The War on Drugs

Dear Mr. Gray:

       I do thank you for the cordial tone of your letter. It’s a nice contrast to the hate mail (and a rather intimidating phone call and a frankly chilling e-mail) I received in response to the book review. A book review! The shock troops of the legalization movement are, indeed, a touchy lot. In this reply, I’ll respond to your two points, one historical, one scientific. First, some history.
       Re the extent of an addiction problem in the early 1900s: You say there was “no significant drug problem in the United States” and cite historian David Musto as your source. But you badly underestimate the significance of the “medical addict” (the middle-age Southern white woman–think of the mother in Eugene O’Neill’s Long Day’s Journey Into Night–who was, as you put it, “strung out” on laudanum. In Mrs. Tyrone’s case, however, it was morphine, a related substance).
       That was indeed perceived as a serious problem. “By 1900,” Musto writes, “America had developed a comparatively large addict population, perhaps 250,000” (Page 5, The American Disease, second edition). “The realization of [drug] abuse and its seriousness gradually undermined confidence in simple regulatory laws and led to a determination that decisive action must be taken” (Pages 8-9).
       This point and the one I emphasized in my review of your book is that drugs can be dangerous, something you and your legalizer colleagues in the drug overclass seem to have forgotten.
       But since you brought up laudanum, it is a good example to show how addictive opiates can be. Laudanum is an opiate, like heroin and morphine. The fact that one could merely drink a solution of an opiate and become hooked attests to its high addictive potential. After all, the oral route is the least efficient, least dangerous way to consume an intoxicating drug. Compared with current methods of use–inhaling heroin vapors (“chasing the dragon”) and smoking crack, injecting into the veins or snorting high purity heroin or powder cocaine–the laudanum-drinking lady seems like a quaint foreshadowing of today’s most desperate and diseased addicts.
       Re organized crime: Federal drug prohibition around 1914 (with the passage of the Harrison Narcotic Act) did not lead to the “birth of organized crime,” as you state. It was already entrenched by the late 1800s. I refer you to the work of my colleague Professor Peter Reuter of the University of Maryland.
       Second, some scientific methodology. The Swiss heroin “experiment” failed every standard of the experimental method. There were no control group(s); there was no systematic verification of improvement (it was largely self-report, notoriously unreliable among addicts); and there was no effort to account for other interventions that could have led to the (alleged) social improvements, such as government-created jobs and housing for the patients. So, this was no experiment. The World Health Organization plainly acknowledged that in its 1996 report.
       I’ll grant you that giving heroin away to Swiss addicts may have reduced crime (not stopped crime, mind you, just reduced it). After all, some tightly run U.S. morphine maintenance clinics in the early ‘20s helped reduce crime. But why settle for bribing addicts with drugs so that they’ll behave better, while making taxpayers foot the bill? What the “hell are we after,” you ask? Not that. I’m after a society where people are responsible. So why not advocate for proven ways to help people relinquish drugs altogether–an effort I don’t at all mind paying for–instead of lobbying to keep them, yes, “enslaved,” with three-times-a-day heroin injections?
       And yes, of course, I’m glad that some Swiss patients decided to give up heroin on their own. But that’s the problem. If you wait for addicts to do what is good for them “on their own,” it can be too late. That’s the fatal flaw in the “harm reduction” philosophy you promote.

Sally Satel