Today I read the first half of Marc Lewis’ Memoirs of an Addicted Brain – a fascinating combination of a personal memoir of a drug-laden life and a scientific description of the neurochemistry of common psychologically active drugs. I have also been watching ‘Boardwalk Empire‘, which explores some other elements of the societal treatment of drugs.
It occurred to me that perhaps the world would be a better place if there was a licensing system for alcohol use akin to the system for driving. Instead of just gaining the right to drink at a set age, we could require people to take a class in high school and pass an exam. The license would be subject to temporary or permanent revocation in the event that a person was causing harm to others though alcohol use. For example, people convicted of driving drunk could have their alcohol licenses suspended or terminated.
It’s an idea that could theoretically be extended to other psychologically active drugs. By educating people, it would allow people to make more informed choices. The revocable licenses would also help maintain the balance between respecting the right that people have to make use of their own bodies with the obligation that people have to avoid harming others. It could also bring in a bit of much-needed state revenue.
Related:
Ending drug prohibition
Restricting purchase locations and pricing options for drugs
Planet Money on drug legalization and ‘Freeway Rick’
Warning labels for booze
Legalize, regulate, provide treatment
The nature of addiction
I’m not sure such a licensing system would be practical. One, alcohol is pretty highly addictive. Two, at a pinch, one can make the stuff with just about anything; Three, prohibition demonstrated that cutting off access created demand for large underground supply networks that transferred booze from legal to illegal jurisdictions for profit. Wouldn’t graduated licenses do much the same thing, on a micro scale…?
A few would cheat, but whereas prohibition created a huge market of deprived drinkers, only a small minority of adults would be likely to lose their licenses for bad conduct.
I think that it is a great idea. ICBC has reported that the new and stricter driving rules and graduated licenses have substantially reduced accidents. The no-tolerance for drinking and driving rules have also reduced the incidence of drinking related automobile accidents. I don’t know how such a system would be implemented and monitored, but I am all for it. Binge drinking and driving take away several students each year during graduation frenzy, yet perhaps that is unavoidable. I am hoping that research will one day find a way to turn off the part of our brains that causes addiction or find a way to make drugs and alcohol so repulsive that a person would only try them once.
I agree with Coyote. Just as many criminals would benefit from a “prohibition” style method of regulation.
In a perfect world, the system is sound. But the world is never perfect, and there are too many variables.
Some people would lose their licenses and cheat, fine. The objective isn’t perfect compliance – just a better system than what exists now.
The educational component would have value even with cheating. Less directly, the system might encourage people to remember that their drug use choices affect others.
Also, licensing seems like a more appealing option than prohibition when it comes to drugs like cannabis and MDMA.
I don’t see it working – or at least, it would only work for relatively responsible middle class people who currently tend not to end up in our prisons. Marginalized populations who have high rates of addiction would be unlikely to go through a regulation system in my view, not least because a) many of them drop out of high school, b) many of them have mental health issues that are not adequately treated & are self-medicating, c) many of them have very troubled home environments in which they can access alcohol and perhaps illegal drugs, and d) they tend not to be very deterred by breaking rules or criminalization, and may even expect it. This strikes me as another example of well-meaning people wishing that the poor would act more like the middle class, and efforts to teach the poor ‘better’ behavior without addressing structural causes of disadvantage have consistently failed.
Moreover, enforcing the licenses would be impractical and raise huge issues around privacy. Driving happens in public where police, other people, and cameras can oversee it. By contrast, alcohol and drug use often happens in enclosed private spaces where the state does not have (and should not have) equivalent powers of surveillance and search.
I’m not sure what drugs you’re proposing it for, but if used for alcohol then it strikes me as *maybe* helpful for some middle class kids (e.g. as a strategy for reducing harmful drinking and associated problems on university campuses), but clearly unhelpful like this http://www.news.com.au/breaking-news/native-americans-sue-beer-companies-over-alcoholism/story-e6frfku0-1226267940947 or marginalized populations in general. For currently illegal drugs it *might* have positive impacts where there are high rates of use by the middle class (e.g. pot), but would almost certainly fail for other drugs (e.g. heroin & crack). Moreover, it would almost certainly not decrease (and might well increase) the extent to which those targeted for drug policing and incarceration are disadvantaged populations, particularly the poor, aboriginal people, and low income racialized & ethnic minorities. Personally, I have no interest in devising a drug regulation system that helps the middle class and not marginalized populations, and this strikes me as a classic example of that.
For productive policy change I think you’d be much better off looking into harm reduction approaches.
Sarah,
I agree that it would be important to evaluate how different groups within society responded to the licensing system, and I certainly wouldn’t advocate a system that makes things even worse for those who are least advantaged now. One benefit of an incremental trial approach is that it could allow problems to be identified and potentially remedied.
Similarly, dealing with privacy concerns would be important. That seems pretty manageable, however. People would only need to show their licenses in order to buy drugs. What they did in their homes would not need to be observed or monitored in any way. No doubt, some people would cheat and make unregulated drugs. But, as you say, the objective is harm reduction, not perfection.
If there is a way licenses could encourage people to use drugs more responsibly, while weakening criminal gangs and not producing any major new problems, they seem potentially viable to me.
Really, I think the larger consequences of the system would be more cultural than anything. Seeing alcohol as one drug among many seems healthier than seeing it as the one serious drug people are allowed to use, while anyone who uses anything else is a criminal. Similarly, it seems like it would be good if people internalized the notion that the biggest problem with drugs is the harm they cause to third parties.
What sort of harm reduction would you favour? Total legalization?
The poor handle drivers’ licenses pretty well. Why wouldn’t they be able to handle drug licenses?
One conclusion I’d reached long before this rogue Thanksgiving was that if I were to go back to drinking, I needed a plan. The one I decided on involved instituting a maximum number of drinks — three to four — with a loophole built in for special occasions. No more endless refills; instead I’d keep track like a data scientist. The caveat was that these special occasions had to be premeditated. I wouldn’t allow myself to just say “fuck it” on any random night and get turbo-hammered — it would have to be a measured, organized chaos. Those were the rules. They would be my own personal Konami code for winning at alcohol.
Marc Lewis: the neuroscientist who believes addiction is not a disease
Lewis, famous for detailing his own years of drug addiction in a book, divides the medical profession by arguing it is a behavioural problem, not a medical affliction
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For decades the medical profession has largely treated addiction as as a chronic brain disease. The US government’s National Institute on Drug Abuse characterises addicts as compulsive drug seekers and users who continue taking drugs despite harmful and unwanted consequences. “It is considered a brain disease,” the institute says, “because drugs change the brain; they change its structure and how it works.”
Dr Marc Lewis, a developmental neuroscientist – perhaps most famous for detailing his own years of drug addiction and abuse in Memoirs of an Addicted Brain – strongly refutes this conventional disease model of addiction. His new book, The Biology of Desire: Why Addiction is not a Disease, argues that considering addiction as a disease is not only wrong, but also harmful. Rather, he argues, addiction is a behavioural problem that requires willpower and motivation to change.
Lewis’s theory has divided the medical profession and those suffering from addiction. He has been lauded by some for putting the theories challenging the disease model together into one book; others have labelled his ideas dangerous, and him a zealot.
Alcohol: 2.5 million people bust weekly limit in a day
By Michelle Roberts Health editor, BBC News online
Around 2.5 million people in Great Britain – 9% of drinkers – consume more than the new weekly recommended limit for alcohol in a single day, latest figures from the Office for National Statistics show.
The 2014 data predates the new limit of 14 units of alcohol per week for men which began in January.
Although habits may start to change, experts say the figures are concerning.
The chief medical officer says there is no safe level of regular drinking.
The ONS figures show 58% of people – 28.9 million – drink some alcohol in a typical week.
This figure is lower than a decade ago but has remained stable over the last few years.
Young people are less likely to have consumed alcohol in the last week than those who are older.
Wine (including champagne) is the most popular choice of alcohol.