05/22/16 Doug McVay

Century of Lies

We speak with author and journalist Maia Szalavitz about addiction, overdose, and her new book Unbroken Brain; plus we talk about criminal justice with death row DNA exoneree Kirk Bloodsworth.

Audio file


MAY 22, 2016


DEAN BECKER: The failure of drug war is glaringly obvious to judges, cops, wardens, prosecutors, and millions more now calling for for decriminalization, legalization, the end of prohibition. Let us investigate the Century Of Lies.

DOUG MCVAY: Hello, and welcome to Century Of Lies. Century Of Lies is a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I'm your host Doug McVay, editor of DrugWarFacts.org.

I recently had the opportunity to interview the journalist and author Maia Szalavitz. Maia Szalavitz is one of the premier American journalists covering addiction and drugs. She's co-author of Born for Love and The Boy Who Was Raised as a Dog, both with Dr. Bruce D. Perry. Her book Help at Any Cost is the first book-length exposé of the tough love business that dominates addiction treatment. She writes for TIME.com, VICE, the New York Times, Scientific American Mind, Elle, Psychology Today, and Marie Claire, among others.

Maia's new book is called Unbroken Brain: A Revolutionary New Way of Understanding Addiction. Challenging both the idea of the addict’s broken brain and the notion of a simple addictive personality, Unbroken Brain offers a radical and groundbreaking new perspective, arguing that addictions are learning disorders and shows how seeing the condition this way can untangle our current debates over treatment, prevention, and policy. Like autistic traits, addictive behaviors fall on a spectrum, and they can be a normal response to an extreme situation. By illustrating what addiction is, and is not, the book illustrates how timing, history, family, peers, culture, and chemicals come together to create both illness and recovery, and why there is no addictive personality or single treatment that works for all. Combining Maia’s personal story with a distillation of more than 25 years of science and research, Unbroken Brain provides a paradigm-shifting approach to thinking about addiction.

How about, let's start at the beginning. Could you tell folks a little bit about yourself, and how you got started as a journalist writing about drugs and addiction?

MAIA SZALAVITZ: Sure. Well, in my 20s, I unfortunately became addicted to cocaine and heroin. I got into coke, oddly enough the first time I did cocaine was with Jerry Garcia, which is a story I tell in the book. And I was involved with the Grateful Dead scene, as that would suggest. And I, you know, I had discovered that drugs, and even just talking about drugs, was a way to make social connections, and I'd always just had a really, really hard time making social connections. And, I was always this sort of obsessive person who just got really, really into things, and then went on and on and on about them. And so people were not especially interested when I was going on about, like, science fiction or opera, but when it was drugs, it kind of gave me social currency. And so I got into psychedelics, I got into the Grateful Dead, and then, you know, got into coke that way. I should say that was the 80s, when, you know, something like 50 percent of American adults said that they had used cocaine, so it was incredibly prevalent and it has never been that prevalent since. This was right before crack.

So, anyway, so that is how I got into the whole drug thing. And how I got into journalism was, basically, that I'd always kind of wanted to either be a journalist or a scientist, and I was too squeamish to slice up rats. So, I decided that I -- and neuroscience is my interest, so there was kind of a lot of rat slicing that was going to be involved. So, I basically decided that writing about science would be the best sort of way down the middle, and because of my personal experience with addiction, I realized that this was an area that really could benefit from science writing in particular, because so much of what we know about drugs and addiction, or think we know, is actually wrong.

DOUG MCVAY: Indeed, and you, in your book, go through and puncture many of the myths that are so prevalent about drugs, and drug dependence. Now, for instance, for years, people thought of drug use and dependence as a moral failing. These days, we're told -- by the drug czar's office, by the National Institute on Drug Abuse, and others -- that it's a brain disease. Those are both wrong, but, could you explain to the listeners how are those ideas wrong?

MAIA SZALAVITZ: Sure, sure. I mean, actually, so, basically, we have said for the last, you know, hundred years of drug prohibition, that, you know, addiction is a disease, but the treatment is either locking you up or putting you into a 12-step program, which requires confession, finding a higher power, praying, and all kinds of moral things. So it's really hard to convince people that they have a brain disease but, unlike Alzheimer's, which unfortunately for which we have no treatment for, but unlike any brain condition that we do have a treatment for, we're going to make you list your sins. This does not sound like any other disease, and it does not make a very convincing argument, so I'm not surprised that the public, you know, sort of doesn't buy it, when the politicians and the experts and the doctors, you know, make this disease claim.

And I'm not saying that addiction is not a medical problem. I'm saying that the kind of medical problem that it is, is a learning disorder, and what I mean by that is that addiction requires learning in order to occur. Like many developmental disorders, it seems a mix of both environmental and genetic stuff's going on. And so with addiction, if you don't learn that a drug solves your problems, you can't be addicted to it because you wouldn't know what to crave. That sounds kind of dumb and obvious, but it is the case that, without that learning piece, the whole thing falls apart. The way addiction is defined medically is as compulsive drug use despite negative consequences. So what this basically means is that if you learn that drugs fix you, and then you continue to use them despite negative consequences, you meet the criteria. What's interesting about that to me is that, you know, for the last hundred years we've tried to use punishment to treat addiction, and yet, addiction is actually defined by resistance to punishment, which is just another word for negative consequences. So basically, if negative consequences worked, addiction couldn't exist.

DOUG MCVAY: Why do you think we have such a hard time shaking that idea of addiction as a moral failing?

MAIA SZALAVITZ: I mean, I think there's a few pieces to it. I think one very unfortunate and very tragic piece is that our drug laws come from racism. And if you look at the historical origins of the drug laws, they are so racist as to be almost humorous in a very, very sick way. So you have, you know, cocaine being made illegal because supposedly it made black men resistant to bullets. You get opium being made illegal because it would make Chinese men seduce white women. You have all these things that are basically results of racist and ethnic fears, that are projected onto the substances, and that really have nothing to do with the substances, but all of that gets mixed into our concept of addiction, for one.

And then the other thing is that, when you see people with addiction, they look like they're doing what they want to do. They look like they're deliberately planning to get high, deliberately lying about it, deliberately hiding what they do in order to preserve it, and so that doesn't look like a disease to people. What people are missing when they see that, though, is that if you become addicted, it's basically like falling in love with a drug. So, when you fall in love with somebody, or when you have a kid, your priorities become completely rearranged, and because that's in a positive way when you fall in love, usually, and a positive way when you have a kid, almost always, universally pretty much -- I don't think it's ever bad to love your child -- so, you know, if you have those, you know, sort of priority changing experiences in your brain, it does rewire your brain such that your stress is only relieved when you are feeling okeh about those connections. And if that connection is with a drug, then you will behave very strangely.

The thing that, you know, people don't get is that, this idea that all people with addiction are like liars or cheats, or that kind of thing, you know, you could say the same thing about all people who are having affairs. It's the same kind of behavior. Does it mean that people with addiction have absolutely no self control? Obviously not, because nobody's shooting up in front of the police. But, you know, does it mean that there's an impairment in control that cannot be seen necessarily? Yes. And so, you know, your brain isn't hijacked, but your priorities have been shifted.

DOUG MCVAY: It sounds like it could be -- it sounds like, practically, loneliness would be a, is a big reason for drug use. Is that fair?

MAIA SZALAVITZ: Absolutely. I mean, for drug use that becomes problematic, yes. I think there's plenty of people, you know, 80-90 percent of people who take drugs and do not end up having addiction. But, the people who are having addiction tend to have a few things in common. For one, they tend to have some kind of developmental difference that may be a predisposition to other mental illnesses, maybe sort of some experience of sensory overload. About fifty percent of people with addiction have another mental illness, and, you know, the genes that set that up are, you know, pre-existing, and they may require some kind of environmental stimuli to come out, but, you know, they are something that is not chosen.

Then the environment, you know, something like two thirds of people with addiction have at least one really traumatic childhood experience, and the more child trauma you have, the higher risk you are for addiction. So, you know, those two things are crucial in setting up addiction risk, and then the other thing is this sort of general despair. If you have no sense of meaning and purpose, if you feel like there's no hope in your life, if you feel like there's no reason to bear the, you know, sort of awful stuff that happens in the world all the time, then you may well be drawn to things that can blot out your consciousness.

DOUG MCVAY: You're listening to Century of Lies, a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I'm your host Doug McVay, editor of DrugWarFacts.org. My guest is Maia Szalavitz, author of the new book Unbroken Brain: A Revolutionary New Way Of Understanding Addiction.

Maia, we're told that there's an opioid epidemic in this country. Is that an accurate statement at all?

MAIA SZALAVITZ: Well, there's certainly an overdose epidemic. I mean, we've never had this level of overdoses. And, you know, there certainly is a higher level of opioid misuse than there has been in the past. I think that what -- it's not necessarily problematic to phrase it as an epidemic. What's problematic is to think that the cause is simply the fact that pharma advertise these drugs. I mean, I'm not saying that Purdue Pharma, which made Oxycontin, is innocent, by any means. But what I am saying is that two thirds of people who -- or more than two thirds of people who misuse prescription opiates are misusing somebody else's prescription. So most of the misuse that's going on is not in pain patients, and is in -- involves drugs that have been diverted from the medical system. So, this idea that doctors are turning people into addicted people is simply, generally, not the case. While it is possible to get addicted during pain treatment, since most pain patients are over, you know, 30 or 40, and most addiction starts in the 20s or teens, if you don't have a previous addiction, and you are prescribed opioids, your odds of becoming addicted are generally very low.

So why are we seeing this big overdose problem? I think that what's going on is that the middle class is collapsing. Particularly, the white middle class is under stress in ways that it has not been in the past, and this has caused a sense of despair. And it has led to a lot of opioid misuse, particularly among young people, who are just, you know, so-called recreational users. And then what you're also seeing is middle aged people with previous addictions getting exposed to these drugs, and you're also seeing people who are just using these drugs to commit suicide, and it's not being labeled as suicide because, you know, that is better for insurance purposes, it's less stigmatizing, etc. So we really don't know what proportion of these overdose deaths are actually suicide, and I think that's something that we really need to find out.

DOUG MCVAY: Indeed. I know that there are quite a few folks in the veteran's community doing a lot of advocacy around the number 22, which is the reported -- the estimated number of suicides per day among US veterans. It's scary. But, yeah, the notion then that there might actually be more -- [low whistle]

MAIA SZALAVITZ: I know, I mean, it is truly awful, the way things are, and I think, you know, we as a society have unfortunately, you know, we have this idea that you're supposed to be independent, and that, you know, your success is entirely due to whether you work hard or not. And when it becomes impossible to succeed because the economy is basically rigged against the average guy, you end up with people becoming suicidal because they blame themselves. And when people come back from, you know, having fought for their country, and getting no support whatsoever, you end up with that same kind of thing. We really have, like, a fraying social fabric here, and, you know, one of the best defenses against addiction is love and social support. And obviously that's not to say that you can't become addicted if you have that, but it's almost impossible to recover without it.

DOUG MCVAY: Before we talk more about addiction generally, let's talk for a second about, well, about pain. And some of the -- back in the 90s, we started taking pain seriously as an actual, treatable condition. Opiates began being more widely prescribed, medical marijuana started to become available as a treatment option. In the last ten or so years, there have been steady attacks on pain docs, and patients, and policies have been shifting again. How far has the pendulum swung, in terms of how we view and treat pain as a condition? And the way we treat the patients who suffer?

MAIA SZALAVITZ: Yes. I mean, this is an absolutely horrible situation, and not enough media attention has been devoted to it. The vast majority of people with chronic pain who use opioids do not misuse them. Now, there are certainly cases where people are taking opioids chronically, and they're not benefiting from them especially. But that doesn't mean they're addicted, and there are also people who are taking opioids chronically who benefit tremendously from them, and are not addicted. And those people I hear from virtually every day online, telling me about how they got, you know, screened out at the pharmacist or their doctor cut them off, or, you know, there was an article today about how patients with sickle cell anemia are just being made to wait hours and hours in the emergency room. And, you know, doctors are terrified to prescribe, there's all this pressure from the CDC guidelines, which means that, you know, if your prescribing is at all different from everybody else's, you're going to get looked at and somebody's got to be the top one percent prescribers.

So, it's just causing people to say, you know what? I could go to jail, I could lose my license. this is too much of a hassle. I'm going to just assume that anybody who wants opioids is an evil drug seeker, and this is easier for me to deal with and, you know, if somebody could have benefited but can't now, well too bad, I can't risk, you know, my whole life for that. So yeah, so this has gotten really, really terrible for pain patients. I think we may be beginning to see, you know, some more attention paid to the plight of pain patients. You know, there's been this whole push, oh well if they just do yoga or get acupuncture, or whatever. I have not talked to a single chronic pain patient who hasn't tried ten thousand things before they discovered that opioids was the thing that worked for them. And so, if I were a chronic pain patient, I would find it frankly offensive to be told some of this stuff. But, you know, it is a complicated thing. Opiates probably work about a third of the time, which is as good as anything -- which is better than anything else we have. You know, I mean, any, even anti-depressants only work probably about a third of the time, and yet for many of us, those drugs can be lifesavers.

So, you know, this is a complicated problem. But what we're doing now, by simply shifting people from legal sources to illegal sources, and not providing support, not providing effective treatment, you know, it's just dumb, and tragic.

DOUG MCVAY: That was part of an interview I did recently with the journalist and author Maia Szalavitz. Her new book is titled Unbroken Brain: A Revolutionary New Way Of Understanding Addiction. You can find out more about that, and her other works at Maia's website, which is MaiaSZ.com, that's MAIASZ.com.

You're listening to Century of Lies, a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I'm your host Doug McVay, editor of DrugWarFacts.org.

We have a few minutes left, so let's shift focus for a minute to look at the criminal justice system. One of things I point to when talking about drug legalization is how that would let us shift law enforcement resources to more serious problems such as property crime and violent crime. Clearance rates in both of those categories are awful – fewer than one in five property crimes are ever cleared by an arrest, and less than half of all violent crimes are ever cleared.

Clearing an offense, by the way, simply means that we've indicted someone, it doesn't mean that anyone has been found guilty, and more importantly, it doesn't mean that we've found the real guilty party.

That's an important distinction. If we only look at the high success rates for prosecutions in this country, we could be excused for believing that we're good at indicting guilty parties because people usually get convicted once they're indicted. Yet we know that's not true.

There are more and more stories coming out about people who've been pressured to accept a guilty plea even though they were innocent, because they believed that fighting would just make things worse. Police are good at bringing in the usual suspects and fitting people up, but how really good are we at finding the real criminals?

That question becomes even more urgent when we're talking about serious crimes, such as murder. Now you'd think that law enforcement would take murder seriously enough to try and find the real culprits. I mean, murder's a heinous offense. And yet more than one hundred fifty people in this country who had been convicted of murder and sentenced to death have had their innocence proven because of DNA evidence. Those innocent people have been released from prison, and in many of these cases the real criminals were finally caught and convicted.

Who knows how many innocent people weren't so lucky and were put to death? Who knows how many killers have been able to escape detection simply because law enforcement didn't do its job properly?

Recently, I had the good fortune to meet a man who had been put through that experience. In 1985, Kirk Bloodsworth was convicted of a truly horrible murder in Maryland. He was sentenced to death. He spent nine years in a state penitentiary, until finally DNA testing of the evidence proved his innocence. Kirk was exonerated and given a full pardon, plus authorities were eventually able to find the real killer.

Kirk now spends his time working for criminal justice reform and an end to the death penalty. I spoke with him during his recent visit to Portland, Oregon. Here's part of that interview.

Moving forward, what do we need? You spent time -- what do we need for folks?

KIRK BLOODSWORTH: Repeal the death penalty in the United States. Period. I mean, everywhere, wherever it's at. Oregon too. Oregon's got to get rid of it. So, what I'm saying is, everyone. And then the federal death penalty has to go. Criminal justice reform, we need to pass laws, preservation of evidence.

DOUG MCVAY: Your's was found in the --

KIRK BLOODSWORTH: In the closet.

DOUG MCVAY: In the closet of a judge.

KIRK BLOODSWORTH: In a paper bag.

DOUG MCVAY: That's not exactly standard procedure..

KIRK BLOODSWORTH: You know, we shouldn't be -- evidence shouldn't be relegated to a treasure hunt to find out whether or not, you know, you find somebody's innocence or whether they're going to be protected or not. And so, I -- you know, I think that's a necessity. And to have decent compensation. We need a federal compensation law in the United States. I alluded to that a while ago. One of the things is, there needs to be a federal compensation law in the United States, and there should be one in every state in the union, but really meat and potatoes. Not -- you know, really some substantial compensation, not just money at a person, but, that should be one of the first things, but, you know, housing, job placement, counseling. There's three or four different things that need to happen, and all this is in conjunction with exonerations in the United States.

Until that happens, you know, these people are, you know, just living day to day and don't know where to turn, until people can't turn anywhere. PTSD, it's awful. So, I mean, I suffer from it, and I mean, I was diagnosed with it years ago, and I'm lucky. I worked through it, and, with counseling, but I need those kind of things, and I have to pay for that out of my pocket. So, you know, and these men and women need all the help they can get. They shouldn't be paying for their own jewelry school. You know? I mean, honestly, I mean, that's just the way I see it, it's like, you know, when I got out, I should have been able -- you know, I had to pay for my own fishing license, to go commercial fishing. I had to do all this other stuff. You know, and I'm not just trying to talk about giving a hand out, I'm talking about giving a hand up, in life, to these people. And, you know, because this could be you. You know? This could be any one of us, by god's grace.

And -- criminal justice reform, end the death penalty first, criminal justice reform, help these exonerees. and you don't have to necessarily do it in that order, but all at the same time.

DOUG MCVAY: A hundred and fifty some death row exonerees. How many people -- what, how many people do you think are inside now that really shouldn't be?

KIRK BLOODSWORTH: Well, we have a prison population of 2.3 million. So, you figure it, it's probably -- if it's one percent, that's a jag of people. And, I don't -- somebody do the math for me real quick.

DOUG MCVAY: That would be twenty thousand.

KIRK BLOODSWORTH: See, there you go. So -- and we think it's even higher than that, so, you know. We need to support the Oregon Innocence Project, and their programs. That is the best way. It's a nonprofit organization, they don't get money from the government, they need some help. And, you know, I found out today that I also helped pass what is called the Kirk Bloodsworth Post-Conviction DNA Testing Program. That's, I just found out today, Senator Patrick Leahy of Vermont tweeted that it was reauthorized by the Judiciary Committee today.

DOUG MCVAY: Fantastic.

KIRK BLOODSWORTH: Yeah, that's great. And so, he, and so I tweeted him back. You know, I don't tweet much, but he's one of the guys I do. And, so -- and we work with people across the aisle, we work with both sides. This issue, people really want to help people, you know, kind of legislation, and this is a big thing. And so, I know some of the men, and people, that have gotten out because of the Bloodsworth grant. Thomas Haynesworth from Virginia, he was one of the, Michael Von Allmen from Kentucky, several others. And it gives grant moneys to organizations like the Innocence Project so they can hire staff attorneys, and people like Alice over here, to help them do their job, and find out those innocent people behind bars.

DOUG MCVAY: And, people need to realize too, that it's not just a question of, it's not just a question of doing justice by getting someone out. Someone's going in for a crime they didn't commit, that means the person who committed that crime is still out there, probably.

KIRK BLOODSWORTH: Absolutely, absolutely. And I am a firm believer, and a supporter of doing that. I think it's, you know, we have a tendency to neglect that thing. And also, in the same token, victims' family members. I think we cannot neglect them in any kind of way. And I wouldn't want to marginalize anybody in this effort, because they need help too. The money -- if we got rid of the death penalty, we could use the money and the savings to help victims' families. So, you know, it's a win-win, if you ask me. And it's tragic enough, for these things to happen, but we need to put the right man in bars and convict the right people.

DOUG MCVAY: That was part of an interview I had recently with Kirk Bloodsworth, the first person in the United States to have been sentenced to death for murder, only to eventually be exonerated by DNA evidence and given a full pardon based on his innocence. The documentary about his experience is called Bloodsworth: An Innocent Man.

And well, that's it for today. Thank you for joining us. You have been listening to Century Of Lies, a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I'm your host Doug McVay, editor of DrugWarFacts.org. The Drug Truth Network is on Facebook, please give its page a like. Drug War Facts is on Facebook too, give it a like and share it with friends. You can follow me on Twitter, I'm @DougMcVay and of course also @DrugPolicyFacts.

We'll be back next week with thirty minutes of news and information about the drug war and this Century Of Lies. For now, for the Drug Truth Network, this is Doug McVay saying so long. So long!

For the Drug Truth Network, this is Doug McVay asking you to examine our policy of drug prohibition: the century of lies. Drug Truth Network programs archived at the James A. Baker III Institute for Public Policy.