it, so one has a sense of mellowness and calmness. The commonality of such effects across a range of products, if focused on in public presentations, would help to convey the impression that those substances are having *drug* effects.
C- Frequent use of recreational psychoactives reduces their effectiveness. From a consumer point of view, one ought to adopt a usage modality that will avoid this problem, called tolerance to sought effects. This is a long term rebound effect. Over a long period of time, one is able to "hold one's liquor," not because of increased skill (although there is some of that too), but because one is experiencing psychomotor agitation *without* the substance. Similarly, with heroin, one needs the substance to feel normal. Contrary to what is commonly preached about psychoactive consumption, one uses most often not to get high, but to feel normal. And if one crosses a line, of frequency of use, one is doomed to need more and more as time goes on. With heroin, that rate can go up rapidly. With alcohol, less rapidly. With tobacco, less rapidly. Now, this might make heroin seem more dangerous. But, if one is thinking in terms of consumption dynamics, instead of medical effects, one might become alarmed that one is spending more and more money for the same effect, instead of being caught in a medical denial-trip. Actually, the long term accommodation to tobacco, insidious as it is, makes it hard to notice this progression of expense.
Comparisons of such market, and consumer, dynamics, make it easy to compare chemicals. We see pictures in health textbooks, of increasingly full needles with heroin in them. How helpful it would be, to see pictures alongside those, of increasingly full ashtrays.
D- Drug effects are dose related, and the curve relating effect to dose plateaus out. Other curves exist, relating ratios of lethal use to effective use, at various dose ranges. And curves of relapse rate, rebound effects, tolerance reversal after long term use, and so on, can be shown and illustrated with ALL PSYCHOACTIVES. The detox curve for alcohol is straighter than that for nicotine. Why is that? Questions of that sort, when raised in a classroom, focus attention on the facts the curves represent. Such curves are about as hard to understand, or as simple, as a supply/demand curve in economics. I have never seen a single such curve presented at a public lecture (except mine). I have seldom heard effects such as these mentioned at public presentations. This broadcast missed lots of opportunities.
E- Drug denial is at the core of drug abuse. Denial of the problems the chemicals are causing. Denial of the feelings associated with use. Denial that behavior patterns are changing. Ironically, the illegality of sub- stances exacerbates these problems, by making it easy to deny that legal substances are as bad as illegal ones, and by causing users of illegal stuff to sequester themselves, isolate themselves, away from non-consumers. Why would someone using something illegal want to hang around other citizens? It would be risky. So, users of proscribed substances lose contact with people who could be alerting them to dangers, and negative changes in behavior. This amounts to a de facto denial system. It also makes it harder for the other, non-users, to see what is going on, making it easy to deny that things of that nature are going on. Referring to the point I made earlier, #4 above, attitudes, I've had quite animated discussions with young people, many as yet not dependent smokers (Consumer Reports related that after a few cigarettes, 85% of smokers were still smoking decades later), about why grown ups smoke, at the same time saying it is not good for you. Kids understand, and are more willing to talk about, denial than grownups, in the recreational chemical area. They can see commonalities among caffeine, nicotine, pot, heroin, and so on, when it comes to denial. So, make that one of the things talked about publicly.
Currently, the move to sequester tobacco smokers is a mistake, in my opinion. Even if they have to smoke on the ledges of buildings, as some cartoons show, they are not seeing what it's like not to smoke! They don't get to have people come up to them and reflecting their behavior with comments like "Excuse me, but did you notice there's smoke coming out of your nose?" Or, "I don't mind your smoking, but please keep your smoke out of my air." Regulations against smoking in public are pushing the problem underground, so to speak. And we know what happens when we push problems underground. They get worse.
F- I propose five simple "Rules for Psychoactive Management" of recreational psychoactives. These are couched in terms that apply to any substance one might use recreationally, for whatever effect, and using these rules helps people discuss drug problems with reference to their own chemical use. I've seen this happen over and over at public lectures, radio talk shows, and in seminars I've given, including at the State level. (* footnote 10)
1- When considering using something, think about why (desired effect) 2- When using, use "as little as necessary", not "as much as possible." 3- Discuss sought effects with others. 4- Discuss side effects with others. (* footnote 6) 5- Include, in the "others", non-consumers.
This is a little more complicated than "Just say no," but "Just say no" doesn't work, because of the aforementioned inconsistency. Brandon, on the broadcast, got into this topic, but the implications of his comment are more profound than they were taken at the time. For "Just say no" to be a consistent message, we -- the producers of the 11am ABC radio program yesterday, drug educators, school personnel, and everyone using alcohol, tobacco, caffeine, and so on -- would have to say NO to our OWN use! Not likely! The communications gap is already bad. We make it worse when we divide drug messaging into "target populations" -- whites vs. blacks, doctors vs. patients, police vs. other citizens, adults vs. youth. Drug messaging should be like a teacher saying "I used cigarettes a lot when I don't want to; do any of you use any other chemicals when you don't want to?" "I don't pay attention to side effects when I drink, and I think it would be a good idea if I did. What side effects (effects not sought) are there? Like the long term psychoactive rebound of getting so used to booze that I'm able to drink a lot with little sought effects?"
Therefore, it follows that "Just say no" is actually a harmful slogan, because it promotes denial.
Promoting these "rules" means promoting public discussion of personal recreational chemical use. Not following the rules means operating in the dark ages. We are currently operating in the dark ages. Incidentally, one of the consequences of the "5 Rules" is that it is highly inadvisable to consume psychoactives illegally. Why? Because one will not likely follow Rule 5, which is, include among those with whom you discuss effects, non-consumers. In other words, illegal psychoactives are dangerous *because* they are illegal, as well as their being illegal because they are dangerous. Not to mention that the market dynamics for contraband are very different than for legal substances. Do you call the Better Business Bureau, when your dealer provides impure heroin? Do you know how weak or strong it is, before you use it? Is competition in quality or price encouraged? No, no, no!
To prevent a misunderstanding, I want to point out that this view I'm promoting is *not* "safe drug use" or "harm reduction" because those phrases imply "safe use of poisonous, addicting substances", which is oxymoronic. This view I'm promoting is "sensible consumer use of risky stuff", aiming toward zero consumption. My intention is to combat the myth that recreational psychoactives are necessary for having certain sorts of experiences, and reducing their apparent power. Yes, such chemicals are a *factor* in getting high, or feeling normal, or getting addicted, but they are not the whole story, and they are not in many cases the necessary factor.
Of course, there will always be people who want to use chemicals to get bombed, or to blame their behavior on something else; but even they can get messages of common sense and self-interest as consumers. It's less likely that they'll be reached by the hype, scare tactics, and condescension toward youth expressed by this program yesterday, and Mr. Jennings. (* footnote 3)
Ultimately, I would like to see "drug education" change from authoritarian presentations and public guidance by experts, into the promulgation of clusters of attitudes and slogans that would spread easily through the population by themselves. The drug abuse education field is a faux- service industry, which ought to be putting itself out of business. I favor an approach described by Richard Dawkins as "meme spreading." (Dawkins was not addressing psychoactive mismanagement problems per se.) Memes are little conceptual modules or expressions that are easy to transmit, like jingles, slogans, tunes, and so on. A novel that focused on this notion is by Alfred Bester, called "The Demolished Man." (Bester was an advertising person, aside from being a novelist.) Dawkins' ideas about memes were discussed quite a bit on the Internet a year ago, and in Wired magazine, when the "Good Times" faux-virus was making one of its semi- annual runs through people's email. A meme spreads of its own accord because it's easy to think, easy to hum, easy to remember, whatever; easy to transmit from person to person. In the drug education area, appropriate memes would function to keep the culture immune to inappropriate recreational psychoactive consumption behaviors, scarfing up bad attitudes like phagocytes, and sticking to bad habits like antigens in a person's immune system. Etiquette, rather than law, would govern psychoactive consumption. Ideally, psychoactive consumption would fade out, as responsible consumers became aware of what they are putting into the activity, and what they were getting out of it.
This is a view of taming, not controlling, chemical use.
I have been watching closely, trends in the "drug abuse" field, for 30 years. Yesterday's broadcast was like out of the late '60's. Very little has changed. Teen Challenge and DARE are firmly entrenched strategies at the public school level. Federal policy is firmly oriented toward targeting teens and illegal psychoactives. "It's deja vu all over again." I'd like to see drug task forces augmented by a committee of those kids who were on the air yesterday-- sensible, polite, reflective kids, charged with the task of coming up with some memes, to replace the tired old lectures and public forums I've heard over and over. To quote a friend, a former heroin user (he stopped when he stopped throwing up when he used, because he knew that was a sign of addiction), who told me back in 1968, "Trying to stop drug abuse with the police is like trying to stop a swarm of bees with a sledgehammer."
Because of these entrenched programs, and the billions of dollars invested in the legal psychoactive industry and its fostering of massive denial and finger pointing away from the public's massive psychoactive consumption, toward the relatively small minority of illicit consumers, and the probable response of fax networks of citizens resisting anything resembling harm reduction, I predict there will be no improvements in this situation in a lifetime. But I feel obligated to make these statements. There could be a start.
ADVANTAGES OF THE PSYCHOACTIVE MANAGEMENT APPROACH
In a nutshell: Modeling rules.
A major advantage of the psychoactive management approach is that, in order to communicate sensible handling of illegal substances, should someone choose to use them, we don't even talk about them as such. We don't go out on a limb, bringing into someone's mind, thoughts of the substances we want them to avoid. We don't waste time and resources figuring out how to communicate with different target populations. Instead, we communicate styles and skills of psychoactive management, by talking about and showing our own use -- and avoidance -- of coffee, tobacco, alcohol, and chocolate; and by acknowledging their drug-type qualities, by extension we teach those skills in regard to the proscribed substances. Do we want to communicate dangers? We talk about loss of sought effects (Rule 3) and increases in side effects (Rule 4), like how we are drinking more now than we used to, to get the same effect. Instead of bragging how much well we can hold our liquor, we say "This is probably a sign I'm getting addicted; I'd better cut back to where a single drink now and then gives me that pleasant glow." Instead of valuing side effects like memory loss, we say openly, "Hey, I can't remember what I did last night; I'm having blackout experiences. Better stay away from booze."
Another advantage of the psychoactive management strategy is that it is cheap and self-spreading. It reduces the expense of training trainers to train trainers, as is the current system, trainers who train local citizens' groups in "how to wage war on drugs." I talked with one of these trainer-trainer-trainers once, when I was at a week-long meeting being trained. I asked, "After four days here, why no mention of AlAnon, which is a self-supporting and self-spreading program to inculcate sensible family strategies against addicted relatives?" Her response: "AlAnon? What's that?" Psychoactive management has nothing to do with AlAnon, but I once coined a "12-steps of preventianon" semi-humorous list of alternative governmental objectives.
Of course, the economic devastation of a really effective "drug education" program is very serious. If most recreational chemical use is by addicts, and we want addiction to stop, then effective psychoactive management means the diversion of 20-40 billion dollars a year from the legal psychoactive substance market. I suggest to President Clinton, and the news media, that we start public discussions of where we want all that loose money to go, and what we're going to do about the massive job losses in the tobacco and alcohol industries, when their sales drop to one tenth.
If proper psychoactive management is a goal of public policy, those discussions will be evident. But in my three decades of attention to this topic, I have never once heard someone else discuss this problem openly. I conclude that proper psychoactive management is not a goal of public policy. I strongly urge that it be so.
"If we don't manage our psychoactives, they will manage us."
Sincerely,
William B. Weitzel
Footnotes
1* (p.1,4) I'm using a rough estimate here, "tobacco is 80 times worse than illegal drugs." I'm comparing "lost people years," assuming 400,000 deaths per year from tobacco use, happening 10 years early, and 1000 deaths from illegal drugs, happening 50 years early-- Following the popular ideas about "drugs" being a "youth problem". Ten times 400,000 is 4 million. 50 times 1000 is 50,000. The ratio is 80 to 1. I've called the Lung Association, NIDA, and other agencies, trying to get exact figures to base this on, and this seems very hard to do, but I think I have a ball park estimate.
2* (p.2) I consider the sidestream smoke debate to be a faux-issue, a red herring happily nurtured by the Tobacco Institute, who wish to foster the impression that the only thing that could be wrong with tobacco is that it causes cancer or some other horrible disease; then they pound away at the statistics. In fact, sidestream smoke stinks, and/or causes coughing, and that alone should be reason enough for banning public smogging. By the way, I'm a tobacco addict, having smoked 265,000 tobacco joints. After four attempts, I quit for good, 24 years ago.
3* (p.3,9) Although Mr. Jennings' rudeness toward the kids annoyed me, I remain an admirer and he remains a role model, and if I ever make a mistake (ahem!) I can feel not so bad about it by saying, "Well, at least Peter Jennings made a mistake, back in 1997, and if he can make a mistake, certainly I can."
4* (p.4) Friends of mine in the forced-counseling business, working for government agencies that work hand in hand with probation and parole offices, are annoyed at the abuse of their training and expertise, in wasting a lot of time trying to "break the denial structure" of their court-ordered clientele, while not able to share their concerns and practice their skills with clients who are more motivated to change. This practice, of forcing people into treatment, mentioned in glowing terms during yesterday's broadcast, is a travesty of counseling, an abuse of counselors, and one of the worst scandals and wastes of time in the counseling industry, in my opinion. An ironic consequence is that it fosters an impression of drug dependence that it is more compulsive and harder to stop, than it actually is, of course ending up in a self-fulfilling prophecy and self-justification of the alliance between courts and counselors, that helps both, by relieving pressure on the one, as an alternative to longer incarceration, and by providing a source of third-party income for the other. But the "true" addicts, and the public, pay and suffer more in the long run. I was sorry to see involuntary counseling promoted, in yesterday's broadcast.
5* (p.6) Nicotine smokers take a dose (a puff) automatically, hundreds of times daily. Because this is done automatically, to raise one's blood level of nicotine, the relief brought about is associated with other stressors in the environment. Thus, the consumer believes that the stress that's being reduced is that of the environmental stressor, and thinks, "Smoking relaxes me". Suppose this person tries to quit smoking. Deprived of nicotine, and being hit with a stressor, long after the blood level of nicotine has dropped to zero, the person will think of smoking, to relieve the stress. This "psychological habituation" is incredibly strong, being repeated *hundreds* of times a day, and is enough to wear anyone down. Some people in smoking cessation clinics I ran, wept all day, wanting to smoke. It's like the drip, drip, drip of the "Chinese water torture," the relentless, little faux-cravings. A lot of heroin users in recovery, will report they are more strongly addicted to tobacco than heroin. Consumer Reports showed statistics indicating the relapse rate was about the same, to both substances. (* footnote 7)
6* (p.8) This letter was written under the influence of caffeine, manifested to some extent by the length of the letter. I drink very weak tea, diluting the source bottle with tap water each time I pour from it, as the day goes on, thus consuming about 4 tea bags worth per day. Perhaps without the caffeine, the letter would have been ten percent shorter. :-)
7* (p.12) This difficulty of quitting is no doubt due partly to the pharmacology of nicotine, and to the reinforcement of use-habits by relief of withdrawal. I want to return to a point made earlier (language problems, section 3). A couple of years ago, we were treated (if that is the word) to the literally incredible sight of seven tobacco company CEOs testifying in congress, that they did not think tobacco was addicting. Representative Henry Waxman put materials in the Congressional Record in July 1995, indicating that Philip Morris knew in 1969 that people smoked "because of the pharmacological effects of the smoke," as one of their scientists put it, in a speech for the annual meeting of the Board of Directors, 27 years ago. Mr. Waxman pointed out that in 1979, a typical year, P.M. had sixteen research studies under way, on the pharmacological effects of nicotine. How, then, could the P.M. CEO, William Campbell, testify in 4/94 that he believed tobacco was not addicting? I am the last person to defend the marketing of mass death, disease and addiction by tobacco companies, but it is fair to point out that when this testimony was given, one of the seven men holding up their right hands, said "because it doesn't have withdrawal symptoms." In that regard, he was wrong (see Licit and Illicit Drugs, for a long list), but his use of "addiction" was consistent with a popular definition, and one can say that the CEOs were not contradicting their knowledge of pharmacological dependence, in their testimony. This incident focuses attention on the need for vocabulary building. (See Congressional Record--House, July 24, 1995, p.H7471, upper right.)
8* (p.3) In Licit and Illicit Drugs, a report by Campbell says that after smoking a few cigarettes, 85% of consumers are smoking decades later. Philip Morris described, in internal documents quoted in the Congressional Record and published on the Internet, research on the results of intravenous nicotine administration, balanced against smoked nicotine, with resulting unconscious adjustments by the smoker to keep a constant blood level; and how changing brands would affect "puff volume" (H8128, 8/1/95, "6. We plan to systematically observe puffing patterns across different cigarettes using portable recorders being developed by Engineering...")
9* (p.13) Licit and Illicit Drugs, by Consumer Reports, has a whole list of suggestions for changing public "drug abuse" policy, as well as a balanced discussion of "drug abuse." It was published about 30 years ago. It is still relevant and describes the current situation. I urge that its recommendations be the subject of public discussions, and adopted.
10* (p.8) "The 5 Rules of Psychoactive Management" in a little more detail.
1- When considering using something, think about why (desired effect). Focusing on desired effects during use, helps one learn the effects per se, and reduces the need for the psychoactive substance. Beginning this focus before using, may suggest to one an alternative to using, or to a use-modality. For example, if the desired effect is to "go along with the crowd," one can sip, or puff lightly, on the substance, not really becoming intoxicated, and depend on the "contact high" effect to join in the group mood. Or one could simply not consume the substance at all, like drinking water with an ice cube at a drinking party. I did this once at a faculty party, and mimicked the conviviality successfully, and got away with it until the host, the President of the college, asked me what I was drinking. When I told him "water" he got angry. 2- When using, use "as little as necessary", not "as much as possible." Aiming toward zero consumption is safer and more economical, in both the short and the long run. Undershooting is better than overshooting, when it comes to experience altering chemicals, and tolerance is unlikely to build if I'm constantly striving toward less and less use. Of course, one could "just say no" and avoid using altogether, but in an environment where some use has been consented to, aiming down is far better than aiming up. This violates the conventional wisdom of "know your limit", that is, "use as much as you want before negative results happen." Negative results will always happen, with upward aiming, namely, increase of tolerance and expense.
3- Discuss sought effects with others. This activity minimizes the possibility that one's reasons for consuming will become private, or secret, and thus minimize the possibility of addiction. If one has been practicing open and frank discussions, one will be more likely to spot a growing reason, "to feel normal."
4- Discuss side effects with others. (* footnote 6) Side effects are just as real as sought effects-- They're just effects the consumer doesn't want, or isn't interested in. Increase of tolerance is an effect no one wants, from an economic viewpoint, but may be a sought effect, if one is proud of being able to, say, drink without impairment. For a while, as tolerance increases, this happens; until one becomes physically ill. Knowing that this is a risk, one can, having discussed effects openly, be on the alert for a change in the curve of number of doses per unit time, over time, and when the curve begins flattening out, or nosing down, one can stop using for a while (maybe forever), to regain tolerance. Those talking about their own experience using psychoactives, in a public awareness campaign, can also mention the "instant increase effect," whereby tolerance soars when one resumes using, after a period of abstinence.
5- Include, in the "others", non-consumers. Accurate, unbiased feedback is needed from others who are not committed to the same hobby as the consumer may be (may be committed to). This means I should include some people who aren't aware of my psychoactive use pattern as such, but who may tell me about behaviors I know are related to it, like forgetting promises I've made, while I'm practicing a drinking hobby, or that my clothes smell stale, while I'm practicing my smoking hobby. This rule is vital. It rules out illegal consumption, because illegal activity is not likely to be described to others not engaging in it.
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2 attachments:
(1) (p.14) Psychoactive rebound with any sedative, muscle relaxant, alcohol, downer-- Illustrated re. beer. The myth that the presence of a drug in one's body is the major cause of the drug effects, keeps observers from understanding that the rebound is a powerful effect. It isn't "drinking problems", it's "dranking problems", that are of major concern. Experiencing the effects illustrated by this curve, most beer consumers brag about how little drinking affects them adversely. But most of their money is going toward balancing the rebound effect, making it invisible.
(2) (p.15) Research on nicotine dependence-- Showing an experiment illustrating unconscious self-titration of nicotine, from a draft of NIDA's Report to Congress on Drug Dependence, in Philip Morris research documents (Congressional Record), and in Licit and Illicit Drugs. (* footnote 9)
The point of these two attachments is to illustrate the general nature of pharmacological dynamics. One titrates not only one's smoking, but one's drinking, pill taking, etc., to get particular effects. One's psychoactive rebound curve is always a factor in one's motivation to consume.
At this moment, 6:44am, 3/13/97, an ad appeared on my TV screen for an ABC news special this evening at 10pm-- Peter Jennings, with a report on "Pot of Gold", about marijuana. Hopefully, some time during this month of special reporting on drug problems, we'll see attention to sensible psychoactive management, illustrated by personalities, perhaps ABC personnel, describing their own consumption. The only time I've ever seen this happen was on NBC about 3 years ago, when Catherine Couric mentioned the trouble she'd had with smoking tobacco, and her decision to abstain.
"If we don't manage our psychoactives, they will manage us."
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