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Just Say No .. to John Stuart Mill
September 22, 2007 8:23 AM   Subscribe

"An open society must be prepared to listen to those who offer a critique of its conventional wisdom—and our conventional wisdom about drugs and addiction should be no exception."
posted by daksya (50 comments total) 2 users marked this as a favorite

 
No matter how many erudite articles someone writes about the War on Drugs, it simply won't stop in prosperous times. In fact I doubt it would stop until it reaches the point where it so expensive economically, continuing funding is seen as overwhelming absurd. I would hate to see the depths of a depression that would cause this, but there's a large chasm in thought between intellectual magazine and Molly Busybody on the city council enraged that some no-good teens are shrooming in the park across the street from her child's school. Much like abortion, drug war rhetoric is too emotional to argue about in a public forum.

"Thus, the first step on the road to sanity about drug addiction is to stop treating it like a medical condition and to begin looking upon it as a moral failing."

I agree that calling it a disease severely undermines the addicts ability to stop. I mean, getting rid of the flu isn't a conscious choice ... it is something our body does implicitly. Yet anyone who has met someone with a deep heroin or cocaine addiction would have to agree that there are underlying illnesses being "treated", perhaps not in the most beneficial way. Assuming that drug use is as off and on as playing video games is as much a fallacy as believing that it turns otherwise upstanding men into slaves of a substance.

Right now we treat drugs like we used to treat homosexuality. As in, I was just in the public bathroom minding my business, when one of those wily homosexuals seduced me with their gay magic.
posted by geoff. at 8:45 AM on September 22, 2007 [1 favorite]


Good lord, that guy could use an editor. I agree that the disease model is flawed, but I don't agree in burying the lede in mush.
posted by Bookhouse at 9:23 AM on September 22, 2007


Dalrymple:
“When self-indulgent actions, such as taking heroin, are deprived of some [of] their worst consequences, it is hardly to be wondered at that they spread like wildfire through a population. If consequences are removed from enough actions, then the very concept of human agency evaporates.... Harm reduction as a policy is inherently infantilizing of the population: it assumes that the authorities are, and ought to be, responsible for the ill-consequences of what people insist upon doing.”
This strikes me as the same flawed reasoning as those fundamentalists who would deny HPV vaccinations -- they are seeking to discourage behavior by exposing people to unnecessary and deadly risks.

I've always been of the opinion that drug use and abuse comes with it's own natural penalties, which are proportionate to the drug's respective harm or harmlessness. Smoke weed habitually and maybe you'll suffer from lack of motivation and develop a nasty cough. Smoke meth habitually, and you'll become a subhuman husk of pathetic depravity and probably die. Unlike man's misguided punitive inventions, these inherent penalties are elegant and truly fair.
posted by edverb at 9:36 AM on September 22, 2007


edverb: "This strikes me as the same flawed reasoning as those fundamentalists who would deny HPV vaccinations -- they are seeking to discourage behavior by exposing people to unnecessary and deadly risks.

I've always been of the opinion that drug use and abuse comes with it's own natural penalties, which are proportionate to the drug's respective harm or harmlessness.
"

Aren't you contradicting yourself here? I mean, surely the fundamentalists, by your argument, are saying that STDs are "natural" and "elegant" penalties for unsafe sex?
posted by Drexen at 10:00 AM on September 22, 2007


I mean, surely the fundamentalists, by your argument, are saying that STDs are "natural" and "elegant" penalties for unsafe sex?

No. Dalrymple is arguing against clean needle programs so that addicts (unnecessarily) risk HIV. Fundamentalists argue against HPV vaccinations so that sexually active teens (unnecessarily) risk STDs. Both are seeking to control human behavior by stymieing progress.

My point is that drugs exact their own penalties. I don't agree with the argument that we need to artificially increase those natural penalties, and certainly not at the expense of progress against avoidable, negative outcomes.
posted by edverb at 10:15 AM on September 22, 2007 [1 favorite]


The idea that drug use should exact any penalty at all is medieval thinking. The idea that pleasure for the sake of pleasure is inherently sinful, that happiness needs somehow to be earned is straight out of the 15th century.

If a miracle cure for the physical side effects of drug-taking -- addiction, organ and brain damage, etc -- were invented tomorrow I see no reason why everyone shouldn't do drugs all the time.

Drug use is bad because it causes undesirable side-effects. It's not the cast that drugs have side-effects because they are bad.

All emotion is chemical, and all of it is artificial. If you eat candy, you're manipulating your brains chemical balance. If you're skydiving, you're altering the balance of chemicals in your brain. If you're in love-- again, same thing.

There's absolutely no ethical reason why we should be able to feel exactly as we choose to feel all the time.
posted by empath at 10:36 AM on September 22, 2007 [1 favorite]


(shouldn't be able to)
posted by empath at 10:37 AM on September 22, 2007


Anything that deforms fetuses and induces mental illness is primarily a disease that should be prevented from spreading, although the vector are usually other people who have equal rights, and who spread their disease by way of marketing. in other words, they aren't just germs and insects. This fact merely complicates it, but it doesn't discount the argument for disease.
posted by Brian B. at 10:46 AM on September 22, 2007


Indeed. Especially when innovative programs like Vancouver's "Safe Injection Site" have such clear, documented benefits. Harm is down, addiction counselling is up, it's freakin' win-win all the way around.

As a society we need to grow t.f. up. Drug use has always been around and will always be around. It is stupid to the point of malicious to support the criminalization of use: it drives distribution underground and makes it damnably difficult to effectively ameliorate the risks of use.

Full-on legalization of all drugs and the ability to purchase quality standardized product will all but eliminate the problems associated with production, trafficking, and financing of addictions. Provision of safe environments for the use of drugs will all but elminate the problems associated with street use, sterility, overdose. The familiarity with nursing staff at safe sites leads to an increase in the rate of users seeking addiction counselling, too.

Unfortunately, the sane response to the reality of drug use will never, ever be tolerated by the mostly ill-informed, irrational, and fearfully stupid majority of our population.
posted by five fresh fish at 10:47 AM on September 22, 2007


geoff. - "No matter how many erudite articles someone writes about the War on Drugs, it simply won't stop in prosperous times.
...
there's a large chasm in thought between intellectual magazine and Molly Busybody on the city council enraged that some no-good teens are shrooming in the park across the street from her child's school
"

I'll be presumptious and guess you didn't read the article at the time of this comment. It ends:

"In sum, an open society has no realistic choice but to concern itself with the harm that people do—not just to others, but to themselves. It has not only a right but a duty to do this. The question is not whether it should exercise this duty, but only how and under what circumstances. With respect to drugs and addiction, the conventional wisdom may have much still to learn—but it is closer to the truth than those who seek to overthrow it."

Within the essay, there's a lot of vague and broad-strokes reasoning applied upon the same prohibitionist premises that the author exhorts his readers, in the beginning, to not uncritically assume. In particular, he assumes two recent books as a template for the rethink viewpoint. Of which, one actually argues for keeping the status quo.

I was/am going to critique it later. My post is not an endorsement of the essay.
posted by daksya at 10:49 AM on September 22, 2007


Empath, I see your point and largely agree with it. You could take the fundie/Dalrymple argument to the extreme and apply it to all sorts of things: surgery inherently carries the risk of bacterial infection, and for whatever fundie reasoning to discourage medicine they could say that antibiotics should be banned. (In a way, this is ostensibly their reasoning for banning stem cell research too.) Eating fish carries inherent danger, so if they were opposed to eating seafood due to something the Bible told them in Leviticus, those who get food poisoning after eating shrimp should be denied medical treatment.

If a miracle cure for the physical side effects of drug-taking -- addiction, organ and brain damage, etc -- were invented tomorrow I see no reason why everyone shouldn't do drugs all the time.

Well, that's the extreme opposite argument. There is a natural penalty that goes along with being high all the time -- in essence, disconnected from reality -- that I think no amount of progress can overcome.

All emotion is chemical, and all of it is artificial.

I disagree, b/c that reduces all of human experience to the artifical, and that's not so. Love may have a chemical component, but it is not artificial. Unlike crystal meth, you don't synthesize love or excitement in a lab.

There's absolutely no ethical reason why we should be able to feel exactly as we choose to feel all the time.

Sure, any way to allow people to have experiences and inoculate them from negative consequences is what I'd consider progress. (This could encompass airbags, motorcycle helmets, parachutes, refrigeration...anything that makes the inherently unsafe a little bit safer.)

What I don't agree with is the idea of imposing an artificial penalty.
posted by edverb at 11:07 AM on September 22, 2007


I tend towards agreement with the Aristotelian akrasia idea that addiction is a mental weakness, but Christ the first guy is an asshole. Heroin addicts have this facet of mental weakness -> they are the scum of the earth. To draw an analogy from physical strength/weakness, a lot of people can probably beat me at arm wrestling but that doesn't make them automatically better than me.


Full-on legalization of all drugs and the ability to purchase quality standardized product will all but eliminate the problems associated with production, trafficking, and financing of addictions.


I realized the big practical problem with full on legalization of everything pretty recently: You would have Phillip Morris marketing and selling crack rocks and meth from bodegas to poor kids in the ghetto, using everything they learned that has double digit percentages of the population addicted to cigarettes, which aren't even that fun to smoke.
posted by TheOnlyCoolTim at 11:10 AM on September 22, 2007


you don't synthesize love or excitement in a lab

Several million MDMA users would disagree, I think.
posted by empath at 11:49 AM on September 22, 2007 [1 favorite]


I disagree, b/c that reduces all of human experience to the artifical, and that's not so.

I could just as well have said it's all 'natural'. The distinction between natural and artificial is somewhat arbitrary. Some people are addicted to falling in love and go through just as many self-destructive behaviors (and destructive of others) to feel that over and over again.
posted by empath at 11:52 AM on September 22, 2007


TOCT: Operate it as a government program, then, just like liquor stores in some provinces.
posted by five fresh fish at 12:41 PM on September 22, 2007


The biggest problem I had with this was his simplification of Mill—On Liberty actually has a pretty complex argument regarding prohibition, and Mill considers that the harm of a drunken father (especially in his inability to support a family) necessitates the involvement of the state. He just disagrees that the answer is a broad prohibition (if I recall correctly, he argues for imprisoning those who have done harm to others through their drunkenness, including harm that has been passively dealt).

Instead, he holds Mill up as an ultra-libertarian, which has rather different connotations these days, than the utilitarian Mill was. Mill isn't arguing any moral necessity to freedom, but rather that using the state to ensure greater freedom to a society would result in greater happiness and prosperity. As such, every instance of that liberty comes with an implicit calculation of the cost, and makes Mill ultimately a moderate through pragmatism.
posted by klangklangston at 1:10 PM on September 22, 2007



What the guy (and Dalrymple) misses is *why* some people get addicted and why others don't. What they also miss is that this is a tiny proportion of the population, even with lots of stress and widely available heroin.

During the Viet Nam war, 50% of American soldiers tried heroin or opium, only 10% continued to use it once they returned home and only 1% became long-term addicts. The same statistic holds for pain treatment-- even with people exposed long enough to become physically dependent on opioids, only about 1% without a prior history of addiction become addicts.[My article which cites this and details my own position on the definition question is here, from the Washington Post. Note that part of the correction is wrong, Robins, who authored the Viet Nam study is both a sociologist and a psychiatrist]

About 50% of those who become addicts have some known additional mental illness, whether it be depression, bipolar, schizophrenia, anxiety, etc: they are basically self-medicating.

This is probably why Halsted (who devised surgical techniques still used today but wouldn't be allowed to practice now) could not kick morphine. Nothing to do with avoiding withdrawal-- or "moral weakness"-- and everything to do with avoiding return of anxiety/depression.

Imprisoning addicts is a very foolish, ineffective idea because addiction is defined as compulsive use of a substance *despite* negative consequences. If negative consequences solved addiction, IT WOULDN"T EXIST.

And the business about Mao being the world's greatest drugs worker is simply nonsense: we really don't know how well his approach "solved" China's opium problem because the statistics are hardly going to be reliable (how many people are going to admit addiction when execution is the punishment?) and because we know for a fact that it rebounded afterwards. Currently, China IS ALLOWING NEEDLE EXCHANGE, because they recognize that the research evidence shows that this does not increase drug use but does reduce HIV!!!!!

Many of the things these articles worry about are now empirical questions that can be answered: the harm reduction stuff has showed clearly that the fears that reducing HIV by making the "consequences" of addiction less bad would raise addiction levels are not based in fact. The consequences of addiction were plenty bad before HIV came along-- it's silly to think that without it, lots of people would just run out to shoot up.

And you could determine which kinds of regimes would minimize the harms of drug use as much as possible while simultaneously minimizing the harms inflicted by our legal/regulatory systems. It's certain that the U.S. has it wrong-- but the details of fixing it are complex.
posted by Maias at 1:34 PM on September 22, 2007 [2 favorites]


Dalrymple is a legendary nutcase who writes weekly misanthropic screeds in the Spectator.

I'm proud to say that I caught him out - in one of his rants against modern England he railed against the state of Blackpool's streets which were, he told us, littered with "empty packets of marijuana".

Come again? I wrote to the Spectator enquiring what, exactly an empty packet of marijuana looks like and they acknowledged the absurdity of the notion with good grace. Whenever I read his dark and unpleasant ventings I think of those mysterious packets and can crack a smile.
posted by grahamwell at 1:45 PM on September 22, 2007 [1 favorite]


An empty packet of marijuana is quite a familiar sight in the u.s. -- a small ziploc baggie with some bits of shake left.

I admit I've never seen one on the street anywhere, and the very claim makes me giggle as well.
posted by mrgrimm at 1:57 PM on September 22, 2007


In Manhattan I saw empty packets of marijuana on the sidewalk all the time, unless people had some other reason to be littering 2" square baggies. Stop littering, stoners.
posted by TheOnlyCoolTim at 2:10 PM on September 22, 2007


You would have Phillip Morris marketing and selling crack rocks and meth from bodegas to poor kids in the ghetto, using everything they learned that has double digit percentages of the population addicted to cigarettes, which aren't even that fun to smoke.

This comes up from time to time and empirical data shows that on average, a population will tend toward the least harmful alternative. Meth and crack cocaine both deliver the drug fast and hard. We are more likely to see good old fashion cocaine and amphetamine abuse given the subsequent drop in price. You know, like it was before amphetamines were made the target of the DEA sometime in the 70s. You could get dexedrine inhalers on first class planes in the 50s! Meth was around, but its use was limited to military context, by and large not recreational.

I would be all for standardized, government regulated packaging. No advertising and in completely plain boxes except for basic information (quantity, price, dosage), with side effects prominently displayed. Data suggests that the later in life someone starts using, the less likely they are to become addicted. Treat it like alcohol in this regard.

N.b., you're right, I stopped reading it 3/4 of the way through because the article sucked.
posted by geoff. at 3:57 PM on September 22, 2007


If the price is lowered on a commodity, its consumption will increase. Therefore, trying to prevent drug use has nothing to do with legalizing it, which would make it far cheaper and as widely available as cigarettes (which currently afflict about 25% of the US population on an addiction and/or dependency basis, with higher rates among those who can least afford to smoke). Even in countries where drugs are decriminalized they typically offer expensive treatment to lower drug demand. Incarcerating some drug dealers is fair because they are sociopaths who are skilled enough to capitalize on the vulnerable by using affinity marketing techniques. Incarcerating users is nonsense, but this mistake has nothing to do with legalizing drugs, and it is common in the conservative mindset to see a set of either/or propositions that ignore demand side treatment solutions.
posted by Brian B. at 3:59 PM on September 22, 2007


That is a twitter-brained counter-argument, Brian. You have erected strawmen: legalization is not a lack of control. Quite the opposite, in fact.

[deletes a substantion response]

Here, read this. It proves, repeatedly and definitively, that you are pulling your opinions from your ass.
posted by five fresh fish at 5:08 PM on September 22, 2007


fff, yours is the strawman. I didn't see the word "legalization" anywhere on your link. Check this FAQ out to see the word used in two different contexts, both signifying legal distribution, one controlled, the other wide open ("supermarket" approach).

Quote: The libertarian approach to legalization advocates free-market distribution of all drugs, including cocaine, heroin, and marijuana. This is perhaps the most common popular conception of legalization, yet most 'legalizers' favor a more controlled distribution.
posted by Brian B. at 5:27 PM on September 22, 2007


Meh. My review of the Dalrymple book was better. Unfortunately, you can only read it if you subscribe to Druglink.
posted by PeterMcDermott at 5:31 PM on September 22, 2007


Who the hell has advocated a free-market distribution?! And what was the point of your "trying to prevent drug use has nothing to do with legalizing it, which would make it far cheaper and as widely available as cigarettes (which currently afflict about 25% of the US population on an addiction and/or dependency basis, with higher rates among those who can least afford to smoke)" comment? What the heck? Cheaper than ciggies? How can you assert that?

You appear to be arguing against legalisation and, therefor, controlled distribution and use.
posted by five fresh fish at 7:59 PM on September 22, 2007



The tricky part of alternative regimes to the present one is figuring out how to deal with the fact that addiction and heavy use (which can cause just as much, if not more, harm because it is more common and therefore affects more people) *are* price sensitive and the harms vary between drugs. You need to balance the harms of the black market and the harms of under-regulation (Philip Morris crack would be an example of under-regulation; Philip Morris cigarettes are another!)

So, one could imagine few problems with decriminalizing or even legalizing marijuana because we have already have periods where close to 70% of the young population tried it and we didn't break out in a giant rash of schizophrenia or massive un-ambition (in fact, we created the internet). (and no, today's "stronger" marijuana doesn't make a difference because people titrate their dose and get the same amount of high as they did in the 70's and early 80's, the peak of drug use in the US).

Cocaine is a very, very different story and opioids are different yet again.

But again, all of these are now empirical questions that can be tested and the incredible harm of doing things like locking up 1/3 of young black men and spreading HIV massively makes a compelling case for at the very least, eliminating mandatory minimum sentences and dealing with use by offering treatment (or just drug testing so that those who can get clean without treatment aren't wasting spaces in treatment: See Mark Kleiman for elaboration of this idea).
posted by Maias at 6:01 AM on September 23, 2007


Cocaine is a very, very different story and opioids are different yet again.

Not exactly. There have been instances of opium use in Persia, China and other places where the instances of abuse/addiction were no different than alcohol. One can imagine that we would see the same addiction rates and harm reduction we do with alcohol.

I've become more and more convinced over time that there is a certain percentage of a population who will always abuse illicit substances, whether it be legal (alcohol) or not. The only way to prevent this sort of abuse is to put in place totalitarian practices that not even this country would be comfortable with.

But of course, this is a morality issue, as stated above. Just like gay marriage and the myriad of other things that are illegal in this country. I wish it would be framed as a morality issue and keep bad science out of the public. I fear the real long term repercussions of the drug war will be the use of science to manipulate the public and a distrust with a methodology that has done so much good.
posted by geoff. at 11:16 AM on September 23, 2007


Geoff, we see pretty darn bad addiction rates with alcohol-- and pretty darn bad rates of alcohol-related harm amongst non-alcoholics. And we do a crap job of harm reduction because we don't believe in it as a country.

I agree that there is a group that will always be addicts-- that isn't the only group you have to worry about. It's the group that will use enough to fuck up their lives only under certain circumstances, and it's a far larger group and is influenced by social trends and contagions.

Cocaine really *is* different and we don't know how much of a substitution v. an addition situation there is. In other words, there may be people who will have no problem ever unless they are exposed to cocaine (alcohol is fine, etc) and for others, they will find something no matter what's legal and what isn't.

Cocaine-- particularly injected and particularly crack-- produces a kind of crazy, paranoid dysfunction that is especially problematic. It can increase violence in the already violence-prone: not a good thing.

This is not the problem with opioids- - and people tend not to be able to stand the intense cocaine thing for more than 3-4 years or so if they have unlimited access-- but you can do a lot of damage in that time.

Opioids allow many to function perfectly well on maintenance-- in fact, many alcoholics would probably be more functional with methadone maintenance because with opioids you can get to a state of being "straight" (not high, not withdrawing, not cognitively impaired) where as with chronic, daily heavy alcohol there is no such state. However, there are also those who simply want to be off their heads all the time and will mix everything and adding more into the mix doesn't help.


I am well familiar with the history of legal opioids and cocaine in the U.S. The problem is, availability matters. Believe me, I really, really wish it didn't because I think general fairness is a pretty good principle (ie, why should you be allowed to alter your consciousness in one way but not another?) but it is not as easy as just legalize and all will go well.

Whatever framework you create has to be very carefully tailored to balance the harms of prohibition against the harms of unfettered use. I am not claiming by any stretch of the imagination that everyone would go out and become a junkie crackhead if cocaine and heroin were legalized and made cheap tomorrow. But you might realistically see their numbers doubling (ie, 3% to 6%-- some of these would not be long term addicts, but again, even short term the risks of these drugs can be significant. For example, 1-3% of all heroin addicts die annually: no one knows if this is a self-selection effect for suicidal people or to do with weirdness of pharmacology) and that could be significantly problematic.

Higher price, no ads, limited availability times, intensive education (and availability of the antidote to opioids) would reduce that problem-- but if you make price too high you start increasing criminality to obtain the drugs and a black market to supply them.

So, it's about balancing harms-- you are going to have some harms. Which ones do you want? I personally prefer substance related harms to incarceration-related harms since the substance-related harms are generally far less dire. But you can't pretend that they don't exist or that availability has no effect on them. Demonstrably-- with alcohol and tobacco-- it does.

Alcohol taxes, for example, have significant effects not only on binge drinking but on alcoholism itself. It is way, way complicated. But many of these issues are empirical questions and we should be looking at them instead of sticking with this stupid, pointless, fake moralizing drug war.
posted by Maias at 12:30 PM on September 23, 2007


But of course, this is a morality issue, as stated above.

I don't think so. Drugs like meth and heroin are a toxic form of mind control that produces large profits accordingly, whether legal or not (but one profits from the many, while the other profits from the few). There is nothing moral or immoral about who succumbs to it, and rational people find it necessary to protect their irrational children from market forces by outlawing or regulating drugs precisely because it takes over one's central nervous system if one is vulnerable to it by many different factors, including repeated exposure or depression, just like any opportunistic germ infection would.

The public health and safety priority is to minimize competition, not increase it, because normally productive people would crash their buses and neglect their children and monthly bills if it were more available. The solution to the problem is to reduce demand without increasing the supply. The same market approach some people advocate has already failed the addicted and dependent in this regard, because they bought it with cash from a distributor even when they paid a hugely inflated price for it. If the price gets any cheaper, the US would look like present day Iran with 8% addicted to heroin and climbing.

Imported heroin was once found in most baby nostrums across the US in the early 1900's. This is not a new problem, and just because civic cheap Republicans want to use jail for the lowest cost drug treatment does not support or imply legalized distribution. Neither do half-baked political theories that that see the most harm in the least dogmatic practical solutions.
posted by Brian B. at 12:59 PM on September 23, 2007



Brian, drug treatment is actually *way less* expensive than prison, so the moralism argument makes way more sense as an explanation for current policy.

Unfortunately, under a "drug war" regime, drug treatment itself is deeply problematic as it is punitive, highly stigmatizing and as a result, far less effective than it could be. I have written extensively on this, my book Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids is one example.

Second, heroin and methamphetamine are in no way toxic forms of mind control. In fact, used at appropriate doses in appropriate ways, they are therapeutic. Methamphetamine is used to treat ADHD and is not especially problematic at clinical doses, heroin to treat pain and opioids in general are good antidepressants and antipsychotics and anti-trauma sequelae drugs but we are not allowed to use them medically as such officially.

Drugs do not "take over your central nervous system"-- even addicts do not have a complete loss of free will and most people exposed to these drugs never become addicts. If you pay attention, you will see that, for example, addicts don't shoot up in front of the police. They don't steal if they are rich. Some are violent, most are not-- this has more to do with what predisposed them than with the drugs themselves. Some will prostitute themselves, others would stay in withdrawal rather than consider that. It's complicated.

Normally productive people *will not* neglect their children or crash their buses under the influence of drugs. Normally productive people might get wasted on weekends, but they wouldn't "drug and drive" just like normally productive people don't neglect their children when using alcohol and don't drink and drive. Neglecting one's children as a consequence of addiction generally happens when one has become an addict because one was a neglected or abused child. Those who do not have that history tend to stop using immediately when they become pregnant/have a child.

The people who go on using despite harm to their children are a very different (and thankfully much smaller) group of people than those who don't.

In fact, if you interview crack mothers (as I have done) or look at the data from others who have done so more systematically, several things stand out. You don't see any rich ones and very few middle class ones. 70-80% have experienced multiple traumas of the type that you can't even imagine-- for example, watching their stepfather (who has sexually abused them for years) murder their mother. And then losing a sister to gun violence. And then going to prison for drug possession and getting raped. Etc. When you take their histories, you are amazed that any of them ever *stop* using.

I don't think the Iran comparison is at all accurate: look at the U.S. experience in Viet Nam and the American experience in the 1800's. We didn't wind up with that high a proportion of addicts-- and in terms of the pre-prohibition use by women, what was mainly a problem was variation in purity and not knowing what you were getting, not addiction itself. We didn't worry about opioid addiction when the main opioid addicts were middle class housewives-- we panicked when it was foreigners like the Chinese or when it became associated with black people.
posted by Maias at 1:54 PM on September 23, 2007 [1 favorite]


I warrant few people are going to choose crack over cocaine when they are both legal, affordable at non-addicting rates of usage, and available over-the-counter.

I believe one of Brian's bigger challenges in this discussion is his lack of awareness of other societies. I get the impression he believes legalization necessarily means willy-nilly access at give-away prices.

Alcohol is legal in my province. Until recently, distribution and sales were wholly controlled by the government: if you wanted wine and beer, you went to the government liquor store. Substantial monies were put into education campaigns (directed at kids, expectant mothers, drivers, and general "don't abuse" messages) and law enforcement. Penalties for inappropriate use, ie. drunk driving, have gone sharply upward over the years. I've no idea how our addiction counselling stands up, never having used it; suffice to say it seems available to those who desire it.

Tobacco is also legal. And, again, it is tightly controlled: there are age limits, harsh penalties for selling to minors, restrictions on where you can use the drug, education campaigns, addiction counseling, the whole ball of wax. As a result, we have some of the lowest tobacco addiction rates in the world and yet it's still legal and readily available.

I see no reason why other drugs can not be successfully managed using similar strategies. In fact, I think it is just outright stupid to think controlled legalization is anything but the best answer to the problem.

People do not want to be addicted: they just want to escape. Given alternatives that are safe, they will generally choose them. That is why moonshine isn't really a problem in our society: we have safe, affordable, legal alternatives.
posted by five fresh fish at 2:35 PM on September 23, 2007


Maias, here is the point I see you making: Nothing will change if we increase availability, because of the way it is now. Conversely, I assume market expansion and growth based on bedrock supply and demand principles due to legal distribution, so quoting statistics about here and now of who currently uses is missing the point.

To address your minor points, drug treatment is not an option for most people because we don't have it subsidized on demand for the uninsured. This is a costly policy decision. Tell the politicians it's cheaper to fund new programs, because they don't always agree, and they are the ones who believe it. Even debating neglect, you ignored those people who have neglected their children until it was convenient with mothers on crack, which assumes an amount of neglect. It isn't a free product and takes money and attention away from possibly brain-damaged children.

Just because society worries more about opiate addiction when white women get involved doesn't make your point about panicking over foreigners who introduced it to them. Racism doesn't yet apply here because it was never assumed white people sold it to them. Iran does make my point, however, because Vietnam isn't America and one drug can be replaced with another, although that will surely confuse some people--the bottom line is that Iranians are addicted based on available supply, while those soldiers aren't in Vietnam today.

And finally, because there are clinical uses for meth and heroin does not mean they aren't highly addictive and prone to abuse, and therefore a form of mind control. Street meth production is highly toxic in the industrial sense, leading to condemned buildings. And your implied theory of mental stability while using drugs is contradicted by the cost people will sacrifice for them--even their own teeth. We never even defined mind control, which includes a loss of self-control over one's best interests due to someone else's gain. The ignorance of basic affinity fraud techniques (a form of mind control), with canards about racism, do not add up here. Nowhere did anyone effectively challenge the assertion that drug use would rise if legally distributed, or that different classes of people with solid jobs to lose would be affected, if that was the point you were trying to refute.
posted by Brian B. at 2:52 PM on September 23, 2007


Brian, you have it backwards: we worried *less* about opioid addiction when white housewives were involved. It was only when it became associated with poor people and crime and foreigners that we panicked over it.

Second, did you actually read the post? i said explicitly that increased availability will increase use. the way to deal with this is to restrict availability, which can be done under regulatory regimes but cannot be done under prohibition effectively because we cannot actually control supply via prohibition. if we could,we wouldn't be having this discussion.

Third, I am actually an expert on drug treatment-- and the problems are often less with availability than with quality. Most poor people have access to treatment via Medicaid. They don't go because treatment is punitive, demeaning, hard to find, has no child care and a host of other reasons but it's largely not because it's not out there.

This is why we have all manner of efforts to force people into treatment-- we don't get that if you treat people like utter crap, addicts or no, they aren't going to want your services. We then turn around and say we need to use *more* force because addicts won't go otherwise! When you make attractive, effective services available, you get far better results but because of our moralism and attachment to 12-step programs as the "one true way" and general resistance to change, we do not make much progress.

Fourth, crack is actually equally harmful to fetuses to cigarettes--ie, slightly harmful but nowhere near as bad as alcohol. You can read about that with citations here.

Fifth, when you are talking about "use," for the vast majority of people, heroin and cocaine will not be attractive at all. In the early 1980's, cocaine was ubiquitous and about 1/3 of young adults tried it. The rest didn't, even though most had the opportunity. Not everyone wants to take drugs. The vast majority of those who did use had no problem stopping when they became aware of its dangers or decided it was a waste of money and making them paranoid. They went on to become or continue as stockbrokers, lawyers, doctors, etc. little worse for wear. The country did not collapse.

The problem is the 20-30% of people who will have short term problems and who are very sensitive to availability and social pressure. These will not be long term addicts, but they can have serious short term harm. This is where drug policy needs to be the most fine-tuned-- but we are usually either talking about the hammer of prohibition or the feather of commercialized legalization.

The middle ground-- decriminalization of use, regulation of some drugs legally, use of maintenance, other harm reduction tactics, ending mandatory minimums, making decent treatment available, making decent jobs available, reducing child abuse via early childhood education efforts and things like visiting nurse programs, treatment of mental illness, national health care-- is where the interesting and effective policy solutions lie.

Btw, I am a former cocaine and heroin addict, so I am well familiar with actually dealing with the constriction of will that can happen at certain points during addiction.
posted by Maias at 3:25 PM on September 23, 2007


Brian, you have it backwards: we worried *less* about opioid addiction when white housewives were involved. It was only when it became associated with poor people and crime and foreigners that we panicked over it.

I got your take backwards, but I think you have it backwards to begin with. Histories of the Harrison Act cite white women in Chinese opium dens, and whether it was true or not has nothing to do with your point because laws were made. It was also billed as the "soldier's disease." It was obviously a moral crusade, but there was no foundation for it, because it had more to do with the widespread tinctures and nostrums sold over the counter with hidden ingredients that enough people secretly knew was imported drugs.

As for your other points, I have no idea what you are talking about. Crack and cigarettes are the same? This is your red herring, but I doubt it, and you have a substantial investment in your theory which in the end is fallacious to make any points about crack on its own because cigarettes are not crack, but are a domestic product that nobody can afford to lobby against. Are you suggesting hypocrisy, or proof of safety here?

Interesting to me that you are openly mindreading point five, when price alone would make drugs attractive to those who find them a waste of money now. Becoming a stock broker after avoiding drugs is proof of nothing, and you cite a list of high paying jobs that probably experienced the lowest rate of experimentation. Regardless, the country is what it is because of the paranoia you suggest is unwarranted. And you are claiming to know who would use drugs by citing current conditions, which for some reason causes me to wonder how you can speak for people who would shun drugs but love smoking and drinking. You may do well to spend more time wondering why they put cocaine in cola and then outlawed it. Hint: White people were buying it. And finally, the soldiers in Vietnam trying heroin and coming home to small towns do not make your case at all.
posted by Brian B. at 4:45 PM on September 23, 2007


Brian, learn to read.

1) Current drug policies explicitly favor your proverbial middle-class white women on opioids. Compare drug sentencing guidelines for prescription drug abuse versus crack cocaine or heroin.

2) Crack and cigarettes do roughly the same amount of developmental damage, and alcohol does more. This does not mean that the drugs are the same. The rest of your gobbledy-gook about fallacies and theories makes me wonder wonder what your fetal damage was.

3) Supply and demand is not purely based on price; these are complex curves, not flat slopes. Becoming a stock-broker or obtaining another high-pressure, high-responsibility job does prove that some people can indulge in drugs with little to no adverse longterm effects.

4) Maias is putting up fairly non-controversial points based on a fairly large body of commonly-accepted evidence, though he's not citing any literature. You're firing back apoplectic gibberish.
posted by klangklangston at 5:10 PM on September 23, 2007


And if anyone wants the citations, I am happy to provide them. The housewives addicted to opiates (it wasn't opium, it was "patent medicine" often cough syrup) were long before the Harrison Act. The promoters of the Harrison Act used fears of Chinese men using opium to seduce innocent white women and fears of black men using cocaine to rape innocent white women to sell prohibition. The first antidrug laws were state laws, which used these explicitly racist rationales for their enactment: the opium law in California, the other was somewhere in the South, I forget which state.

If you read the link, you would see that numerous researchers have looked into the question of "crack babies" and found that the idea was mostly a pernicious myth and that being labeled a "crack baby" can actually be more harmful to a child than actual exposure to cocaine in utero.

Again, this is not controversial amongst anyone who actually knows the research. Ira Chasnoff is perhaps the most prominent researcher on this; my co-author of my latest book, Bruce Perry, MD, Phd, also did some of the early research on prenatal effects of cocaine.

Btw, I know whereof I speak in terms of the stockbrokers etc. because I attended an Ivy League school during the peak years of cocaine use in America and took the drug with those people, most of whom are now firmly ensconced in the middle and upper class (many started out there, of course-- but cocaine didn't take them down).
posted by Maias at 5:27 PM on September 23, 2007


1) Current drug policies explicitly favor your proverbial middle-class white women on opioids. Compare drug sentencing guidelines for prescription drug abuse versus crack cocaine or heroin.

Again, the nostrums, some called them "mother's little helpers" and they came in bottles over the counter. A hundred years ago women were ingesting cocaine and opiates (and cannabis) in larger quantities than today, but nobody wanted to admit it in public, and they didn't have to if they could blame someone else. And to think that class harassment versus class privilege is somehow inconsistent in an opposing class structure is strange to me.

2) Crack and cigarettes do roughly the same amount of developmental damage, and alcohol does more. This does not mean that the drugs are the same. The rest of your gobbledy-gook about fallacies and theories makes me wonder wonder what your fetal damage was.

Nobody knows this because crack mothers usually smoke. This is an old argument for libertarians. There was a backlash a few years ago as part of reaction to racist stereotyping, citing a "crack baby" myth, but nobody cited anything except a guy who said that we should worry about smoker babies instead because there were more of them.

3) Supply and demand is not purely based on price; these are complex curves, not flat slopes. Becoming a stock-broker or obtaining another high-pressure, high-responsibility job does prove that some people can indulge in drugs with little to no adverse longterm effects.

Nobody said anything about slopes or curves, I sense a bad bluff here. The companion point to this statement is equally baffling. We don't need to help people get drugs because our stockbrokers can get drugs and manage their addictions. It is a cynical pitch to make in the context of drug policy, as if the secret to success itself.

4) Maias is putting up fairly non-controversial points based on a fairly large body of commonly-accepted evidence, though he's not citing any literature. You're firing back apoplectic gibberish.

I have no idea what Maias is trying to argue because she's taking issue with everything but my main point.
posted by Brian B. at 6:14 PM on September 23, 2007



Read the links, Brian, we *do* know that crack is no more harmful that cigarettes in terms of its effects on child behavior and cognition. There are now quite a few studies on this, looking quite far past infancy.

In fact, there is research showing that what makes a difference in a child's life is not whether the mother used cocaine while pregnant, but whether she *continues to use* after giving birth. If she doesn't, you can't tell 'crack babies' from other poor babies.

And I'm taking issue with the rest of your arguments because they make no sense.

For example, no one has argued that we should legalize so stockbrokers have easier access to drugs. I am saying that regulated access to drugs wouldn't have much effect on the vast majority of stockbrokers because they either already have access or don't have interest.

And that well-done regulation is likely to be more effective at controlling access to illegal drugs than prohibition because regulation actually controls supply, price, quality and number of sales outlets whereas prohibition cannot easily manipulate these variables without becoming prohibitively (hah!) expensive or totalitarian.

Btw, you seem to be missing the fact that libertarians tend not to favor regulatory solutions, as well. And missing the fact that I am saying that there are ways of improving drug policy vastly without going anywhere near Philip Morris crack.
posted by Maias at 6:33 PM on September 23, 2007


Read the links, Brian,

Post the links Maias. You raised the issue out of the blue unrelated to anything I said, and I called it a red herring from word one, saying I doubted it, and then you imagined this was our debate. That is a strawman. It's a tired old libertarian strawman too.
posted by Brian B. at 6:42 PM on September 23, 2007


2) Crack and cigarettes do roughly the same amount of developmental damage and are roughly as addictive.

I think this discussion needs to gain focus. "Five points" is becoming a smorgasbord of conflicting, misleading, and poorly-informed statements.

"Would controlled legalization of drugs improve our society?" is my candidate.

I think that in Canada, it has and it would. I believe that should we elect a government interested in progressing our culture and society, we would come up with a workable solution that would acknowledge the reality of drug usage, provide a safer means of using drugs, support all drug users — including the nicotine, alcohol, and prescription-addicted — in kicking or controlling addiction, and educate both users and non-users truthfully, perhaps even Erowid-style.

I honestly believe that our culture is both ready and capable of taking that step. I don't know about American culture. Some of it is, I think.

At any rate, anything we do that results in public control of the distribution of drugs is orders of magnitude better than what we have now. DEA claims of ever-bigger drug busts aside, illegal drugs requires us to have no real control of drug manufacturing, distribution, or abuse. In short words, what we do now is plainly fucked up.
posted by five fresh fish at 7:28 PM on September 23, 2007



Brian, the crack baby link is in the post!!! Hint: it's on the word "here," right where I said it would be. It's not a strawman at all and in fact, the argument has mostly been made by straightforward liberals who are fond of big government regulation, not by libertarians. If you want to propound on drug policy, it's a good idea to actually know the research.

Five fresh, I think that the best way to improve current policy is incrementally-- but there is no doubt that marijuana regulation as opposed to prohibition makes sense on every possible dimension.

And btw, I would argue that none of my posts are poorly informed or misleading at all-- you might disagree with them, but I can provide numerous links and citations to back everything I say and I am very straightforward about what I mean.
posted by Maias at 5:22 AM on September 24, 2007


There's some evidence that addiction may have as much or more to do with a drug user's external surroundings as with his or her brain chemistry.

Therein lies the true tragedy of the Drug War -- we are ensuring continued addiction in our very attempts to eliminate it. You couldn't purposefully create a better environment for drug abuse than the vicious cycle of poverty and jail that lower-class drug users are exposed to in America. This is why legalization of drugs is not enough. I'm strongly for it, and believe it would eliminate many of the problems caused by our drug policy, but legalization is not a panacea, because neither drug use nor drug policy are the true heart of the problem.

If we want to minimize the harm associated with drug use, we need to change our culture and our environment, first and foremost. Anything else is like stitching over a deep puncture wound -- it obscures the real problem, even to the extent of causing further harm.
posted by vorfeed at 2:09 PM on September 24, 2007


Brian, the crack baby link is in the post!!! Hint: it's on the word "here," right where I said it would be.

I was referring to your study links, but only because you accused me of not reading something that wasn't there. I didn't ask for a link to your own story, which was your attempt at persuasion. There is a difference to me.

It's not a strawman at all and in fact, the argument has mostly been made by straightforward liberals who are fond of big government regulation, not by libertarians.

A strawman argument ignores the main point to dwell on a lesser and easier point in order to substitute the disagreement, often after introducing it as a red herring. And, not as a complaint, but posting your own links is also a SEO technique, but I don't care obviously. And I could care less what some liberals think about anything as far as persuasion goes.

If you want to propound on drug policy, it's a good idea to actually know the research.

If you think your research proves that crack is harmless and/or should be legalized to reduce its spread or effect, then you have only succeeded in convincing yourself by it because the logical conclusions aren't there. By raising the specter of cigarettes, you must deal with the counter argument of 25% addiction-dependency rates. Furthermore, cigarettes are only legal, not safe, and two wrongs don't make a right. No research was required to make that assessment. All of your special pleading doesn't add up to legally increasing the problem in order to provide treatment on demand.

The war on drug users fades with the medicalization of drug policy, but apparently some people don't really want it. The possibility is that if drugs became a worse problem, as legalizers would risk, then we may risk all of our civil liberties from backlash.
posted by Brian B. at 4:15 PM on September 24, 2007


You are an idiot, Brian.
posted by five fresh fish at 5:16 PM on September 24, 2007



Brian, talk about straw men!! Where did I ever say anything along the lines of crack is harmless and must be legalized to reduce its spread or effect?

Second, the article I linked about the crack babies contained the citations of the research that supports my claims. I am not going to do your homework for you-- but if you chose to do a pubmed search, you would see that every research claim in that article checks out.

Third, the point about cigarettes was simply to quantify the harm: crack is as harmful to fetuses as tobacco, less harmful than alcohol.

That says nothing about harms to addicts, harms to communities, etc. It says nothing about whether crack should be legal and alcohol illegal. Fetuses are only part of the story. Regarding cigarettes, of course, they have a higher addiction (which is not synonymous with dependency, see, here.
rates than any other drug, including crack, methamphetamine, heroin and alcohol.

Does that mean cigarettes are less safe than crack, heroin, alcohol, etc-- well, that depends on how you define "safe." Cigarettes rarely kill young people, while alcohol, crack and heroin sometimes do-- but cigarettes kill 50% of their users, which the others don't even approach. It's hard to fit all the different types of harm into one dimension and find a balance that makes sense of it.

This is a hugely complex issue that both sides seem compelled to try to make simple: you, by claiming that any other policy than what we have now is going to be insane free market madness and the people on the extreme legalization side by saying that availability isn't related to harm at all and that strong forms of drugs won't sell much if weaker forms are available. The evidence suggests that they will sell enough to cause problems if appropriate limits aren't set.

Effective policy solutions are in-between, must be culturally specific and flexible-- but they are not what we have now and they are not an unregulated free market. British and Dutch drug policy actually come pretty close to being decent-- definitely not perfect, but thousands of times better than the American drug war.
posted by Maias at 7:51 PM on September 24, 2007


Maias: that strong forms of drugs won't sell much if weaker forms are available. The evidence suggests that they will sell enough to cause problems if appropriate limits aren't set.

I'd like to see this evidence.
posted by daksya at 10:30 PM on September 24, 2007


Daksya, all you have to do is look at alcohol: while the market is not dominated by hard liquor, it certainly is a big money-maker and certainly causes problems.

Similarly, crack certainly made a splash in the cocaine market. You can argue that crack wouldn't have existed without prohibition, but the truth is, freebase was around for a long time without crack and certainly managed to cause problems before it was marketed as a ready-made product.

But *after* it was marketed as a ready-made product, it sold even more.

This is not an argument against any type of drug regulation-- it is an argument against an unregulated free market in drugs (which is what we have now thanks to prohibition and which is what we could have if we went to a system of legalization without any regulation).
posted by Maias at 9:58 AM on September 25, 2007


We could do with tighter regulation of the alcohol industry: those tetrapak-style one-shot instant shooters are targeting the teen market, not the adult market. That's just depraved on the part of the alcohol companies, and we need goobermint to step in and bitchslap them for it.
posted by five fresh fish at 5:27 PM on September 25, 2007


Maias, debating your original claim,

"that strong forms of drugs won't sell much if weaker forms are available. The evidence suggests that they will sell enough to cause problems if appropriate limits aren't set.",

is problematic because it is non-specific and subjective. How much is 'much'? What does "available" mean? As easily available as the stronger forms? As economical? Same with 'enough'.

The critical variable isn't the mere physical availability of weaker forms, but the attitude of the buyer. What sort of messages are conveyed about the relative risks and how does that conform with the evidence? If the buyer has an active or passive belief that stronger forms aren't more problematic, then why wouldn't they use the stronger form? But prohibition, as demonstrated by the Scottish minister, doesn't give you that much wiggle room. The aim there is to stop all drug use. Regarding alcohol in the US, I don't remember many, if any, messages, conveying the relative dangers of harder liquor. There's more of an unspoken tacit acknowledgement that spirits are more risky, but no explicit elucidation on why this is the case, and what the magnitude of difference is.

if we went to a system of legalization without any regulation

We have gone through this before. Considering the lack of fundamental progress the legalizers have had over the last 25-30 years, your nightmare scenario is a strawman.
posted by daksya at 3:51 AM on September 26, 2007


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