I've written before about the crazy world of drug policy and the arms race between dealers and police that marks our futile efforts to outlaw various substances. We are caught in an endless loop of first order change, doing more of the same and hoping for a different result. The victims, it has always seemed to me, are the poor people at the bottom of the heap - people with addictions, trauma and other issues in their lives who end up jailed or homeless as casualties of a pointless war. So I was excited to learn about the existence of Johann Hari's Chasing the Scream: The Search for the Truth About Addiction.
To explain the history of our drug policies he takes us to the USA in the 1930s. Up until the early years of the 20th century there was no widespread practice of outlawing drugs. Narcotics, cocaine, cannabis and so forth were as easily obtainable as alcohol, with cocaine used in small quantities in soft drinks and narcotics used in sleeping draughts and soothing teas you could buy at your local chemist. Then in the dying years of World War 1 the abolitionists got their way and alcohol and narcotics were banned. Of course we all know about the history of alcohol prohibition in the US and the way it backfired spectacularly, finally abandoned in 1933. What we generally don't think about is that the same set of laws also affected narcotics.
Through the 1920s most of the enforcement efforts, and most of the criminal activity, focused on alcohol. Narcotics continued, in practice, to be freely available at pharmacies and doctors prescribed them quite readily. When the ban on alcohol was repealed in 1933 the ban on narcotics remained in place, and now became the main focus of abolitionist efforts. Hari tells the story of this time through the lives of four people - Harry Anslinger, Arnold Rothstein, Billie Holiday and Henry Williams.
Harry Anslinger became the head of the Federal Bureau of Narcotics in 1930. This was the remains of the federal body that had attempted to enforce alcohol prohibition and it was clear that he had been sold a lemon. Its mission was in the process of abandonment and its budget tiny and shrinking. He decided to revive it by promoting a relentless campaign to stamp out cannabis and narcotics, spreading vast amounts of misinformation about the dangers of these drugs, pressuring officials to take action and enforcing the most extreme interpretation of the law he could get away with. At the heart of his campaign was a ruthless and cynical strategy to ride the wave a racist panic, suggesting that cannabis and narcotics turned black and Latino people into raging killers. The stories he used to promote this idea were not worth the crappy newspapers they were reported in, but Anslinger never let the truth get in the way of his ambitions. He remained in place for over 30 years, using his position not only to wage relentless war in the US but to pressure governments around the world to do the same. If anyone was the architect of the present day War on Drugs it was Harry Anslinger.
Arnold Rothstein, meanwhile, was a ruthless New York gangster. When alcohol was legalised he was among the first to see the opportunities presented by the narcotics market, and cornered this market in his city by violently forcing out rivals. He set up supply chains from South America, kept prices high by protecting his monopoly, ensured he was paid through assault and murder, and subverted police and public officials to make himself untouchable. It was only when he refused to pay a debt from a rigged poker game that he eventually met his match in 1928, shot down during a business meeting. He never got to cross swords with Anslinger but there was no shortage of others lining up to take his place.
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Billie Holiday, meanwhile, was a victim of all this politicking and racketeering. Holiday is a legend of American jazz music, a singer with a glorious voice and an insightful songwriter. She was also a high-profile heroin addict. Her childhood was a tale of tragedy and abuse, abandoned by her mother, brought up strictly by a distant relative, raped for the first time at the age of ten and ending up with no option but to make a living as a prostitute before finally getting a break as a singer. Even after she found fame she was still trapped, with her abusive pimp morphing into abusive manager. For her, heroin was a comfort, an escape from her world of pain and trauma. Where else was she to turn? Yet her comforting drug was illegal and as a high profile black woman she was a perfect target for Anslinger, who pursued her relentlessly and finally hounded her to death.
The final character in this little drama was Henry Williams, a doctor who was one of the foremost medical minds of his era. He was no liberal and he saw addicts as weak and deserving of whatever happened to them. However, he was incensed when his brother Edward was arrested in the early 1930s as part of a nationwide crackdown on doctors prescribing narcotics. Edward saw plenty of addicts in his practice and ended up setting up an addiction clinic. His experience showed that if addicts were prescribed a controlled dose of their substance they would be able to bring it under control, get their lives back on track and in many cases eventually stop taking the drugs altogether. He prescribed doses of narcotics to hundreds of patients, with great success.
But Anslinger plumped for an interpretation of the law which forbade such prescribing, launching coordinated raids on clinics around the country in which his officials arrested hundreds of doctors on charges of supplying a prohibited substance. Incensed at seeing his brother and so many of his colleagues thrown into jail, Henry assembled all the evidence he could find about narcotic use and published a book which firmly advocated treating addiction as a medical issue not a crime. He lost his battle, the clinics remained closed, and Edward was forced to watch on in despair as his patients went back to sourcing expensive, contaminated narcotics from criminal networks and their lives went quickly off the rails.
Here, in four little cameos, is the story of the War on Drugs in a nutshell. We are left with a deeply entrenched policy which doesn't reduce either the supply of drugs or the levels of addiction (in fact, ensures there will be more or both) while further traumatising addicts through jail time, criminal records and being driven into the arms of criminal gangs.
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It's tempting to say that it doesn't work, but whether it works or not depends on what you are trying to achieve.
Certainly, it doesn't work for drug users. The medical evidence is very clear. While some drugs have chemical properties which 'hook' users physically, this is only a small factor in the causes of addiction. The root of addiction is in trauma and social isolation. Billie Holiday's addiction was an escape from the unrelenting pain of her life. She, and millions like her, can only kick their habit by coming to terms with this trauma and by building supportive, caring relationships around them.
You see this in the stories of so many high profile addicts. For instance, Jimmy Barnes managed to get off cocaine through a stint in a rehab clinic but fiercely resisted any suggestion that he needed to address his experiences of trauma. It was only after a relapse and a brush with suicide that he tried again and started to talk about his horrendous childhood, memories he had spent decades blocking out. And you can see the weakness of the chemical theory of addiction in the life of Eric Clapton, who was able to successfully break his heroin addiction only to fall into alcoholism before finally addressing the trauma of his abandonment by his mother.
But the other part of this is that while it might have been good for Billie Holiday to kick her heroin habit altogether, there are other options. As Edward and Henry Williams found almost a century ago, a person can live a normal productive life while taking a moderate dose of narcotics each day. The problem is that this option is not available to addicts in our world. The closest we come for heroin addicts is to prescribe methadone, a substance that provides the chemicals in heroin without the psychotropic effects. It helps them to avoid withdrawal (the effects of which, Hari tells us, are frequently exaggerated) but does not provide the comfort a traumatised person is seeking. They can't truly deal with their addiction until they deal with their trauma and find a way of living their life that brings them support and healing.
In the meantime, they can only source their drugs on the street. This option is bad in every way. There are no quality controls in the criminal world so you can never know precisely what you are taking - hence the frequency of accidental overdoses. There is also a logic to prohibition which favours the supply of more concentrated forms of the drug over weaker ones, because a small quantity of a highly concentrated drug is easier to conceal than a large quantity of a weak one. You can get oxycontin on prescription (but not if you are an addict) but on the street you can only get heroin or cocaine.
The product is expensive, so you often have to commit crime to pay for it (most often, joining the distribution network yourself and hence embedding yourself ever deeper in the underworld). Of course since the whole enterprise is illegal you can wind up in jail and add whatever trauma you experience there to your lifelong list. Some of the most harrowing scenes in Chasing the Scream come when Hari visits a drug prison in Arizona where prisoners are detained in tents in the middle of the desert and forced out each day in literal chain gangs to labour in the hot sun chanting rhymes made up by their jailers about what failures they are as people. This is somehow supposed to persuade them to give up drugs.
So, the policy doesn't work for addicts, and couldn't possibly work because it adds to the very conditions that created their addictions in the first place. You get more addiction and worse impacts, not less, But there are two groups the policy DOES work for - criminal networks, and police. These two, caught in a dance of mutual escalation, get access to ever-increasing resources to fight the war.
You might think that this increasing level of enforcement would harm the interests of organised criminals but the opposite is the case. The biggest threat to organised crime networks is legalisation. Prohibition grants criminals an effective monopoly and each effort at enforcement merely drives up the price. Police may sometimes succeed in seizing a shipment of heroin or cocaine but for every one they intercept ten more slip through. The loss is just a cost of doing business, as is the occasional arrest of a mid-level member of a criminal network. Organised criminals are no fans of drug law reform and where they can they will actively work against it. The evidence seems to suggest that Harry Anslinger did not take bribes from criminal bosses but many of his subordinates clearly did - the officers who arrested Edward Williams as part of the effort to shut down legal prescription of narcotics were heavily subsidised by their city's criminal organisations.
The effect of this is devastating on poor communities around the world. Hari describes entire city neighbourhoods in the US and Canada that are effectively ruled by criminal networks, but it is even worse in places like Mexico and Colombia where entire countries are at the mercy of gangs who make their money selling the products of their illicit plantations in the cities of North America and Europe. This is also the rarely-told story of the Taliban, those Islamic puritans who dominate Afghanistan using money raised by selling opioids to decadent Westerners.
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What are we to do? We are at a point in history where this has been going on for so long it becomes hard to imagine the alternatives. Nonetheless they are out there.
Possibly the most comprehensive example is Portugal. The Portuguese government fully decriminalised all drug use in 2001. They judged that full legalisation, with the licensing of production and supply, would lead to them falling foul of various international conventions and being subject to sanctions. This means the supply of drugs is still in the hands of criminal networks. Nonetheless, no-one is now sent to prison for possessing small quantities of anything. In place of massive enforcement there is now widespread treatment and support. The country has a network of legal injecting rooms where people can take their drug under the supervision of medical professionals before getting on with their day. There are outreach teams actively finding homeless people and offering them help - not necessarily just help to quit, but advice on where to get clean needles, health support, information about housing and so on. It's far from perfect but there have been dramatic falls in drug-related deaths, reductions in use and addiction and a consequent reduction in crime.
There have been smaller experiments elsewhere. In Vancouver's Downtown Eastside local addicts led their own revolution, sick of being caught between the police and the drug lords. They organised themselves and started doing things like banding together to support fellow addicts, distributing information on safe drug use and supporting one another through withdrawal. As they gained strength they started lobbying for law reform and better rehabilitation programs, eventually shifting their State's regime from punishment to harm reduction and education.
Other initiatives have been led by professionals. Liverpool in the UK had a clinic through the 1990s which exploited a loophole in British law to prescribe heroin to addicts. The program was hugely successful in helping addicts to rebuild their lives and in many cases stop using altogether, but it was hounded out of existence and its founder ended up decamping to New Zealand to escape the persecution. A decade or so later a similar network of clinics was created in Switzerland with similar results. Even in the US, home of the drug war, a number of States have now held popular ballots which legalised cannabis, frequently over the opposition of police and elected politicians.
Here is good drug policy in a nutshell: act in ways that minimise the harm, not in ways that exacerbate and perpetuate it while pretending to eliminate it.
1. Decriminalise possession and use of drugs, so that no-one gets sent to jail for their addiction.
2. Legalise and regulate the supply of various substances. Hari points out that we don't need to create a new system to do this as we already have two that work fine. The system we use to regulate the sale of alcohol can be adapted for less potent drugs like cannabis - you could go to your local bottle shop and find beer, wine, spirits and cannabis. For more potent drugs like heroin you would use existing medical regulations, licensing their sale through pharmacies on prescription.
3. Redirect some or all of the billions we currently spend on policing the drug war to treatment and rehabilitation programs - drug education and advice, supervised injecting rooms, counselling and rehabilitation programs, along with associated housing, mental health and employment schemes.
4. Provide balanced, fact-based education in schools about drugs - their uses, the way to stay safe while using, the drawbacks and pitfalls - just like we do about alcohol and sex.
The evidence says that many drug users, of all sorts of drugs, don't become addicted. We know this from alcohol, which is freely available in our community. Most people use it in moderation and it's perfectly safe and pleasant. Some people use it to excess for a time but then realise that's not a good idea and stop. For some people it's a poison they need to diligently avoid, often because it taps into the trauma of their life experiences. This last group need support and treatment, and its helpful if their friends and families support them in this and create safe spaces where they don't get encouraged to relapse. But to do this you don't need to ban it for everyone else.
Other drugs are the same. In moderation they may not be that good for you but they are not as harmful as the drug war mythology would like us to believe. But if they are supplied on the street, laced with impurities and of indeterminate dosage, the risks are greatly multiplied. We wouldn't legalise them because they are great. We would legalise and regulate them because the alternative is not their non-existence, it is the blossoming of an illegal, unregulated and dangerous supply.
The 'cure' of prohibition is worse than the disease of addiction. If we are serious about stopping people dying of drug use we will stop sending addicts to prison and start offering them medical support and rehabilitation. We will stop handing drug supply to criminal gangs and give it back to the people who are best equipped to manage it - doctors and pharmacists. We will stop demonising drug use and start talking about it as a fact of life. We will stop trying to wipe out the results of trauma and start pouring resources into preventing it and treating its results.
On the other hand, if we don't care about addicts and we are ourselves profiting from the War on Drugs then by all means we should carry on as we are.
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| The Angels of Juarez are young men who bear witness at the scene of murders in their Mexican city, where drug gangs have the upper hand. His sign reads 'for those who do not believe, Christ is coming'. |
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