Tag Archives: public health

Re-imaging drug use among (rich) consumers

Among policy experts it is common knowledge that the war on drugs really means civil war in many places on this earth. In Mexico alone the drug war costs more than 10,000 people’s lives per year. Many policies such as the eradication of plants or violent engagement with criminal traffickers and organized crime have been suggested. Some of these proposals, while often suggested are rarely tried. An example is the legalization of softer drugs. In all these efforts, the place of action is the often poorer countries of origins and trafficking.

This is remarkable, since most of the consumption of expensive drugs still takes place in the richer countries. Although in recent years drugs are increasingly consumed in poor countries, the big money is still made in Europe and the US. And within these countries it is often very specific segments of the society that use (different types of) drugs. Cocaine, for instance, is still consumed very much by middle to upper class people. It is an expensive drug, for recreational use.

Price and effects of drugs are factors that segments the market for drug use, but another is images of drugs. Cocaine, for instance, still has a positive imagine of a party drug, even if it also has a connotation of a heavy, strong drug. This image of cocaine is quite persistent, and visible in many countries.

Public and private campaigns try to alter this image. There are, for instance, information campaigns about the detrimental consequences of drug abuse. The UN has an international day against drug abuse. But the arguments for these campaigns usually follow a paternalistic concern for citizens’ lives. They are purely domestic. The campaigns are supported and implemented by politicians and people working for the health sector, because these people care about the human and financial costs of drug abuse. And the campaigns, if carefully designed, are effective.

To the best of my knowledge, nobody has included the detrimental impact of drug abuse for people in the countries of origin. There is no reason why this should remain the case. In other areas drastic reimaging, usually quite literally in combination with strong and negative graphic images has shown at times tremendous success. Some countries have regulated that cigarette packs need to show pictures with the serious health risks of smoking. And again, if carefully designed, these campaigns seem to work.

An even better example is the campaign against wearing fur. Lynx was an activist group that made use of strong graphical images against the use of luxury furs. Here is a tv ad I saw probably 20 years ago, and i still remember it: http://www.youtube.com/watch?v=lohEqT1_C_o. The idea has been often copied by similar NGOs like Greenpeace or PETA. The shocking, bloody images helped to reimage fur wearing from something of class to something more like a murderous affair. It made people associate a product with the circumstances of its production.

If it works for animals, why not for people? A re-imaging campaign against the use of party drugs such as cocaine would be relatively easy. The milieus can be identified, the channels of communication can be tailored. The re-imaging should make consumers aware that there is nothing fashionable about their drug use, but that this drug use costs some people’s lives. One could experiment with the use of graphical images or other information campaigns. It should generate the (unconscious) association of drug use with drug war. It is, of course, no magic bullet against the war on drugs. But it would be part of an overall strategy of awareness arousal and of making the problem sharing more transnational than it is as of now.

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Do Antidepressiva Explain Why Some Countries are Happier Than Others? Or: Why Hungarians Don’t Buy into Happiness.

Who wouldn’t want to be happy? Experts and politicians promise us more gross national happiness. Cynics might say, it’s because we see less gross national product these days, but probably there is some truth to the claim that we should rather care about a better life, and even – behold the gigantic anthromorphism – a happy planet.

No small wonder, serious academics have joined the quest for measuring subjective well-being, life satisfaction or happiness (for data and literature see, for instance, Ruut Veenhoven‘s website). With data come explanations. People have related well-being to economics, to health, family states and social ties and culture (eg. website of the World Value Surveys).

The findings of these measures are remarkably consistent. In Europe, Scandinavia often ranks top, Eastern Europe bottom, with the rest somehow getting by. Hungary is always among the bottom countries. And it all makes sense, doesn’t it? Hungarians are well-known for their melancholy and pessimism. Suicides seem a national pastime. Suicide rates reached so high a level that the Communist government stopped its publication in the 1970s (NY Times). Pretty much any important intellectual or politician of some historical importance chose hara-kiri in one way or the other. To top it all, Rezso Seress, the composer of the famous song Gloomy Sunday ended his life in 1968.

So, should Hungarians collectively move to Sweden, a second Finland if you will? Maybe not. The OECD recently published statistics on the consumption of antidepressiva across countries.

The results are astonishing. Not only is there a considerable increase over the last decade, but there are also large differences over countries. Hungarians take relatively few antidepressiva, about 26 daily dosages per 1000 inhabitants. In some Scandinavian countries people take four times as much. And Scandinavians report to be happier.

Graph1

As the figure shows there is a clear relationship: Countries with higher intake of antidepressants have higher levels of reported happiness. It holds for other indicators of subjective well-being. Could it be explained by something else? If you control for the level of prosperity, as the theory above would suggest, the effect of antidepressants on happiness still holds, and quite strongly so (regression results available on request).  There is a timing issue: what causes what? However, the relationship also holds for the values around 2000, and for looking at changes in happiness over time. So maybe there is a causal pattern, but what does this mean?

One thesis could be that antidepressants have a direct impact on aggregate happiness. Though there might be some truth in this, the magnitudes are different. Usually far less than five percent of the population takes antidepressants, but reported happiness differs by much more across countries. Even if effects spill over to other people, the total would arguably not be big enough to explain this variation in happiness. Instead, one could think of two interpretations. In the first, people in certain countries truly invest more in happiness (drugs, therapies, sports, recreational activities etc.) and are indeed happier. In the second, people try to convince themselves that they are happier, because they invest a lot of resources in their happiness. This by the way, should create some headaches for happiness researchers, as it reveals in part the social habit of stating that you are happy while, in fact, you may be not.

So what’s in this for Hungarians? Well if the former interpretation is true, Hungarians should take mental problems more serious as an issue of public policy. If the latter interpretation is true than Hungarians should be proud to be honest in reporting their state of the world, and indulge in the culture of melancholy as a country that is happily sad.

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Does Chocolate Really Make You Smart?

Some weeks ago a graph went viral in the internet showing a correlation between chocolate and nobel prize winners per capita comparing countries. Among others the BBC commented on this, based on a study published in the the New England Journal of Medicine (Messerli 2012). Now, I am a big consumer of chocolate myself, so no harm done there. And it is clear that the whole exercise was meant to be fun. But apart from the obvious problem that a micro theory was supposedly be tested by macro data (see, for instance, here), it is also funny how the public seems to get hypnotized by statistics like little Mowgli by sneaky snake Kaa in the Jungle Book. Anyways, when I checked the relationship with the same source for the number of nobel prize winners, but different data for chocolate consumption, I don’t get anywhere near the perfect relationship of Messerli. (By the way, I am not claiming that my data is better, to the contrary, but it illustrates nicely the problem of lacking robustness in statistics.)

The non-relationship between chocolate and nobel prize winners

Lesson learnt: there are very few really robust relationships in social science, and the one between chocolate and nobel prize winners is, unfortunately, not among them…

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