This morning I listened to a discussion on the radio about drugs policy – the policy of targeting drug production and criminalising drug users (the so-called ‘war on drugs’). It seems clear the policy at best contains drug use at a very high level rather than reduces it. An alternative approach of seeing drug-use as a health problem was mooted.
I won’t comment on how best to combat the supply of drugs but rather concentrate on the user end of the chain. It seems to me that this discussion could be enlightened by thinking about the kind of agency at work.
Some people use drugs recreationally – the vast majority actually. These people are otherwise law-abiding and use drugs only in moderation, so they are plainly not ‘criminals’. Their usage should be treated as a health issue.
But how to approach the issue? The traditional approach is to give out information and scare people with the long-term consequences of drug use. But we know that affects a long way off won’t influence most people’s behaviour because the human brain has a massive bias to what is temporally near. Moreover drug-use is a habit and changing habits through self-conscious reflection on information is something most people find very difficult.
Making drug-use a taboo will not work either, as drug-users form a kind of club, and membership of the club is in part premised on rejecting such ‘establishment’ taboos. Once you’re in the club the messages from on high become a joke made by ‘squares’ who don’t understand.
Finally, although people who use drugs do so out of habit they probably tell themselves a story that they have decided it’s perfectly safe, that they’re in control, not like all the others etc. So the point is that even if they don’t indulge in drugs based on rational deliberation, they probably think they do.
So we have a dopamine-enforced behavioural habit combined with a rationalisation of that habit, and a feeling of membership in a club, plus a difficulty in taking seriously long-term effects. These are the fundamental elements of the decision-making agency of most recreational drug-users.
Here are some suggestions as to how behaviour change should be approached in this area given this analysis:
- don’t rely on giving out information about long-term harms;
- when you make harms apparent, make sure they are temporally close to the user (show how they’ll screw up at work on Monday or spend the night sitting in the corner gurning rather than chatting with girls/boys);
- make sure the harms are not overplayed – don’t insult the intelligence of the user (who, remember, believes they have ‘decided’ to be a drug-user);
- make the harms appear commensurate with what drug-users own experience tells them (that they’ll feel depressed for the first three days of the week after a heavy weekend);
- make the drug-user ‘club’ appear one not to be a member of, or, make it so that the ‘cool’ things that make up membership characteristics can be seen to be obtainable in other clubs, or, make membership of clubs in general feel a bit silly and sheepish;
- when you do this, do it by comparison of social identities – do you really want to be part of a club that has terrible sex lives, ends the night talking nonsense etc?;
- concentrate on steering behavioural patterns not changing attitudes – change the patterns and the attitudes will adjust.