Libertarians On Drugs

This essay Freedom Fetishists by Kay Hymowitz is making the rounds in libertarian and conservative circles.

Ilya Somin of the Volokh Conspiracy has some things to say about Kay Hymowitz, Libertarianism, and Lifestyle Excesses:

To reiterate a simple but oft-misunderstood point: that which should be legal is not coextensive with that which is desirable or right. Libertarians believe that racist and communist speech should be legal; that does not mean that libertarianism implies support for such speech. The same is true of excessive drug use, cheating on your spouse, and so on. "People ought to be free to do whatever the hell they want, mostly, so long as they aren't hurting anyone else" is not "the libertarian vision of personal morality." It is the libertarian vision of the limits we should place on the power of government.
Well the "excessive drug use" bit caught my attention. What exactly is up with that?

How can drug use still be called destructive when people who chronically take drugs do so because of medical need?

Addiction Is A Genetic Disease

Heroin

PTSD and the Endocannabinoid System

People who think drugs are a "lifestyle" issue have bought into the "conservative" view of the subject. Of course it is why after 90 years of trying we have made so little progress. We are lost in "choice" when we should be focused on "need".

If we don't want people to take drugs to solve their problems then we have to make sure their problems are solved some other way. Of course that just multiplies government intervention. Better than jailing people for their needs and jailing their suppliers for serving those needs.

So of course the question comes up what portion of the chronic drug users population is need based on need and how much is recreation.

Actually we don't know if those who need are a few, many, most, or all.

No comprehensive studies have ever been done on the subject. The closest we come is Dr. Lonnie Shavelson's book/study mentioned in the above "Heroin" link.

He found that 70% of the women chronically using heroin were sexually abused when children. So for women using heroin we can say the number is at least 70%.

My take on the subject: no one will do the study because our whole drug war will be seen to be based on a wrong premise. You might as well say insulin use is a life style choice.

Ever notice how hard the courts fight the medical necessity defense? There is a reason for that. It would open the floodgates if allowed.

Cross Posted at Power and Control

posted by Simon on 09.13.07 at 02:42 AM










Comments

uh Simon... a lot of addicts get that way because they like getting high. Getting and staying high is their highest priority.

In CA we have three... THREE, drug rehab alternatives to incarceration ... Diversion (PC1000), Prop 36 (PC1210.1) and Drug Court. Some graduate the programs to sobiety, most don't. There's a revolving door on the court house ... test clean, test dirty, don't show up for court dates, show up and be reinstated. Chance after chance after chance.

Definitely there is a physiological connection... brain chemistry locks people into their addiction. But there is also a character component where some of these people find their only reality in the bowl of a crackpipe.

Darleen   ·  September 13, 2007 3:07 AM

Darleen,

Drs. prescribe stimulants for ADD/ADHD, one of the reasons "addicts" use them.

Of course the court is a revolving door. The people involved need medication, however, Drs. are reluctant to prescribe medication to "addicts". They can go to jail for it.

What Dr. would be allowed to dispense Ritalin to a meth user? Synthetic opiates to a heroin user? So far we don't know how to cure any of these problems. We only know how to treat them. However, it is illegal to give addicts drugs similar to the one's they prefer.

So tell me if you can what is the cure for adult ADD/ADHD? What is the cure for severe PTSD? Mild PTSD?

The reason your well intentioned court system is not working is that it is based on the wrong premise. The idea that people who take drugs for mental health issues can be weaned off them without solving those issues (most of which currently have no solution).

Police power, however much we might wish otherwise, can't solve these types of mental health issues.

Well any way. Bravo to you. It is better than locking up users and throwing away the key.

M. Simon   ·  September 13, 2007 5:20 AM

You are saying people should be free to do . . . what other people prefer them to do. You can take a Darvon if you stubbed your toe, but if you want to relax after dinner limit yourself to Scotch. I approve of Scotch. You are medicalizing morality, under your view if the DA could prove that you were pretty mentally stable and able to function fine without drugs it would be OK to lock you up for 30 years.

Doug_S   ·  September 13, 2007 8:21 AM

Doug_S,

Good point. However, that would be an interim position not my final hoped for result.

The first place to start in considering any such law is to determine what we know, what we don't know, and what we know that is wrong.

It turns out most of what we know is wrong.

In any case I'm focusing on the chronic users.

Once we understand that drugs do not cause addiction it is a whole new ballgame.

M. Simon   ·  September 13, 2007 8:59 AM

I've read some of Ms. Hymowitz's other stuff, and she strikes me as a cranky conservative who's angry that significant numbers of people aren't leading the kind of life she leads and would like them to lead. In previous articles, she has never explicitly come out and dropped the other shoe--or the Iron Boot--and said, "And we should legislate against them," although it seemed pretty clear that that's what she was thinking. In this new article she seems to have dropped that other shoe, or at least set it down where we can see. I wish social conservatives--and "liberals," too, for that matter--would spare us the rhetoric and philosophizing (often against straw-man versions of what those of us in the pro-freedom camp actually believe) and simply address the basic question: "Okay, Lycurgus--at whose head are you going to point the gun, and what gives you the right to do so?"

Bilwick   ·  September 13, 2007 9:33 AM

The 'excessive drug use' caveat exists precisely to separate medicinal from non-medicinal drug use. Appropriate (as deemed by the medical professions) being considered non-excessive.

This is stated thus because medicalization of the issue solves nothing. It is really just another version of morality attempting to justify personal behavior to others.

I'm not denying the benefits of medicine. But medicine, being the province of legally regulated professions is de facto part of the government. Sure we could completely unregulate the practice of medicine - leave it solely in the hands of the professions themselves, but this is highly unlikely and more than a little unrealistic.

So invoking medical issues does nothing to advance the principle that we should be concerned with 'the limits we should place on the power of government.' What we need to do is move our perceptions of drug use away from the medical model, stop making excuses for why a person chooses to do whatever it is that they do and eccept that it is their right to do so.

ThomasD   ·  September 13, 2007 1:37 PM

Er. accept

ThomasD   ·  September 13, 2007 1:39 PM

Drugs do not cause addiction. "Medicalization" is not the point. The point is to make the science known.

I favor legalization.

I think understanding the science will help.

DRUGS DO NOT CAUSE ADDICTION

M. Simon   ·  September 13, 2007 2:39 PM

Medicalization very much is the point.

Currently the professions decide what is medicine and what is not. This principle cannot be denied, unless you wish to deny the very existence of the profession, and that would be counterproductive to society.

Unfortunately by relying solely on a 'scientific' (read: medical) model for justification of drug use the professions effectively also decide what is legal and what is not. This is what we must move away from. Medicinal purposes is just another euphemism for a moral judgement.

Without demedicalization we will never escape drug laws, only trade one for another.

ThomasD   ·  September 13, 2007 4:21 PM

OK I get it. Taking drugs for medical problems is bad. Drug taking is only good if you don't need the.

==

My take is a little different. If drugs don't cause addiction what is the purpose of the drug laws?

I'm all for more liberty. However, I have a plan: discredit demon drugs. If that leads to medicalizatioin for 80 years I can live with that. What we have now is worse.

What is your plan.

M. Simon   ·  September 13, 2007 4:55 PM

Medicine is the art of healing. Medicalization is pretending the healing arts reolve moral questions. As when the Center For Disease Control claimed jurisdiction over war and guns because both cause death and injury and their job was, well, to prevednt death and injury. Anything that increases health is not ipso facto good. Last week I paid several hundred dollars to take my sports car on the track at Lime Rock and drive it as fast as I had guts to go - no speed limit at all. It was dangerous, endangered my health and it was my moral choice (at least so far in America). It is not a question of health policy. Someone could medicalize it and claim I became addicted to the thrill and speed and lost all good judgement, even self control. Look I endangered myself for nothing.

Doug_S   ·  September 13, 2007 6:26 PM

Once upon a time I was an absolutist.

These days I'm an incrementalist.

In any case even were I an absolutist I'd still educate people about what I have learned.

Drugs do not cause addiction

M. Simon   ·  September 13, 2007 8:24 PM

Currently the professions decide what is medicine and what is not.

I'd take issue with that, because in the case of scheduled narcotic drugs, the government decides when they are considered medicine and when they are not. Absent government sanctioned Methadone programs, doctors are specifically forbidden to prescribe opiates for addicts in order to help them maintain functionality. Doctors who prescribe marijuana can also go to jail. If the "profession" en masse decided to oppose being told by the government how to practice medicine, and declared that doctors should prescribe as they saw fit, U.S. attorneys would prosecute any violators. It is the government that determines what is, and what is not medicine.

Eric Scheie   ·  September 13, 2007 11:08 PM

Re: drugs do not cause addiction

I do not know what you mean by causality but drugs are a requirement of addiction.

Strictky speaking addiction is a combination of physical dependency (you get sick if you stop the drug - well known as DT for booze or kicking the habit for nicotine or heroin). with increased tolleration (you must increase the dose to get the same effect. A doctor will tell you with no abuse in the picture opiates are bad news because or increased tolleration. Resperation goes down as the dose goes up. YOu cannot simply give a person more opiates as time goes on - unless you want to do murder.

Doug_S   ·  September 16, 2007 10:11 PM

Doug,

Re: toleration.

Yes. That is what you see. It does not mean what you think it means.

If the "high" comes from pain relief, once the pain is relieved you cannot get "high". Another way of saying this is that the high comes from filling receptors once those receptors are filled more drugs will not get you higher. If you stop the drug for a while and let the pain return you can get high again. If you let the receptors empty you can get high again.

In chronic users of heroin the body adapts (a little discomfort is a motivator - evolution wise). So if the receptors are kept filled the body makes more receptors. Thus the dose that experienced users can handle rises to levels that would kill a novice.

What we see really depends on what we believe.

M. Simon   ·  September 17, 2007 12:38 AM

Oh, yeah what do I mean?

Chronic pain causes chronic drug use.

BTW did you know that tobacco addictions are in large part genetically determined?

So you might call them a deficiency disease often triggered by trauma.

M. Simon   ·  September 17, 2007 12:41 AM

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