The Myth of Normal 174

many people’s thinking and underlies the legal system’s assault on drug users. It is so wrongheaded as to be laughable—and it would be, if its consequences were not so tragic. It was expressed succinctly in 2017 by then U.S. attorney general Jeff Sessions, hearkening back to the bad old days of the 1980s drug war: “We need to say, as Nancy Reagan said, ‘Just say no,’” he told a Virginia audience. “Educating people and telling them the terrible truth about drugs and addiction will result in better choices by more people.” The precise success of all the war on drugs campaigns, which have had a half century to make good on their stated goals, can be seen in one sordid fact: even as Sessions spoke, his country was losing as many lives to overdoses every three weeks as had been claimed by the 9/11 terrorist attacks. That year, more than 70,000 Americans would die of a drug overdose.[1] Four years later, in 2021, that figure exceeded 100,000.[2] In the same year, my home province of British Columbia saw over 1,700 such deaths, nearly double the number killed by COVID-19 in the province as of this writing. The “bad choices” view of addiction—which, if we’re honest, amounts to little more than “It’s Your Own Damn Fault”—is not only disastrously ineffective; it is utterly blind. I have never met anyone who, in any meaningful sense of the word, ever “chose” to become addicted, least of all my Downtown Eastside patients whose lives slowly ebbed away or were rapidly extinguished in the streets, hotel rooms, and back alleys of Vancouver’s drug ghetto. If a socially conservative dissenter were to protest, “Didn’t they choose to stay hooked?” I would offer this quote by Dr. Nora Volkow, head of the U.S. National Institute on Drug Abuse: “[Recent] studies have shown that repeated drug use leads to long-lasting changes in the brain that undermine voluntary control.”[3] Translation: when it comes to addiction, “free will” is in many ways a neurobiological non sequitur. In fact, I would take it much further: most addicted people had little choice even before their habits took hold. Their brains arrived on the scene already impaired by life experience, especially susceptible to the effects of their drug “of choice” (another dubious expression). Actually, that’s true whether the