Let's start by acknowledging that it's both, in varying degrees, at different times. But which is dominant is important.

Several of my "vice behaviors" -- smoking, drinking, and promiscuous sex were PULLED. I sought out opportunities. I learned to smoke as an adult; I began regular (not problematic) drinking as an adult by choice, and of course I sought out opportunities for frequent sex. At the same time, were cigarettes not ready available and affordably priced (in 1970), and had I not been surrounded by cigarette smokers, I would not have smoked. Cigarettes are no longer available at affordable prices (they're $8+ a pack in Minnesota). Were there no bars, bathhouses, secluded parks, and adult bookstores, promiscuous sex would have been much more difficult to arrange.

Indeed, one of the key harm reduction strategies for AIDS was to reduce the supply (push) of easily obtainable casual sex (in parks, bathhouses, and adult book stores.). At the same time, fear of dying a very unpleasant death reduced demand (pull).

One element that is definitely push, is advertising.

I'm quite shocked by how much advertising is done for things like gambling, alcohol, and all other sorts of things that people could easily do without and perhaps would never develop a desire for if it weren't for the advertisement. In fact, I wouldn't be surprised if some of it is specifically designed to trigger
(potential/ex-)addicts.

With that said, all of these vices are as old as Antiquity.

True enough, there are no new vices (at least, very few) under the sun.

Vices don't affect everyone equally, but few vices have no effect on society. Pot smoking has been considered harmless at times, but then became Public Enemy #1 (like in "Reefer Madness"). Pot used to be a "pulled drug" mostly for recreational purposes. It wasn't addictive enough to be "pushed". Heroin, on the other hand, was worth the dealer's time to push and hook, setting up long-term sales.

So was tobacco: Tobacco companies worked quite hard to get people to smoke cigarettes, men and women both. In tobacco's "peak year" 54% of the population smoked. It's down to 11% now. Why? Because the push of all-media advertising was halted; another reason, the indoor clean-air act which required smokers to go outside (not a law in all states). Once hooked, smokers can be coaxed from one brand to another -- as in, "I rather fight than switch" But many smokers did switch brands, periodically.



Smoking, whether tobacco, pot, meth, heroin, or whatever does affect society.

One would think that states would not want to engage in vice, but they do. One of the first state to do so was New York, when it launched a lottery to compete (and undermine) the numbers racket. Nevada legalized prostitution (as have a number of countries). Now the various state lotteries sell around $113 Billion worth of tickets. The global business is worth $361 Billion. States legalizing (not just decriminalizing) marijuana become pushers, because budgets always need more revenue, and tobacco taxes are not yielding all that much now but taxes in some states are very high to discourage tobacco smoking, often by the same states legalizing other smoked product. So for many people, pot has shifted from a pulled to a pushed product.

Another factor in pushing is the rotation of addictive drugs: fentanyl, heroin, meth, cocaine, alcohol, and others. Nobody asked for fentanyl to be added to heroin (or anything else), but in tiny amounts it added a kick, apparently. In more than tiny amounts is was the final kick one got. There is a core demand for heroin, meth, and cocaine, but quantities and purity vary a lot. I do not know how far up the supply chain it is that one drug suddenly becomes plentiful and cheaper for a period of time.

The relevance of pulling and pushing is how the state goes about controlling harmful substances (counting gambling as a 'substance' here). When it is both pusher and policer, I would predict tax revenue will trump arrest stats.

Another angle on pushing: One of the strategies of cutting down on overdose deaths and disease transmission connected to drug use is to open supervised shooting galleries where sterile equipment, dosage, and bad reactions can be properly managed on the spot. So far, no state has allowed cities to use this strategy (as far as I know). Some experiments have been tried. The state feels that safe shooting galleries cross the line from public health to pushing drugs. [Safe sites do not supply the drugs, and they do not offer introductory doses for non-addicts.) But the state that says no dice on safe shooting galleries may, at the same time, be degrading lives by promoting gambling and promoting "socially acceptable" drugs like alcohol and cannabis.

Did people start patronizing pain clinics because they had refractory pain and then got hooked on opioids (pull), or did they become interested in opioids because a pain clinic had opened nearby and a Rx was easy to get (push)?

Are prostitutes more or less available because men's demands for quick blow jobs for a fee (or whatever is desired) resulted in women (or men) becoming prostitutes (pull), or did otherwise unemployed women needing income initiate prostitution (push)? — BC

Vices and addictions aren't the same though, and while one can become a 'sex addict' per common understanding, it is a different type of addiction entirely. Opiates and gambling operate with similar processes in the brain - the quick high of a fix or a win, withdrawal, and the alleviation provided by a new 'high'.

(I still recall my prof telling us that heroin was the easier addiction to address than gambling, 30 years ago, and yet Ontario went full-bore into online gambling just a few years ago).

Sex, in this model of addiction, is just not as readily / predictably available. Marijuana, with no withdrawal symptoms, is essentially non-addictive, unless you categorize it as lifestyle-addictions like watching television or poor eating. Smart phones+social media, with the relentless little endorphin hits, are addictive in a profoundly different way than, say, television.

Easily the most sympathetic drug addict is the one with 'refractory pain and then got hooked on opioids'. That seems to be the primary cause of the crisis.

Another angle on pushing: One of the strategies of cutting down on overdose deaths and disease transmission connected to drug use is to open supervised shooting galleries where sterile equipment, dosage, and bad reactions can be properly managed on the spot — BC

We do that here in Canada. To me, it seems the problem of such sites 'pulling' consumers is that they were designed for a different drug crisis. Clean needles are not relevant for fentanyl addictions. The crisis is far greater, numerically, making it harder to manage said 'safe injection' sites.

We got to the point were these facilities would provide addicts with the pills, and the pills would be resold illegally. Because we let them take the drugs away from the site, which is crazy, in that the main benefit is supposedly assistance in case of OD.

Per the OP, I could say that these sites were introduced to deal with the relatively rarer addicts 'pulled' in by heroin addiction, but wildly addictive, readily accessible fentanyl has 'pushed' a different strain of bad actors into these spaces, along with the addicts who genuinely benefit from them.

So, an outdated social policy.

Good observations, all. Thanks. Welcome to The Philosophy Forum; you are not the only Canadian amongst us. Glad you are here. We do not have a tariff on Canadian ideas.

I get that there are different aspects of addition, and that 'addiction' isn't a single kind of experience. I think your professor was right. Gambling addiction is quite difficult--and it's destructive. It's got dopamine, serotonin, and norepinephrine going for it, and there are probably lifestyle and 'self image' issues involved. Plus its got everybody from the Mafia to to the church to the state pushing it.

Substance addictions aren't all equal either, and habituation sometimes gets confused with addiction. I'm addicted to caffeine, but am habituated to the morning routine of making coffee. I have quit drinking coffee on a couple of occasions, and it was easy. I've been addicted to nicotine too, and that was far more difficult an addition to break. I liked "being" a smoker (the stage business of smoking) and smoking, of course, soothed the desire for another dose. Plus, the smokers' lounge was communications center. I used to run smoking cessation classes which were attended by people who had not been successful in quitting on their own. This was before nicotine gums, patches, and so on became readily available -- which has changed the picture (since 1984).

Once, back then, I was looking for the hospital meeting room my quit-smoking group had been assigned to, and I mistook the number and opened the door on a Gambling Anonymous group. I was struck by how different the two groups looked! A totally different demographic.

Minnesota plows a portion of its gambling income into an Arts and Heritage fund. Smart move! It buys off some of the criticism from people that object to gambling -- culture snobs like me, for instance. I think it's an abomination when people at the supermarket buy stacks of lottery tickets. The odds are stacked heavily against their winning a ¢, and they aren't going to get an arts grant from the fund. Ditto for horse racing, sports betting, on-line gambling, or real slot machines and poker games, etc.

Public health, public order, law enforcement, and various community interests have conflicting goals and conflicting constituencies. Conflicts makes it difficult for legislators to decide what to allow and what to forbid -- for legalization of addictive substances, criminalization, and for harm reduction. Then there is tax revenue.

I have mixed feelings and thoughts about legalizing cannabis. On the one hand, pot doesn't do for me what it seems to do for other people, which is annoying. On the other, getting high is a form of intoxication. I have nothing against intoxication (been there), but driving high and driving drunk aren't all that much different. At least that's what I've gathered. I guess one should have a sober designated driver for pot, too.

I'm 78. Maybe it gets harder to get pleasantly high as one ages?

Several of my "vice behaviors" -- smoking, drinking, and promiscuous sex were PULLED. — BC

But how do you know you weren't manipulated by the marketing machine or by social pressures cast upon the young impressionable Bittercrank? The candy Camels of your v youth were part of the grooming process.

And like you say, this applies to everything. Demands are created and then filled. Maybe you have some of your unique demands, but most hit the marketplace first, then we run to get them, thinking we're pushing to get that new iPhone, but really we were reeled in by a shiny lure.

Naive, impressionable Bittercrank has often been lured by the relentless marketing machine. I was not just pushed -- I was rammed into the Apple Store against my will where I bought an iPhone 16+, proof of my susceptibility to the devious powers of Capitalists. PUSH

On the other hand, as a naive young gay man in post-stonewall Podunk City, it was necessary to go out and find sexual opportunities (pull). No one was marketing gay bars and bathhouses; there was no place in which to advertise such establishments (1970). No push.

Part of the attraction of smoking cigarettes derived from the many instances in B&W movies where suave or tough characters lit up, inhaled smoke, and expelled it with what seemed like great sophisticated satisfaction. Typewriters and smoking were often paired, the writer struggling to get the story out. Pull.

Nicotine is a stimulant, and maybe it really does help writers get their thoughts together. But then you smoke too much and it begins to repel, until the OD wears off and it becomes suave again.

This is from memory. I haven't smoked for ... 25 years?

Hi BC, thanks for the welcome!

Once, back then, I was looking for the hospital meeting room my quit-smoking group had been assigned to, and I mistook the number and opened the door on a Gambling Anonymous group. I was struck by how different the two groups looked! A totally different demographic. — BC

Interesting. I would have bet money (ha) on those two groups being more similar than different. I am a smoker, but fortunately never had a taste for gambling beyond a casual poker game. I don't think I've ever gambled without smoking, tbh.

I think it's an abomination when people at the supermarket buy stacks of lottery tickets. The odds are stacked heavily against their winning a ¢, and they aren't going to get an arts grant from the fund. Ditto for horse racing, sports betting, on-line gambling, or real slot machines and poker games, etc. — BC

I agree 100%. And now you carry a casino around in your pocket. It's wrecking lives, in particular, young male lives.

Public health, public order, law enforcement, and various community interests have conflicting goals and conflicting constituencies. Conflicts makes it difficult for legislators to decide what to allow and what to forbid -- for legalization of addictive substances, criminalization, and for harm reduction. Then there is tax revenue. — BC

I continue to think that most 'progressive' social policy is in danger of being too rigid. What worked in the past may not work now, in our post-liberal, social media driven new world.

Last year we had a tragedy in my neighbourhood in Toronto, a young mom walking around was shot and killed in a dispute associated with a safe supply site.

The pro safe-site crowd fail too often to consider the community impacts of sites such as these. The opioid crisis is categorically different than the drug crises of the past, in which the safe supply sites made more sense.

I have mixed feelings and thoughts about legalizing cannabis. On the one hand, pot doesn't do for me what it seems to do for other people, which is annoying. On the other, getting high is a form of intoxication. I have nothing against intoxication (been there), but driving high and driving drunk aren't all that much different. At least that's what I've gathered. I guess one should have a sober designated driver for pot, too.

I'm 78. Maybe it gets harder to get pleasantly high as one ages? — BC

I read recently that roughly one in seven people who try pot will never find it agreeable, which anecdotally feels consistent to me as a lifelong user.

Perhaps a low-dose edible would do the trick for you? The beauty of eating rather than smoking is that the substance has a gradual onset, rather than the kick in the head of a bong-hit, for example. Gives the body/brain more time to adapt.

I tried to get my 70 year old mom into edibles when her Parkinsons worsened. I am pro older people experimenting!

Yes to the pot DD. I can recall an era when pot smokers denied that it impacted your driving - it impacts your driving, just not to the same extent as alcohol, would be my non-scientific judgement.

Pot simply doesn't belong in the same category as any other recreational drugs. For me, it's closer to coffee and cigarettes than it is to alcohol. The two dangers I see are driving stoned and in young users - before the brain is done developing, it can lead to psychosis.

One can never attribute an illness like schizophrenia to just one cause, but I certainly believe that my brother smoking weed regularly from the age of 14 onward contributed to his psychosis at the age of 19.

I think this entirely depends on the individual and the vice. I've been at the mercy of several vices through my life, and am pretty strong-willed generally (eg: I quit smoking cigarettes cold turkey 0o 25 March 2020 and have never looked back once).

When I was heroin addict it was because I sought out heroin (though, tbf, the situation in which i encountered it finally was lets say lucky). I pulled it to me, in some sense, because I was 13 and entirely taken with the romantic view of heroin as an accessory to the tortured artist (or some such.. can't quite remember, as you can imagine).

When I was an alcohol addict, it was because drinking curtailed (significantly) heroin withdrawal when I quit heroin and it was readily available (I had a full beard and ass-length hair by 15 when I quit). Push?

When I was a sex addict, I was both approached, and sought sex. Both?

Hard to know - I think it's more interesting to think of something like social media which is 100% pushed. Its a much more subtle "push" that Curtis Mayfield would want. But I don't think that changes it.

I agree that cannabis is simply not a class I drug like cocaine, heroin, meth, et al. I rate it as more consequential than coffee. Cigarettes (pipe tobacco, cigars, chewing tobacco) are all certified carcinogens. IF one smoked as much pot as millions smoke tobacco, I would expect negative health outcomes. Still, I rate cannabis as more consequential than cigarettes, because it has a more significant immediate effect on the brain. Tobacco is a long-term killer.

Two of my nephews (brothers) were both heavy pot smokers and were alcoholics. One of the two was a multi-drug user. Both of these guys were once bright effective persons. Over time pot, booze, and benzodiazepines gradually degraded their lives and brains to wrecks. Both of them died early. Not typical, of course. Maybe both of them suffered from mental illness which had nothing to do with alcohol, pot, or benzos. There's no way (in retrospect) to sort that out.

I continue to think that most 'progressive' social policy is in danger of being too rigid. What worked in the past may not work now, in our post-liberal, social media driven new world. — Jeremy Murray

When I last worked in a public health / education role the personal computer had just arrived and the internet didn't amount to much yet. There were no smart phones and no social media. It's difficult for me to imagine how different it would be if AIDS made its first appearance in 2021 instead of 1981.

Social policy is always in danger of rigidity, which is a significant problem. Oddly enough, it was easier to do cutting edge work under Reagan (1980-1988) than it was under Bush. Reagan didn't care about AIDS and he didn't want anything to do with it. Under Bush (2000-2008) social policy in connection with AIDS was much stricter, more rigid.

Even though I think safe drug use sites are a good idea, I wouldn't want to work or live next to one or have it next to a school; it would attract some disreputable people. I wouldn't want to live next to a gay sleaze bar or an outdoor cruising area either, even though I was one of the disreputable people who used to patronize such venues. Gay bath houses usually presented no problems to the public because they located themselves as inconspicuously as possible. Straight health clubs (aka brothels), on the other hand, tended to locate in heavy traffic areas, and bothered the public a lot.

Still, I rate cannabis as more consequential than cigarettes — BC

Negatively?

ven though I think safe drug use sites are a good idea, I wouldn't want to work or live next to one or have it next to a school; it would attract some disreputable people. — BC

Definitely.