"Why does he say most people don't need treatment? Because... the vast majority of drug users aren't addicts. "

'Drug Users Need Treatment,' Says President Obama. Not So Fast, Says Dr. Carl Hart - Hit & Run : Reason.com: "Why does he say most people don't need treatment? Because—contrary to widespread perceptions—the vast majority of drug users aren't addicts. 

"When I say drug abuse and drug addiction, I'm thinking of people whose psycho-social functioning is disrupted," he said later in the talk. But for more than three-quarters of drug users (and we're not just talking about marijuana here, either), that description doesn't apply. 

This overturns the conventional wisdom on drug addiction, but Hart thinks that's a good thing. We've all been fed a diet of panic-inducing misinformation about what drugs actually do to our brains, he says. Most of us were taught that drugs like cocaine are so addictive that a rat in a laboratory experiment will continue to press a lever to receive the substance—to the exclusion of all its other physical needs—until it actually dies.

Hart said at first even he believed that finding to be true. But it turns out, those studies weren't what they were cracked up to be. "When you have the rat in a cage alone, and there's nothing else for the rat to do, the rat will repeatedly choose to take cocaine," he said. "That's logical. If the only thing you had to do in your life was press a lever to receive cocaine, what are you doing? I hope you're pressing for the cocaine." But if additional stimuli are introduced to the environment, the finding completely falls apart. 

"When you enrich the rat's environment such that you provide something like a sweet drink, or a sexually receptive mate, or some other alternative, the rat doesn't repeatedly take cocaine," he explained. "In fact, it's difficult to get the rat to self-administer or press the lever to take cocaine if you provide the rat with food!"

When he tried to replicate the experiment with drug-addicted humans instead of rats, he found they too behaved logically, choosing, say, $20 in cash as opposed to a $10 hit of coke. "This 'hijacking' of the brain's reward system, that's a nice sexy metaphor," he said. "But what we said was that cocaine addicts could not inhibit certain types of responses. They could not delay gratification. They had cognitive impairment such that they couldn't engage in this long-term planning." Yet repeatedly in tests, they did. Once you realize that drugs don't actually rewire people's brains, making them unable to function, you can start to focus on things that matter more—like preventing overdoses. The way to do that, according to Hart, is through educational initiatives, not treatment programs."