Q: In your view, are some addictions more harmful than
others, and what are they?
A: In terms of
damage to population health, the deadliest addictions are to alcohol and
tobacco, because they are legal, and therefore, easy to access, inexpensive,
skillfully marketed and widely available.
Children and
adolescents are the group that suffers the most from addictive drugs, for two
reasons. First, because their brains are still developing, they are
particularly likely to become addicted when they use. You hardly ever, for
example, meet an addicted smoker who didn't start smoking as a teenager.
Second, unlike someone with an addicted boyfriend or sibling or friend,
children don't have the power to escape an addicted parent. They may therefore
endure years of coping with the addiction and with the emotional and physical
abuse that their addicted parent dishes out.
Q: What measures would help reduce addictive behavior in the U.S.?
A: Higher taxes on
alcohol, increased restrictions on the advertising of tobacco products, more
careful prescribing of pain medication by doctors, and greater availability of
addiction treatment would all be helpful. Some progress has been made on all
these fronts, but the basic political problem is that when a drug is legal
(e.g., tobacco, alcohol, prescription pain medication), it is hard to regulate.
Industries that sell the products make large campaign contributions and hire
armies of lobbyists which keep taxes and regulation on their products as
minimal as possible. That's a key reason why the legalization of more drugs,
such as marijuana, will lead to more addiction.
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