Netherlands

Depression and the War on Drugs

PNRJ cognitive science, current events, politics, public policy , , , , , , , , , , , , , , , , , , , , , , , , ,

Jan 7 JDN 2460318

There exists, right now, an extremely powerful antidepressant which is extremely cheap and has minimal side effects.

It’s so safe that it has no known lethal dose, and—unlike SSRIs—it is not known to trigger suicide. It is shockingly effective: it works in a matter of hours—not weeks like a typical SSRI—and even a single moderate dose can have benefits lasting months. It isn’t patented, because it comes from a natural source. That natural source is so easy to grow, you can do it by yourself at home for less than $100.

Why in the world aren’t we all using it?

I’ll tell you why: This wonder drug is called psilocybin. It is a Schedule I narcotic, which means that simply possessing it is a federal crime in the United States. Carrying it across the border is a felony.

It is also illegal in most other countries, including the UK, Australia, Belgium, Finland, Denmark, Sweden, Norway (#ScandinaviaIsNotAlwaysBetter), France, Germany, Hungary, Ireland, Japan, the list goes on….

Actually, it’s faster to list the places it’s not illegal: Austria, the Bahamas, Brazil, the British Virgin Islands, Jamaica, Nepal, the Netherlands, and Samoa. That’s it for true legalization, though it’s also decriminalized or unenforced in some other countries.

The best known antidepressant lies unused, because we made it illegal.

Similar stories hold for other amazingly beneficial drugs:

LSD also has powerful antidepressant effects with minimal side effects, and is likewise so ludicrously safe that we are not aware of a single fatal overdose ever happening in any human being. And it’s also Schedule I banned.

Ahayuasca is the same story: A great antidepressant, very safe, minimal side effects—and highly illegal.

There is also no evidence that psilocybin, LSD, or ahayuasca are addictive; and far from promoting the sort of violent, anti-social behavior that alcohol does, they actually seem to make people more compassionate.

This is pure speculation, but I think we should try psilocybin as a possible treatment for psychopathy. And if that works, maybe having a psilocybin trip should be a prerequisite for eligibility for any major elected office. (I often find it a bit silly how the biggest fans of psychedelics talk about the drugs radically changing the world, bringing peace and prosperity through a shift in consciousness; but if psilocybin could make all the world’s leaders more compassionate, that might actually have that kind of impact.)

Ketamine and MDMA at least do have some overdose risk and major side effects, and are genuinely addictive—but it’s not really clear that they’re any worse than SSRIs, and they certainly aren’t any worse than alcohol.

Alcohol may actually be the most widely-used antidepressant, and yet is clearly utterly ineffective; in fact, alcoholics consistently show depression increasing over time. Alcohol has a fatal dose so low it’s a common accident; it is also implicated in violent behavior, including half of all rapes—and in the majority of those rape cases, all consumption of alcohol was voluntary.

Yet alcohol can be bought over-the-counter at any grocery store.

The good news is that this is starting to change.

Recent changes in the law have allowed the use of psychedelic drugs in medical research—which is part of how we now know just how shockingly effective they are at treating depression.

Some jurisdictions in the US—notably, the whole state of Colorado—have decriminalized psilocybin, and Oregon has made it outright legal. Yet even this situation is precarious; just as has occurred with cannabis legalization, it’s still difficult to run a business selling psilocybin even in Oregon, because banks don’t want to deal with a business that sells something which is federally illegal.

Fortunately, this, too, is starting to change: A bill passed the US Senate a few months ago that would legalize banking to cannabis businesses in states where it is legal, and President Biden recently pardoned everyone in federal prison for simple cannabis possession. Now, why can’t we just make cannabis legal!?

The War on Drugs hasn’t just been a disaster for all the thousands of people needlessly imprisoned.

(Of course they had it the worst, and we should set them all free immediately—preferably with some form of restitution.)

The War of Drugs has also been a disaster for all the people who couldn’t get the treatment they needed, because we made that medicine illegal.

And for what? What are we even trying to accomplish here?

Prohibition was a failure—and a disaster of its own—but I can at least understand why it was done. When a drug kills nearly a hundred thousand people a year and is implicated in half of all rapes, that seems like a pretty damn good reason to want that drug gone. The question there becomes how we can best reduce alcohol use without the awful consequences that Prohibition caused—and so far, really high taxes seem to be the best method, and they absolutely do reduce crime.

But where was the disaster caused by cannabis, psilocybin, or ahayuasca? These drugs are made by plants and fungi; like alcohol, they have been used by humans for thousands of years. Where are the overdoses? Where is the crime? Psychedelics have none of these problems.

Honestly, it’s kind of amazing that these drugs aren’t more associated with organized crime than they are.

When alcohol was banned, it seemed to immediately trigger a huge expansion of the Mafia, as only they were willing and able to provide for the enormous demand of this highly addictive neurotoxin. But psilocybin has been illegal for decades, and yet there’s no sign of organized crime having anything to do with it. In fact, psilocybin use is associated with lower rates of arrest—which actually makes sense to me, because like I said, it makes you more compassionate.

That’s how idiotic and ridiculous our drug laws are:

We made a drug that causes crime legal, and we made a drug that prevents crime illegal.

Note that this also destroys any conspiracy theory suggesting that the government wants to keep us all docile and obedient: psilocybin is way better at making people docile than alcohol. No, this isn’t the product of some evil conspiracy.

Hanlon’s Razor: Never attribute to malice what can be adequately explained by stupidity.

This isn’t malice; it’s just massive, global, utterly catastrophic stupidity.

I might attribute this to Puritanical American attitude toward pleasure (Pleasure is suspect, pleasure is dangerous), but I don’t think of Sweden as particularly Puritanical, and they also ban most psychedelics. I guess the most libertine countries—the Netherlands, Brazil—seem to be the ones that have legalized them; but it doesn’t really seem like one should have to be that libertine to want the world’s cheapest, safest, most effective antidepressants to be widely available. I have very mixed feelings about Amsterdam’s (in)famous red light district, but absolutely no hesitation in supporting their legalization of psilocybin truffles.

Honestly, I think patriarchy might be part of this. Alcohol is seen as a very masculine drug—maybe because it can make you angry and violent. Psychedelics seem more feminine; they make you sensitive, compassionate and loving.

Even the way that psychedelics make you feel more connected with your body is sort of feminine; we seem to have a common notion that men are their minds, but women are their bodies.

Here, try it. Someone has said, “I feel really insecure about my body.” Quick: What is that person’s gender? Now suppose someone has said, “I’m very proud of my mind.” What is that person’s gender?

(No, it’s not just because the former is insecure and the latter is proud—though we do also gender those emotions, and there’s statistical evidence that men are generally more confident, though that’s never been my experience of manhood. Try it with the emotions swapped and it still works, just not quite as well.)

I’m not suggesting that this makes sense. Both men and women are precisely as physical and mental as each other—we are all both, and that is a deep truth about our nature. But I know that my mind makes an automatic association between mind/body and male/female, and I suspect yours does as well, because we came from similar cultural norms. (This goes at least back to Classical Rome, where the animus, the rational soul, was masculine, while the anima, the emotional one, was feminine.)

That is, it may be that we banned psychedelics because they were girly. The men in charge were worried about us becoming soft and weak. The drug that’s tied to thousands of rapes and car collisions is manly. The drug that brings you peace, joy, and compassion is not.

Think about the things that the mainstream objected to about Hippies: Men with long hair and makeup, women wearing pants, bright colors, flowery patterns, kindness and peacemongering—all threats to the patriarchal order.

Whatever it is, we need to stop. Millions of people are suffering, and we could so easily help them; all we need to do is stop locking people up for taking medicine.

Are people basically good?

PNRJ core principles, ethics, tribal paradigm , , , , , , , , , , , , , ,

Mar 20 JDN 2459659

I recently finished reading Human Kind by Rutger Bregman. His central thesis is a surprisingly controversial one, yet one I largely agree with: People are basically good. Most people, in most circumstances, try to do the right thing.

Neoclassical economists in particular seem utterly scandalized by any such suggestion. No, they insist, people are selfish! They’ll take any opportunity to exploit each other! On this, Bregman is right and the neoclassical economists are wrong.

One of the best parts of the book is Bregman’s tale of several shipwrecked Tongan boys who were stranded on the remote island of ‘Ata, sometimes called “the real Lord of the Flies“ but with an outcome quite radically different from that of the novel. There were of course conflicts during their long time stranded, but the boys resolved most of these conflicts peacefully, and by the time help came over a year later they were still healthy and harmonious. Bregman himself was involved in the investigative reporting about these events, and his tale of how he came to meet some of the (now elderly) survivors and tell their tale is both enlightening and heartwarming.

Bregman spends a lot of time (perhaps too much time) analyzing classic experiments meant to elucidate human nature. He does a good job of analyzing the Milgram experiment—it’s valid, but it says more about our willingness to serve a cause than our blind obedience to authority. He utterly demolishes the Zimbardo experiment; I knew it was bad, but I hadn’t even realized how utterly worthless that so-called “experiment” actually is. Zimbardo basically paid people to act like abusive prison guards—specifically instructing them how to act!—and then claimed that he had discovered something deep in human nature. Bregman calls it a “hoax”, which might be a bit too strong—but it’s about as accurate as calling it an “experiment”. I think it’s more like a form of performance art.

Bregman’s criticism of Steven Pinker I find much less convincing. He cites a few other studies that purported to show the following: (1) the archaeological record is unreliable in assessing death rates in prehistoric societies (fair enough, but what else do we have?), (2) the high death rates in prehistoric cultures could be from predators such as lions rather than other humans (maybe, but that still means civilization is providing vital security!), (3) the Long Peace could be a statistical artifact because data on wars is so sparse (I find this unlikely, but I admit the Russian invasion of Ukraine does support such a notion), or (4) the Long Peace is the result of nuclear weapons, globalized trade, and/or international institutions rather than a change in overall attitudes toward violence (perfectly reasonable, but I’m not even sure Pinker would disagree).

I appreciate that Bregman does not lend credence to the people who want to use absolute death counts instead of relative death rates, who apparently would rather live in a prehistoric village of 100 people that gets wiped out by a plague (or for that matter on a Mars colony of 100 people who all die of suffocation when the life support fails) rather than remain in a modern city of a million people that has a few dozen murders each year. Zero homicides is better than 40, right? Personally, I care most about the question “How likely am I to die at any given time?”; and for that, relative death rates are the only valid measure. I don’t even see why we should particularly care about homicide versus other causes of death—I don’t see being shot as particularly worse than dying of Alzheimer’s (indeed, quite the contrary, other than the fact that Alzheimer’s is largely limited to old age and shooting isn’t). But all right, if violence is the question, then go ahead and use homicides—but it certainly should be rates and not absolute numbers. A larger human population is not an inherently bad thing.

I even appreciate that Bregman offers a theory (not an especially convincing one, but not an utterly ridiculous one either) of how agriculture and civilization could emerge even if hunter-gatherer life was actually better. It basically involves agriculture being discovered by accident, and then people gradually transitioning to a sedentary mode of life and not realizing their mistake until generations had passed and all the old skills were lost. There are various holes one can poke in this theory (Were the skills really lost? Couldn’t they be recovered from others? Indeed, haven’t people done that, in living memory, by “going native”?), but it’s at least better than simply saying “civilization was a mistake”.

Yet Bregman’s own account, particularly his discussion of how early civilizations all seem to have been slave states, seems to better support what I think is becoming the historical consensus, which is that civilization emerged because a handful of psychopaths gathered armies to conquer and enslave everyone around them. This is bad news for anyone who holds to a naively Whiggish view of history as a continuous march of progress (which I have oft heard accused but rarely heard endorsed), but it’s equally bad news for anyone who believes that all human beings are basically good and we should—or even could—return to a state of blissful anarchism.

Indeed, this is where Bregman’s view and mine part ways. We both agree that most people are mostly good most of the time. He even acknowledges that about 2% of people are psychopaths, which is a very plausible figure. (The figures I find most credible are about 1% of women and about 4% of men, which averages out to 2.5%. The prevalence you get also depends on how severely lacking in empathy someone needs to be in order to qualify. I’ve seen figures as low as 1% and as high as 4%.) What he fails to see is how that 2% of people can have large effects on society, wildly disproportionate to their number.

Consider the few dozen murders that are committed in any given city of a million people each year. Who is committing those murders? By and large, psychopaths. That’s more true of premeditated murder than of crimes of passion, but even the latter are far more likely to be committed by psychopaths than the general population.

Or consider those early civilizations that were nearly all authoritarian slave-states. What kind of person tends to govern an authoritarian slave-state? A psychopath. Sure, probably not every Roman emperor was a psychopath—but I’m quite certain that Commodus and Caligula were, and I suspect that Augustus and several others were as well. And the ones who don’t seem like psychopaths (like Marcus Aurelius) still seem like narcissists. Indeed, I’m not sure it’s possible to be an authoritarian emperor and not be at least a narcissist; should an ordinary person somehow find themselves in the role, I think they’d immediately set out to delegate authority and improve civil liberties.

This suggests that civilization was not so much a mistake as it was a crime—civilization was inflicted upon us by psychopaths and their greed for wealth and power. Like I said, not great for a “march of progress” view of history. Yet a lot has changed in the last few thousand years, and life in the 21st century at least seems overall pretty good—and almost certainly better than life on the African savannah 50,000 years ago.

In essence, what I think happened was we invented a technology to turn the tables of civilization, use the same tools psychopaths had used to oppress us as a means to contain them. This technology was called democracy. The institutions of democracy allowed us to convert government from a means by which psychopaths oppress and extract wealth from the populace to a means by which the populace could prevent psychopaths from committing wanton acts of violence.

Is it perfect? Certainly not. Indeed, there are many governments today that much better fit the “psychopath oppressing people” model (e.g. Russia, China, North Korea), and even in First World democracies there are substantial abuses of power and violations of human rights. In fact, psychopaths are overrepresented among the police and also among politicians. Perhaps there are superior modes of governance yet to be found that would further reduce the power psychopaths have and thereby make life better for everyone else.

Yet it remains clear that democracy is better than anarchy. This is not so much because anarchy results in everyone behaving badly and causes immediate chaos (as many people seem to erroneously believe), but because it results in enough people behaving badly to be a problem—and because some of those people are psychopaths who will take advantage of power vacuum to seize control for themselves.

Yes, most people are basically good. But enough people aren’t that it’s a problem.

Bregman seems to think that simply outnumbering the psychopaths is enough to keep them under control, but history clearly shows that it isn’t. We need institutions of governance to protect us. And for the most part, First World democracies do a fairly good job of that.

Indeed, I think Bregman’s perspective may be a bit clouded by being Dutch, as the Netherlands has one of the highest rates of trust in the world. Nearly 90% of people in the Netherlands trust their neighbors. Even the US has high levels of trust by world standards, at about 84%; a more typical country is India or Mexico at 64%, and the least-trusting countries are places like Gabon with 31% or Benin with a dismal 23%. Trust in government varies widely, from an astonishing 94% in Norway (then again, have you seen Norway? Their government is doing a bang-up job!) to 79% in the Netherlands, to closer to 50% in most countries (in this the US is more typical), all the way down to 23% in Nigeria (which seems equally justified). Some mysteries remain, like why more people trust the government in Russia than in Namibia. (Maybe people in Namibia are just more willing to speak their minds? They’re certainly much freer to do so.)

In other words, Dutch people are basically good. Not that the Netherlands has no psychopaths; surely they have a few just like everyone else. But they have strong, effective democratic institutions that provide both liberty and security for the vast majority of the population. And with the psychopaths under control, everyone else can feel free to trust each other and cooperate, even in the absence of obvious government support. It’s precisely because the government of the Netherlands is so unusually effective that someone living there can come to believe that government is unnecessary.

In short, Bregman is right that we should have donation boxes—and a lot of people seem to miss that (especially economists!). But he seems to forget that we need to keep them locked.