Ending the War on Drugs: How Studying the Brain Gives Us Optimism for an Effective Drug Policy

 

In complete contrast with his brother’s views about drug policy, Christopher Hitchens expresses a more libertarian view, criticizing and advocating an end to the War on Drugs in the United States and Britain. In conversation with David Frum, it is pointed out how if drugs were legalized, addiction rates may increase. Well, why the hell should we ever advocate for a policy that would have such a result?

Well, for one thing, we’re learning more and more about addiction: how addiction works in the brain, why some people become addicted to substances they use while others don’t, and how to treat addiction once it occurs, though there is still plenty of work that needs to be done in these areas.

We already know about the concept of neuroplasticity, the brain’s ability to change both in structure and function in response to experience. In fact, though it was previously thought that we’re born with all of the brain cells we’ll ever have, Eriksson et al. showed in 1998, that neurogenesis, which is the generation of new new neurons from a certain type of stem cell located in the brain known as a neural progenitor, occurs well into adulthood in humans.

eriksson

A newborn neuron, labeled in yellow, showing us how pulchritudinous neuroscience can be (Eriksson et al, 1998).

This occurs in a regoin of the brain known as the hippocampus, a structure that, in communication with the cerebral cortex, establishes long-term memory from short-term memory.

Hippocampus, highlighted in blue. Source

The problem with addiction, is that the memory of the drug reward is very strong, the strength of which correlates with the severity of addiction (thus, abstinence from substance use is essential for effective recovery so as not to initiate activity in these harmful circuits once they’ve become dormant). This is where neurogenesis and neuroplasticity are important. We can generate new neural pathways for healthy memories and habits. Though neurons are generated in the hippocampus, new cells migrate to other brain regions including the cerebral cortex.

How could I ever write an article without mentioning the center for executive brain functioning – the prefrontal cortex? The dorsolateral prefrontal cortex (remember that in the brain, “dorso” means near the top, and “lateral” means to the side) is involved in our processing of immediate and long-term rewards. Those with poor processing in the dlPFC are more willing to accept an immediate award over a larger award in the long-term, even if the immediate award has consequences for our long-term health, such as taking a drug versus staying healthy.

I thought about showing a picture of the dlPFC, but you’re getting so good at anatomy, I figured I’d let you find it yourself:

Magnetic Resonance (MR) scans of a brain in the coronal (left), saggital (center), and transversal (right) imaging planes. Images from http://www.mr-tip.com/serv1.php?type=img&img=Brain%20MRI%20Inversion%20Recovery

Magnetic Resonance (MR) scans of a brain in the coronal (left), saggital (center), and transversal (right) imaging planes. Source

Don’t forget about our optimism, though. Working memory, which is the type of memory used during tasks such as sorting your computer files into different directories, is also a function of the dlPFC. Developing your working memory by practicing related tasks, may enhance dlPFC function in such a way that it may also enhance our ability to decide between short and long-term rewards, both of which are kinds of processing we see compromised in the case of addiction (this doesn’t in any way mean that I recommend any “get smarter” computer games).

Also, I won’t allow you to forget that in the brain, function is limited by structure. Thus, these working memory tasks improve the structure of the dlPFC, refining it’s connections within itself and with other brain regions. Structure can be improved too by an enriched environment, which promotes neurogenesis. When we talk about an enriched environment, we mean an environment that engages the brain and stimulates our cognitive faculties, such as working memory. I don’t think there’s too much to say about prisons being enriched environments, other than that, for the most part, they aren’t.

Why stop at enriching the environment, when we can add exercise? Mice who excercised more have exhibited higher levels of neurogenesis. It’s important to note here that the mammalian brain has mostly been evolutionarily conserved among the different mammalian species, which allows us to looks to animals like mice, rats and other primates as models for human brain functioning (perhaps there should be a post about this in the future).

In a must-see talk criticizing how American History is understood, Howard Zinn reminds us that, “in between war and passivity, there are a thousand possibilities.” Here, I have presented what I think are better alternatives to dealing with drug use than the War on Drugs, which can have very violent consequences, even for innocent babies, when put into full effect. Incarceration and poverty go hand-in-hand and our current approach in the United States disguises many victims as perpetrators. Regardless of what you think of either of these men, Hitchens and Frum have a point: in learning more about drug addiction, science is discovering more about how to treat it medically. Addiction is becoming more and more treatable, much more so than say death as a result of the violence associated with drug dealing. Further, Ron Paul makes a good point about the unnecessary fear associated with drug legalization. And though, Peter Hitchens has asserted that harsh prison sentences and showing the public that ‘we mean it’ will deter others from committing crimes, including drug use, Russia has a much higher murder rate than the US, despite having some of the some brutal prisons of their own. We should remember, that though Paul, Frum, Hitchens, and even Hitchens can be polarizing figures on many issues, we shouldn’t let previous opinions about them affect our views of what they’re saying – only evidence should do that.

Consider the success and effectiveness of anti-smoking campaigns in the US, yet cigarettes are legal. Consider, how likely it would be for yourself or for those you know to try heroin tomorrow if it was made legal tomorrow. Consider, in the case of those who have had a past issue with substance abuse, whether it’s the fact that it is illegal that’s deterring them from using, or some other factor, such as social support. Consider whether those who are addicted are able to, given what we know about decision making, logically balance the costs of addiction taking over their lives versus the rewards of a high. As Mr. Paul states, we should have a bit more respect for ourselves than to think that the government needs to give us these kinds of rules in order for us not behave that way.

The War on Drugs has been a failure. It may be that at one time, this was the best approach we could have known about. However, in seeing how it has failed and in learning that it is not just an important social issue, but also a biological issue, we can now begin to establish more effective, humane ways of preventing drug abuse and addiction, and treating those who are already sick. As Canadian neuroscientist and recovering addict Marc Lewis says, “more suffering doesn’t help someone who is trying to alleviate suffering.” If you haven’t yet, check out the interview with Carl Hart on the problem of drugs.

Wow. You’re getting smarter and smarter every time we chat. Keep the conversation going by leaving a comment and/or subscribing. Be sure to pass along to any friends or family who may be interested – which means everyone.

Also, be on the look out for an upcoming guest post by most pulchritudinous girlfriend, Regis Shanley, about the organism that boasts the most impressive nervous system.

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