Researchers argue 'addiction' a poor way to understand the normal use of drugs

A new review from UK and German researchers claims that the vast majority of people who routinely use drugs are using them to achieve their goals and cope better with the stresses of modern life.

Christian Muller and Gunter Schumann suggest that drugs, from alcohol and nicotine through to ecstasy and even cocaine, can have ‘beneficial effects for an individual in modern environments’. They argue for an acknowledgment that typical, non-addicted use of drugs by many people improves their experience, behavior, or performance in various contexts such as career or social life. By accepting this reality, they suggest, drugs advice in schools and clinical settings can be made more realistic and effective.

Muller and Schumann acknowledge the risk that a fraction of users will become addicted or engage in risky drug related behavior but they advocate that giving realistic advice based on how the majority of people are using drugs would actually help to cut addiction rates:

“A better understanding of the mechanisms of drug use in non-addicts might serve to better prevent the transition to drug addiction in the future.”

In the journal of Behavioral and Brain Sciences published by Cambridge University Press, Muller and Schumann’s article, 'Drugs as instruments – a new framework for non-addictive psychoactive drug use', introduces the concept that drugs are being routinely used by many as helpful ‘instruments’ in their lives.

After an exhaustive trawl of scores of studies into drug use, they claim that most regular consumers of drugs are not, and will never become, addicts. While considerable research effort has been made to understand drug addiction and how it develops, they write, there has been no similar attempt to research the beneficial effects of drugs on non-addicted users.

Presenting a new framework for non-addictive drug use, they list the advantages reported by people engaged in this behavior, including beneficial effects on mood enhancement, stress reduction, sociability, mental health, long-term cognitive functioning and work performance.

Muller and Schumann write: “We propose that the majority of non-addicted humans, who consume psychoactive drugs as a normal part of their life take drugs because their effects are useful for their personal goals. When it comes to using drugs or other stimulants as instruments, for example, most adults can drive a car un-drugged. However, after a long working day, having a last coffee to awake and refresh the mind may enable the driver to drive home more safely. In this case, caffeine is the instrument that improves the mental state.”

Muller and Schumann go on to suggest that a non-addictive use of drugs may have evolved to help the human race adapt to different aspects of life, and that we have learned to use drugs in ways that enhance our chances for survival and reproduction. Examples include alcohol helping a shy person overcome their shyness and initiate a sexual encounter, or amphetamines helping a tired student stay awake and study for crucial exams that will determine success in their professional life.

They also suggest that our modern environment demands that we constantly move between ‘microenvironments’ which require stressful rapid transitions:

“In fast-changing microenvironments, short transition times between mental states may be advantageous. We suggest [that] psychoactive drug use facilitates the transition between different mental states.”

For instance, drugs like alcohol, cocaine, amphetamine and ecstasy help us make the rapid transition from a work microenvironment to a social one: “alcohol reduces social inhibition, social anxiety, and increases talkativeness”. Similarly the demands of modern work microenvironments cause fatigue and declines in cognitive performance: “having the means to ‘artificially’ prolong performance may be a benefit”.

Acknowledging that their thesis has implications for drug policy, they suggest three new approaches:

a. For ‘drug naïve’ individuals, usually adolescent to early adult age, provide information not only on the adverse effects of addiction but also on how drugs are being successfully ‘instrumentalized’: “the goal should not be to prevent drug use in general, but to foster control over it by the individual.”

b. For people who have already integrated drugs in their life’s routines, emphasize the need to stay in control of drug use. In particular, during stressful periods of transition in life, there is an increased danger of developing new forms of drug instrumentalization. Education programms “should aim to train young people to self-analyze their drug instrumentalization”.

c. For people who are at risk of a transition to drug addiction, over-instrumentalization of drugs, and a dependence on the drug to achieve major goals in life, needs to be prevented. A drug-use ‘biography’ should be created predicting whether the user is likely to be able to maintain use of drugs to help with goals or lose control of their use.

Muller and Schumann admit that their ideas will be seen as controversial: “Although we argue for evolutionary benefits of non-addictive drug use, it has to be emphasized that the instrumentalization of psychoactive drugs comes at a price, which ultimately qualifies it as a risky behavior.”