Nora Volkow, Director of the National Institute on Drug Abuse, argues that abusers should be treated the same as anyone with a debilitating disease.

Question: How should drug addicts be treated in society?

Nora Volkow: Drug addiction is a disease of the brain. It's a disease of the brain. We don't put people that have diseases in the jail or in prison because they actually, that's what we decide, right? I don't even dare myself to the concept of putting someone in jail because they have a disease. My brain doesn't even allow me to think that way.

And yet we do that with addicted people and I've thought a lot, why is our society criminalizing the person that's addicted to drugs? And I think it's because it has been very hard for people to recognize that our behaviors and our ability to control our desires is basically the product of very complex systems in the brain that enable us to perceive these desires, to control them, to make the right choices. This is very difficult for people that have all of their faculties intact, to understand that not everybody can do it. And so I sort of easier to say, "Well, if I can do it, that person is not doing it because they are choosing to just have a good time." And so we've taken that approach and I guess the other element that happens with drugs, the drive to take these drugs can be so overpowering, so, so overpowering, because it's hard wiring of the brain, the signaling is this is something that is necessary for survival. That's what drugs have done in a person that's addicted. They've generated the message as the same intense as if you haven't eaten. And it's a signal, you have to eat or you'll die, you have to drink water or you'll die, very, very powerful signals. Very difficult to control. You haven't eaten for one week and you have food in front of you, just try to say no to that food. It's the same drive.

So they can, when they are in those situations, this intense drive, they can do behaviors that are criminal, they can go and steal, in order to be able to get the drug. Like someone who has not eaten for one week, if they have nothing but to steal the food, they may steal the food. So that leads to the criminal behavior that then leads the person and the system to react very negatively, you should not steal. Of course you should not steal. But people should not be hungry, people should not be in the situation that they have to steal in order to eat. That should not happen. Like a person should not be, not given treatment that is in a situation where their body's experiencing the drug as if it were a survival need. They should be provided with treatment.

So yes, we should deal with drug addiction as a disease, like we deal with any of the other medical diseases. We should not be criminalizing it. When we criminalize a drug addict, nobody wins. Certainly you're not going to improve the behavior of that person that is thrown into jail. When they get out of the jail, the first thing they'll do is relapse. Unless you treat them in jail. If you treat them in jail and you maintain the treatment when they leave jail, then you're giving them a chance. If you're throwing them in jail and not providing any treatment or treating them in jail and then throwing them out, they will relapse.

So, and that costs an enormous amount of money, to put people in jail because they are addicted to drugs is very, very costly. It doesn't make any sense. Your tax dollar goes into the criminal justice system, it's much less expensive to treat. And if you treat the person, you're giving that person a chance. And you're giving the family of that person a chance. So it's a win-win. You're basically decrease your cost on criminal behavior, you decrease reincarceration and the person can go back and become an active member of society at all levels.

Recorded on November 6, 2009