We absolutely should legalize marijuana.

We absolutely should legalize marijuana.

There's traditionally been two different ways of seeing addiction. Either it's a sin and you're a horrible bad person and you are just choosing to be hedonist or it's a chronic progressive disease. And while I certainly believe addiction is a medical problem that should be dealt with by the health system, the way we've conceptualized addiction as a disease is not actually accurate, and it has unfortunately become stigmatizing and it's also created a lot of hopelessness in a lot of people.

When President Nixon declared war on drugs on June 17, 1971, about 110 people per 100,000 in the population were incarcerated. Today, we have 2-3 million prisoners: 743 people per 100,000 in the population. The U.S. has 5% of the world's population, but 25% of its prisoners. As Senator Jim Webb once put it, Either we are home to the most evil people on earth or we are doing something different and vastly counterproductive.

Because of the war on drugs, pain patients are treated with skepticism and pain doctors live in fear of being prosecuted for overprescribing. The end result is that addicts still get their opioids without much trouble, while genuine patients often can't find treatment. Those who do must typically be tracked in a database and must schedule frequent, expensive doctor visits for surveillance like urine testing.

Addiction is when you fall in love with a drug instead of a child or a lover and the learning that takes part in that part of the brain is designed by evolution to get us to persist despite negative consequences to do what we need to do - because I don't know anybody who could survive a relationship or parenting if not for the ability to persist despite negative consequences. The problem is when that gets misdirected to a drug and then you can find yourself in some very negative and potentially deadly situations.

There is a safe, nontoxic drug called naloxone that can instantly reverse opioid overdose and prevent most of these deaths. But the drug war interferes with saving overdose victims in two ways: first, because witnesses to overdose fear prosecution, they often don't call for help until it's too late. Second, because the drug war supports the belief that making naloxone available over-the-counter or with opioid prescriptions would encourage drug use, the antidote is available only through harm reduction programs like needle exchanges or in some state programs aimed at drug users.