Introduction
The voices in my mind were like a howling drill sergeant in an old Vietnam War movie, shrieking abuse at the recruits. You are an idiot to do this. This is shameful. You are a fool for not shopping. Somebody should prevent you. You should be punished.
So even as I criticized the drug war with my words, I was often waging it in my head. I can't say I was evenly divided—my rational mind always favored reformed—but this internal conflict wouldn't stop
The Black Hand
We don't know whether Jimmy joined in, but we do know he had no pity for addicts: "I never knew a victim," he said. "You victimize yourself by becoming a junkie"
When Billie sang "Loverman, where can you be?" she wasn't crying for a man—she was crying for heroin. But when she found out her friends in the jazz world were using the same drug, she begged them to stop. "Never imitated me," she cried. "Never do this"
"And I had so many close conversations with her, about so many things," he would remember years later. "She was the type who would make anyone sympathetic because she was the loving type." The man Anslinger sent to track and bust Billie Holiday had, it seems, fallen in love with her. Confronted with a real addict, up close, the hatred fell away
When Billie was busted again, she was put on trial. She stood before the court looking pale and stunned. "It was called 'The United States of America versus Billie Holiday," she said, "and that's just the way it felt." She refused to weep on the stand. She told the judge she didn't want any sympathy. She just wanted to be sent to the hospital so she could kick the drugs and get well. Please, she said to the judge, "I want the cure."
She was sentenced instead to a year in a West Virginia prison, where she was forced to go cold turkey and work duringthe days in a pigsty, among other places. In all her time behind bars, she did not sing a note. Years later, when her autobiography was published, Billie tracked Jimmy Fletcher down and sent him a signed copy. She had written inside it: "Most federal agents are nice people. They've got a dirty job to do and they have to do it. Some of the nicer ones have got feeling enough to hate themselves sometime for what they have to do ... Maybe they would have been kinder to me if they'd been nasty; then I wouldn't have trusted them enough tob elieve what they told me." She was right: Jimmy never stopped feeling guilty for what he'd done to Lady Day. "Billie 'paid her debt' to society," one of her friends wrote, "but society never paid its debt to her"
She began to push away even her few remaining friends, because she was terrified the police would plant drugs on them, too—and that was the last thing she wanted for the people she loved
The arguments we hear today for the drug war are that we must protect teenagers from drugs, and prevent addiction in general. We assume, looking back, that these were the reasons this war was launched in the first place. But they were not. They crop up only occasionally, as asides. The main reason given for banning drugs—the reason obsessing the men who launched this war—was that the blacks, Mexicans ,and Chinese were using these chemicals, forgetting their place, and menacing white people.
It took me a while to see that the contrast between the racism directed at Billie and the compassion offered to addicted white stars like Judy Garland was not some weird misfiring of the drug war—it was part of the point.
Harry told the public that "the increase [in drug addiction] is practically 100 percent among Negro people," which he stressed was terrifying because already "the Negro population ... accounts for 10 percent of the total population, but 60 percent of the addicts." He could wage the drug was—he could do what he did—only because he was responding to a fear in the American people. You can be a great surfer, but you still need a great wave. Harry's wave came in the form a race panic
Billie didn't blame Anslinger's agents as individuals; she blamed the drug war itself—because it forced the police to treat ill people like criminals. "Imagine if the government chased sick people with diabetes, put a tax on insulin and drove it into the black market, told doctors they couldn't treat them," she wrote in her memoir, "then sent them to jail. If we did that, everyone would know we were crazy. Yet we do practically the same thing every day in the week to sick people hooked on drugs."
Still, some part of Billie Holiday believed she had done something evil, with her drug use, and with her life. She told people she would rather die than go back to prison, but she was terrified that she would burn in hell—just as her mother had said she would after all those years before, when she was a little girl lying in the brothel floor, listening to Louis Armstrong's music and letting it carry her out of Baltimore. "She was exhausted," one of her friends told me. She didn't want to go through it no more."
And so, when she died on this bed, with police officers at the door to protect the public from her, she looked—as another of her friends told the BBC—"as if she had been torn from life violently." She had fifteen fifty-dollar bills strapped to her leg. It was all she had left. She was intending to give it to the nurses who had looked after her, to thank them
It is easy to judge Harry Anslinger. But if we are honest, I suspect that everyone who has ever loved an addict—everyone who has ever been an addict—has this impulse in them somewhere. Destroy the addiction. Kill the addiction. Throttle it with violence. Harry Anslinger is our own darkest impulses, given a government department and a license to kill.
As I researched the book, I traveled a long way from the farm fields of Pennsylvania—but at every step, I began to feel I was chasing the scream that terrified little Harry Anslinger all those years ago, as it echoed out across the world
Sunshine and Weaklings
There is no evidence that Anslinger ever worked for the Mafia, and it's fair to assume it would have emerged by now if he had. Anslinger really believed he was the sworn enemy of the drug gangs, even as they were paying his officers to enact his policies. Henry Smith Williams assumed that Anslinger—and prohibition—were rational, like him. They were not. They are responses to fear, and panic. And nobody, when they are panicking, can see the logical flaws in their thought
The Barrel of Harry'sGun
They wanted to be persuaded. They wanted easy answers to complex fears. It's tempting to feel superior—to condescend to these people—but I suspect this impulse is there in all of us
It is a natural human instinct to turn our fears into symbols, and destroy the symbols, in the hope that it will destroy the fear
The Bullet at the Birth
Under prohibition, dealers were starting to discover, you can sell whatever crap you want: Who's going to complain to the police that they were poisoned by the illicit booze? Outbreaks of mass alcohol poisoning spread across America: in one incident alone, five hundred people were permanently crippled in Wichita, Kansas. But the market for illegal alcohol would live on for thirteen years, and then Franklin Roosevelt—desperate for new sources of tax revenue—would make it legal again in 1933. The greater gift, Rothstein saw, was in the market for drugs. They, surely, would stay banned far into the future
Souls of Mischief
Chino was the unquestioned top dog. When Chino said move, they moved. When Chino said go, they'd go. They were entirely obedient. They watched his anger and aggression with awe, as if he was not a person but an electrical storm with skin [...] Whenever told his crew to do anything he wouldn't do himself: he would always get his hands dirty with you. If the crew had to attack, he would be at the front. And sometimes it was necessary to attack
Deborah would never wake up again. She was thirty-three years old. At the funeral, Deborah's boyfriend sneered at Chino. "So," he said, "you'll cry for her now?"
Not long after, Chino found his corner, and started selling crack. And three years after that, when he was sixteen, he would smoke it for the first time. "I wanted to know," he would say to me years later, "what she chose over me"
One day, the mother of one of his crew approached them and asked to buy crack. Chino recalls: "Seeing the look in my boy's face when his mom came to buy from us ... It wasn't like a look of embarrassment. It was a look of hurt. Sometimes you can see the hurt on somebody." He said later: "It's hard not to feel compassion for somebody ... We were born with compassion"
I asked him in 2012—when Chino was about to turn the age Deborah was when she died—if he was angry with his mother.
"I think so," he said, "even though I constantly try to make peace with it. I do. It's kind of hard to be angry with someone that's death, right? But it's hard not to be when you only have about ten memories and five of them are fucked up. You know what I'm saying? I don't have much goodness to reflect on. The only thing I can say is that—she could've had an abortion. I was a rape baby ... She chose to bring me into the world. That speaks to a lot. Everything else was demons and drugs and shit that got in the way
"Interestingly enough, I'm not mad that she busted my face open and stuff like that. I'm mad that she didn't stick around. I'm mad that I didn't get to watch her change or help her. At this stage in my life, if she was still alive and she was using drugs, we would find an answer to that problem, one way or another. And I know that's easier to say because that possibility's not here, but I hold on to it. I wrap myself in it like a blanket"
"In many ways, he was a victim as well," he says carefully. "It's rape ... He had to be a victim at some level in [his] life to have the ability to commit such an atrocious act, or the inability to see it's an atrocious act. I feel more sorry for him than angry. Do I think what he did was fucked up? Absolutely. But it's kind of hard to contextualize that because as much as it's fucked up, it produced me ... Do I not want to be born? I want to be born. But not in such a horrible way"
Hard to Be Harry
Yet the work Leigh was most driven by was taking on the drug gangs. This was what got her out of bed in the morning. She was sure that her roadside stops and drug busts were disrupting the supply routes through Maryland—and this meant there would be fewer gangsters, fewer addicts, less violence, and less misery in the world.
This is one of the most important fact sabout Leigh, and one that it would be easy for somebody like me—with the politics that I have—to ignore.
Leigh's support for the drug war was an act of compassion. She genuinely believed that she was making the world a better place by protecting people from drugs and drug gangs. She is a kind and decent person, and that is what drove her to fight the drug war
I was inclined to assume that this hugely disproportionate rate of arrest of black men is due to naked racism on the part of cops. But Leigh is not a racist. We know this because she risked her life to expose violent racism. And most of her colleagues, she said with confidence, were not racist, and they would have been appalled if any of their colleagues made racist statements. Yet Leigh was—as she would see later—acting as part of a racist machine, against her own intentions
Now she sees it as a meeting of people who are surrounded by ghosts. As he approaches the car, the police officer has ranged behind him the ghosts of all the cops he has known, "all the funerals he has been to, all the people who've been killed in traffic stops—because it's a lot," she says. And then "there's also the poor black kid" in the car. Sitting in the passenger seat behind him are his ghosts—all of his relatives and friends who have been killed in police raids or vanished into the American prison system.
Neither can see the other side's ghosts.They can only hate
Bart Simpson and the Angel of Juarez
The cartels prefer kids: they don't understand death, so they are less afraid
Marsela's Long March
She was approached by rival cartel members who said they could deal with Sergio if she wanted. Some of her family were tempted—but Marisela refused. She believed in justice, not violence
The Grieving Mongoose
Two months before, the professor had planted a powerful hallucinogen called silver morning glory in the pen. The mongooses had all tried it, but they didn't seem to like it: they stumbled around disoriented for a few hours and had stayed away from it ever since. But not now. Stricken with grief, the mongoose began to chew. Before long, it had turned in and dropped out.
It turns out this wasn't a freak occurrence in the animal kingdom. It is routine. As a young scientific researcher, Siegel had been confidently told by his supervisor humans were the only species that seek out drugs to use for their own pleasure. But Siegel had seen cats lunging at lunging at catnip
In Vietnam, the water buffalo had always shunned the local opium plants. They don't like them. But when the American bombs started to fall all around them during the war, the buffalo left their normal grazing grounds, broke into the opium fields, and began to chew. They would then look a little dizzy and dulled. When they were traumatized, it seems, they wanted—like the mongoose, like us—to escape from their thoughts
I kept returning to the UN pledge to build a drug-free world. There was one fact, above all others, that I kept placing next to it in my mind. It is a fact that seems at first glance both obvious and instinctively wrong. Only 10 percent of drug users have a problem with their substance. Some 90 percent of people who use a drug—the overwhelming majority—are not harmed by it. This figure comes not from a pro-legalization group, but from the United Nations Office on Drug Control, the global coordinator of the drug war. Even William Bennett, the most aggressive drug czar in U.S. history, admits: "Non-addicted users still compromise the vast bulk of our drug-involved population"
All we see in the public sphere are the casualties. The unharmed 90 percent use in private, and we rarely hear about it or see it. The damaged 10 percent, by contrast, are the only people we ever see using drugs on the streets
Some drug use causes horrible harm, as I know very well, but the overwhelming majority of people who use prohibited drugs do it because they get something good out of it—a fun night out dancing, the ability to meet a deadline, the chance of a good night's sleep, or insights into parts of their brain they couldn't get to on their own. For them, it's a positive experience, on that makes their lives better. That's why so many of them choose it. They are not suffering from false consciousness, or hubris. They don't need to be stopped from harming themselves, because they are not harming themselves. As the American writer Nick Gillespie puts it: "Far from our drugs controlling us, by and large we control our drugs; as with alcohol, the primary motivation is to enjoy ourselves, not to destroy ourselves ... There is such a thing as responsible drug use, and it is the norm, not the exception
We are an animal species. As soon as plants began to be eaten by animals for the first time—way back in prehistory, before the first human took his first steps—the plants evolved chemicals to protect themselves from being devoured and destroyed. But these chemicals could, it soon turned out, produce strange effects. In some cases, instead of poisoning the plant's predators, they —quite by accident—altered their consciousness. This is when the pleasure of getting wasted enters history.
All human children experience the impulse early on: it's why when you were little you would spin around and around, or hold your breath to get a head rush. You knew it would make you sick, but your desire to change your consciousness a little—to experience a new and unfamiliar rush—outweighed your aversion to nausea
When Sigmund Freud first suggested that everybody has elaborate sexual fantasies, that it is as natural as breathing, he was dismissed as a pervert and lunatic. People wanted to believe that sexual fantasy was something that happened in other people—filthy people, dirty people. They took the parts of their subconscious that generated these wet dreams and daydreams and projected them onto somebody else, the depraved people Over There, who had to be stopped. Stuart Walton and the philosopher Terence McKenna both write that we are at this stage with our equally universal desire to seek out altered mental states. McKenna explains: "We are discovering that human beings are creatures of chemical habit with the same horrified belief as when the Victorians discovered that humans are creatures of sexual fantasy and obsession."
Just as we are rescuing the sex drive from our subconscious and from shame, so we need to take the intoxication drive out into the open where it can breathe. Stuart Walton calls for a whole new field of human knowledge called "intoxicology." He writes, "Intoxication plays, or has played, a part in the lives of virtually everybody who has ever lived ... To seek to deny it is not only futile; it is a dereliction of an early constitutive part of who we are"
Terminal City
After thinking about it deeply, Gabor came to suspect that it means, as he told me, "nothing is addictive in itself. It's always a combination of a potentially addictive substance or behavior and a susceptible individual. So the question we need to keep asking is—What creates the susceptibility?"
Gabor began to read about a group of American scientists who had carried out something called the Adverse Childhood Experiences Study. It is the most detailed research ever conducted into the long-term effects of early childhood trauma. It looked at ten different terrible things that can happen to a kid, from physical abuse to sexual abuse to the death of a parent, to track how it shapes that child over their life time.
These scientists discovered that for each traumatic event that happened to a child, they were two to four times more likely to grow up to be an addicted adult. Nearly two-thirds of injection drug use, they found, is the product of childhood trauma. This is a correlation so strong the scientists said it is "of an order of magnitude rarely seen in epidemiology or public health." It means that child abuse is as likely to cause drug addiction as obesity is to cause heart disease
And Gabor round that another scientist, Dr. Vincent Felitti, had conducted a similar huge study of the effects of childhood trauma, looking at seventeen thousands kids for the insurance company Kaiser Permanente. Felliti concluded, as Gabor writes, that "the basic cause of adduction is predominately experience-dependent during childhood, and not substance-dependent. The current conception of addiction is ill-founded"
As Liz told me this, I thought about how fiercely critical I had been of the people I love for their addictions over the years, and I realized I was crying.
Long before, one of Billie Holiday's friends, Memry Midgett, told an interviewer: "The reason for her being an addict was because she had a tremendously poor threshold of pain." Another of her friends, Michelle Wallace, said: "People think sometimes people use drugs because they're bad or evil. Sometimes ... the softest people use drugs, because they can't take the pain"
Some people, after absorbing all this, would develop an idealized or sanitized picture of addicts. This was not an option at the Portland Hotel Society.
Gabor was often spat at and told to fuckoff. The staff there have had shit—literal shit—flung into their faces. One of Gabor's patients, Ralph, was a middle-aged coke addict with a dyed Mohawk and a Hitler moustache. He was a Nazi, and he taunted Gabor by muttering "arbeit macht frei." When Gabor explained his grandfather died in a death camp where those words were displayed over the gates, Ralph said his grandfather had it coming
His own mother, he says, "was stressed, depressed. She said the only reason she got out of bed was to look after me. So I saved her life. It's a hell of a responsibility for a four-month-old, to save his mother's life ... She carried tremendous pain ... tremendous grief, and as an infant, you absorb all that." So he developed differently from a baby whose mother was able to offer calm and consistent love. Now, as an adult, he found himself unable to control himself at moments of stress
I picture the look of judgment of the faces of people who stumble into this neighborhood by mistake. I can see them now. The people from stable families, who glance at addicts and shake their heads and say, "I would never do that to myself." I feel an urge [to] stop them and wave Gabor's statistics in their face and say—Don't you see? You wouldn't do this to yourself because you don't have to. You never had to learn to cope with more pain than you could bear. You might as well look at somebody who had their legs amputated in a car crash and declare: "Well, I would never have my legs cut off." No. You haven't been in a car crash. These addicts—they have been in car crashes of the soul.
And then, just as I am rehearsing this self-righteous lecture in my mind, I notice that I, too, am hurrying past the street addicts, with a look on my face that looks like—what? Fear? Disgust? Superiority? Recognition?
Some people do not have traumatic childhoods, yet they still become addicts. What, he wanted to know, is going on with them?
He has shown that the core of addiction doesn't lie in what you swallow or inject—it's in the pain you feel in your head. Yet we have built a system that thinks we will stop addicts by increasing their pain."If I had to design a system that was intended to keep people addicted, I'd design exactly the system we have right now," Gabor would tell me. "I'd attack people, and ostracize them." He has seen that "the more you stress people, the more they're going to use. The more you de-stress people, the less they're going to use. So to create a system where you ostracize and marginalize and criminalize people, and force them to live in poverty with disease, you are basically guaranteeing they will stay at it."
"If negative consequences led people to transformation then I wouldn't have a single patient left," he says, "because they've experienced every negative consequence in the book. Being jailed. Being beaten up. Being traumatized. Being hurt. HIV. Hepatitis C. Poverty." Gabor looks at me, his eyes sagging a little, as if picturing it all. "What haven't they suffered yet?"
Hannah never stopped seeking out abusive relationships, and she never stopped drinking, although over time she did transfer from heroin to methadone. She had contracted the HIV virus back when there were no needle exchanges in the city, and so she died in the hotel of AIDS at the age of forty-eight. Because of the Portland, she did not die alone. She was surrounded by people who loved and admired her.
To the prohibitionists, Hannah is a failure, because she continued using drugs. To the Portland, she was a success, because she knew she was loved
Batman's Bad Call
There was no heroin in the city—but all the heroin addicts were carry on on almost exactly as before. They were still scrambling desperately to raise the money—robbing or prostituting—to buy this empty cocktail. They weren't in agonizing withdrawal. They weren't getting gut-wrenchingly sick. They thought the "heroin" they were buying was weak, to be sure, and they were topping it up with heavier drinking or more Valium. But the core of their addiction didn't seem to be affected. Nothing had changed.
This wasn't some freak event: a similar effect was being seen in other North American cities where heroin was successfully blockaded for a while, either by police action or by strikes on the docks that prevented anything being unloaded.
This is perplexing. You can get rid of the drug—yet the drug addiction continues in pretty much the same way
They had—like all of us—been told that one of the worst aspects of heroin addiction is the fierce and unbearable sickness of physical withdrawal. Henry Smith Williams believed this process was so harrowing it could kill you. But Bruce saw addicts in withdrawal all the time—and their symptoms were often minor: at worst, like a bad flu. This is so contrary to what we are told that it seems impossible, but doctors now very broadly agree it is the case. The real pain of withdrawal is there turn of all the psychological pain that you were trying to put to sleep with heroin in the first place
But when Bruce looked at these experiments, he noticed something. These rats had been put in an empty cage. They were all alone, with no toys, and no activities, and no friends. There was nothing for them to do but take the drug.
What, he wondered, if the experiment was run differently? With a few of his colleagues, he built two sets of homes for laboratory rats. In the first home, they lived as they had in the original experiments, in solitary confinement, isolated except for their fix. But then he rebuilt a second home: a paradise for rats. Within its plywood walls, it contained everything a rat could want—there were wheels and colored balls and the best food, and other rats to hang out with and have sex with.
He called it Rat Park. In these experiments, both sets of rats had access to a pair of drinking bottles. The first bottle contained only water. The other bottle contained morphine—an opiate that rats process in a similar way to humans and that behaves just like heroin when it enters their brains. At the end of each day, Bruce or a member of his team would weigh the bottles to see how much the rats had chosen to take opiates, and how much they had chosen to stay sober.
What they discovered was startling. It turned out that the rats in isolated cages used up to 25 milligrams of morphine a day, as in the earlier experiments. But the rats in the happy cages used hardly any morphine at all—less than 5 milligrams. "These guys [in Rat Park] have a completely total twenty-four-hour supply" of morphine, Bruce said, "and they don't use it." They don't kill themselves. They choose to spend their living doing other things.
So the old experiments were, it seemed, wrong. It isn't the drug that causes the harmful behavior—it's the environment. An isolated rat will almost always become a junkie. A rat with a good life will almost never will, no matter how many drugs you make available to him. As Bruce put it: he was realizing that addiction isn't a disease. Addiction is an adaptation. It's not you—it's the cage you live in
Bruce and his colleagues kept tweaking the experiment, to see just how much your environment shapes your chemical compulsions.
He took a set of rats and made them drink that morphine solution for fifty-seven days, in their cage, alone. If drugs can hijack your brain, that will definitely do it. Then he put these junkies into Rat Park. Would they carry on using compulsively, even when their environment improved? Had the drug taken them over?
In Rat Park, the junkie rats seemed to have some twitches of withdrawal—but quite quickly, they stopped drinking the morphine. A happy social environment, it seemed, freed them of their addiction. In Rat Park, Bruce writes, "nothing that we tried instilled a strong appetite for morphine or produced anything that looked to us like addiction."
Bruce naturally wanted to know if this applied to humans. Oddly enough, a large-scale human experiment along similar lines was carried out shortly before. It was called the Vietnam War
The war ended. The addicts came home. And something nobody expected took place. The place in the Archives of General Psychiatry—and the experiences people could see all across the country—show that 95 percent of them, within a year, simply stopped. The addicts who received drug treatment and rehab were no more likely to stop than those who received no treatment at all. A tiny number of vets did carry on shooting up. They turned out either to have had unstable childhoods, or to have been addicts before
If your problem is being chronically starved of social bonds, then part of the solution is to bond with the heroin itself and the relief it gives you. But a bigger part is to bond with the heroin—the tribe of fellow users all embarked on the same mission and facing the same threats and risking death every day with you. It gives you an identity. It gives you a life of highs and lows, instead of relentless monotony. The world stops being indifferent to you, and starts being hostile—which is at least proof that you exist, that you aren't dead already
Remember: when the actual heroin was gone, they carried on acting as heroin addicts. The horrifying fact is that, as Bruce puts it, "it's a lot better to be a junkie than nothing at all, and that's the alternative these guys face—being nothing at all." So when the heroin was cut off, "They maintained the essence of their heroin addiction—which is a subculture addiction." When you have been told you are a piece of shit all your life, embracing the identity of being a piece of shit, embracing the other pieces of shit, living openly as a piece of shit—it seems better than being alone.
As one addict told Bruce: "This is a life. It's better than no life"
Bruce says that at that moment, when we think about recovery from addiction, we see it through only one lens—the individual. We believe the problem is in the addict and she has to sort it out for herself, or in a circle of her fellow addicts.
But this is, he believes, like looking at the rats in the isolated cages and seeing them as morally flawed: it misses the point. He argues we need to refocus our eyes, as if staring at a Magic Eye picture, to see that the problem isn't in them, it's in the culture. Stop thinking only about individual recovery, he argues, and start thinking about "social recovery."
If we think like this, the question we need to answer with our drug policy shifts. It is no longer: How do we stop addiction through threats and force, and scare people away from drugs in the first place? It becomes: How do we start to rebuild a society where we don't feel so alone and afraid, and where we can form healthier bonds? How do we build a society where we look for happiness in one another rather than in consumption?
Everyone agrees that cigarette smoking is one of the strongest addictions: it is ranked on pharmaceutical addictiveness scales alongside heroin and cocaine. It is almost the deadliest. Smoking tobacco kills 650 out of every hundred thousand people who use it, while using cocaine kills four. And we know for sure what the chemical hook in tobacco is—its nicotine.
The wonder of nicotine patches, then, is that they can meet a smoker's physical need—the real in-your-gut craving—while bypassing some of the really dangerous effects of smoking tobacco. So if the idea of addiction we all have in our heads is right, nicotine patches will have a very high success rate. Your body is hooked on the chemical; it get the chemical from the nicotine patch; therefore, you don't need to smoke anymore.
The pharmacology of nicotine patches works just fine—you really are giving smokers the drug they are addicted to. The level of nicotine in your bloodstream doesn't drop if you use them, so that chemical craving is gone. There is just one problem: even with a nicotine patch on, you will want to smoke. The Office of the Surgeon General has found that just 17.7 percent of nicotine patch wearers were able to stop smoking.
How can this be? There's only one explanation: something is going on that is more significant than the chemicals in the drug itself. If solving the craving for the chemical ends 17.7 percent of the addiction in smokers, the other 82.3 percent has to be explained some other way.
Now, 17.7 percent certainly isn't a trivial amount. That's a large number of people with improved lives. It would be foolish and wrong to say the drug has no effect—tobacco cigarette are considerably more addictive than menthol cigarettes, to give just one example. But it would be equally foolish to say what we have been saying for a century—that the chemicals themselves are the main cause of drug addiction. That assertion doesn't match the evidence.
This point is worth underscoring. With the most powerful and deadly drug in our culture, the actual chemicals account for only 17.7 percent of the compulsion to use
To make sense of this conclusion I talked to many scientists, and they explained a distinction that really helped me—between physical dependence, and addiction. Physical dependence occurs when your body has become hooked on a chemical, and you will experience some withdrawal symptoms if you stop—I am physically dependent on caffeine, and boy, can I feel it this morning.
But addiction is different. Addiction is the psychological state of feeling you need the drug to give you the sensation of feeling calmer, or manic, or numbed, or whatever it does for you. My coffee withdrawal pains will have totally passed in two days—but two weeks from now, I might feel the urgent need to get my mind focused again, and I will convince myself I can't do it without caffeine. That's not dependence; that's not a chemical hook; that's an addiction. This is a crucial difference. And what goes for a mild and fairly harmless addiction like caffeine goes for a hard-core addiction like meth. That's why you can nurse addicts through their withdrawal pains for weeks and see the chemical hooks slowly pass, only for them to relapse months or years later, even though any chemical craving in the body has long since gone. They are no longer physically dependent—but they are addicted. As a culture, for one hundred years, we have convinced ourselves that a real but fairly small aspect of addiction—physical dependence—is the whole show
Snowfall and Strengthening
Winick, like everyone else, used to believe that once you were a heroin addict, you were heroin addict until you died, but what he found was something very different. "Heroin use was concentrated in the 25 to 39 group, after which it tapered to very little," he wrote. Most addicts simply stopped on their own accord. They "mature out of addiction ... possibly because of the stresses and strains of life are becoming stabilized for them and because the major challenges of adulthood have passed."
This process—the fancy names for it are "maturing out" or "natural recovery"—is not the exception: it's what happens to almost all of the addicts around you. This finding is so striking I had to read about it in slews of studies before I really took it onboard: Most addicts will simply stop, whether they are given treatment or not, provided prohibition doesn't kill them first. They usually do so after around ten years of use.
So once John Marks knew this, he came to believe his job was a matter of keeping them alive long enough to recover naturally. That's why every week, the addicts of Widnes turned up at John's office for a meeting, and left with a prescription for smokable heroin or—in a small number of cases, as we will see shortly—cocaine. John explained to the public: "If they're drug takers determined to continue their drug use ... the choice that I'm being offered, and society is being offered, is drugs from the clinic or drugs from the Mafia"
Imagine you are a street heroin addict. You have to raise a large sum of money every day for your habit: £100 a day for heroin at that time in the Wirral. How are you going to get it? You can rob. You can prostitute. But there is another way, and it's a lot less unpleasant than either of them. You can buy your drugs, take what you need, and then cut the rest with talcum powder and sell it to other people. But to do that, you need to persuade somebody else to take the drugs too. You need to become a salesman, promoting the experience.
So heroin under prohibition becomes, ineffect, a pyramid of selling scheme. "Insurance companies would love to have salesmen like drug addicts," with that level of motivation, John remarked
The program costs thirty-five Swiss francs per patient per day, but it spares the taxpayer from having to spend forty-four francs a day arresting, traying, and convicting the drug user. So when people ask "Why should I pay for this?" the pragmatic Swiss answer is: This doesn't cost you money. It saves you money
This effect is called "the iron law of prohibition." To understand it, we have to first go back to the early 1920s, and the reign of Arnold Rothstein, where our story began.
The day before alcohol prohibition was introduced, the most popular drink in the United States was beer, but as soon as alcohol was banned, hard liquor soared from 40 percent of all drinks that were sold to 90 percent. People responded to a change in the law by shifting from a milder drink to a stronger drink. This seems puzzling. Why would a change in the law change people's tastes in alcohol?
It turns out it didn't change their tastes. It changed something else: the range of drinks that were offered tothem. The reason is surprisingly simple. One of the best analysts of the drug war, the writer Mike Gray, explains it in his book Drug Crazy. When you are smuggling a substance in a country, and transporting it in secret, "you have to put the maximum bang in the smallest possible package," he writes.
Imagine secretly transporting a trunkload of beer across the United States. You will be able to get, say, a hundred people their drink for the night. But load the same trunk with whisky, and you will be able to get a whisky—and when your drinkers come into your speakeasy, that's all that you will be able to offer them, along with even more toxic drinks like Billie Holiday's favorite, White Lightning, a booze so strong that even hard-core alcoholics would turn it down today.
Most people want to get mildly intoxicated. Relatively few of us want to get totally shit-faced. But if no mild intoxicants are available, plenty of people will use a more extreme intoxicant, because it's better than nothing. Prohibition always narrows the market to the most potent possible substance. It's the iron law
This is where the prescription drug crisis comes in—and we are forced to see it in a radically different light. Almost everyone who is addicted to Oxycontin, and gets cut off by their doctor, wants to carry on using Oxycontin. But under prohibition, it's really hard to get a mild opiate like Oxy, and pretty easy to get a hard opiate like heroin. That's how prohibited markets work: it's the iron law
The Spirit of '74
"It was very frustrating," he says, to see a patient fight really hard to get clean only to hear him say: "What kind of live am I going to have now? I am unprepared, I have no place to go."
So he and his colleagues proposed to build a system based on a radically different notion: they should offer addicts "the possibility of having a new life," and give them "pleasure" instead of pain. His goal as a doctor was always "trying to identify what happened in the past" of an addict that made them find everyday life unbearable, and to help them overcome it by offering compassion and helping them to build a good life as an alternative. Now they were asking: If this is the goal of all good doctors, why can't it be the goal of government policy?
In the United States, 90 percent of the money spent on drug policy goes to policing and punishment ,with 10 percent going to treatment and prevention. In Portugal, the ratio is the exact opposite. Back on Chino's block in Brownsville, Brooklyn, the state spends one million dollars for every five people it arrests and convicts of midlevel drug offenses: that's what it took to get the Souls of Mischief of fthe streets for a while. What Joao did in Portugal was to use all that money in a very different way.
He believed that if you removed the stigma and shame caused by making addiction a crime, it would be possible to invite addicts into a welcoming web of care and treatment and support
Six addicts are lying on a mat in a gym, being gently massaged. Some have their eyes closed; some are looking sideways, with a little smile. These messages help them to cope with the withdrawal pains, one of the nurses tell me, but it was a more important function. It helps them learn how to calm down without a chemical cocktail, often for the first time
Once you take those first courageous steps to Taipas or a center like it, the government will prioritize you a job with a decent wage, away from the world where you used drugs. "They want to be a part of the society," he tells me. "We can't [tell] them to behave like a normal citizen and deprive them ... of a role in society: having a job, having work, having a salary." His aim is to give them something to lose.
So the government gives a hefty yearlong tax break to anybody who employs a recovering addict. Almost always, when the year is up, the employer keeps the former addict on in his garage or bakery or shop, because she has turned out to be a good worker
For many people of my generation growing up in the 1980s, drug education consisted mainly of being told that if you tried drugs, your life would be ruined, and that was that. As soon as you smoked your first spliff and survived, you dismissed your teachers as liars on the issue of drugs, and you stopped listening—even to the parts you needed to hear
It would be very risky to use this drug, one of the kids says, because it is more addictive than the marijuana he has tried a few times at parties with his friends. All of life is risk, another boy says, rebutting him. Yes, a girl replies, but that's no reason to take risks unnecessarily
The class giggles a little at the subject matter, but they seem engaged. This is clearly a conversation that takes place between teenagers everywhere. I can remember how we would have it when I was that age—on buses, in the park, at parties—but we were alone, with only our own ignorance to reflect back at each other.
Luz mediates neutrally. She listens. She doesn't ever look judgmental, or shocked. So when she refers to the real risks involved in taking this drug, the kids seem to listen, precisely because she is not pretending it is the whole picture
Prohibition is based on externally preventing people from using drugs through fear and force; the Portuguese alternative is based on the belief that drugs aren't going away, so you need instead to give people the internal tools—the confidence, the knowledge, the support—to make the right decisions for themselves
This is the kind of mature approach liberals have been advocating for years. But there is a strange anxiety about seeing your proposals put into practice. What if they fail? What if we end the drug war, and drug use explodes? What if punishing people really does keep large numbers of people sober? What if more people end up, like too many of the people I love, addicted? What if you saw other disasters start to emerge—ones I can't even now predict?
After I left my meeting with him, I walked the streets of Lisbon for hours lost in a head-rushof optimism, because I saw now, for the first time, how narrow the gap is between even the most passionate prohibitionists and people who want to radically change the laws.
Most of the people I have met on this journey who support the drug war are not like Harry Anslinger, driven by racism and hatred and personal inadequacy. They are like João Figueira: admirable people who have a series of understandable worries about the alternative. They support the drug war out of compassion for all the people they fear might become victims if we relaxed the laws. They are good people. They are acting out of decency.
It occurred to me as I walked up and down those Lisbon streets that we all—the vast majority of drug warriors, and the vast majority of legalizers—have a set of shared values. We all want to protect children from drugs. We all want to keep people from dying as a result of drug use. We all want to reduce addiction. And now the evidence strongly suggests all want to reduce addiction. And now the evidence strongly suggests that when we move beyond the drug war, we will be able to achieve those shared goals with much greater success.
At the start of my journey, I set out to find an answer to a contradiction within myself, and within our culture—between the impulse to be compassionate to addicts, and the impulse to crush and destroy our addictive impulses. Now, at last, I see—and really feel—that it is not a contradiction at all. A compassionate approach leads to less addiction. The conflict within me—the one I found so disturbing—is not a conflict at all. It's not a question of one impulse winning over the other. They can both win—if we just do it right
The Man in the Well
Here's an inconvenient fact for those of us who favor reform. There is strong evidence that during alcohol prohibition, fewer people drank, and after it ended, more people drank. It's hard to tell precisely, because measuring an illegal activity is always tough, but you can look at rates of cirrhosis of the liver, which corresponds with heavy alcohol use, and get a fairly good sense. Drinking seems to have fallen by between 10 and 20 percent during Prohibition, and after it ceased, there was a very slow rise back over several decades. They weren't transferring to other intoxicants—there wasn't anything else. They weren't transferring to other toxicants—there wasn't anything else. They were staying sober—insubstantial numbers. It wasn't just a fall in drinking either. It was a fall in alcoholism.
Why? The best explanation is that there are significant numbers of people who want to obey the law because it is the law. If something is illegal, that has a deterrent effect all on its own. Then, on top of that, if you ban something, it does become somewhat harder for most people to get hold of. I have complained in this book that people who support the drug war sometimes use propaganda to promote their cause, so it's important that I resist the temptation to produce propaganda of my own. Those of us who have come to believe we should end the drug war have to be candid. The evidence suggests there will probably be a modest but real increase in use
When I discussed it with Danny one afternoon in the café at the British Library, he pointed out that most of us don't object to drug use in and of itself. We worry about the harms caused by drug use. If I told you that your neighbor smoked a spliff or snorted a line of coke last weekend, I doubt you would be deeply concerned. But you would—rightly—be worried if she was a teenager, or if she became an addict, or if she overdosed. It is not drug use that worries us, but the harms caused by drug use.
And the evidence about these harms is quite striking. Legalization slightly increases drug use—but it significantly reduces drug harms
Nobody in my nephews' schools, it occurred to me as Fred talked, is selling Budweiser or Jack Daniel's. But there are plenty of people selling weed and pills. Why? Because the people who sell alcohol in our culture have a really strong incentive not to sell to teenagers: if they do, they lose their license and their business. The people who sell other, prohibited drugs in our culture have a really strong incentive to sell to teenagers: they are customers like everybody else.
If we legalize, there will be a barrier standing between our kids and drugs that does not exist today. This isn't theoretical; the societies that have tried this have shown it to be the case. Some 21 percent of Dutch teenagers have tried marijuana; in the United States, it is 45 percent. I picture my nephew and my niece. If I decide to support legalization, it won't be despite them—it will be because of them
When you ban a drug, it's very risky to transport it—so dealers will always choose the drug that packs the strongest possible kick into the smallest possible space. That means that under prohibition you can only get the most hard-core form of a drug. Beer disappeared during alcohol prohibition, and moonshine shone; as soon as alcohol prohibition ended, moonshine vanished
We still think—as I discussed earlier—of addiction as mainly caused by chemical hooks. There's something in the drug that, after a while, your body starts to crave and need. That's what we think addiction is. But chemical hooks are only a minor part of addiction. The other factors, like isolation and trauma, have been proven to be much bigger indicators. Yet the drug war increases the biggest drivers of addiction—isolation and trauma—in order to protect potential users from a more minor driver of addiction, the chemical hook. If we legalize, somewhat more people will be exposed to the chemical hook in drugs—but the even larger drivers of addiction, trauma and isolation, will be dramatically reduced
How, in the end, can you decide whether you support drug legalization, and for which drugs? I can't decide for you. It comes down to what you, personally, value more. What I did was draw up a balance sheet, and try to figure out what I personally value more.
I urge you to draw up your own balance sheet
High Noon
"This is perhaps what you'd like to believe, but the science doesn't support it. Dependence is a risk. Driving accidents are a risk. Teenagers using marijuana early and regularly and becoming derailed ... is a risk, and to say marijuana is harmless is misinformed, and it's misinforming those people you're talking to."
The Washington campaign argued that drugs should be legalized not because they are safe, but because they are dangerous. It's precisely because they are risky that we need to take them back from the gangsters and cartels, and hand them to regulated stores—and use the tax money we gain to pay for prevention and treatment. They wouldn't have dreamed of telling parents their kids would be better off using marijuana rather than alcohol. Instead, they would explain: "Street dealers don't check ID." Legalization, they said, would restrict access to weed for teens
And slowly, while the intricate logistics of marijuana licensing were explained to me, I felt a strange sensation washing over me. I couldn't quite figure out what it was—and then it hit me. I was bored. For the first time in the entire process of writing this book, my eyes were glazing over [...]
This, it occurs to me, is what the end of the drug war looks like. It is not a mound of corpses. It is not a descent into a drug-fueled frenzy. It is a Colorado soccer mom talking about excise taxes in a gray conference room long into the night. Brian Vicente, an attorney who played a key role in the Colorado campaign, told an interviewer: "For years, the only discussion was: 'How long should be we locking people up for possessing marijuana?' Now we're discussing what the font should be on the label of a marijuana brownie."
I am bored at last
CHASINGTHE SCREAM: http://chasingthescream.com/
Photo by Tommi Selander on Unsplash