Translator: Lauren Smith Reviewer: Theresa Ranft
Good evening.
I want to talk to you about your drug use.
Well, not just yours.
Yours, mine, everyone's.
It's an awkward subject in the United States
where we have very specific ideas
about drugs,
but we need to talk about it
because our thinking about drugs
is completely disconnected from our behavior.
It's disconnected from our drug use.
Let's do a thought experiment:
Close your eyes and imagine a drug user.
OK, I want you to hold that image.
We'll come back to it.
So let's start at the beginning.
For over 40 years the United States has waged a devastating drug war.
In that same period of time
we've experienced an unprecedented boom
in the pharmaceutical industry.
The result of these two trends
is that on the one hand we've incarcerated millions of drug users
while becoming the most medicated people
in American history.
How did we get to this conflicted place
about drug use?
And is it where we want to be?
Let's say, for the sake of conversation,
"No, it's not where we want to be."
The thing is, we can change our behavior and our approach to drugs
if we all change our thinking about drugs and the desire to use them.
Let me define what I mean by drugs
because I'm sure by now your mind is just skittering around.
When I say drugs, I mean psychoactive drugs.
These are substances that affect our thinking,
our affect, and our behavior.
They include amphetamines, cocaine,
hallucinogens, marijuana,
opiates, alcohol, caffeine,
nicotine, and psychotherapeutic drugs
like antidepressants and stimulants.
We rarely think about these drugs as an entire category.
Instead, we tend to split them into two different kinds of drugs.
We think of good drugs and bad drugs,
or we think of illegal drugs and legal drugs.
Cultural historian, Nancy Campbell, says that we tend to think of them
as problem-solving drugs
and problem-causing drugs.
You know what I mean.
(Laughter)
These are socially created attitudes and categories.
They don't tell us very much about the effects of these drugs,
but they tell us a great deal about what we think about drugs.
So what are good drugs and bad drugs?
Well, let's start with our stories about good drugs.
We tell ourselves the good drugs are problem-solving drugs,
medically necessary or harmlessly pleasant.
(Laughter)
They're readily available in two ways:
we either get access, openly available,
the caffeine you had this morning or the beer you have at dinner,
or we have to seek them through a prescription,
a physician's consent.
Ask your doctor, we do a lot.
It's common.
It turns out that even just a tiny subset of good drugs,
the American Psychological Association
says that of the psychotherapeutic drugs,
use has risen 22% in the last decade.
That means that one out of five of you
are on at least one of these substances right now.
Or across the country, 51 million people.
Another 7 million use them without the consent of a physician.
Consider another good drug: alcohol.
A hundred years ago it was a contested substance.
Now, cultural attitudes have changed
and we look back on that period of alcohol prohibition
as a misguided attempt
to control the desire of millions of Americans to drink.
In fact, we celebrate the use of alcohol.
We serve it at our social functions,
we give it as gifts to family and complete strangers,
and we expect it to be at most of our meals.
In other words, alcohol is a psychoactive drug
whose use has become normative for most Americans.
It's a good drug.
Bad drugs...
Well, the stories we tell ourselves about bad drugs
are that they are problem causing.
They are criminal, dangerous, addictive.
They're not for medical use.
In fact, we use them to avoid reality or to escape responsibility.
They are a one-way ticket to self-destruction.
Our media is full of the horror stories
of the users of bad drugs.
Do you remember the frying egg? (Chuckles)
Well since then, we've had crack babies,
meth tweakers, coke heads, junkies.
Their ravaged faces have been plastered
all over public service announcements
in Hollywood and television programs
for decades.
We know what happens to people who use bad drugs.
Or do we?
When I talk about drugs and desire, people make two assumptions:
they assume I'm talking about illicit substances
and they assume that if you desire a substance
you can't control your use of that substance.
For the majority of users of psychoactive substances
in the United States,
it turns out that is wrong.
The National Institute of Health
does an annual survey of alcohol and drug use.
And in that survey, for just illicit drug users,
they note that 22.5 million users
use regularly,
and of them,
an average of 18% are addicted to whatever substances they're using,
because it's a whole category of illicit substances.
I say 18.5% is an average because it ranges from 10% to 30%
depending on the exact drug.
Of the 131 million users of alcohol,
11% become addicted.
Hmm...
Addiction is a real issue
and many Americans struggle with it.
It is also a serious social concern
because of all psychoactive drugs 15 to 30% of users become addicted.
The exception is nicotine:
80% of nicotine users become addicted.
But I think it's important to realize two things.
The first is:
when I talk about this subject people often react right about now,
and the reason is that you probably know somebody who struggles with addiction.
I do,
and I have compassion for that suffering.
On the other hand, it's important to realize
that if 15-30% of the users of psychoactive drugs become addicted
that means that 70-85% of the users don't.
That means that 70-85% of users of psychoactive drugs
are controlled users.
It's almost hard to believe because we never hear that.
Instead, we tend to focus on the people who are addicted,
which is a very tiny subset of a very tiny subset.
But like a researcher in chemical dependence said to me -
his name is Robert Whitney -
"It's like the flu,
the virus is all around you but not everybody gets it."
So on the spectrum of people who abstain and the people who are addicted
are all the other users.
And what are they using?
Well,
of the psychoactive drugs that we could possibly use
and the ones we hear the most about are illicit drugs.
Under 9% of the users of all psychoactive drugs
use those illegal drugs.
Another 15.7% use pharmaceuticals, non-medically,
so recreational or repurposed for other reasons.
We'll talk about that in a minute.
Another 20% use pharmaceuticals as prescribed.
And then there are the majority of users,
over 50% who use alcohol and over 68% who use nicotine.
The thing to notice
is the majority of these drugs are socially approved.
And in fact, the majority of the users of these drugs, of all of them,
use in a controlled fashion.
So I have to ask,
can millions of happy, controlled drug users be wrong?
(Laughter)
We're all users.
Whether you run seven miles to feel energized or to shake your stress.
Whether you smoke that bowl before you go to a movie with your buddy.
Whether you drink that bottle, or bottles of wine with your family.
Or you eat a handful of mushrooms to go out on a hike.
Or maybe you just have to have
that first, second, and fifth cup of coffee in the morning.
We're all users
and our practice reveals how we want to live.
I want to talk about one substance and three sets of users
to kind of illustrate what I'm talking about.
Psychostimulants have become a much more prescribed drug
over the last ten years.
They're typically prescribed for psychological disorders,
or people who have something like Attention Deficit Disorder.
And so a lot of teenagers and college students use these drugs.
So do their friends
because everyone has figured out these are "performance enhancing" drugs.
In other words,
they help you focus for an extended period of time.
If you go to the library in a college campus
within two minutes you can have Ritalin or Adderall
and can sit down to study for your exams or write a paper.
It's a common practice.
Well, the first set of users I want to talk about
are elementary school children
because the parents of those teenagers and college students
have figured out they have an academic edge.
In fact, they now call those drugs "smart drugs."
They're going to their pediatricians
and asking for their middle school and elementary school children
to be put on these drugs.
Not because they evidence the symptoms of ADD
but because they want that performance enhancement.
So, I wonder if these parents know
that one of the most prescribed drugs is an amphetamine.
These same parents would be horrified
if their children turn to methamphetamine.
But as the parent of one elementary school child
who had a dramatic turnaround after being put on this drug said,
"Well, she was miserable, so she wasn't doing her school work,
and she was completely socially withdrawn.
Now she's happy,
she's excelling at her school work and she's socially active.
Why not?"
Why not, indeed.
The second group of users I'll talk about
are professional athletes.
If college students figured this out
you know that professional athletes have figured out
that performance enhancement is a good thing.
And some leagues have decided to allow the use of this drug
with the prescription of a doctor.
Suddenly, across Major League Baseball,
every other player has ADD.
It's crazy.
The thing is, who can blame them?
If I had to play over 180 games (Chuckling)
over the year, that went on for hours and hours
and sometimes extra innings,
I would want a stimulant too.
(Laughter)
The third group of users are writers and thinkers.
Historically, some of our most famous philosophers and writers
have openly used amphetamines and have extolled their purpose.
For the same reason that the college kids,
the high school kids, the professional athletes,
want to use them.
They help refine focus,
they help you focus for extended periods of time.
So, writers like W.H. Auden or Graham Greene,
or thinkers like Jean-Paul Sartre, are famous for their amphetamine use.
Lots of writers use them, including this writer.
When people come and tell me
about the propaganda they've heard about methamphetamine,
people who have clearly never tried the drug,
I sometimes will say,
"I wrote my dissertation in nine months
with the occasional help of methamphetamine.
It was a really functional drug, it worked for me."
So here's my question:
Does it matter, if I'm a controlled user
does it matter if I use to get my work done?
If I use to feel good?
Does it matter if you use to avoid feeling bad?
Or your friend uses to have an introspective spiritual experience?
Does it matter if we all use because we want to be celebratory
and feel intoxicated?
Our practices reveal how we want to live.
The majority of users are controlled users
All of them.
They are your teachers, your mentors,
your friends, your neighbors.
Cultural norms are learned.
We create them
and we can change them.
I'll drink to that.
(Applause)