A Most Disastrous War
Periodically I feel the need to blast away at our now 40 years old War on Drugs. To deal adequately with this topic takes a whole book---a few responsible such books have been written but little read. To write a short musing on this topic requires the kind of condensation most difficult to achieve, especially for a wind bag like me. With many problems I like to start with Lincoln's wisdom on approaching a problem: "If we could first know where we are, and whither we are tending, we could better judge what to do, and how to do it."
After 40 yrs of our expensive War on Drugs, just where are we? The U.S., of all the modern industrialized nations, has the greatest percentage of people in jail for drug use or trafficking, has created more urban and suburban ghettoes as a consequence of this War, and has a recreational drug abuse level as high or higher than these other industrialized countries. Why then do we continue a War which, after 40 years, has achieved little---if anything---and permanently destroys the life of so many young people most in need of help? When it comes to recreational drug abuse we live in the Dark Ages, a most unenlightened stubborn adherence to politically and religiously instilled fabricated notions.
We cannot responsibly confront recreational drug abuse until we understand what constitutes drug abuse and why people abuse recreational drugs. Everyone knows recreational drug use CAN be bad, we have all seen examples of it, and so the existence of recreational drug abuse is self evident. There are two aspects of recreational drug abuse which can be harmful: physical harm to the body, and the imposition of mental states not conducive to improving one's life situation.
Not all recreational drug use is bad. The person who has a glass of wine before dinner may even be doing a healthy thing. The person who drinks a moderate amount of alcohol in social situations is not likely to harm their health or life situation. The alcoholic, however, manages to endanger both their health and their life situation. So recreational drug abuse does not follow the all or none law. For the most part the typical attitude toward recreational drug use is one of two venues; I do not abuse the recreational drug I use so it should not be made illegal and I am not responsible for those who cannot use it correctly---and the other venue is "It is my body and I will do what I want with it". If the drug in question is a drug which is not a long standing drug of popular choice then most everyone wants it banned. Period.
All recreational drug use is done to alter our mental states. People don't spend money on recreational drugs if the use produces no desirable effects. And if the effects are not desired or needed, the person doesn't use the drug. It is really not that much more complicated. The next question is what effects? We take recreational drugs to stimulate a more exciting mood, to alter reality in subtle ways, to reduce pain, to make us more mellow or sociable, to relieve inhibitions, and to relieve stress. At first glance all of this seems reasonable enough, like let's all just make our lives for the better using recreational drugs. But using recreational drugs only makes sense if the person's life really improves with the use of the drug in question.
Thus, each person has to ask themselves if they are physically harming their body by introducing a toxic substance into their system, and if so, just how toxic is the substance. The second question each person need ask themselves is just what effect does using the drug have on their real life situation. Notice none of these questions involve criminality. To treat anyone as a criminal with these kind of decisions is illogical. And when people make bad decisions in these areas they need medical help, not be forced to live in the shadows or jailed. If just one quarter of the money being spent on this so called War on Drugs were spent on treatment centers accessible to all who need help with recreational drug abuse, the drug problem in this country would be substantially reduced, criminal behavior in this country would be reduced, the poorest of the young would not be give long term jail sentences for selling others their recreational drug of choice, and urban/suburban/ rural ghettoes would become safer places to live with businesses more willing to exist in a safer environment.
Recreational drug abuse should not be treated as a criminal endeavor. Progress can only be made through education and medical treatment centers. When I first was asked to teach a Course entitled the Physiological Aspects of Drugs and Drug Abuse I was asked to do so because I was the only Physiologist on board who had ever taken a Pharmacophysiology course. It was the same course taught to medical students in Medical School. The trouble is, while it has changed a bit these days, until recently prospective doctors were given little information about the drugs of abuse. And the scientific literature about them, in terms of actual scientific studies, were hard to find---simply scarce. Why? Sadly, most all scientific studies in this country are funded by federal grants. And the federal government was not interested in any federal funding of studies involving the recreational drugs of abuse. Nixon tried that once in an attempt to bolster support for his newly launched Criminal War on Drugs. When the results were not politically helpful to this criminal approach to recreational drug abuse, he simply refused to accept the report and every President since has appointed Drug Czars whose only interest is waging a criminal War on Drugs. But studies have been done, if not often in this country, then abroad, and we are not exactly without any data about the physiological effects of these drugs.
Toxicity is relatively simple. We know how toxic each of the recreational drugs are to the body. And one must remember the most basic premise of drug use. All drugs have side effects. The question is always do the side effects out weigh the benefits? In order of toxicity, the most common drugs of abuse are listed as follows: Nicotine, Alcohol, Cocaine, marijuana, heroin. The less commonly used drugs have less extensive research but generally are quite toxic. In terms of deaths per year from use in the U.S. it goes as follows: (not current---1996)
Tobacco----419,000
Alcohol-----108,000
Alcohol mixed with other drugs----4,000
Heroin mixed with other drugs-----4,000
Cocaine------2,000
Marijuana---75
The figures above need further explanation. In 1990 one in five deaths in the U.S. were related to smoking. In Oregon it is required to list on a death certificate if smoking contributed to the death. This is where the 25% figure is arrived at. Note that Oregon collects $74 million in cigarette taxes and spends $634 million on smoking related health costs. Perhaps if a person has a right to do what they want to their body they have an obligation to pay the medical costs involved. Smoking is related to 30% of cancer deaths, 20% of deaths from Coronary Heart Disease, 80-90% of deaths from Chronic Obstructive Pulmonary Disease. The total health care costs in the U.S. is estimated to be $100 billion annually. All of these figures go back 10 years so are not recent ( I am retired now), but the general gist is still valid.
For alcohol roughly 10% of those who drink are alcoholics. Alcohol accounts for 40% of admissions to mental hospitals. However, it is not clear whether alcohol caused the mental illness or the mental illness caused them to become alcoholics. 50% of arrests in the U.S. involves alcohol. Half of fatal auto accidents are alcohol related. This figure may be down considerably now. In 50% of homicides either the victim or the slayer has measurable amounts of alcohol. Most people know alcohol is not particularly good for the liver, the stomach, the heart. At any rate, alcohol, when abused, can have substantial health and social effects on society.
With cocaine, 25 million people in the U.S. have tried it, and 1.6 million people are said to use it at least once a month. 5-20% of these are dependent on it. In some areas of South America 90% of adults chew on the leaves daily. Cocaine is used to create increased alertness and euphoria. With acute poisoning there can be respiratory or cardiac arrest. No real evidence exists that occasional use of small amts of cocaine is a threat to health. HOWEVER, the toxic reactions are unpredictable and can kill quickly via cardiac arrest. In one study, cocaine users earned 37% higher wages than non users. Of course one study proves little, just interesting.
Marijuana use is essentially a non health issue, at least compared to how one eats, how one exercises, etc. No one knows anyone who died from marijuana use. Our hospitals and mental institutions are not loaded with marijuana abusers. Marijuana is used because it at first produces mild stimulation followed by a feeling of well being and the person may become introspective, tranquil, or sometimes giddy/silly followed by mellowed silence. It may lead to a modest impairment of short term memory, probably because the person is less motivated to remember some things while high. They feel more like focusing on 'deeper' issues.
Heroin is basically non toxic simply because it is a natural body chemical. Heroin and morphine operate via the same receptors in the body. The body produces it's own endogenous opiates under certain conditions like severe stress, including long distance running. Yes, long distance runners do get an opiate high, which explains their devotion to running long distances. If someone dies from heroin use it is because they mixed it with another drug or they didn't take care of their health. More about heroin later. Let's just point out here that toxicity is not a problem with heroin.
At this point I need point out that except for a glass of red wine with my dinner I do not use any of the above drugs and essentially never have. This has nothing to do with anything other than I guess I get high enough without any assistance or am able to handle stress without additional assistance, or just basically prefer not to ingest drugs whose long term implications are uncertain.
Aside from toxicity, drug use can be addictive. Of course the question then is which drugs are most addictive? The answer is not simple. Addictiveness varies from person to person. Each of us, in our own way, are unique mental cases. Nevertheless, in general, rating addictiveness on a scale of 100, with 100 representing the greatest addictivenes, it would go roughly as follows:
Nicotine----100%
Crack Cocaine----98%
alcohol----80%
Heroin----80%
Cocaine---75%
Caffeine----70%
Marijuana---25%
But it is quite tricky to separate physical addictiveness and psychological addictiveness. Certainly nicotine, cocaine, caffeine, and alcohol produce predictable withdrawal symptoms. All recreational drugs of abuse act on neurotransmitters by either affecting neurotransmitter production, storage, rate of destruction, rate of reuptake, blocking receptors, blocking release, mimicking a neurotransmitter or potentiating the effects of a neurotransmitter.
It is important to keep in mind that people use recreational drugs to create a certain mental state, and if the mental state serves a valued purpose, then a person may strongly resist not using the drug and it has nothing to do with physical addiction. I will use heroin as the best example here. One cannot understand morphine/heroine use without first understanding that this drug is used to reduce pain---both physical pain and mental pain. The sensation of pain involves two separate pathways to the brain. These pathways serve two different purposes. One pathway simply identifies the type of pain. This is how we know what kind of pain we feel. The second pathway determines how we FEEL about the pain. The threshold for detecting whether we sense pain is about the same for all people. How people FEEL about the pain varies a lot. Morphine/heroin blocks the pathway which activates how we FEEL about pain. This is why morphine is so useful in medical situations. You can't give a patient something which simply blocks all pain because pain helps the doctor know what the situation is. When a patient says "I can't stand this pain" the doctor administers morphine/heroin and when he comes in the next day he might say, "Do you still feel pain" and the patient will respond, "the pain is still there but it doesn't bother me like before". Heroin and morphine are really wonderful drugs and you can see why the body will produce it's own morphine/heroin under certain conditions.
Early on politicians and the public at large decided that heroin and marijuana were 'bad' and 'dangerous' drugs. And nothing, absolutely nothing, was going to deter politicians from using this to win elections. The more a politician was willing to punish users or sellers of these drugs, the easier it was for them to get elected. And everyone knew, in their heart, that heroin was a drug of choice in the ghettoes and marijuana was a youth drug which led to more serious drug use. OF course these were simply beliefs, hardly the stuff to formulate policy. And thence the Drug War was commenced, and has proceeded to this day with Americans now having a greater percentage of our citizens in jail than any other country, our inner cities destroyed, and a huge expense to locate, arrest, and keep drug users and sellers in jail, out of sight . Aside from the cost of finding, arresting, and prosecuting all these people---mostly young people---it costs a good $30,000 a year to keep someone in jail. And the mandatory sentences now are up to 10 years. After ten years in a jail most any person emerging from jail has little future, for various reasons, and is most likely to be sent back to jail. The kid that sold others their recreational drugs thus becomes a permanent ward of the state at a cost of $30,000 a year with a ruined life. Onward Christian soldiers, marching as to war, locking up our young most in need of help.
But let us return to heroin and to a lesser extent marijuana. Because of the War on Drugs and all the misinformation it dispenses, for decades patients in hospitals were not allowed unlimited use of morphine to relive pain. The reason put forth was that the patient would become addicted to morphine/heroin and become a drug addict. And doctors knew no better because the medical curriculum did not not include any substantial scientific information about drugs of abuse. Only in the last ten years have patients finally been given as much morphine as they wish to relieve their pain. Here is the point to keep in mind. You take morphine/heroine to relieve how you feel about pain. When the pain is gone, there is no need to take morphine/heroine anymore. It is about as simple as that. During the Vietnam War a good percentage of soldiers used heroin on a regular basis. It was readily available and the soldiers used it. They sniffed it, they smoked it, they mainlined it. It was estimated that 10-50% of the soldiers used it and the percentage was higher on the front lines. Yet 8-12 months after returning home only 1-2% were still using heroin. It is not just physical pain that heroin relieves, but mental stress too. My guess is that those soldiers who use heroin to relieve the mental stress of their situation, if it is really bad, are less likely to suffer post traumatic stress syndrome when they come home. But that is just my guess. At any rate, heroin is a drug mostly of the ghetto because it relieves the mental stress of their environment. If you live a miserable life with no clear view of how to improve it, you then use heroin so you just don't care anymore, the stress of it all no longer BOTHERS you. But here is the clinker: IF YOUR BAD SITUATION NO LONGER BOTHERS YOU, YOU HAVE LOST SOME OF THE DRIVE TO IMPROVE YOUR SITUATION. Thus, heroin is not the solution, it is purely a palliative measure. Clearly, people, young and old, who live in the worst of our neighborhoods and family environments, need help and opportunities. That is the best way to spend money---to help them overcome their environmental situation. If society can't do that, then let them have their heroin, at least let them have relief from their feelings about their lives. If they are all doped up on heroin they at least are far less likely to be violent, and if they didn't have to pay underground prices in an illegal drug market, they wouldn't have to steal things to get the money to pay for the drugs.
As far as marijuana is concerned, only an indoctrinated fool would choose nicotine or binge drinking as the recreational drug of choice. If one feels a real need to relax, mellow out, to be more social, to settle your mind or get relief for a bit from stress, marijuana is a far better choice. And what people need to be educated about, from early age on, is that recreational drugs, if used intelligently, can only be temporary lifts to your mental state, that real progress in anyone's life depends on serious attention to the stresses in one's life. In a caring, healthy society---certainly in the richest society on earth---any citizen should be able to go to drug abuse centers and get help to reduce the stresses in their lives so they can turn their lives for the better and become productive responsible citizens, spouses, parents, and workers.
The current War on Drugs is, and has been for 40 years, a page right out of the dark ages---a perfect example of where ignorance has ruled and justice denied to those most in need. So where is this all heading? Perhaps if this War on Drugs was not overshadowed by so many other pressing needs----pollution, depleting natural resources, depleting water supplies, overpopulation, use of violence to resolve global conflicts, the use of world wide 'slave labor' to produce cheap goods for the affluent, etc.-----maybe if all these issues were not in our face big time, then maybe the War on Drugs would get attention. This same sort of dilemma occurred back in the twenties when 'for the good of the people' alcohol was made illegal. After ten years of turmoil similar to the turmoil with the present War on Drugs, alcohol was made legal and things settled down. It is not like no one understands the folly of our current War on Drugs. A few Congressmen, Barry Goldwater, Walter Cronkite, and others I forget right now, see or saw the picture in realistic terms. If just marijuana were made legal the traffic in drugs would drop significantly. It is the sale of marijuana which makes the whole trafficking in drugs so lucrative. The only hope for any sanity and forthrightness in this area of recreational drug abuse lies in the ever growing need for Government money on other matters. At some point maybe Obama will realize how expensive this War on Drugs really is, and take steps to dismantle it and replace it with treatment centers as part of a total health care package. If marijuana were legal and taxed this also would add a lot of money to the Government coffers. Many foreign governments, especially in South America and parts of Asia would not be terrorized by drug cartels if some drugs were made legal. The jail population in this country would drop substantially. Our urban ghettoes would become safer and businesses have a chance to locate in areas now off limits due to the violence associated with drug trafficking. The door to participating in illegal drug sales would be closed to young people in our rural, suburban, and urban ghettoes, and there would be help centers instead to assimilate these forgotten 'nothingburgers' into productive employment and help them become responsible citizens. But of course none of this can really happen until there are global minimum wages so that those who work to produce the products we buy are making living wages, and themselves can afford to buy things and have things. Slavery in this country is not dead---it has just been moved offshore in the name of unrestricted capitalism----and all countries, including our own country, are being moved into third world economies in which a small privileged wealthy class acquires more and more wealth off the backs of slave labor. If anything is going to bring total global chaos, this will. And if overpopulation cannot be successfully addressed, nothing else----nothing else---really matters in the not so long run.
Welcome to the Presidency Mr. Obama.
