"The Neuroethics of Pleasure and Addiction in Public Health Strategies"

The Neuroethics of Pleasure and Addiction in Public Health Strategies; Moving Beyond Harm Reduction: Funding the Creation of Non-Addictive Drugs and Taxonomies of Pleasure by Robin Mackenzie has been published in the current issue of Neuroethics:

Abstract

We are unlikely to stop seeking pleasure, as this would prejudice our health and well-being. Yet many psychoactive substances providing pleasure are outlawed as illicit recreational drugs, despite the fact that only some of them are addictive to some people. Efforts to redress their prohibition, or to reform legislation so that penalties are proportionate to harm have largely failed. Yet, if choices over seeking pleasure are ethical insofar as they avoid harm to oneself or others, public health strategies should foster ethical choice by moving beyond current risk management practices embodied in the harm reduction movement. The neuroscience of pleasure has much to offer neuroethics and public health strategies. Distinguishing between ‘wanting’ and ‘liking’ fosters new understandings of addiction. These hold promise for directing the search for pharmacotherapies which prevent addiction and relapse or disrupt associated neuromechanisms. They could inform new research into creating lawful psychoactive substances which give us pleasure without provoking addiction. As the health and well being of human and other animals rests upon the experience of pleasure, this would be an ethical objective within public health strategy. Were ethical and neurobiological obstacles to ending addiction to be overcome, problems associated with excessive consumption, the lure of unlawful psychoactive substances and the paucity of lawful means to achieve pleasurable altered states would remain. Non-addictive designer drugs, which reliably provided lawful access to pleasures and altered states, would ameliorate these public health concerns insofar as they fostered citizens’ informed, ethical choices according to a neurobiological taxonomy of pleasures.

Comments

[Julia]

Seeing exciting articles like this one in Neuroethics makes me wish I could afford to read it.

The author is absolutely right that drug prohibition has failed. However, I disagree that efforts at reform have "largely failed." 14 states have decriminalized marijuana and 17 states have legalized medical marijuana. The U.S. FDA has approved research on MDMA for treatment of PTSD. Portugal has decriminalized all drug use. I agree that there is a lot of work to be done, but to say efforts have "largely failed" ignores the drastic paradigm shift from when Nixon declared drugs "public enemy #1" 30 years ago.

Also, the author seems to assume psychoactive substances that might prevent addiction or provide pleasure without being addictive need to be created. Natural psychoactive substances such as ayahuasca and iboga have proven to help people overcome addiction. (http://www.foxnews.com/health/2011/07/25/psychedelics-for-drug-addiction/)In my opinion, other illicit substances such as MDMA, marijuana, LSD are not addictive. Creating non-addictive designer drugs is a good idea, but we also need to legalize the ones that already exist.