That’s a pretty common idea and a pretty common solution to attempt. Our culture tried that with alcohol back in the 20’s. The argument is that alcohol prohibition decreased drinking and decreased alcoholism even after prohibition ended. Here’s a chart of gallons of alcohol consumed by every 10 people. It shows that, indeed, prohibition (the area of missing data) decreased drinking behavior. Before prohibition on average every 10 people drank 20 gallons a year; after prohibition every 10 people only drank 10 gallons a year.
But what happened to the alcoholics? Did they disappear? Did they stop drinking? Did they use something else? What other common drugs might they have switched to now that they couldn’t get alcohol? Here’s a graph of cigarette use per person. This graph is in 100’s of cigarettes so that in 1920 the average American was smoking about 600-700 a year. By 1934 the average was over 1000. There’s no blank on this graph because there was no prohibition of cigarettes and we have data for every year.
But what if we got the same thing from alcohol as cigarettes? What if the disease of addiction is a brain disease that doesn’t particularly care what drug we use? What would be the effect of alcohol prohibition then? In science when you want to see if two variables interact, one simple way to do that is to multiply them. Since people drink to get dopamine and they smoke to get dopamine, we can see the effect of alcohol prohibition on this made up “Dopamine Load” which is the combined use of cigarettes and alcohol.
I made the preceding graph a close up so you can see that making alcohol illegal didn’t change the combined use of cigarettes and alcohol at all. Just as much of the combination was used after prohibition as before. But you may also notice that the combined use rises a good bit after prohibition. We need to know that there is good evidence that dopamine receptor levels decrease with certain stresses. Remember the equation I showed you; lower dopamine receptors mean lower dopamine signal. Take a look at the next graph in relation to the great depression and World Wars. Notice the drop off at the end of WWII and the blip during Korea, then the rise during the social upheavals of Vietnam and the inflationary spiral of the 70’s.
But did life get a lot easier in America in the 1980’s? We worked on nicotine suppression, and we continued to tell people how dangerous alcohol is. So if they stopped using these drugs as much, did they just need less dopamine? Was Ronald Regan that good a president that no one needed extra dopamine anymore? Or did they switch to something else?
The USDA keeps track of the calories that are taken in per capita every year. Before the 1950’s the data is erratic due to the depression and the rationing during the wars. But you can see that when we got the message about alcohol and cigarettes around 1980, we just went out and found a new reward—excess food.
So what generally happens when we get rid of a drug is that people with addiction are not going to relax and say “Oh well, I guess I’ll just not use it anymore.” They go find another drug.
From “Questions and Answers on Addiction” by Howard Wetsman MD (copyright 2007)
© Howard C Wetsman MD FASAM