Fred Nyberg: Choose the right path for a sustainable way forward

2021-08-16

In an ongoing eagerness to densify cities and suburbs, there is a great risk to create environments that not only increase the nearness of the desirable, but also greatly reduce the distance to drug suppliers and crime in our courtyards and stairwells, writes Fred Nyberg, Professor emeritus in Biological Research on Drug Dependence.

Fred Nyberg, professor em. and initiator of U-FOLD
Fred Nyberg, professor em. and initiator of U-FOLD

Do policy makers really have to choose to fulfill a decision made under preconditions that were once relevant, but at present may very well be completely wrong? Must a person carrying genes that increase the risk of abuse and dependence follow the path of the genome? Can individuals make choices that will lead in a different direction? Can authorities take action to reduce the risk of vulnerable individuals getting into trouble?

On many occasions in recent years, pedestrians on the sidewalks in my hometown have been met and stopped by signs with clear text in large letters "Choose another path". This is about protecting pedestrians from ending up in the dead ends that arise as a result of intensive street work that the authorities has decided on for various reasons. "Choose another path" is a call that fits into many contexts that can ease for individuals to move forward, not only along the road, but also along life itself. The only question is who in society should ensure that accessibility is optimal for everyone – especially for young people with limited abilities to make the right choices. The constant, urgent issue regarding drug use is also about making choices. It is easy to blame the one who caught in an addiction as a result of a wrong choice, but it is not quite that simple.

From a scientific point of view, we know that there are three decisive factors that can lead an individual to become addicted to drugs, namely a hereditary vulnerability, a growth in or an ongoing life in a complicated environment and, thirdly, the occurrence of and access to drugs. Regarding the hereditary part, science knows of a genetic vulnerability that no human can amend. An individual who carries a hereditary vulnerability does not have the same conditions to forbear by choice, compared to a person without this vulnerability. For a person with hereditary vulnerability, growing up in an environment of misery and exclusion makes it difficult to opt out of drugs. In addition, there is clear evidence that the presence of mental illness increases the risk to develop addiction and dependence.

With that knowledge, it is clear that there are more people who can and should make decisions that can influence and affect whether someone will develop a drug addiction. The fact that Sweden has been at the top in the EU when it comes to drug-related deaths is less due to the fact that we lack good treatment alternatives than that we have had uncontrollable access to lethal drugs. In addition, there is ample scientific evidence to suggest that a careful and safe upbringing and living environment significantly reduces the risk of a young person using drugs. Thus, it is not just about young people's choices but to a large extent also about choices made by authorities and also about how our housing environments are shaped.

In an ongoing zeal to densify populated cities and suburbs, there is a great risk to create environments that not only increase the nearness of the desirable, but also greatly reduce the distance to drug suppliers and crime in our courtyards and stairwells.

It is well known that poverty, segregation and exclusion can contribute to mental illness and thus the risk of drug abuse, but what is often overlooked is that mental illness quite often also rooted in destructive housing environments. The ambition to expand and increase the population of the cities can have its downsides when areas that border to and reach into the city centers are affected. Although experts see economic benefits by densification, research clearly points out negative effects on mental health in densely populated living environments. It has been shown that overcrowding and the centering of populations with social difficulties in small areas creates environments where mental illness flourishes.

The ambition to minimize the distances between the house walls should be re-evaluated. To change the views from green areas to closely adjacent brick and concrete walls is not conducive to sustainable development, whether it is mental health, drugs or crime.

Thus, for the desirable goal for as few as possible to start using drugs, the responsibility cannot be placed solely on the young. It is clearly more about the governing body to choose the right path, which can quite frequently be another than the one previously chosen. Those responsible for the planned densification have every reason to consider their choices. Choosing another route would also help reduce the risk of densification of pandemic viruses, tobacco smoke, and household-produced toxins, but above all it is a matter of reducing the risks of mental illness and access to drugs. Only with a focus on drugs and mental illness, there is enough scientific evidence to choose another path.

Fred Nyberg
Professor e.m. in Biological Research on Drug Dependence,
Senior Professor, U-FOLD

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Last modified: 2021-11-05