The Public Debates Worth Witnessing

I’d have Mark Zuckerberg or Sheryl Sandberg debate U.S. Surgeon General Vivek Murthy about the damaging effects of social media on the mental health and well-being of young people. I find it quite frustrating that Zuckerberg and Sandberg were so eager to engage with the media about the positive impact of Facebook (Bringing the world together!) or their confidence about creating change (Move fast and break things!). Now that it’s apparent that social media has caused serious problems, we don’t hear from them. Do they agree that children have been adversely affected? Can they offer any solutions to the problems their product caused? What is their response to Dr. Murthy’s report?

As someone who went to drug-rehab centers all over the country, experienced the opioid crisis over a decade, watched a dozen or so of my friends die, and overdosed multiple times myself, I believe that an under-discussed issue is drug-rehab programs—not only drug rehab but the concept of the “disease of addiction” and the entire 12-step rehab regime that has basically had control of the alcohol and drug narrative for 100 years.

Having been to treatment something like 15 to 20 times (anything from seven-day detoxes to 90-day rehab programs), I’ve seen and experienced so many of these places that it’s embarrassing. But I did finally “recover” and have since been drug-free for more than 5 years.

With that in mind, I want people to understand that nearly every single one of these places offered nearly the exact same treatment program. Some were better than others; most were mostly bullshit. Some really did try, and had honest, kind, and compassionate staff that really cared. Some were full-on grifts, run by former (and current) addicts who took advantage of desperate parents and insurance companies to enrich themselves at the expense of these poor folks. Besides all that, the one thing they all had in common was that the absolute main aspect of the “treatment” was exposure to the 12 steps of Alcoholics Anonymous and Narcotics Anonymous. Sometimes it was very in-depth, with “therapists” who were essentially 12-step evangelists spreading the good word of AA. Some were credentialed and kind and talented. Almost all preached the 12 steps like it was pretty much the gold standard of treatment. Not only that, most would casually even make snide comments about other methods of treatment, dismissing them as if they were completely absurd and irrelevant. That mindset is highly prevalent in the 12-step ecosystem.

Why am I talking about all this? Because people talk about how difficult the “disease” of addiction is, and the dismal success rates of treatment. In my opinion, there are better, more effective, evidence-based treatments that are underutilized and disregarded, if not outright demonized. I have been attacked on social media for stating my views about the 12 steps by vicious AA evangelists, some of whom I used to consider friends. All because I said that I think the 12 steps don’t work and that we should be trying something else instead of the same thing over and over.

I just so happen to be one of those people for whom the 12 steps did not work. Over and over, I was told I “must not have been totally honest,” or “Maybe you’re just not done yet,” as if there is some magical “bottom” you have to hit before you’re ready to stop destroying yourself. None of that stuff ended up being true. What I was missing the entire time was direction and connection. And also medication-assisted treatment, or MAT.

MAT [incorporates] medications that a drug-dependent person can take to ease withdrawal symptoms and more easily reenter normal life. These drugs are heavily stigmatized and demonized in the 12-step community. When I left NA, one could not be considered “clean” if they were taking medication for this purpose. Because of this stigma and the general idea that MAT is just replacing one drug with another—and for that reason is doomed to fail—therapists, doctors, and families are generally pushed away from these treatments. Not only that, but to access them one typically must pay some cash [since insurance often does not offer full coverage]. This leads many users to go back to drugs like heroin and fentanyl, because it’s almost cheaper to continue to use heroin than to afford the doctor visit, travel expenses, and crazy-high prescription costs. These medications have been shown to be highly effective at stopping withdrawals, curbing craving, and preventing future use.

If I could have any two people debate, I would say Dr. Nora Volkow, the director of the National Institute on Drug Abuse (NIDA), versus either Dr. Carl Hart of Columbia University or Dr. Gabor Maté, a Canadian addiction and harm-reduction expert. The topic would be the merits of the entire disease concept, and the effectiveness of 12-step programs versus other, evidence-based modalities. I choose Dr. Hart or Maté because both are highly regarded in their fields and have written incredible books on relevant topics. Hart mainly focuses on neuroscientific aspects of addiction, while Maté mainly focuses on behaviors and things like past trauma. Both have talked about how the idea of addiction as a “disease” is highly questionable, and how many of the assumptions about drug use and addicts are totally wrong.

Volkow has been the head of NIDA for years, is also highly regarded in her field, and has been very vocal about her belief in the “disease of addiction” and access to 12-step programs.

I’d love to see them debate the topic of addiction as a lifelong, incurable disease and the effectiveness of the 12 steps. I believe that we have erred in accepting that heavy, dependent drug use is some kind of incurable disease and that once you have it, you'll never kick it, and you can never be the same again.

I’m living proof that this idea is nonsense.

I would argue that the most important debate has already occurred and very few people noticed: John Maynard Keynes vs. F. A. Hayek. Although this version is a parody, the questions raised by these two individuals are still debated by governments throughout the world today. Another important debate resolution: “Is the U.S. federal administrative state in 2023 constitutional?” I’d nominate Woodrow Wilson to argue the affirmative and Alexander Hamilton to argue the negative. Because both support stronger federal governments, we would take Hayek as the moderator, giving him the moderator’s prerogative to ask questions throughout. For the past 100 years there has been a significant shift in the size and scope of both the federal and state governments, and in the responsibilities they claim. What is unclear today is where the limits are. Having a serious debate by “uninterested” (in this case, dead) parties might be useful in starting that conversation.

What I think is dividing this country is a lost ability to have back-and-forth, unscripted conversation. What is the quickest way to win an argument these days? Don’t engage in one. The second quickest way? Dismiss the opponent’s position as a radical, fringe thought. Planned speeches with little Q&A are becoming more popular. Even more, any appearance of an adverse opinion is shunned instead of addressed. Our political leaders have adopted these methods, and as a result, the virtue of good-faith debate is fading.

My answer to the Question of the Week will thus focus less on the substantive issue and more on reviving spirited, rigorous, and professional debate. So here is what I would like to see (and why): Arthur Brooks debating Joe Biden on whether a hot dog is a sandwich.

One caveat: No notes or teleprompter allowed. This debate, I believe, would juxtapose a levelheaded, articulate, finely tuned oralist with our president. Hopefully this would remind Americans of how real leaders present themselves. The topic is, of course, silly and meaningless. But if it is plainly shown that our president cannot form coherent thoughts on something so simple, then Americans should be skeptical of how he performs behind closed doors with other world leaders. At bottom, what disheartens me most is that those who garner the most attention are either not sharp enough to engage in spontaneous speech or possibly so insecure in their beliefs that they resort to character attacks, leaving the merits of important issues unaddressed and unresolved.

The proposition to debate would be: “Farmers and ranchers should be treated the same as other businesses with regard to the water pollution they generate.” I limited it to just water pollution because including all types of pollution would make the topic too broad for an effective debate. (If you want names of debaters, I suggest Carrie Vollmer-Sanders, sustainability director, U.S. Farmers and Ranchers in Action, versus Anne Schechinger, agricultural economist and Midwest director, Environmental Working Group.)

The debate premise would be: Currently, the damage to the general public that is done by agriculture-related groundwater and surface-water pollution is principally dealt with by education of farmers and ranchers regarding new practices, monetary incentives, and appealing to whatever environmental ethic they may have––in contrast to other businesses (paper mills are one example in my area) that are required by law to clean up their pollution to a certain level prior to discharge into waterways. Because there are readily available ways to reduce agricultural pollution, farmers and ranchers could be similarly required by law to do so. Any increased cost would be passed on to those consumers who choose to buy their product. This seems like a reasonable transition since the vast majority of farmers/ranchers impacted are now “businesses” in every sense of the word.

Should Joe Biden stack the Supreme Court?

The debate opponents would be Elizabeth Warren (pro) and Mitt Romney (con). I picked them specifically for the following reasons: They are both current sitting senators but not the leaders of their party. They both have run for president, so there would be name recognition, and neither can truthfully claim to represent the majority of their respective parties any longer. They can both articulate a position fairly well. I am going to give credit early that both would equally wish to win the debate and therefore prepare accordingly.

Let’s assume that I could choose the format of the debate, pick a neutral moderator committed to enforcing time limits, and guarantee that the audience is randomly selected from a pool of all Americans. I have reservations about forcing figures I respect to participate in massively viewed debates. Not every smart person is a smart debater, and some people do not appreciate the possibility of being laughed at by millions of people. I would love to see Natalie Wynn debate Jordan Peterson on whether postmodern neo-Marxism is a real threat, but I would not want Wynn to face death threats from Peterson’s more extreme supporters.

I would choose myself as one of the debaters. I am a persuasive speaker, and I know I would be able to deal with the consequences of participating in such an event. I would make you debate me on the following question: “Are the principled pursuit of near-absolute freedom of speech and the practical pursuit of intelligent debate mutually exclusive?” Despite the fact that I sent you a very long email giving away many of my arguments last August, I am completely confident that I could win defending the proposition that the two cannot coexist. I think this debate would be fun, and it would probably force you to defend one over the other in future writing. There would be no good reason to refuse!