No one disputes that America has a problem with drugs. In 2021 alone there were almost 100,000 overdose deaths. This is why we need the government sponsored war on drugs, right?
Just imagine how bad things would be if no one was doing anything to resolve the various issues surrounding drug use. But is that true? Is there any data to support that our policies are even working?
Join us as the late activist David Poses explains why we are thinking about overdoses and drug policy all wrong, and how the War on Drugs is actually a war on our own people – a war that is literally killing us.
David Poses (1976 – 2022) was a writer, speaker, and activist. After hiding his struggle with depression and opioids for twenty years, he started opening up and challenging conventional addiction wisdom. He has been published by the Washington Post, Los Angeles Times, and New York Daily News and has appeared on national TV programs, including The Doctors TV Show, and numerous radio shows and podcasts. With candor, humor, and a unique perspective informed by science and experience, he advocates for evidence-based approaches to drug policy, prevention, and treatment. David lived in New York with his wife and two kids and entirely too many guitars for such a mediocre player. See more at DavidPoses.com. His book, The Weight of Air, can be found on Amazon.
Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.
Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without.
To book Gabe for your next event or learn more about him, please visit gabehoward.com.
Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
The interview you are about to listen to with David Poses was recorded in January of this year. Sadly, David passed away a few weeks later, on February 16th. All of us at Inside Mental Health and Healthline Media were very sorry to hear about David’s death. He made it his life’s mission to help people struggling with mental health challenges and addiction. He will be missed but his influence and legacy will live on. With the permission of his estate and publicist, we are airing this interview exactly as it was recorded.
Announcer: You’re listening to Inside Mental Health: A Psych Central Podcast where experts share experiences and the latest thinking on mental health and psychology. Here’s your host, Gabe Howard.
Gabe Howard: Welcome, everyone. I’m your host Gabe Howard and calling into the show today we have writer, speaker and activist David Poses. He has been published by The Washington Post, Los Angeles Times and The New York Daily News. And he advocates for evidence-based approaches to drug policy, prevention and treatment. David, welcome to the show.
David Poses: It’s great to be here. Thank you for having me.
Gabe Howard: I am 45 years old. So if you do some simple math, you will discover that my formative years were right in the middle of Nancy Reagan’s Just Say No campaign, and, of course, the war on drugs. It was drilled into my head as a child that not only were drugs bad, but in order to save us all, they needed to be outlawed, literally, 100% forbidden. But, David, you maintain that the war on drugs is not only harmful, but it’s actually lethal for people suffering from addiction. How?
David Poses: When something is dangerous, we find ways to make it safer. I mean, that holds true with everything. We’ve got gun locks, we’ve got bike helmets, we’ve got seatbelts. Any legal, regulated substance is going to be safer than anything that you get on the street. I mean, you buy drugs from somebody. You don’t know who the person is. You don’t know what you’re getting. You don’t actually know what’s in the bag. There’s no milligrams, there’s no ingredients. You go to the liquor store and you buy alcohol. It’s got the ABV label. You know exactly what you’re getting. Anybody can pour a drink. You know it’s 40 proof, whatever it is. So with drugs, the reason that people are overdosing is because overdose is an overly potent dose. And if you don’t know the potency of the dose, you have no way to prevent it. Accidental means preventable. How can you prevent overdose, an overly potent dose, if you don’t know how potent the dose is? There’s no question that that is what’s making drugs more dangerous.
Gabe Howard: This explains a little bit, and I want you to expound a little bit more. But you say that alcohol isn’t legal because it’s safer. Alcohol is safer because it’s legal.
David Poses: Sure. I should also mention that I’m also 45 years old, so I went through the same Nancy Reagan program.
Gabe Howard: We’re the right age, yes.
David Poses: Yeah. So alcohol is ubiquitous. Hey, it’s New Year’s. Let’s celebrate with some champagne or, you know, I had a rough day at work. I’m going to unwind with a beer. Whatever it is, there’s always an occasion for alcohol. And we believe that it’s legal because it’s safer. But the laws are what make it safer. During prohibition, alcohol fatalities surged for the same reasons that people are dying today from drugs. You didn’t know what you were getting. If we were together right now and I said, Hey, I’ve got two glasses of alcohol on the table here. I poured you a drink. One of them is methanol and the other is hard seltzer. Have a go. And you didn’t know which was which, you’ve got a 50% chance of dying because the methanol is going to kill you. Right? So knowing what it is, is what makes it safer. It’s the consistency. It’s the known consistent potency, the purity. It’s knowing what you’re getting. That’s all because alcohol is legal. It has nothing to do with alcohol being inherently safer. And as far as the illegal drugs go, I mean, we have these ideas of heroin being this terrible hardcore substance and nobody can possibly function on it and it destroys your life and all of these things that we believe.
David Poses: And yet we know that all over the world, doctors prescribe much more powerful opioids to people for all kinds of chronic physical maladies. Nobody ever says, Oh, my God, you know, Grandma, after hip replacement surgery, she really became an untrustworthy criminal. And you’ve got to watch out because she’s stealing your VCR and she’s violent since she started taking that morphine. So we just, we buy into this propaganda and it’s simply not true. Don’t get me wrong. I’m not suggesting that people should go out and use drugs, but it’s the laws and the stigma that are causing the problems, not the drugs themselves. And the inverse is true with alcohol. It’s so baked into our collective consciousness that drugs are so terrible. You know, heroin is this hardcore substance that’s so bad for you. Alcohol is legal. Obviously, it’s safer than these drugs. The fact is, alcohol can shut down every organ in your body. All other substances, drugs, in the world can’t cause that much damage. Alcohol is so much more addictive than any other substance. That withdrawal can be fatal. It can cause strokes. It can cause heart attacks, can wreak all kinds of havoc on your body. So alcohol is, without question, objectively, infinitely more dangerous than everything else.
Gabe Howard: David. You mentioned that you had an opioid addiction. I know from reading your book that you suffered from depression and addictions. You feel that you were given incorrect information and it caused you further problems than were necessary. So this is very personal for you.
David Poses: It wouldn’t be fair to say I feel that I was given incorrect information, I was given incorrect information. The things that I was told in rehab are simply not true. And I find it outrageous that this information is going around out there. And I understand that a lot of the things that I say, I’m taking some unpopular positions. I live in a small town. I have two kids. I’ve certainly run into all manner of neighbors who tell me I’m out of my mind and irresponsible for saying what I’m saying. But everything that I’m saying is true. These are the facts.
Gabe Howard: Why are so many people so quick to buy into the idea that drugs turn you into a bad person or that only bad people do drugs? It’s everywhere. You could probably randomly pick anybody and say, what’s your opinion on drugs? And they would say, a bunch of dirty addicts do that. People want to believe that drugs are bad, the people that do drugs are bad, everything is bad. And that’s the end of it. That’s where the conversation just naturally wants to stop. Why?
David Poses: It’s not a rational conversation because fear isn’t rational, right? We’re afraid of drugs. If you look at the history of every outlawed substance in America, there is a serious racist catalyst for every drug that has been outlawed, starting from when smoking opium was made illegal in San Francisco in the 1870s. A bunch of white guys were upset the white women were sleeping with the Chinese guys that owned the opium dens. You can look up articles all over the Chicago Tribune, in the New York Times from the 1920s, when there were reports that black men were impervious to bullets when they were on cocaine and God forbid, anybody gets their hands on cocaine. So it’s this fear-based, racist catalyst. And when you look at the data , since 1971, overdose fatalities have only increased year over year since the beginning of the drug war. There is no data anywhere that shows that it’s preventing drug use. It’s obviously making overdose impossible to prevent. I think the problem is also that we have the drug war confused with drug prevention. Laws don’t stop anybody from doing anything. If you’re going to go out and murder somebody, you’re not sitting there going like, well, you know, I really want to kill this guy, but it’s illegal.
David Poses: So I guess I probably shouldn’t do it. Or if you’re going to drive too fast, you’re on your way somewhere and you’re speeding, you’re not discouraged by the laws. The drug war is not curbing drug use. It’s not discouraging drug use. It’s not slowing drug use down. People are using drugs. It’s only making drugs more dangerous. 100,000 overdose fatalities last year. And you can’t find any politician who’s going to tell us, oh, you know, thank God for the drug war, because there would have been many more overdose fatalities. Like nobody, nobody can give us a single reason, a single positive benefit of public health and safety. We all know that it’s failed, but we’re so afraid of this worst-case scenario. You remember in the nineties when Bush was talking about if the drug war ended, there could be as many as 10,000 deaths a year from drugs. If that was the worst-case scenario, it’s here. And right now, we’ve got 100,000 overdose fatalities. The drug war is its own worst-case scenario. Ninety something percent of overdoses involve illicit drugs because you don’t know what you’re putting in your body. So clearly, the legal, regulated drugs are safer.
David Poses: That’s not to say they’re safe and you should use them, again. But 90 something percent versus. The legal, regulated drugs are safer.
Gabe Howard: I think the vast majority of society honestly believes that criminalizing these substances will make people less likely to use them. You seem to be saying that that’s not true.
David Poses: It’s not. I am saying that and it’s not true. When the drug war began, Nixon gave a speech in June of ’71 where he talks about interdiction, it was basically a fool’s errand because if somebody is compelled to use drugs, they’re going to do whatever it takes to get them. And he wasn’t speaking in a, you know, the hyperbolic dope fiend sort of way. He was just saying, you know, look, if somebody wants to use drugs, they’re going to use drugs. So we know that. There’s no information anywhere that suggests otherwise. We never really take a step back and think about that. You’re addicted to drugs. You have this problem, right? It’s illegal. And so we put you in jail because of this. How is that helping you? There’s nothing rehabilitative about that. I’ve never been in jail, but I imagine that if ever there was a time that I was going to really want to get high, that would be it. You know, there’s nothing about this experience that is positive or even remotely proven to be doing what, what we think it does. But we have this idea that that’s what you do. The absence of logic is really, it’s just stunning when you kind of walk it through to its logical conclusion, because we look at it as if the alternative is nothing. If drugs are illegal, so therefore people won’t use drugs. Like it’s it’s either the illegal drugs or nothing.
David Poses: And that’s not what it is. You ask the average parent, do you want your kids to use drugs? No, of course not. Right? Do you want your kids to die from drugs? No, of course not. So in the outrageously unlikely event that 100% of kids don’t listen to their parents and decide to use drugs anyway, would you prefer that they use the safe drugs and have a chance of not dying? Or would you prefer that they just die? I mean, I have this conversation with my mother about the overdose fatalities. And she says, hey, look, if you’re not going to be careful about it, it’s not important enough to you to be safe, and whatever it is, then know, hey. And I said, All right, so what if that was me? Because it’s not about being careful. I mean, it’s not careful measuring. I just didn’t know what I was taking. And this bag of heroin was 20 times more powerful than the last one. And I died. Would you just be like, Oh, well, too bad he wasn’t careful. I guess that sucks. My son is dead. No, of course not. Oh, my God. You’re my kid. You know, how could. No. But who do you think is dying out there? It’s other people’s kids. Everybody has a parent. We don’t think this through.
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Gabe Howard: And we’re back with the author of “The Weight of Air,” David Poses. It seems to me that what you’re saying is that the biggest danger in drug use isn’t the actual drug, but it’s the manufacturing process because there’s no oversight, there’s no standardization. And frankly, the people making it may not care about you at all.
David Poses: The biggest danger in every bag of heroin is not knowing what’s in the bag of heroin. You buy a can of Diet Coke. It’s got all of those words that you can’t pronounce because they’re enormous. You know exactly what’s in there, right? It tells you how much caffeine. It tells you how much that, you know what I’m talking about. Right? It’s the same everywhere. And the same holds true with alcohol. You go buy a bottle of Bacardi rum in Connecticut, it’s going to be exactly the same ingredients with the same potency and purity as the bottle of Bacardi you buy in California. So I buy a bag of heroin on the street from some dealer. Right? What’s in the bag of heroin? How strong is it? Is there an 800 number I can call? Is there a quality assurance statement? What am I going to do if I’m not satisfied with this product? What if it turns out that it’s not even heroin at all? People are dying. Nobody goes up to a drug dealer and says, you know, look, give me the fentanyl analogs that are killing people. That’s what I want. We are a nation in pain, this is an epidemic of untreated pain and pain is physical and it’s emotional, and we’re not doing anything about that. It’s very easy to say, oh, well, you know, you just you, shouldn’t have used heroin. Well, what were the alternatives? I was suicidal when I was 16, and I had plenty of resources. I had therapists, my parents had money. I had it better than most. But my options were if heroin didn’t do what I thought it was going to do, I was going to kill myself. So what do you do for those kids? Like telling a kid to just say no to painkillers when they’re desperately hurting and you’re not giving them an alternative and there’s no resources and there’s all kinds of mental health stigma. What do you think is going to happen?
Gabe Howard: You have a quote where you say that addiction is actually the symptom. Is this what you’re talking about when you talk about addiction being a symptom?
David Poses: Yeah.
Gabe Howard: The mental health challenges, the self-medicating, the painkilling?
David Poses: Yeah, it absolutely is. I mean, anybody can look up addiction in the dictionary. It’s compulsive use despite negative consequences, right? So addiction, the physical, medical condition of you drink a bunch of beer every day for five years or whatever, and then one day you don’t do it. You’re going to get sick. You’re going to be in alcohol withdrawal because you are physically addicted to alcohol. Right. So let’s say you go through alcohol withdrawal, somehow you don’t die. The booze is all out of your system. You have cured your alcohol addiction. You’re sober, you’ve abstained. You’re no longer addicted to alcohol. Right? But addiction is a compulsive use despite negative consequences. Compulsive behavior is a mental health disorder. Nobody’s problem is I can’t stop my arm from pouring booze down my throat. It’s I’m drinking to drown some kind of problem. I’m using drugs to drown some of a problem. My compulsive painkiller use is a compulsion to kill pain. The addiction is a symptom. The physical addiction is definitely, it’s a physical problem, physical condition, no question. But the compulsion to use drugs is a symptom, and we don’t think about that. It’s been so siloed off from science and medicine for so long because it was thought to be an incurable moral defect.
David Poses: And we’ve been listening to Alcoholics Anonymous, which has nothing to do with science or medicine. When they were developed in the 1930s, they labeled addiction a disease in order to reduce stigma because it was thought to be an incurable moral defect. And people just believe this. Perfectly rational people who know that if an oncologist told you, Oh, skip the chemotherapy and the surgery, what you’ve got to do is go to an anonymous support group and ask God for forgiveness and your cancer will go away. That is crazy. And we know that, right? So if we know that that doesn’t work for any other medical condition, and yet, for whatever reason, we think that that’s absolutely true. And it’s the only way to cure your addiction, to go to an AA meeting and all that kind of business. But we’re not looking at why are we using these drugs? What is the pain that we’re trying to kill? Why am I compulsively using painkillers? So the addiction is a symptom and we don’t want to look at that. We just say, oh, well, he’s a drug addict.
Gabe Howard: David, I know there’s going to be a lot of pushback from AA because many people, it has helped them. They believe in it. Their lives are better because of it. What do you say to those people?
David Poses: Alcoholics Anonymous works for a lot of people, and if it works for you, that’s great. I would never discourage anybody from doing anything that works for them. I know a lot of people who go to AA meetings. I know a lot of people whose lives were saved by AA and I couldn’t be happier for them. I also know that it’s not a scientific operation. So there’s a lot of shaming that goes on where we’re told, and this was my problem in rehab, where they said, you’re going to die unless you go to an AA meeting. And I just couldn’t buy into it. There’s AA groups that do incredible work with lots of people who are doing so much better because of it. And there’s something to be said for the camaraderie, like, no question, that’s great. But there are a lot of people who it just doesn’t work for and especially with opioids. Of all of the things that you can be addicted to, whether it’s a substance or gambling or hoarding or sex or whatever it is, opioids are the only thing that have a natural target in your brain. They flood your brain with dopamine and serotonin, and they bind to your opiate receptors and they take hold with a ferocity that is unlike any other substance or vice. It’s like I tell people, heroin was an effective antidepressant and they’re looking at me like I’m speaking some kind of Martian language. How can that possibly be? That’s impossible. People use this stuff for hip replacement surgery pain. How can it possibly do that? Because it kills pain. And depression is emotional pain.
Gabe Howard: You say that sobriety is not the solution to addiction, but how is that even possible? Isn’t sobriety literally the only solution for addiction?
David Poses: Well, sobriety is the solution to addiction, the physical, medical condition. You stop drinking, you’ve solved your physical addiction. Sobriety is not the solution to compulsive drug use, because when you stop a compulsive behavior, you stop the behavior. But you have no insight into why the behavior is taking place and what you can do about it.
Gabe Howard: David, I think that many people think that there are just fundamental differences in the way that different drugs affect the body, like the way that it affects your brain. And for example, the illegal drugs affect your brain differently than, we’ll use alcohol as an example. And that’s what makes it illegal versus legal. Is that true? Is that what they’re basing it on?
David Poses: Well, you know, it’s interesting that you should say that because, I mean, I’m sure you remember the DARE assembly in fifth grade, that, you know, we both went to the same.
Gabe Howard: I do. I have the song stuck in my head. Dare to keep your kids off drugs. It’s. It’s that ingrained in me.
David Poses: Oh, yeah. Yeah. We were told that you can’t drive a car if you drink alcohol. Pot makes you stupid. Cocaine makes you angry. Heroin is the worst drug. I was told about a kid who took LSD and thought he was an orange and peeled off his skin. So that’s why you don’t want to do that. So in early childhood education, drug prevention, we were told that each type of substance affects our neural pathways differently. But we know that. You don’t have to have smoked crack and taken LSD to know that they’re completely different substances that do something different to your brain. I’ve never taken a hallucinogen, but I’m quite certain that it’s different than beer. But we were told when we go to rehab that a drug is a drug as a drug. And drug addicts just want to use drugs and they just shovel drugs into their bodies. And that’s what it is. Why would that be true? That doesn’t actually make sense.
Gabe Howard: One of the things that you say is that the war on drugs is just an unmitigated disaster, and many people would just angrily disagree with you. Why do you say that? And what proof do you have of that being true?
David Poses: It’s an unmitigated disaster because there’s no data that shows anything good that it has done. Right? Yeah, it’s put more people in jail and it’s certainly increased overdose fatalities. Overdose fatalities have increased exponentially beyond exponentially year over year since 1971. Right. More people are in jail. More people are using drugs since the drug war began. So if those are kind of our yardsticks of measure, like if the idea was, well, we should start this war on drugs because we don’t want people to use drugs. And drugs are dangerous and we don’t want people to die. Then that right there, that’s all the information you need. I feel like because it’s not a rational conversation, I can come up with a litany of reasons for legal regulated substances are safer than anything illicit. That’s just common sense. We have plenty of reasons and hard data that shows that drugs are safer when they’re legal and regulated and that overdose is very easy to prevent when you know what you’re putting in your body. I mean, look, if a shot of heroin, the potency of a shot of heroin could be measured as easily as a shot of tequila, then less people would die. I mean, you look at the deaths during alcohol prohibition, it’s the exact same thing. So we know all of these things and yet all of these reasons are never going to be enough for the pro-drug war side because they’re operating from a place of fear.
David Poses: So I think the conversation needs to be turned on its head. What it needs to be is, look, you guys are telling us the drug war is so great and we’ve got 100,000 overdose fatalities and an annual increase year over year since the drug war began. We’ve got more people using drugs. We’re spending $48 billion a year on interdiction. And the DEA can’t stop the bad drugs from entering our country. You’ve got the DEA out there with this one pill can kill message. They restricted prescription opioids a few years ago and now they’re saying, oh, these counterfeit drugs are everywhere over the past couple of years. And we can’t imagine why that happened. Supply and demand. I would say, explain to us how the drug war is working. Tell me why it’s working. Tell me why it’s good for us. Tell me why it’s good that overdose fatalities, that 100,000 deaths is a success. There are no shortage of reasons to end the drug war, whether it’s common sense or scientific data, all of these things. Nobody can give you a single reason why it’s good. What’s the positive health and safety benefit? So, anybody who wants to say that to me, I would just turn the question right back around on them then. It’s kind of unfathomable to me that there really isn’t any data that shows anything good. I kind of can’t believe that, but it’s true. I mean, are you aware of any studies that show that it’s better to have 100,000 overdose fatalities?
Gabe Howard: We know that you would end the drug war. But that’s not so simple. There’s, you know, almost 400 million people in America. This has gone on for a long time. But what would you like to see the policy move toward?
David Poses: We don’t have a drug prevention program, we have a drug war. DARE is not drug prevention. I mean, it’s not education. It makes the assumption that, well, you don’t need any information about these drugs because we told you not to do them. What we’re doing right now, like, it’s just, it’s just not working. We need a drug prevention program. We need real overdose prevention, you can’t prevent overdose if you don’t know what you’re putting in your body. I mean, I don’t mean to oversimplify because it’s obviously a very highly nuanced problem. But it’s actually not as complicated as we think it is. The alcohol model, you just replicate that with drugs. It works. We know it works. It’s been in place for a very long time. Alcohol related fatalities plummeted when prohibition ended because people were able to know what they’re putting in their bodies. Like, look, a pint of beer is going to kill you if you don’t know it’s methanol. So that would solve that problem. The amount of conversations that I’ve had with people where they don’t want to legalize drugs because they’re afraid that they don’t want more people using drugs. And that’s what’s going to happen. And there’s tons of studies that show that that’s not actually what happens. And you can actually walk somebody through that because alcohol is legal. Do you buy beer every time you go to the gas station? No, I mean, nobody does. Would you start using meth if it was legal? And of course not. You say to somebody. Are legal, regulated substances safer than I have no idea what this is, it’s just a bag full of powder? And they all say yes, 100% of people say yes. Right. Okay. So then you understand why less people will die if we did that? Yeah. Okay. So you don’t want to legalize drugs? No, no, no, no. Well, why not? Because I don’t want more people to use drugs. So, it’s like we’re more horrified by the idea of more people using drugs safely than people dying from drugs.
Gabe Howard: David, what effects does a punitive drug policy have on people who are suffering from addiction?
David Poses: You’re punishing people who are suffering. You’re struggling with a physical problem and a mental health disorder. And now we’ve put you in jail. We’re making it impossible for you to get a job. And you can’t see your kids. And, you know, all of these things that go along with it and you’re in jail now. How is that helpful? What about that is helpful? And I don’t think that you can find any politician that’s going to tell you that that’s not true. If there were something to be said for the punitive drug policy, we’d be hearing about it right now. I mean, 100,000 overdose fatalities and you can’t find an elected official with anything good to say about the punitive drug policy or the drug war. If they had anything good to say, they’d be jumping up and down and screaming about it on every TV station. If it was working, they’d be telling us that it’s working and they’d be telling us why it’s working.
Gabe Howard: David, thank you so very much for being here. Where can folks find you and your book?
David Poses: My book called “The Weight of Air,” and you can order it from any bookstore. It’s on Amazon. Any place you buy books. My website is DavidPoses.com.
Gabe Howard: David, thank you so much for being here and a big thank you to all of our listeners as well. wMy name is Gabe Howard and I am the author of “Mental Illness Is an Asshole and Other Observations,” as well as an award winning public speaker who is available for your next event. My book is on Amazon, or you can get a signed copy with free show swag or learn more about me by heading over to my website at gabehoward.com. Please follow or subscribe to the show. It’s absolutely free and recommend the show to your friends and family and colleagues. Do it by email, text, social media. Word of mouth is still a thing. I will see everybody next Thursday on Inside Mental Health.
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