The definitions of use and abuse, dependence and addiction can be blurry, whether debated by treatment providers or a user’s concerned peers. Questioning the meaning of addiction as a diagnostic term was the purpose of a conference sponsored by the New York State Psychological Association (NYSPA) at New School University in Manhatten, April 23, 2004. “Going Too Far: When the Ordinary Becomes Addictive” drew students, clinicians, and researchers from New York and the surrounding New England areas to examine the question.
The harm reduction paradigm was not only accepted at this mainstream psychology conference, it actually seemed to be considered the ideal. Leading harm reduction psycho- therapist Andrew Tatarsky, PhD, was at the top of the speaker lineup, setting a tone for the rest of the day. He challenged the “drug war mentality” that blames society’s drug problems on drugs, and outlined the harm reduction approach, which emphasizes the user’s relationship with, motives for, and methods of drug use.
Stanton Peele, PhD, J.D., whose once radical ideas about substance abuse and addic- tion have now become the norm, challenged the audience with still more controversial insights about the relative ineffectiveness of substance abuse treatment compared to no treatment at all. Also on the recreational drug panel was social worker Sippio Michael Small, C.S.W., who offered a racial perspective on drug use with observations from his work with children of color. A mostly educated, white-collar, Caucasian audience re- mained transfixed as Small explained how it is illegal in his hometown of Harlem to pass around a brown-bagged bottle of liquor in the park, while a few blocks away fancy street cafes serve wine and beer on the sidewalk to people of a different socio-economic back- ground.
Psychiatric medications earned their own panel, classified separately from illegal drugs in the conference (just like in the federal government regulatory systems). Presi- dent of the NYSPA Division of Addictions Julie Barnes, PhD, presented several scenarios in which patients “tricked” their doctors into prescribing a medications for recreational or otherwise illicit reasons. Robert Forman, PhD, of the Treatment Research Institute, gave an illuminating lecture on the availability of drugs on the Internet. Addictions psychia- trist Mark Green, MD, explained how heroin use has been replaced by use of prescription opioids such as oxycodone among teenagers.
Other panels at the conference addressed addictive patterns of eating and sex. This further served to lessen the stigma on addicts and take the emphasis off of the objects of their addictive behaviors. The therapists themselves could all accept and relate to the pleasures of eating and sex, even though many of them may have been inexperienced with the pleasures of drug use.
Changing views on addiction reflect a step forward in our society’s understanding of drugs. While addiction is a lesser problem in the psychedelic community than in some other communities of drug users, the issue of drug addiction influences the moral and legal classification of all drugs. At this conference, I saw mainstream psychologists embracing the harm reduction model-yet another sign that the prohibitionist paradigms are changing. As the harm reduction model switches the responsibility to the user, and not the substance used, psychologists and the rest of the public may re-evaluate psyche- delics and marijuana, noting the often beneficial ways these substances are used. By switching the control, and the blame, away from the drugs themselves-we come one step closer to changing outdated drug prohibitory laws.