The most dangerous drug of 2023: Loneliness, Donald Trump and you

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Consider two phenomena that might seem unrelated.

This fall, the Centers for Disease Control and Prevention released new data showing a marked increase in overdose fatalities nationally. Nora Volkow, director of the National Institute on Drug Abuse, told CNN that she had expected overdose deaths to decline after a sharp spike during the pandemic. Instead, such fatalities have only gone up.

Meanwhile, by the end of November, Donald Trump was riding high with nearly 60% support in Republican primary polling. In the past 43 years, according to the Washington Post, no candidate has had such a commanding lead and failed to win his party’s nomination.

On the face of it, his astonishing poll numbers would appear to have nothing whatsoever to do with the continued rise in overdose deaths. As it happens, though, the two phenomena are horribly intertwined, connected to a fundamental question so many Americans are grappling with: In a world that feels increasingly lonely and often hopeless, how can we feel better?

Being honest about our loneliness

One of us, Mattea, is a writer who currently uses drugs, and the other, Sean, is a doctor living in long-term recovery from a substance use disorder. Both of us were raised to believe that our accomplishments were the measure of our worth and that something out there — status, money, accolades — would make us whole. Both of us bagged various degrees and have admirable résumés, but neither of us found that such achievements brought any sense of wholeness. In fact, it’s often seemed as if the more impressive we appeared, the emptier we felt.

It took us about 40 years to realize that our quest to be accomplished and better than other people was, in fact, causing us despair. And today we’re writing because we remain in pain and want to be honest about it. We have come to understand that even those people who appear to be on top often feel an emptiness they try to fill with work, antidepressants, cannabis, wine, benzodiazepines, you name it.

Meanwhile, there is a nascent but growing awareness in the medical and recovery communities that loneliness is at the root of so much addiction — and that loneliness is on the rise. According to Surgeon General Vivek Murthy, loneliness in America has indeed grown into a public health crisis. Earlier this year, Murthy released a report entitled “Our Epidemic of Loneliness and Isolation,” in which he described taking a cross-country tour and hearing countless Americans of all backgrounds disclose that they feel invisible, insignificant and isolated. That experience of loneliness coupled with trauma and a wide spectrum of mental health challenges is now tearing at the fabric of American life, driving new levels of despair and death, much of it drug-related, that are ripping through families and communities and lowering life expectancy.

In such a bleak landscape, one way to feel better is to put your hopes into a magnetic leader who makes you feel like you’re a part of something meaningful. Another way is to have a martini and any mood- or mind-altering substance — anything to numb the pain.

This is not an individual problem. This is not a moral failing or a flaw in our brain chemistry (or yours). This is a vast social problem, one that benefits The Donald immeasurably.

Disconnection nation world

Bruce Alexander is a professor emeritus of psychology at Simon Fraser University in British Columbia and the author of “The Globalization of Addiction.” He struggled with alcohol as a young man and then left the U.S. for Canada, where he devoted his professional life to the study of addiction. He focused on the significance of “psychosocial integration,” the healthy interdependence with society an individual experiences when he or she feels both a sense of self-worth and of belonging to a larger whole. According to Alexander, psychosocial integration is what makes human life bearable and its lack is called “dislocation” or, in common parlance, disconnection.

In a bleak landscape, one way to feel better is to put your hopes into a magnetic leader who makes you feel like you’re a part of something meaningful. Another is to have a mood- or mind-altering substance — anything to numb the pain.

In a sense, disconnection goes hand-in-hand with our modern free-market society. Many potential sources of psychosocial integration like the sharing of food among all members of a community are today seen as incompatible with free markets or otherwise logistically implausible. Instead, each individual is meant to act in his or her own self-interest. According to Alexander, this makes a sense of disconnection not the state of a relatively few members of society, but the condition of the majority.

Such disconnection generally proves to be a psychologically painful experience that all too often leads to confusion, shame and despair. As individuals, we tend to try to manage such feelings by numbing ourselves or reaching for a substitute for genuine connection, or both. This leads masses of people to compulsively pursue and become addicted to work, social media, material possessions, sex, alcohol, drugs and more. Of course, simply to pursue any of these things doesn’t mean a person is addicted. It’s possible to have a healthy relationship with work or an unhealthy one — and that’s true of just about anything.

In this view of modern existence, addiction is a very human answer to the conditions in which we find ourselves. According to physician and childhood trauma and addiction expert Gabor Maté, addiction is so commonplace in our world that most people don’t even recognize its presence.

Yet to label people “drug addicts” is to strip them of their humanity and assign them to the lowest echelons of our society. It’s a term that implicitly undermines the validity of a person’s experience and negates their very worth. Even though different types of addictions — to drugs or money, for instance — are inherently similar, the former is stigmatized, while the latter is acceptable or even revered.

“To ostracize the drug addict as somehow different from the rest of us is arrogant and arbitrary,” writes Maté, who has been candid about his own addictions — to work and shopping — to the point of sharing his experiences with patients who were addicted to drugs. His patients, he reports, were astonished that he was “just like the rest of us.”

“The point,” Maté said in an interview with the Guardian earlier this year, “is we are all just like the rest of us.”

After more than half a century of studying addiction, Bruce Alexander no longer separates compulsive drug use from other dependencies. He categorizes addictions to alcohol, drugs, food, gambling, power, a sense of superiority and a litany of other things as responses to the same underlying pain.

Yet he does regard one flavor of addiction as distinct from all others.

“What’s the most dangerous addiction of all in the 21st century?” he asked in a conversation with one of us over Zoom last year. And then he answered his own question. According to the octogenarian professor who has devoted his life to addiction psychology, the most dangerous addiction today is the rising obsession globally with cult political leaders like Donald Trump.

What drugs and autocracy have in common

Today, there is an emerging awareness among medical professionals that loneliness lies behind our addiction crisis. But political scientists have long known that loneliness can drive social decay, eroding political stability in unnerving ways.

Historian and philosopher Hannah Arendt understood isolation and loneliness as the essential conditions for the rise of an autocratic ruler. For a politician to seize absolute power, she wrote in 1951 in “The Origins of Totalitarianism,” people must be isolated from one another. She referred to widespread isolation as a “pre-totalitarian” state, suggesting that totalitarian domination “bases itself on loneliness, on the experience of not belonging to the world at all, which is among the most radical and desperate experiences of man.”

Hannah Arendt described widespread isolation as a “pre-totalitarian” state, suggesting that totalitarian domination “bases itself on loneliness, on the experience of not belonging to the world at all.”

In her moment, Arendt also saw political propaganda as both an art and a science that Adolf Hitler and Joseph Stalin had developed to near perfection. She labeled it the “art of moving the masses.” Had she lived into our time, she would undoubtedly have been struck by the ways in which the science of drug chemistry and the art of political propaganda have soared to novel heights. After all, we carry in our pockets, day and night, tiny computers that all too often deliver disinformation, while the drug supply has become so potent that fatal overdoses regularly occur from both legally obtained prescription pills and a continuously shifting assortment of illicit drugs.

This should be terrifying, but we’ve also learned something significant from our own experiences and those of other people who use drugs. Every person’s drug of choice — whatever it is — deserves to be understood and respected as a strategic coping mechanism. Follow the drug to the pain underneath. Gabor Maté’s mantra is: “Don’t ask why the addiction, ask why the pain.”

No matter whether people ease or numb their suffering with drugs, alcohol, television or by following a leader determined to be the one and only in their world, that strategy serves an important purpose in their life. And that’s true even if today’s widespread addiction to a would-be all-American dictator were to lead to the awarding of incontestable power and control over the world’s largest nuclear stockpile to a vengeful demagogue. It’s important to understand that a romance with a drug or with Donald Trump (or both) helps people tolerate their pain — very often, the pain of feeling that they don’t have a place in the world.

This molecule understands me, it doesn’t judge me. This guy understands me, he doesn’t judge me.


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Arendt grasped early on that the lies of political propaganda offer an alternate reality, and when masses of people support an autocratic leader, they’re casting a vote against the world as they know it — a world marked by loneliness. It’s just such loneliness that fuels support for the iron-fisted politician, while creating a hunger for mind-numbing molecules, both impulses born of a frustrated need for connection. As a New York Times headline put it, opioids feel like love (and that’s why they’re so deadly in tough times). That one can experience love through drugs might seem fantastical to many — but such love is all too real and feels better than no love at all.

Amid endemic loneliness, drugs and autocracy each provides an escape from a reality that otherwise seems unbearable.

We decided to witness each other’s pain

Our cultural modus operandi is to judge people who use drugs or are in the throes of addiction — to consider substance use an essential character flaw, a deep moral problem. In 2022, one of us led a national public health survey that found 69% of respondents across the U.S. believe society views people who use drugs problematically as “somewhat, very, or completely inferior.” In other words, the vast majority of us believe that people who use drugs are outcasts. Meanwhile, our legal system criminalizes certain substances (while similar or even identical molecules are legal and widely prescribed) and regards the people who use them as bad actors who must be punished and supervised in jails and prisons or through parole or probation.

It’s important to understand that a romance with a drug or with Donald Trump (or both) helps people tolerate their pain — very often, the pain of feeling that they don’t have a place in the world.

But once you grasp the underlying problem — that people are lonely, traumatized and in pain — it becomes all too clear that incarceration or other similar punishments are not the answer. They represent, in fact, just about the worst policy you could possibly bring to bear against people who are hurting and self-medicating in an attempt to feel better. The U.N. Office of the High Commissioner for Human Rights recently called on all nations to regard drug use as a public health issue and curb punitive measures to deal with it. In the U.S., even as there is a dawning awareness that the war on drugs has been a miserable failure, many elected officials (and presidential candidates) only want to double down on harsh policies.

One of us has personally experienced criminal punishment for substance use, and the shame of being judged and punished is so physically palpable that it’s the equivalent of being stabbed and then having the knife twisted in you again and again. On top of devastating repercussions that touch every dimension of your professional and civil life, it’s common to be judged badly for your substance use by friends, family and neighbors — nearly everyone you know. That, in turn, makes recovery from a substance use disorder seem all but impossible because drugs are what numb the shame.

So we personally decided to try something different. We’re two people who have experienced loneliness and, rather than judge each other, we’ve chosen to witness one another’s pain. That means listening to our experiences without diminishing, deflecting or trying to fix the problem. And what we’ve found is that this makes us less lonely and provides a strong measure of healing.

Notably, research indicates that nonjudgmental peer support is a genuinely effective strategy for addressing substance use disorder. Whereas being jailed or otherwise punished or dismissed as weak or dirty is a barrier to emotional health (and all too often proves deadly), having the support of trusted peers and loved ones is associated with a reduction in the psychic pain that drives people to use drugs in the first place.

This squares with what Arendt thought, too. In “The Origins of Totalitarianism,” she wrote that loneliness is “the loss of one’s own self” because we are social creatures, and we confirm our very identity through “the trusting and trustworthy company of [our] equals.” That is, we need one another to be our fullest selves.

To put that another way, when it comes to addictions, whether to drugs or to a dangerous leader, the true medicine is connection to each other.

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