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Most of What you know about Addiction is wrong
In Most of What You Know About Addiction is Wrong, distinguished psychiatrist Anirudh Kala debunks common myths on the largely misunderstood topic of addiction. The book introduces readers to the ways in which humankind has been engaging with addictive substances over time and our complicated ongoing relationship with them. Beginning with the early humans and the formation of their bonds with mindaltering substances, it goes on to share a comprehensive account of the use of various substances in India with a special focus on Punjab. In the late 80s, drug addiction peaked in Punjab and it continues to be a major public health concern today. The book closely examines the links between addiction and the social and economic changes plaguing the state, urging policy makers and law enforcement to stop viewing addiction through a moralistic prism and to adopt a more holistic and scientific approach to manage it. Both the history and the science of addiction are explained in an easy-to-read, accessible style. The nature-versus-nurture debate about the origins of addiction also feature prominently in the book. The benefits of decriminalization and legalization of addictive substances, which countries like Portugal have achieved through pragmatic initiatives are substantiated with ample data. Statistics about the number of people using drugs or affected by addictions are not just quoted; readers are shown how to derive meaning from this data. Most of What You Know About Addiction is Wrong sends out a set of well-researched, informed and timely messages about how mature societies should be handling addictive drugs. This makes the book essential reading for policy makers, politicians, health professionals as well as general readers everywhere.
248 pages, Paperback
Published May 10, 2023
3 people are currently reading
23 people want to read
About the author
Anirudh Kala
9 books3 followersAnirudh Kala is a psychiatrist by profession and Clinical Director of Mind Plus, Ludhiana in Punjab. The latter is an intermediate stay facility for treatment of psychiatric illnesses and substance use disorders. He was a member of the expert group tasked by Government of India with writing Mental Health Policy for the country, which was released in 2014.
He also writes fiction and has published several short stories. An anthology of interconnected stories, Unsafe Asylum: Stories of Partition and Madness was published in 2018 by Speaking Tiger books. Two and a Half Rivers is a novel based on a young Dalit couple caught in the vortex of terrorism in Punjab and is his second work of fiction. A non-fiction book Most of What You Know About Addiction is Not True with focus on addictions in Punjab will be released early next year.
He has been instrumental in forging cross border links between two sides of Punjab and is founder of “Indo-Pak Punjab Psychiatric Society.”
He is fond of Urdu poetry, travelling and semi-classical music.
He also writes fiction and has published several short stories. An anthology of interconnected stories, Unsafe Asylum: Stories of Partition and Madness was published in 2018 by Speaking Tiger books. Two and a Half Rivers is a novel based on a young Dalit couple caught in the vortex of terrorism in Punjab and is his second work of fiction. A non-fiction book Most of What You Know About Addiction is Not True with focus on addictions in Punjab will be released early next year.
He has been instrumental in forging cross border links between two sides of Punjab and is founder of “Indo-Pak Punjab Psychiatric Society.”
He is fond of Urdu poetry, travelling and semi-classical music.
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August 5, 2023
A psychiatrist by profession and a member of the expert group related to drafting the mental health policy for India, Dr. Anirudh Kala is a credible voice to write on this contentious topic. There is a lack of understanding among the general population on what makes a drug, its addiction, the ways to counter it, and the need for liberal policies. As the preface points out, there is a lack of comprehensive literature pertaining to the topic of addiction, and this book rightly serves as a preliminary reading to understand the nuanced elements, such as decriminalization, legalization, rehabilitation, and deaddiction, as well as the fundamentals of various classes of drugs.
Firstly, to understand why we consume certain drugs, even if not in the manner of addiction, but in amounts that make it pleasurable, we need to understand the mechanism of the reward function in the brain. Dr. Kala rightly points out, "The reward is a feeling of pleasure often described as ‘high’. All addictive substances and addictive behaviors affect this circuit. This brain circuit also happens to be the same part of the brain responsible for normal motivation and the desire for a reward. Normally, to achieve a reward system, a person involves hard work or the pursuit of a hobby that brings pleasure, but that sustained diligence takes some time before it brings a reward. Drugs provide a shortcut to pleasure by causing an intense activation of the reward system. Because the reward can now be obtained through a shorter, much easier route, one does not have to ‘work’ for it."
One of the most fascinating topics in the book is the author’s hypothesis on how the saturated agrarian economy of Punjab and the lack of industrial development facilitated drug addiction among the educated youths of the State. This warrants immediate reforms in the agriculture sector, where the income has remained stagnant for the past few decades after the Green Revolution. Hailing from the same state, Dr. Kala provides multiple anecdotes to point out the general fallacies carried out by the State in tackling addiction at public policy levels. The policy framework often drafted solely by politicians and civil servants lacks the scientific understanding of addiction.
With urbanization proliferating the culture where drinking alcohol is passed as a ‘way of socialization’ or for ‘relaxation,’ Dr. Kala has given a profound summary of the perils of alcohol and the irony behind some drugs being illegal while alcohol, with the highest potential for harm, gets a free pass. Though the addiction rates for alcohol are lower in India, the sooner we move away from the discussion regarding ‘total prohibition,’ the better we will be at handling consumption. The rational ways to strike a balance are to raise taxes on liquor and utilize the collected revenue for public healthcare, to impose additional duties on alcohol carried across boundaries, and to implement age verification at the point of sale.
The book also discusses why some people get addicted while others don't. The scientific literature points to two factors: genetics and environment. Though genetic factors are crucial, the social environment in which the consumer finds themselves plays an important role as well. Interestingly, people who had abusive relationships and painful experiences with their parents and faced sexual violence during childhood tend to end up addicted. In addition, unemployment, peer pressure, parental attitude, and cultural sanction are other major social factors leading to addiction.
In answering the question ‘How much is too much?’, Dr. Kala rightly stuck with the updated scientific consensus that ‘no amount of alcohol is safe’. There were times in the early 60s and 70s when smoking was culturally sanctioned and even considered healthy, with manufacturers pumping money into advertisements until the established scientific consensus linking smoking with lung cancer emerged. Today, a sense of sanity prevails in acknowledging that smoking is injurious to health, and we are probably a few decades away from acknowledging the same with respect to alcohol.
The book argues that in the ethical dilemma faced by the state between liberalization and prohibition, science should take center stage. To what extent we can inculcate this scientific temper depends on what kind of informed conversation we have around the topic of drugs. And to have many such conversations, this book is a must-read.
Firstly, to understand why we consume certain drugs, even if not in the manner of addiction, but in amounts that make it pleasurable, we need to understand the mechanism of the reward function in the brain. Dr. Kala rightly points out, "The reward is a feeling of pleasure often described as ‘high’. All addictive substances and addictive behaviors affect this circuit. This brain circuit also happens to be the same part of the brain responsible for normal motivation and the desire for a reward. Normally, to achieve a reward system, a person involves hard work or the pursuit of a hobby that brings pleasure, but that sustained diligence takes some time before it brings a reward. Drugs provide a shortcut to pleasure by causing an intense activation of the reward system. Because the reward can now be obtained through a shorter, much easier route, one does not have to ‘work’ for it."
One of the most fascinating topics in the book is the author’s hypothesis on how the saturated agrarian economy of Punjab and the lack of industrial development facilitated drug addiction among the educated youths of the State. This warrants immediate reforms in the agriculture sector, where the income has remained stagnant for the past few decades after the Green Revolution. Hailing from the same state, Dr. Kala provides multiple anecdotes to point out the general fallacies carried out by the State in tackling addiction at public policy levels. The policy framework often drafted solely by politicians and civil servants lacks the scientific understanding of addiction.
With urbanization proliferating the culture where drinking alcohol is passed as a ‘way of socialization’ or for ‘relaxation,’ Dr. Kala has given a profound summary of the perils of alcohol and the irony behind some drugs being illegal while alcohol, with the highest potential for harm, gets a free pass. Though the addiction rates for alcohol are lower in India, the sooner we move away from the discussion regarding ‘total prohibition,’ the better we will be at handling consumption. The rational ways to strike a balance are to raise taxes on liquor and utilize the collected revenue for public healthcare, to impose additional duties on alcohol carried across boundaries, and to implement age verification at the point of sale.
The book also discusses why some people get addicted while others don't. The scientific literature points to two factors: genetics and environment. Though genetic factors are crucial, the social environment in which the consumer finds themselves plays an important role as well. Interestingly, people who had abusive relationships and painful experiences with their parents and faced sexual violence during childhood tend to end up addicted. In addition, unemployment, peer pressure, parental attitude, and cultural sanction are other major social factors leading to addiction.
In answering the question ‘How much is too much?’, Dr. Kala rightly stuck with the updated scientific consensus that ‘no amount of alcohol is safe’. There were times in the early 60s and 70s when smoking was culturally sanctioned and even considered healthy, with manufacturers pumping money into advertisements until the established scientific consensus linking smoking with lung cancer emerged. Today, a sense of sanity prevails in acknowledging that smoking is injurious to health, and we are probably a few decades away from acknowledging the same with respect to alcohol.
The book argues that in the ethical dilemma faced by the state between liberalization and prohibition, science should take center stage. To what extent we can inculcate this scientific temper depends on what kind of informed conversation we have around the topic of drugs. And to have many such conversations, this book is a must-read.
August 17, 2023
As a cop, the title of the book drew me towards reading it. As a cop working in Himachal Pradesh, I have had the experience of dealing with the problem of rising drug abuse in the society and the many facets of it.
The author Dr. Anirudh Kala, a psychiatrist by profession explains about the many myths associated with the topic of addiction which is heavily misunderstood by large sections of the society. The book begins with the historical context of how narcotic drugs like opium, cannabis were commonly used by humans since 10,000 years ago.
With a special focus on Punjab, it discusses about how the people in the region have been engaging with addictive substances since long. The author draws parallel on how socio-economic changes in Punjab combined with the legal restrictions have resulted in the changing profile of drugs being consumed especially after the 'war on drugs' campaign started by the US resulting in the adoption of UN Conventions and international treaties against narcotic drugs and psychotropic substances. As a result, the most visible and harmful effect of prohibition has been that the consumers have moved towards stronger, concentrated drugs due to ease of smuggling and lesser detection during transit. The book also explains about the many stereotypes faced by addicts resulting in social exclusion and further mental health issues. Then, it moves on to do a critical review about the Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985 - it's provisions, shortcomings in enforcement especially in Punjab. The challenge faced by the police while dealing with a drug addict is an ethical dilemma of whether to treat him as a criminal to be punished or as a victim to be provided medical intervention.
In Chapter 5 of the book, the author talks about the contradictions in the very definition of drugs by excluding tobacco and alcohol due to vested interests by the western countries. He also argued how alcohol and tobacco are more dangerous, harmful and addictive compared to the other "drugs". The book moves on to explain about how over dosage deaths are largely due to absence of regulation and quality control of illicit drugs.
Towards the end of the book, the author talks about the various shortcomings in the prevailing treatment infrastructure in the country. Also how addiction needs to viewed as a long term disease like diabetes that required medical interventions on a continuous basis for helping the patients. Environmental and genetic factors also play a major role as far as addiction is concerned and it is not necessary that all those who consume drugs become addicts. The problem of drug addiction is here to stay. The author gives successful models of countries like Portugal, Switzerland which can be adopted in tackling this challenge in the long run. The author also makes a distinction between legalization and decriminalisation of drugs. Beyond the regular drug awareness programs being conducted, the author gives a comprehensive set of recommendations that need to adopted systematically with a scientific approach.
As Kofi Annan said, "Drugs have destroyed many lives, but wrong government policies have destroyed many more". I would strongly suggest my fellow cops and bureaucrats to read this book. It will lead us to look at the problem of substance abuse in a different perspective so that better solutions come forward in saving the future generations especially the youngsters.
The author Dr. Anirudh Kala, a psychiatrist by profession explains about the many myths associated with the topic of addiction which is heavily misunderstood by large sections of the society. The book begins with the historical context of how narcotic drugs like opium, cannabis were commonly used by humans since 10,000 years ago.
With a special focus on Punjab, it discusses about how the people in the region have been engaging with addictive substances since long. The author draws parallel on how socio-economic changes in Punjab combined with the legal restrictions have resulted in the changing profile of drugs being consumed especially after the 'war on drugs' campaign started by the US resulting in the adoption of UN Conventions and international treaties against narcotic drugs and psychotropic substances. As a result, the most visible and harmful effect of prohibition has been that the consumers have moved towards stronger, concentrated drugs due to ease of smuggling and lesser detection during transit. The book also explains about the many stereotypes faced by addicts resulting in social exclusion and further mental health issues. Then, it moves on to do a critical review about the Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985 - it's provisions, shortcomings in enforcement especially in Punjab. The challenge faced by the police while dealing with a drug addict is an ethical dilemma of whether to treat him as a criminal to be punished or as a victim to be provided medical intervention.
In Chapter 5 of the book, the author talks about the contradictions in the very definition of drugs by excluding tobacco and alcohol due to vested interests by the western countries. He also argued how alcohol and tobacco are more dangerous, harmful and addictive compared to the other "drugs". The book moves on to explain about how over dosage deaths are largely due to absence of regulation and quality control of illicit drugs.
Towards the end of the book, the author talks about the various shortcomings in the prevailing treatment infrastructure in the country. Also how addiction needs to viewed as a long term disease like diabetes that required medical interventions on a continuous basis for helping the patients. Environmental and genetic factors also play a major role as far as addiction is concerned and it is not necessary that all those who consume drugs become addicts. The problem of drug addiction is here to stay. The author gives successful models of countries like Portugal, Switzerland which can be adopted in tackling this challenge in the long run. The author also makes a distinction between legalization and decriminalisation of drugs. Beyond the regular drug awareness programs being conducted, the author gives a comprehensive set of recommendations that need to adopted systematically with a scientific approach.
As Kofi Annan said, "Drugs have destroyed many lives, but wrong government policies have destroyed many more". I would strongly suggest my fellow cops and bureaucrats to read this book. It will lead us to look at the problem of substance abuse in a different perspective so that better solutions come forward in saving the future generations especially the youngsters.
Displaying 1 - 2 of 2 reviews