Choosing Differently in our Reptilian War on Drugs

Last year the Organization of the American States (OAS) had a conference that dealt largely with our drug problems and the violence associated with them. It was easy for the conferees to see that the base of the problem was all of the money pumped into this system by purchasers in the U.S. It was much harder, if not futile, for them to persuade the U.S. to do something different.   Yet we need to do something different–what we are doing is not working and we are not insane–different thinking is needed. Our main point in Common Sense Medicine is that we need to change the way we think from Cyborg Science, which deals with predictable linear–connect-the-dots–thinking, to the type of thinking that sees living organisms, and especially humans, as adaptable and able to choose in novel ways. In a way cyborg science is reptilian in its thinking because it ignores this ability to create novelty. The reptilian brain is the most primitive part of our brains; it is focused on survival and its main tools are fight or flight–there is little or no novelty. Laying on top of that primitive brain is the limbic or emotional brain, and on top of that is the cortex where rational thinking occurs. This is where we need to go.   Kalev Sepp teaches at the Post Graduate Naval Institute in Monterey, California and has written “Best Practices in Counterinsurgency,” which shows that reptilian fight or flight thinking and planning is more likely to result in a bad outcome for the powerful state than is dealing with the issues behind the insurgency. Coping with the issues requires rational thinking.   In another place I applied his ideas to antibiotic resistance, and they are just as applicable in our dealing with the War on Drugs. Applying this reasoning to our drug problem is essentially what the OAS did, and it comes down to us in the U.S. doing some rational rather than reptilian thinking.   David Nutt, who used to be a top advisor to British drug policy advisors before he came up with his radical but rational proposals, is a neurologist, psychologist and pharmacologist at Imperial College in London who has spent most of his career looking at these issues. He has a similar argument to that of the OAS, explained well by Kai Kupferschmidt in the January 31, 2014 issue of Science: our current policies are based on fear and we need to change them to ones with a more rational basis. He points out that we are afraid of mild altering substances and that that fear is the basis of our policies. In other words those policies are written out of fear by our reptilian brains, just like our war on terror discussed previously.   Policies based on reptilian thinking don’t involve the cortex of our brains; they don’t involve the emotional parts of our brains; they come entirely from the brain stem and are based primarily on fight or flight. Doing something different means using the cortex of our brains.   What Nutt points out is that the variety of mind altering substance is long in both numbers and history, and that they don’t all deserve the fear we have attached to them. Some of them are quite harmless. In a Lancet article he uses the following graph to show the relative dangers to both the user and society and asks: Why can’t we replace some of the more socially harmful substances with others less harmful? Why not indeed? (Clicking on the Lancet link above will take you to the article. Look at Figure 2, think about it with your cortex rather than your reptilian brain and decide what is better for you.)

*Insurance is designed to pay for the unexpected crisis. Health insurance started that way in the U.S. but gradually, because the companies we work for were paying for it and getting a better tax break, it morphed into paying for it all. That means we have less interest in getting the ounce of prevention than if we were paying for some of those costs. Children we talk to about the dangers of drugs just say they’ll get a brain transplant if they burn theirs out. That’s why we think that Health Savings Accounts should be promoted by the government more; they put the individual back in a position of responsibility in making more choices in their health care. With Health Savings Accounts an ounce of prevention is worth a pound of cure.

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