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MOYERS INTERVIEW | PAGE 2 OF 2_ The great question in my mind is: When you talk about the illness model, what are the risks of that? Because you do see instances where harshness is actually beneficial for people because it wakes them up and shakes them out of a pattern and forces them to change. Bill: This is why one has to approach the subject with humility. You can say harshness or coercion might be a good general principle for some, not for all. In the policy show, there are two women that I interviewed in the Arizona prison. One is the red-headed journalism student, the other is the Hispanic woman. And the Hispanic woman says to me: "I think if I were not here, I'd be dead now." And the implication is: This was good for me. Both are out now. The journalism student is doing OK, the Hispanic woman has disappeared into the streets again. She got no treatment while she was there. She got out of jail. She had no place to go. I do think society needs to be a deterrent, not in a harsh way but in an effective way. But I don't think that you can construct a one-size-fits-all policy that says everybody is going to benefit from coercion. There are two issues, it seems to me. I wrestle with this existential question of pleasure and the varieties of pleasure that are available to us. The other's political. But one of the reasons we treat certain drugs differently is because there's historically a racial cast to them. Cocaine was never considered a really serious issue in the early part of this century, even though it was widely used among the privileged classes. It's when blacks began to get access to cocaine and all the old stereotypes, particularly in the South, where cheap coke was available, that people began to get scared about their lives and scared about the black menace and all of that. And that's not Moyers' opinion; that's been documented in study after study. And this hypocrisy between the legal and the illegal drugs -- what we need is a policy based on life, which is nuanced and subtle and makes distinctions and is able to refine its focus so that you can deal with one cohort or population differently from another because the DNA is different. We don't have that. Americans have broad policies that acknowledge little room for distinction such as the Europeans, the Swiss [where a government-funded study has for three years provided heroin to serious addicts]. Now, we'll see the results of that over time, but it seems to me that makes sense. Somebody said to me the other day: "What can you do about heroin addiction?" And I said: "Well, the first you could do is methadone." "Oh, I don't want him" -- and then he stopped and said: "Well, I would think that that's just substituting one addiction for another." And I said: "Well, look, the best advice I can give you is talk to a doctor, talk to an expert. But just on the basis of our reporting, try methadone as a beginning." I said, "Look, on heroin, whoever you're talking about"-- and I knew it had to be some member in the family -- "at least can hold a job and function as a parent, can go about the daily routine as long as he or she gets that Methadone." But you could see instantly the cobwebs of ignorance moving around that brain and blocking any subtle, modest progress. Let's say a cocaine user decides to quit. And if he's lucky enough, he gets detoxification and 28 days of treatment somewhere. His brain does not renormalize for about six months. What's he supposed to do in the next five months? If he doesn't have some kind of support system while his brain is normalizing, while the levels of dopamine are getting back to normal -- and he said with some people it may be a year before dopamine reaches a normal level -- what is that person supposed to do? They're feeling the need almost every minute. And they literally do need something; they need dopamine. So he said we have to construct some kind of support system to support people who just come in and say they want to quit. As it is, we're turning away almost everybody. There's a tiny percentage of people who can get treatment. And we also don't have a cultural network, a support system for people in this early recovery stage. It seems to me that point you're making about Methadone is that there are things that are better than sobriety, that sobriety is not a cut-and-dried concept. I mean, there's functioning in the world, there's being a responsible person. Bill: I'm not sure I would say that there's some things better than sobriety -- sobriety is desirable if you can achieve it. If you cannot achieve sobriety, there are ways to be in the world more creatively and productively and joyously even if you're not in sobriety, that there are ways to cope in the world that are better than the stark choice of addiction or sobriety. I do believe that with Cope, for our son, sobriety is the ideal, and he's achieved it. He loves it. Judith: He loves sobriety. He gets a kick out of sobriety. A lot of people do. Bill: The minister at the end of our series, Albert Brown, I thought he came very close to a remarkable analysis when he said what we need to do is to become a recovering nation. We're never going to become a sober nation; that's just apparently not endemic in human nature. Noah comes off the ark, in the famous story, and builds an altar to God, I guess out of gratitude for his life being saved, is the metaphor we suggest, and then the next thing he does is get drunk and abuse his grandchildren. I mean, it's there in the saga human beings have told ourselves for years. Albert Brown says we've got to become a recovering society where we are willing to embrace all the varieties of cooperation and assistance that are required by the individuality of each particular person. Out in Minnesota, where our son now lives, it's not a perfect state, it's not a sober state, but it's a state where recovering people feel they are in the embrace of an understanding community, and where employers understand that a relapse is no reason to fire somebody, it's a reason for helping that person get back into the path of recovery, and where the police know if they pick somebody up who's using, that rather than haul them down in handcuffs they can help him with what's obviously a problem.
Joshua Wolf Shenk is a former staff writer at U.S. News and World Report. He lives in Washington, D.C.
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