Chasing the Scream: The First and Last Days of the War on Drugs
Reviewed by Chris Slee
Chasing the scream
By Johann Hari
Bloomsbury Circus London 2015
April 9, 2017 — Links International Journal of Socialist Renewal — Over the past hundred years, millions of people around the world have been jailed for drug use. The United States has been particularly harsh. Its huge prison population, disproportionately Black and Latino, includes many people jailed for drug use.
But until 100 years ago, drug use was not a crime in the US (or in most parts of the world). Opiates were sold in pharmacies as remedies for a range of ailments. Johann Hari explains that: “You could go to any American pharmacy and buy products made from the same ingredients as heroin and cocaine. The most popular cough mixtures in the United States contained opiates, a new soft drink called Coca-Cola was made from the same plant as snortable cocaine, and over in Britain the classiest department stores sold heroin tins for society women”. [page 9] Most people used these products without any problem: “Just as a large majority of drinkers did not become alcoholics, a large majority of users of these products did not become drug addicts. “A small number did get hooked - but even among the addicted, the vast majority continued to work and maintain relatively normal lives”. [p. 36] This situation began to change with the passing of the Harrison Act in 1914, which banned cocaine and heroin. This was the beginning of what was later called the “war on drugs”. Hari’s book investigates the history and politics of this “war”. It also looks at the scientific evidence on the effects of drugs, highlighting the psychological and social factors that contribute to drug addiction. It looks at various attempts at reforming drug laws, and alternative approaches to dealing with drug addiction. The beginning of the war on drugs was motivated by racism: “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”. [p. 26] For example, it was claimed that cocaine was making Black people rebellious and aggressive. The Harrison Act included exemptions for doctors, dentists and veterinarians. Doctors were allowed to supply a drug to an addict if they believed this was in the best interests of the patient. This would be the case if the patient was unable to function normally without the drug. But in 1931, Harry Anslinger, the head of the Federal Bureau of Narcotics, ordered raids on doctors throughout the United States. Twenty thousand doctors were charged with violating the Harrison Act. This put an end to the legal prescription of drugs to addicts in the US. The banning of drugs resulted in the creation of an illegal drug market. Dr Henry Smith Williams, whose brother was one of those arrested, said: “Here were tens of thousands of people, in every walk of life, frantically craving drugs that they could in no legal way secure…[The lawmakers] must have known that their Edict, if enforced, was the clear equivalent of an order to create an illicit drug industry. They must have known that they were in effect ordering a company of drug smugglers into existence”. [p. 36] Hariri adds that: “The drug dealer could now charge extortionate prices. In the pharmacies, morphine had cost two or three cents a grain; the criminal gangs charged a dollar. The addicts paid whatever they were told to pay”. [p. 36] The high prices meant that “addicts were forced to commit crime to get their next fix”. [p. 37] Another problem was that relatively mild drugs were replaced by stronger ones: “Before drugs were criminalized, the most popular way to consume opiates was through very mild opiate teas, syrups and wines…But within a few years of the introduction of prohibition, these milder forms of the drug had vanished. They were too bulky to smuggle…That’s when coca tea was replaced by powder cocaine, and Mrs Winslow’s Soothing Syrup was replaced by injectable heroin”. [p. 230-231] Thus the “war on drugs” actually worsens all the problems associated with drug use. Causes of addiction Hariri reviews scientific research on the causes of addiction. Why do some people become addicted while others do not? One very important factor is a history of trauma and abuse. Many drug addicts had “horribly disturbed childhoods, marked by violence, sexual assault, or both”. [p. 158] They were “terribly damaged before they found their drugs”. [p. 159] Drug use “takes away the pain, for a while”. [p. 162] On the other hand, many people in hospital are given opiates for pain relief, but most do not become addicted. Hariri quotes Gabor Mate, a doctor working with addicts in Vancouver, who said that “nothing is addictive in itself. It is always a combination of a potentially addictive substance and a susceptible individual”. [p. 159] A group of researchers in the US found that “nearly two thirds of injection drug use…is the product of childhood trauma”. [p. 160] But traumatic childhood experiences are not the sole cause of drug addiction. The current social environment in which a person lives is also a contributing factor. Environments that are highly stressful or extremely monotonous can contribute to addiction. Social isolation is a key factor. A series of experiments conducted by Canadian psychology professor Bruce Alexander showed that environmental factors determine whether or not rats become addicted to morphine. Rats which were put in empty cages by themselves became addicted when supplied with water laced with morphine. But rats which were put in an environment together with other rats, as well as toys to play with, did not become addicted even though water laced with morphine was available. They preferred to drink water without morphine in it. [p. 171-172] This indicates that social isolation and a monotonous environment cause addiction in rats. The same is true in humans. During the Vietnam war, 20 percent of US troops became addicted to heroin. But once the war was over and they left the army, 95 percent of them stopped using heroin within a year. The addiction had been caused by the war environment, and ceased once they were out of that environment. In Vietnam, “the world around them had become an unbearable place to be – so when they couldn’t get out of it physically, they decided to get out of it mentally. Later, when they could get back to a meaningful life, they felt no more need for the drugs, and they left them behind with surprising ease”. [p. 174] Social dislocation creates an environment favourable to the growth of addiction: “The native peoples of North America were stripped of their land and their culture –and collapsed into mass alcoholism. The English poor were driven from the land into scary, scattered cities in the eighteenth century –and glugged their way into the Gin Craze. The American inner cities were stripped of their factory jobs and the communities surrounding them in the 1970s and 1980s –and a crack pipe was waiting at the end of the shut down assembly line. The American rural heartlands saw their markets and subsidies wither in the 1980s and 1990s –and embarked on a meth binge”. [p. 175] However, governments have been reluctant to fund research on the social causes of addiction – perhaps because it leads to a critique of a society where social dislocation is a widespread problem. Hari looks at various attempts to reform drug laws and policies. Canada In the late 1990s there occurred what Hari describes as a “drug addicts’ uprising” in Vancouver. A heroin addict called Bud Osborn convened a meeting in a local church and formed a group to campaign for a safe injecting space. The group began attending city council meetings to put their demands. They put a thousand crosses in a local park, with the names of addicts who had died of overdoses written on them. Eventually their campaign was successful and the safe injecting site was established. As a result, drug related fatalities declined by 80 percent and life expectancy rose by ten years in the Downtown Eastside neighbourhood. [p. 203] Britain Britain had banned heroin, but allowed doctors to legally prescribe it to addicts. In the early 1960s access was restricted further – only psychiatrists could issue prescriptions. Thus heroin prescription continued, but only on a very small scale. John Marks, a psychiatrist working in a Liverpool suburb, decided to greatly expand the program in that locality. The results were very good. Crime in the local area declined. Surprisingly, drug use in the area actually fell. The reason is that prescription abolishes the need for drug addicts to become drug sellers. When drugs are not available legally, addicts have to buy them from dealers. To raise the money to buy drugs for themselves they often start selling drugs to other people. It becomes what Hari calls a “pyramid selling scheme…Prescription, it turns out, kills the pyramid selling scheme, by stripping out the profit motive. You don’t have to sell smack to get smack”. [p. 213] Despite the success of the Liverpool experiment, the British government, under pressure from the US, shut it down. Switzerland In Switzerland heroin prescription was introduced in the 1990s and continues today. Addicts are helped to rebuild their lives, including by getting a home and a job. The result was a fall in crime, HIV infection and other problems. Most addicts receiving heroin on prescription gradually reduced their dose over time. Opponents of heroin prescription made two attempts to overturn the policy by referendum, but were defeated. In 1997, 70 percent voted to keep the reforms. In 2008 the figure was 68 percent. [p. 223] Portugal Portugal had a very high rate of heroin addiction. Police measures failed to suppress the drug trade. Eventually a new approach was adopted. In 2001 all drugs were decriminalized. It was no longer a crime to have drugs for personal use. However, it remained illegal to sell them. The government put resources into the care and treatment of addicts. They were given help in finding a job. Tax concessions were given to employers who hired a recovering addict. Critics predicted an explosion of drug use, but in fact it fell. Hari describes the Portuguese policy as a “strange hybrid”. Possession of drugs is legal but sale is not. This means that drug users still have to buy drugs from criminals. Uruguay Uruguay has legalized both the production and sale of marijuana. The new policy was introduced under the leadership of president Jose Mujica, a former guerrilla fighter and political prisoner. Hari summarises the policy as follows: “In 2014, a legal structure was set up to let pharmacies across Uruguay sell marijuana to people over the age of twenty-one who produce a valid ID. The crop will be grown legally across the country, and taxed. Each home is also allowed to grow a small number of marijuana plants for personal use”. [p. 273] United States Hari reports on campaigns for the legalization of marijuana in Colorado and Washington State. Voters supported legalization by a margin of about 55 to 45 in referendums held in both states Following the referendum in Colorado, “Any citizen over the age of twenty-one can buy up to one ounce of marijuana on any given day from one of the 136 licensed stores, and they can consume it at home. They are also allowed to grow a small amount at home for personal use”. [p. 289] What sort of reform? The moves to reform the drug laws in various countries differ widely. Switzerland supplies drugs to addicts on prescription. Portugal allows possession of drugs, but not sale. Uruguay allows the sale of marijuana. Hari is tentative in his discussion of what is the best approach: “How, in the end, can you decide whether you support drug legalization and for which drugs? I can’t decide that for you”. [p. 271] He acknowledges that legalization of currently illegal drugs will probably result in some increase in the use of those drugs. But any harm that might be caused by this must be weighed against the harm caused by the “war on drugs” – crime, overdose deaths, etc. “Your calculation of the benefits [of legalization] may well vary from drug to drug”, Hari says. “Mine did. When it comes to marijuana and the party drugs like ecstasy, up to and including cocaine, I think the harm caused by a small increase in use is plainly outweighed by all these gains. That’s why I would sell them in regulated stores, like alcohol”. With stronger drugs such as crack and meth, he favours a different approach: “allow safe regulated spaces where users can buy and take them, supervised by doctors”. [p. 272-273]