The Needle, the Cops, and How You Really 'Hit Bottom'

The following is an excerpt from VICE drug columnist Maia Szalavitz's forthcoming book Unbroken Brain, published next month by St. Martin's Press.

I opened the door with a needle in my arm.

Seven plainclothes narcotics cops burst in, five burly men and two women, all shouting. I hastily finished my shot and threw the works down, attempting to be discreet about it. I had been expecting my friend Lina, who should have been returning with money for the cocaine Matt and I had just fronted her. I was also suffering from a painful ear infection, which is how I'd obtained the drug I was shooting. It was Demerol, a narcotic I'd been prescribed by the Columbia Health Service. I must have been quite ill: The doctor prescribed me an opiate as well as antibiotics, even though I'd told her that I had a history of heroin use.

Of course, I wasn't supposed to be injecting the Demerol. In fact, I'd actually managed up until exactly that point to abstain from drugs almost entirely for a few months, in hopes of being readmitted to college after my "year off." Now, I was clearly off the wagon, and life was about to get exponentially worse. My idea that I'd recovered and could safely use drugs occasionally was about to be definitively falsified.

Before that awful day in September 1986, reining in my drug use had seemed relatively easy, at least theoretically. I wasn't exactly a fan of heroin withdrawal—I'd gone cold turkey about four times at this point—but dope sickness did not keep me from quitting during my rare attempts at it. Instead, I always got in trouble a few weeks after stopping, when I felt well again and thought, "Just one will be OK." This time, though, the brief period of abstinence that I'd now violated with the Demerol had been created by an even worse experience—one that I actually thought had solved my drug problem.

Through sharing needles, I'd contracted hepatitis A earlier that summer. (Typically, people get B or C via injection; somehow, I got A, which is usually spread by bad seafood.) My hep A infection, which is normally less severe than the other types, soon made me so sick that even healthy food seemed poisonous—let alone drugs. Broccoli, for example, was indigestible, and if I tried to eat even the tiniest bit of fat, I'd become overwhelmingly nauseous. One pizza craving ended disastrously in the bathroom.

In fact, the way I found out I was sick was by discovering that heroin didn't work to salve what I'd assumed were withdrawal symptoms. And taking more heroin—from a batch that I could see worked fine for everyone else—astonishingly made me feel even worse. I got terrified. Bloody urine and gray feces soon had me headed for the ER. I was so sick that anything I ingested by any means only made me feel toxic and enervated. In such a state, not taking drugs, even while surrounded by them, was relatively easy.

So easy, in fact, that after I left the hospital, I thought I'd been cured, my problem solved. I still didn't understand that ending addiction wasn't just about making it through withdrawal. I also didn't know that I was almost certain to relapse since I hadn't learned alternative ways of coping and was still living in a drug-filled environment. I continued to believe that addiction was primarily driven by physical dependence. Since I was free of that, I thought I was well.

Now it was less than a week into my first semester back at Columbia after my suspension. I'd been allowed to return because I had convinced not only myself but also the school officials that I no longer had a drug problem, thanks to the hepatitis. I was not alone in my belief that getting through withdrawal was all that was needed.

In my essay seeking readmission, I'd written about my illness and recovery from it—and about my genuine desire to study and learn. For the most part, I was surprisingly open: The school knew that I'd left due to a cocaine problem, and I wrote about how I'd then moved on to heroin before "recovering" via my liver disease. I really thought I was making a new start. But I didn't mention that I was still living with and basically working for a coke dealer. I wasn't quite sure what I planned to do about that.

Looking back now, I am shamed and horrified by the entire sequence of events, which took place in our apartment on 49th Street, near Radio City Music Hall and Rockefeller Center, just off Sixth Avenue. It exemplifies both the sheer mindlessness of addictive behavior—and of the way we deal with it as a society. I had no idea what to do when I opened the door and realized that it wasn't our customer, Lina.

Her "friends" turned out to be Long Island–based narcs who had been set on her by a high school chum who needed to bust someone to avoid prison. They had been desperate to meet me when Lina was arranging the sale. I had refused. To protect yourself as a dealer, avoiding selling to people you don't know is generally a good policy. However, I was recorded on a phone call earlier that day coordinating the meeting for the deal. By declining to leave the apartment to make the sale, I ultimately spared myself an additional charge of selling directly to the cops. But Lina was charged with selling, which is actually a more serious charge than I wound up facing, even though I was far more involved with drugs.

Lina was a naive NYU sophomore from Nassau County in Long Island; she had dyed black hair and a few piercings, but she was hardly tough or sophisticated. Her friend from home had been busted in Nassau County. To get a lighter sentence, he needed to find another dealer to implicate. Lina, unfortunately, became his target. I knew her through a crowd that I had gone clubbing with at 80s hotspots like Area and the Tunnel, in happier times before taking drugs had taken over my life. Ironically, Lina wasn't a dealer or even a regular user—let alone an addict. She occasionally did coke and was making this sale as what she thought was a favor for an old friend. I didn't know it at the time, but while the police were storming my apartment, she'd already been arrested and was being held downstairs in a van.

Immediately after they arrived, two of the officers took me into the hallway outside my apartment. I was now high, still feverish and completely dazed; I was also terrified. Their guns were prominent and visible to me in their holsters. They promised that if I signed the form that they shoved in my face, they wouldn't arrest me. Stupidly, I complied. To this day, I still don't understand exactly why: It must have been some combination of fear, fever, intoxication, and perhaps my ongoing Aspie tendency to take what other people said at face value. Aside from selling drugs, it's probably the single most idiotic thing I ever did. Of course, the police were lying to me; if I had been thinking at all clearly, this should have been obvious. The document turned out to be permission to search. They had no warrant. If I hadn't signed, there might never have been an attempt to prosecute me.

The narcs rushed into the bedroom. There, they found Matt, who was sitting in his underwear weighing coke on the scale. Nearby was obviously a large quantity, at least a kilo. That was not typical: Matt was holding most of it for his connection, who had not wanted to have the weight in his possession in case of such an event. Stashed nearby in a file cabinet was $17,500 in cash, most of it needed to pay the connect for the drugs. In my blindly compliant state, I showed the narcs exactly where it was.

As they searched, the cops stomped around, sneering at our messy apartment, with one woman saying sarcastically that it belonged in Better Homes and Gardens. Their behavior was so bizarre and over-the-top clichéd that the whole thing seemed even more unreal. One stocky man with a gun wore a Hard Rock Café T-shirt. (It is strange the details you notice and the thoughts you recall from events that forever change your life.)

And it soon got even weirder. Matt had literally been caught red-handed, or I guess I should say white-handed, but they had no interest in him. When they slapped the handcuffs on me and dragged me off, he actually thought I'd been kidnapped by a gang posing as cops, since real police wouldn't throw away the marlin in favor of the minnows. He just sat there, dazed and confused. For my part, I was in shock, too. I remember being pulled into the elevator, walked by the cops past our doorman and into the street. For one second, while I stood on 49th Street, a strange feeling of relief and utter freedom flooded over me. The thing that I most dreaded would happen had already done so: I didn't need to worry about it anymore. Then the fear returned.

I would spend the next five years of my life dealing directly with the repercussions of what happened that day. My actual recovery would not begin for another two years—and my addiction only worsened after my arrest. While there are certainly legitimate policy arguments about the best way to deal with crimes like drug dealing, there's no doubt that the criminal justice system is ineffective and often actively counterproductive in dealing with addiction. My experience is just one of millions that shows why.

Addiction is not defined by dependence on a particular substance to function or by a desire to avoid withdrawal or by simply being obsessed with the object of the addiction. If it were merely any of the above, it might be possible, perhaps, to use punishment via the criminal justice system to fight it. If withdrawal was really the problem, hepatitis—or, indeed, a two-week stay in jail or somewhere that I would have no access to drugs—could actually have cured me.

Instead, addiction is defined by using a drug or activity in a compulsive manner despite negative consequences. And "negative consequences," of course, is simply a less morally charged phrase for a whole range of experiences that can be experienced as punishing; the terms are fundamentally synonymous. In other words, if punishment worked to fight addiction, the condition itself couldn't exist.

Think about it for a minute: Addicted people continue taking drugs despite losing jobs, loved ones, their homes, families, children, dreams, even sometimes body parts. I continued after contracting a disease that made me feel as though I had been poisoned. I continued after being suspended from the school I'd spent most of my life dreaming of and working toward attending. I continued while facing the daily risk of overdose and AIDS—after I'd already nearly died from an overdose and contracted hepatitis. And I continued even when the cocaine made me feel paranoid, terrified, and as though I was about to die, even though the thing that most frightened me of all was death. While there are many experiences that are not common to all addictions, the compulsion to continue using no matter what is its essence.

In this light, the idea that other sorts of threats or painful experiences will stop addiction makes no sense. Addiction is an attempt to manage distress that becomes a learned and nearly automatic program. Adding increased distress doesn't override this programming; in fact, it tends to engage it even further. If learning were occurring normally during addiction, addicted people would soon learn not to take drugs because the consequences are so bad. The fact that they do not is the crux of the problem.

Moreover, a whole series of studies shows that the brain responses of many addicted people to reward and punishment are abnormal, regardless of what substance is involved. In one, about two thirds of people with substance addictions showed an elevated emotional response to the prospect of monetary gain—an overvaluing of reward. This group, however, responded normally to losses. For these addicted people, similar to what is seen in teens, there appears to be a heightening of desire for reward that may occlude consideration of future punishment. But more interestingly, the remaining third of the participants did not respond to punishment at all. Even after they'd learned that drawing cards from one particular deck resulted in more loss than gain, they continued to select cards from it, showing the characteristic trait of persistence despite punishment. Similarly, other studies have found reduced brain activation during punishment (typically monetary loss) in people addicted to cocaine and methamphetamine.

So why then do so many believe that addiction ends when people "hit bottom" and that criminalizing drug use helps people "bottom out"? Let's set aside for a moment questions about how to deal with drug dealers who don't have addictions and what level of punishment or consequences might be appropriate when selling is illegal. What I want to start to explore here is how punitive and moralistic treatment that claims to view addiction as a disease does not really do so and instead bolsters the law enforcement approach.

The problem begins with the shadow cast by our laws and their history. Indeed, to paraphrase geneticist Theodosius Dobzhansky on biology and evolution, nothing about addiction treatment and drug policy makes sense, except in light of history. To understand how we came to use punishment to "treat" a condition that is literally defined by its resistance to punishment, we have to return briefly to the history of ideas about addiction and how this influenced our laws related to drugs.

America's first drug laws were born in a climate of overt racism, during the Jim Crow years. The rhetoric used to win their passage was explicitly racist and supporters played on white men's fears of miscegenation and losing power. The concept of the fiendish "addict" used to advocate for the laws hewed closely to racist stereotypes.

This unfortunate use of drug policy in support of racism did not end with Prohibition; it simply went underground, reemerging in 1971 with Richard Nixon's declaration of war on drugs as part of the Republican Party's "Southern strategy." This strategy targeted Southern Democrats who were disaffected from their party because of its support for civil rights laws. Expanded further by Ronald Reagan, the strategy used code words like "crime," "drugs," and "urban" to signal to racist voters that Republicans would "crack down" and be "tough" in dealing with black people. As Michelle Alexander points out in her bestseller The New Jim Crow, selective enforcement of harsh drug laws created a new—and apparently legal—way to segregate, control, and incarcerate black people.

But this is only one part of why America remains addicted to a punitive—and failed—drug policy.

From Unbroken Brain by Maia Szalavitz. Copyright © 2016 by the author and reprinted by permission of St. Martin's Press, LLC. Follow Maia Szalavitz on Twitter.