You can find “facts” to fit your desired outcomes, and choose to disregard other information that, in Al Gore’s parlance, are “inconvenient truths.” We’re all guilty of this to one extent or another.
It’s called the backfire effect, conformation bias and a few other labels. Basically it means the more you care about something, the more likely you are to stick to your wrong conclusions no matter how much contrary evidence you see. Sometimes that’s not a big deal.
In matters relating to healthcare, including addiction and substance use disorder treatment, it can be crucial.
Substance use disorder treatment is not a single technique or method. Not everybody responds to the same therapies. If you bar some remedies due to a preconceived bias, that’s not good.
At it’s most basic, substance use disorder treatment doesn’t even mean you have to stop taking drugs or drinking. Sometimes that can be deadly in itself. If you are an alcoholic, to stop cold turkey might kill you. The same is true of addiction to benzodiazepines. A slow, tapering detox might be necessary.
Then some opioid addictions are better handled with medication-assisted treatment (MAT), that is the substitution of a maintenance medication, such as methadone or buprenorphine (a common formulation is Suboxone), that feeds your addiction but doesn’t get you high, allowing you to function.
And there is some evidence that cannabis or marijuana – or at least one of its component cannabinoids CBD (cannabidiol) – can control the chronic pain for which opioids are often prescribed without the addiction, hallucinations or impairment. It may even control opioid addiction; in states with legal cannabis, there are fewer opioid overdoses.
Even doctors sometimes have prejudices from their medical school days that color their treatments and lead to worse outcomes.
So long as substance use disorder is illegal, law enforcement must be part of the remedy. The problem is when the people in charge of policy think that is the only or primary remedy. Attorney General Jeff Sessions has recently restated his position that “treatment” doesn’t always work, so we need to stress prevention – Just Say No! – and that aggressive law enforcement and cracking down on doctors who too freely prescribe opioids is a part of prevention. He also feels that marijuana is only slightly less awful than heroin.
The facts don’t agree. Countries that have legalized possession of virtually all drugs show less crime, less drug use, less addiction. In states where recreational marijuana use has been legalized (though not in the eyes of the federal government), marijuana use and marijuana-caused deaths have not gone up, and opioid overdose deaths and crime have gone down.
But who are you gonna believe: me or those lying facts?
