Media SkepticismScienceSkepticism

Heroin is scary!

Health class in freshman year was full of misinformation–especially about the two controversial, politically charged topics: drugs and sex. Though my health teacher got plenty of other things wrong, too, about anorexia and nutrition. But let’s just focus on one thing at a time.

We were mostly presented with information about the effects of various drugs: cocaine does this, and may cause your teeth to fall out, and meth does this, and may give you a heart attack, ecstasy does this, and may cause you to walk around Disneyland chewing on a pacifier and looking strung out. PCP makes you think you can fly. And bad trips on LSD will give you flashbacks for the rest of your life and permanently scar your mind.

I figured I would never be able to find illegal substances anyway, much less be brave enough to use them, so I never questioned what Mr. Health Teacher told us.

As usual, we also watched Lifetime-style videos dramatizing the ill effects of drug use, dependence, and abuse. You know. Three teenagers–one who gets sucked into the world of heroin, and sucks his other two friends in. Everyone dies of overdoses.

I asked my teacher afterward whether people who try heroin and cocaine for the first time really become so instantly addicted. Oh yes, he said, it happens quite often–that just demonstrates the addictive power of these drugs! Even my usual budding skepticism at the time ingested this tidbit of information, unquestioned. Gateway drugs, I thought! Instant addiction!

Later I learned about how foggy so many of these studies are, and how much propaganda is infused into them. They are far from the ideal of scientific objectivity.

Yes, drugs are dangerous in many cases. And pleasurable (why else use them?). But so powerfully addictive? Maybe not.

According to the National Survey on Drug Use and Health (NSDUH), most people who use heroin for the first time do not use it again in the next year. Drugmonkey provides a great breakdown on his blog, but here’s the jist: given continued use, heroin and crack cocaine are most likely to cause addiction. But since alcohol and marijuana are so widely used, there are far more people addicted to these substances than to heroin or crack.

A widely cited epidemiological study (Anthony et al, 1994 Exp Clin Psychopharm 2(3)) even concludes that those who use nicotine–the most popular drug next to alcohol–are more likely to become addicted than those who do heroin. But the study did not take into account how many times these substances were used until dependence developed, which seems to be an important factor.

Moreover, neither of these studies addresses the issue of why users eventually became addicted–is it really because of some inherent ‘addictive’ quality of the drug? Are there ‘addictive’ personalities or biological types? Is it a combination of these things? Do we have basic biological evidence to support the idea that X is more addictive than Y?

Not only are there no clear answers, but nobody is hurrying to find out what they are, either. I’m not advocating drug use, or that everyone goes out and tries heroin. I just wish my health teacher had the cojones (or the brains) to tell us the truth.

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vreify

vreify

Vy is a recent graduate working in a neuroscience lab with children and monkeys. She likes sewing, knitting, lifting weights, and reading in her free time. Especially reading about science!

18 Comments

  1. MaggieMoo
    August 22, 2008 at 3:51 pm —

    i think that its a combination of an addictive drug and an addictive personality. I’m gonna use the example of my Mr. Health Teacher. He was addicted to chewing tobacco and kinda became addictive with other things, like baseball and sports. so yeah…

  2. August 22, 2008 at 4:06 pm —

    Most of the stuff taught in schools and shown on TV about drugs is bogus, because the War on Drugs is so pervasive and such a big boondoggle for politicians. I try to correct a lot of the bogus stuff here:

    Bogosity Episode 4: The War on Drugs

  3. Shivierie
    August 22, 2008 at 10:08 pm —

    I had health class in 7th grade, where we talked about EVERYTHING (nonetheless, my brother shared the same class and I.) We have it again next year, I think. But I was reading a book, maybe it was realistic fiction, but the kid tried LSD and never tried it again. So, I don’t believe that on first try people become addicted to a substance on the first try. Or the second, maybe.

  4. August 23, 2008 at 2:28 am —

    Ah health class lifetime movies. Good times! I always thought it was extremely bizarre how all the girls in anorexia/bulimia movies were athletes or dancers. It’s true that these occupations often except tremendous pressure on girls to stay slim, but isn’t the unintended message that anorexics/bulimics are more successful than large girls and if you want to be a dancer or track star you do need to be a disordered eater?
    Also, if they really wanted to put kids off heroin they would have them watch “Trainspotting”.

  5. August 23, 2008 at 10:35 am —

    Just because health classes operate at a lies-to-children level doesn’t exactly mean that “nobody is hurrying to find out”. There is a LOT of drug abuse research – from the human user to the laboratory – that is focused on individual differences. Is progress slower than we might like? Sure. Just as with many other health conditions that we do not fully understand.

  6. vreify
    August 23, 2008 at 10:47 am —

    Forgive me, but I was under the impression that research is not very well-funded or supported. What is it really like?

  7. August 23, 2008 at 1:27 pm —

    Oh yes, health class, one of the stupidest class of all. The teacher sucked, and the materials sucked. I remember about that exaggerated video about cigarette. Of course, not to say smoking isn’t bad, because long term use is really bad, but it felt like instead of telling facts, it was drawing its conclusion from the emotional part, which is fear. So yeah, they planned on imforming people by scaring the heck out of them.

  8. darwinfan
    August 23, 2008 at 4:15 pm —

    Thank god for posts like this – it reminds me why I’m so proud to be a skeptic! I work for a tobacco harm reduction group (check out tobaccoharmreduction.org), and harm reduction, as far as I’m concerned, is where it’s at. It’s always been my contention that the war on drugs is more harmful than the drug abuse itself.

    To take a look at some researched graphs of the relative risks of drugs, here is a great article:

    http://arstechnica.com/journals/science.ars/2007/03/23/assesing-the-harm-of-illegal-drugs

    As with many things in our world, our ideas and understanding of things aren’t always based in reality. I believe the war on drugs came about by fear and misunderstanding, and I think our obsession with abstinence-only education and prohibition stems from our religious backgrounds (Judeo-Christian in North America and Europe), where abstaining from pleasure is considered godly.
    Just a brief summary of my thoughts on the matter!

  9. darwinfan
    August 23, 2008 at 4:21 pm —

    Oh, and just to clarify, the graph in my link rates drugs as to how dangerous they are based on addictiveness, physical, and social damage. For those who don’t click on my link, in short, the way the law classifies drugs does not reflect how dangerous they actually are. Tobacco and liquor, for example, are pretty damaging and addicting, whereas cannabis and ecstasy are not (although the psychological effects of ecstasy are still being researched).

  10. August 23, 2008 at 5:05 pm —

    vreify, ‘well funded’ is in the eye of the beholder. yes, all NIH funded scientists are complaining about budget issues these days but this is in part because so many of us are fighting over a shrinking pie.

    darwinfan, the evidence actually suggests that cannabis is far more addicting than is alcohol but then again alcohol is very unique because of the population exposure rates. ecstasy does indeed cause dependence and to say it is not addicting is hogwash. as far as “damaging” goes, the toxicity of MDMA is probably better understood than any other drug of abuse. it is very clear that it is capable, on its own, of producing essentially permanent and very large decrements in many aspects of serotonergic function. what is still being researched is if this property of the drug has a causal relationship to the clearly established cognitive and affective problems reported in abstinent ecstasy users.

  11. darwinfan
    August 23, 2008 at 5:21 pm —

    I actually believe all drugs are addicting on some level (psychological or physical), but I have yet to find any convincing studies that show cannabis and ecstasy as anywhere near as physically addicting as cocaine or liquor. Do you have any I could read? As well, the graph has taken into account social and physical harm from the drugs, not just addiction.

    I’m confused by your last sentence… abstinent ecstasy users? Is that not an oxy-moron? Maybe there was a typo there. The research has shown that ecstasy is capable of producing short-term memory deficits and other psychological deficits, but it is not known the degree, and how permanent they are. It may be one of the more researched illegal drugs, but there is still a lot unknown. It seems that, like most drugs, increased usage will lead to increased problems. I still see it as being much less damaging than cocaine, liquor, and heroin use (the word “damaging” taking into account addiction, physical, and social damage).

  12. livingparadox27
    August 24, 2008 at 9:04 pm —

    i believe that the dangers of drugs and addiction are wildly spun out of control in health classes. yes – drugs are dangerous – and in some cases, drugs can destroy your life. but hooked on a drug on the first try? thats rare. the dangers marijuana and the psychedelic drugs also get incredibly exaggerated – marijuana is not very addictive – neither is it really that dangerous. every health class i was ever in always told me that marijuana was a “gateway drug” and that once i started smoking weed, i was sure to start shooting up heroin soon after. and that is rarely the case – most potheads are just that: potheads. and something like LSD, while it can certainly mess with your head, is nigh impossible to become addicted to.

    personally, i think that addiction has much more to do with your own psychology than it does with the inherent qualities of a substance. thats why i try to avoid drugs – i recognize that i have a very addictive and dependent personality, and have a sneaking suspicion that my getting involved with drugs is bound to end badly.

  13. Shivierie
    August 24, 2008 at 10:08 pm —

    Someone said something about how they thought it was weird that all the Lifetime movies showed the athletes or the skinny girls as the ones with a problem. It makes sense, because they are trying to show that the popular/skinny/athletic kids have problems too.

  14. August 25, 2008 at 6:17 pm —

    Ah, stupid “health” teachers… or should it be health “teachers”? Regardless, the whole class is screwed up in a great many ways – or at least it was when I was in school, and I’ve heard nothing since then about it getting better… only worse.

    I appreciate trying to keep people from falling into drug addiction. It’s a serious problem. Lying about it, though, doesn’t help anyone.

  15. Petitemalfleur
    August 26, 2008 at 11:23 am —

    I think it’s important to keep in mind the medium that you’re receiving this education through. There’s simply no room in a high school health class to go into details about how addictive each drug is or the various degrees each drug impacts one’s health. Yes, some drugs like cannibus are much safer than drugs like heroine or crack, but is it really practical to stress this in the course? Frequent marijuana use does have mind altering effects, including bi-polar like mood swings and extreme paranoia. Ecstasy puts people in the hospital, and causes permanent lowering of seretonin levels in the brain, leading to chronic depression. Is this as extreme as the health effects of becoming addicted to cocaine, which cause people to die of heart attacks at age 20? Certainly not, but is it practical to go into quality of life details to high school students who have no comprehension of what seretonin levels are? Detailed pharmacology isn’t useful at the high school level.

    All illicit drugs, including alcohol and nicotine, have long and short term health effects of various degrees. The argument that villainizing certain drugs over legal drugs are irrelevant to the class. It’s not the health teacher’s place to interject the morality of the politics surrounding the current laws. These drugs are illegal, and no matter how the general public views that fact, it’s irrelevant to the high school curriculum within a health class. Teaching anything else but what is being taught only detracts from the purpose of the lesson, which is to discourage illicit drug use.

  16. vreify
    August 26, 2008 at 3:27 pm —

    Why isn’t there room to go into detail about these drugs? The point of education is not to ensure that students follow federal law, but to ensure that students can make informed and practical decisions about their health and about their own bodies. I don’t see any point in lying to a student about the addictiveness of legal or illegal drugs.

    In our unit about nutrition, our health teacher did not simply say “don’t eat junk food.” He explored the science behind it, explained how our bodies turn food into fat, how our bodies build muscle, and how our bodies absorb vitamins and minerals. Then we understood why eating fat-laden foods and lying around all day caused us to gain weight. And we understood how to lose it.

    There probably was no room to go into tiny details about the murky details of drug studies. But he could have gone into a discussion about federal drug schedules so we could learn about the law in more detail, just as we learned about nutrition in more detail. Then we also could have understood how the government has judged these drugs to be different from one another, but still determined all of them to be dangerous enough to be illegal.

    Not that I entirely agree with the government on this point, but that’s another matter.

  17. darwinfan
    August 26, 2008 at 3:42 pm —

    I agree, vreify. I think Petitemalfleur may be underestimating students. There is no point in lying to students; it does more harm than good. Frankly, being told that doing a drug just once and bam! you’re hooked, simply implies that there is something magical about this drug – I mean, what average person can even imagine something so powerful and life-altering that you’re hooked after one try? I certainly couldn’t, and any student who is intrigued by this seeming magical quality will be all the more curious to try it. Don’t lie to students about the realities of drugs. And the realities aren’t as bleak as the extreme examples shown on news programs and even in the comments on this thread. If you have a healthy (and realistic) approach to drugs, and a healthy respect for what they are capable of doing, then maybe there will be fewer people who get hooked, and more people we can save who are already hooked. Lies don’t get us anywhere. Lies gives us the war on drugs (which is essentially a war on people, to give a cliched quote from “Traffic”, haha).

  18. whitebird
    September 5, 2008 at 11:08 am —

    Ahh! Sorry,this is just me weirdness creeping in – but isn’t the word “addictive”, not “addicting”? Like “nicotine is addictive”, but “those cigarettes are addicting me to nicotine”?

    sorry.

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