Showing posts with label addiction. Show all posts
Showing posts with label addiction. Show all posts

Friday, February 13, 2015

Hume vs. Crank

Methylphenidate has been FDA-approved since 1955, and has been used to treat hyperactivity (the ADHD family of disorders) for over half a century now. But it's only since the 90s that it's been so frequently prescribed to school-aged children to get them to settle down.

Is it euvoluntary to stuff ornery brats full of Ritalin?

When I was in grade school, the convention was "no." Kids took prescription drugs for serious illnesses (and yes, right-tail ADHD is indeed a serious illness) only. If you were fidgety, the teacher told you to shut up and sit still. Recess was the time of day to burn off the jibblies. But now? Conventions have shifted. It is, evidently, no longer outrageous that the ADHD diagnosis threshold has become less rigorous (though, to be fair, the prescription rate of 5.4% of students is dwarfed by the nearly 18% of students who report having taken some sort of prescription drug without a prescription). Still, as a rough guideline, when I was in elementary school, I could expect to find maybe one student in the entire school taking psych medication. Now, I can expect one student in each classroom to be on something. That's a substantial change.

Consider each of the parties to a Ritalin exchange.

The majors:

  • The teacher is better off, since having to deal with discipline problems the hard way takes valuable time away from preparing other students to meet standardized test requirements.
  • The student is better off, obtaining higher marks, which increase the probability of elite college admission and attendant higher lifetime earnings.
  • The parents are better off, what with the Instagram-ready little tykes dutifully doing their homework.
  • The physicians are better off. A few minutes of their time to bill against a diagnosis? There might be a risk of being found negligent for over-prescription, but AFAIK, there's been no big class action for ADHD yet and even if there were, that's what malpractice insurance is for, right?
  • Novartis (Mallinkrodt, Sandoz and Watson for generics) is better off. Particularly if their products are addictive.
The minors:
  • The sovereign. Obedient students make for obedient citizens (and obedient Soldiers/Praetorians). 
  • Employers. I found some observational studies, but long-term controlled experiments are harder to track down. Still, it appears that methylphenidate does affect brain development, producing adults with fewer ADHD symptoms, meaning that if you need to hire someone who can focus on repetitive tasks or work that demands attention, a history of taking meth lite might make a resume more attractive.
  • Other citizens. Paying attention behind the wheel, in the checkout queue, or in the tiny galaxy of other small daily interactions makes life flow more smoothly. Easily-distracted passers-by can be infuriating, particularly for overstarched uptight types (like myself).
Of course, there could be a wide range of hidden costs. Attention is great for rote tasks, for memorizing the dates of history, of solving differential equations, of reciting great speeches. It's great for conformity. And like I pointed out up top, there are genuinely people with severe ADHD who need medication like this to just plain make it through the day. But one of the conditions of a euvoluntary exchange is regret. For some of the marginal cases, what are they giving up? What are their alternatives?

If we assume that legislation like NCLB and culture like "you must go to college or else you're a failure at the game of life" are fixed (at least in the short run), the alternatives are ugly: disruptive kids ruin classroom environments for everyone, and creative classes like art and music (and recess) really do  have to be cut to make room for test prep. That's simply the uncomfortable truth of time management budgeting. Congress cannot bang a gavel and slow the earth in its orbit.

If we relax that assumption, perhaps consider re-evaluating the underlying purpose of education, and instead of treating it an international contest, our elected representatives might conclude that the federal (and state, and often local as well) efforts to boost measured success are misguided post hoc ergo propter hoc fallacies of affirming the consequent. If that happens, perhaps the once-ordinary daily exuberance can be remedied on the monkeybars, or banged out on a drum kit, or poured onto a canvas. Perhaps in the tumult of childhood, a kid might discover how to harness a wild mind rather than force it to conform. 

This is, as are many questions of public interest, a matter of moral intuition. The median constituent has no real incentive to think carefully about the implications of the complex institutions, of the ecology of something as large as the entire education system, let alone the philosophical underpinnings of it. The median constituent is far more likely to adopt a standard status quo bias and quibble over marginal adjustments. And so we fill our kids up with low-dose amphetamines, slap 'em on the rump and sit them down for their learnin'. 

I guess that's one way to prepare kids for the exciting future they'll face. Hm.

Thursday, November 6, 2014

Apple Piety

On Monday, I advanced the proposition that gentlemen's clubs are a sort of "sacred space," that is, there's something special about the site and its purpose that renders it unfit for alternative purposes. Yesterday, at ST, I expanded on this idea a little bit: sacred spaces (under my ad hoc definition, anyway) are all around us—folks seem fond of fitting some places to a single purpose. Moreover, we're fond of training children in the rules of the sacred space. As the father of a toddler, I can assure you that teaching my kid to refrain from taking snacks into the bathroom is a lot closer to a catechism than it is to teaching her how to count to twenty.

And that catechism is the other side of the sacred space. After all, without the devoted, a church is naught but stone and mortar. If you'll indulge me a bit of an Augustinian digression, piety is the compound virtue that allows a sacred space to generate its rents. It's the demand side of the exchange, if you will. And recall that piety arises from the mixture of faith, hope, love, and temperance. Absent an Aristotelian mean, absent phronesis, piety slips into religiosity, fanaticism, or delirium. Since it is such a corruptible virtue, it is unlikely to arise naturally in any but the saintliest or most enlightened people. Luckily for the civilizations of the earth, there are thorough canonical works dedicated to cultivating virtuous piety, ranging from the Rig Veda to the Tao Te Ching to the notes of Maimonides to Aquinas's commentary on the New Testament. Or heck, even Paul's letters for that matter. Praying in the direction of Mecca five times a day instills piety via repetition, much the same way as memorizing passages from the Gospels, much the same way as spinning prayer wheels.

Much the same way as reciting the Pledge of Allegiance every morning.

It occurred to me over dinner with Mrs. Spivonomist last night that the political elite has as much interest in generating secular piety for ordinary Humean reasons (i.e. to encrease the dominion of the sovereign). Witness the wailing and gnashing of teeth after the results of an especially decisive election outcome. Witness the style of language used in election season. Witness the devotion a committed partisan has towards her party. Such devotion is not the rational thinking of finding a first derivative; it is the glamour of the pulpit. And inculcating this sentiment is a lifelong affair, beginning with a daily prayer offered to the symbols of the state, its colors and its seals. And this bond of piety is cured in the sunlight of peer approval. When a muddy apostate dissolves this bond, he is shunned in polite society as surely as might be an atheist. What, after all, is the most common epithet against the anarchist? "Bomb-throwing" surely comes to mind. Does this accurately describe Lysander Spooner? G.K. Chesterton? Me?

Dear Apple, if you really want to generate expropriable sacred rents, you need to take a cue from the Roman Catholic Church or the "two"-party system: get 'em young, and cultivate their brand loyalty over a lifetime. use universal symbols, get them to repeat key phrases over and over again so that their piety comes as naturally as genuflection before the font. How else do you expect to generate an insurmountable BATNA disparity among your partisans?

Thursday, July 31, 2014

The Enigma of Ford

Rob Ford, the "disgraced" mayor of Toronto, still enjoys an order of magnitude more public approval than the US Congress (I know, I know, apples to oranges). This despite rock-solid evidence that he's smoked crack while in office.

There was, in Tudor England, a habit of old that on the Twelfth Night (as popularized by Shakespeare's eponymous play) of Christmas, the night before Epiphany, peasants and nobility would swap roles, the former dining on... well, I'll let Dan D'Amico explain:


If you get the baby (or the bean, or whatever local variant you like), you get to pretend to be a lord until sunup. @danarchism's right on the money; cultural, social... human capital is the name of the game. This festive celebration obliged feudal constituents to adopt some variant on the very sort of sympathy championed by Adam Smith in his Theory of Moral Sentiments. If only for a day, the (un?)lucky peasant would have to don the pantaloons of the lord of the manor and hear the petitions of the governed. It was a great, rollicking joke with a great rollicking punchline and a great rollicking serious message embedded within. Using my Pete Leeson spectacles, Twelfth Night was an institution that, as cheaply as contemporary political technology allowed, permitted greater social stability.

And then there's this guy:



The gentleman behind the wheel is Deadmau5. He is a musical whiz, a Giorgio Moroder for the opening act of the 21st century. And he puts up a 30 minute video of him tooling around with his crack-smoking mayor.

Rob Ford governs as if every night were Twelfth Night. AND THE WORLD IS A BETTER PLACE FOR IT.

Politics minus governance equals politainment (plus ΞΆ, some residual). Three cheers for the City of Toronto to have the courage to admit that politainment is valuable. The grimmest moments in human history were characterized by politics taken too seriously.

I'm none too fond of transactional theories of the state. The analytical fiction of the social contract suffers from Arrovian impossibility problems, and no written constitution can ever hope to bind an active sovereign ruling a clamorous constituency. Despite my reserves, I do still believe that voters basically get what they ask for, within a standard deviation or so. And in Toronto, they've asked for some non-standard deviance. And it seems they've gotten exactly what they want.

Long live the king.

In EE terms, this tests Toronto's Ford on the Shughart/Thomas scale, and I think it finds in favor of euvoluntary institutions. If anything coercion flows in the opposite direction. Conventional morality, conventional politics would have this guy (or Marion Barry before him) out on his ear. Yet buoyed by popular support, he thrives in office. Huzzah!

Wednesday, November 20, 2013

Irrational Addiction

Gary Becker and Kevin Murphy turned the rational choice eye on addiction in a widely-cited 1988 JPE piece "A Theory of Rational Addiction." Not only is it widely cited, but judging by some of the empirical pieces I've had come across my desk, it's occasionally misunderstood. Here's the relevant quote: "[t]he basic definition of addiction at the foundation of our analysis is that a person is potentially addicted to [the consumption good] if an increase in his current consumption of c increases his future consumption of c. This occurs if and only if his behavior displays adjacent complementarity." They rigorously define what that means, but it's pretty much what it says on the box: consumption now implies desire later.

If that doesn't sound like straightforward Chicago school economics, I'm not sure what else would. It's a positive theory of behavior, and if there are any normative claims to be found within, you'd need Coke-bottle Straussian spectacles to find them.

These sorts of rational choice models don't tend to match up with what behavioral economists find in the lab. Subjects tend to display odd aversions to things like loss, risk, ambiguity, and they tend to react to surprising events and pay attention to irrelevant options in ways that rational choice theorists didn't expressly model. Kahneman and Tversky refined basic behavioral models to account for these vagaries. The flagship paper in this literature remains the 1979 Econometrica piece found here. I encourage you to read it, but if you don't have the time, the very short version is that people have asymmetrical preferences between gains and losses rather than simply caring about an end measure of utility. K&T allow for what psychologists call "hedonic adaptation", an empirical phenomenon where people tend to get used to their surroundings. It's this same phenomenon that accounts for people griping about having lousy wi-fi on airplanes or having to stand in line for a Diet Coke at the ATL Delta Skyclub*.

So what's the salient difference? Becker and Miller say that heroin today implies heroin tomorrow. It's a theory of why addicts will continue to consume their substance of choice. Kahneman and Tversky offer a framework to explain why someone would even decide to try heroin in the first place. Prospect theory says that the potential drug user stands at the cusp of a decision, weighs all the potential upsides and downsides adjusted by all the outcome probabilities (and yes, this means going all the way down that slippery slope) and weighs them with whatever heuristics the agent thinks appropriate. Only then does she decide. It's a version of what Buchanan wrote in Cost and Choice, only with a few extra pieces of explicit psychological theory included.

It's the last bit there in italics that concern me from the perspective of euvoluntary exchange. How are heuristics formed? In particular, do programs like D.A.R.E. keep kids off drugs (hint: no)? If not, why?

I submit to you that these sorts of programs (not all that unlike abstinence-only sex education) suffer fatal credibility problems. In a Prospect Theory framework, the downsides of unapproved activity are oversold and the upsides are either never mentioned, are treated dismissively, or are conflated with the costs. Those of you with prior military service will undoubtedly remember the vivid images of sexually transmitted infections more than almost anything else you witnessed in boot camp. Some of you haven't eaten cauliflower since. Do any of you believe that sex isn't fun? Or that recreational drugs can't be enjoyable?

So how should kids react to courses like this? With skepticism, of course. Humans have very finely honed bullshit detection skills, even (especially?) children. If the intent of these programs is to alter behavior using non-credible talk, you might imagine a reversing equilibrium, where some potential users could become more likely to try drugs or unprotected sex or whatever because they knew the prior beliefs they'd been given were bogus.

Okay, so thankfully the meta-study I linked to up there says it's not that bad. D.A.R.E. is "just" a useless waste rather than an active source of harm as measured by addiction rates. But imagine how prospect theory might help folks build a more euvoluntary world by providing accurate, honest information and perhaps trusting that meta-rational people are capable of conducting economic calculus under conditions of if not perfect information, then at least marginally more complete information. Heck, it might even be worth it to help overcome the Holden Caulfield complaint. Yes Holden, you're right. Adults who tell you drugs are nothing but bad are in fact part of a cabal of phonies.




Becker, G. S. & K. M. Murphy. "A Theory of Rational Addiction." The Journal of Political Economy, Vol. 96, No. 4 (1988): 675-700.

Kahneman, D. & A. Tversky. "Prospect Theory: An Analysis of Decision Under Risk." Econometrica: Journal of the Econometric Society (1979): 263-291.


*a useful phenomenon, one that refused to let humanity squat over its laurels after the discovery of fire

Thursday, April 5, 2012

She Sells Her Smelly Socks to Make Men Happy

Okay, sure, lets' get it out of the way: EWWWWWW!

Now, then, this young lady is part of an industry that transfers smelly socks, dirty underwear, and even more icky things to people (men, likely, but who knows?) who ... use these items in ways that these buyers value.

Is the exchange euvoluntary? The young ladies can get $50 for a smelly pair of socks, and lots more for a pair of worn underwear along with themselves wearing the underwear.

Now, on the scale of porn filth flarn filth, a picture of a 20 year old woman wearing modest underwear is pretty tame. Those pictures are in the Sunday adverts, for heaven's sake, in the newspaper.

Of course, one could argue that only a crazy person would pay that much for soiled undergarments. But no one is being harmed. Or are they?