Friday, February 22, 2008

Give drugs a chance

I'm rereading Jacob Sullum's Saying Yes: In Defense of Drug Use, several years after I first picked the book up. I'm struck, once again, by his treatment of the consumption of marijuana, cocaine, methamphetamine, heroin and any other intoxicant you can think of as a not inherently bad thing -- in fact, a potentially good thing if done in moderation. Sullum is one of the few writers I can think of who treats the pursuit of pleasure for its own sake with respect, rather than as an unseemly vice.

Even among many advocates of drug legalization, drugs are treated as an unavoidable curse that burdens the human race, with legalization a necessary evil preferable to the ills, such as loss of civil liberties, that accompany prohibition. The very term "harm reduction," so popular now among advocates of alternatives to the War on Drugs, implies that drug use always damages the user, and that the goal is to reduce drug use by means other than criminal sanction.

This is why so many debates over legalization devolve to discussions of whether removing criminal sanctions will result in more consumption of disfavored intoxicants. See this otherwise somewhat sensible discussion from the Baltimore Sun:

A recent column on jury duty -- my first actual trial in more than 20 years of summonses to the Circuit Court of Baltimore City -- prompted a letter from reader Tom Ryugo about the decriminalization of heroin and cocaine. As you'll see, it's kind of hard to argue with this common-sense take. I've had this discussion with many people, including the former New York cop you runs an organization devoted to decriminalization, and the famous Baltimore attorney Bill Murphy. I can't make up my mind about it. Perhaps I should. . . . My fear is that legalization will lead to more use. I don't think the death penalty is a deterrent to murder, but I think the threat of incarceration and a life of addiction and misery is a deterrent to people who might be tempted to move from reefer to heroin or coke.

If you view drug use as inherently bad, it makes sense to assume that anything that might lead to increased consumption is something of a setback.

But, as many of us who have not just experimented with, but enthusiastically consumed various intoxicants know (Whoops! I bet I just blew my next job interview), the road to perdition is not usually lined with dried vegetation, white powder, pills or crystals. In fact, many a party, evening or weekend afternoon has been made more pleasant by "cocktail hours" that featured refreshments that would make John Walters weep. Some of us dabbled, a few of us indulged and there were occasional bingers, too. The vast majority of us, whether we still smoke or snort or not, suffered little or no harm -- in fact, we downright enjoyed our experiences, improved our moods and released a lot of tension in the process. And then we went about our responsibilities just a little more relaxed than we might have been.

Yet the loser pothead or scrawny junky is the image most often evoked when people think of drug use.

There's a good reason for that. As Sullum writes in Saying Yes:

We see the drug users who get hauled away by the police, who nod off in doorways or on park benches, who beg on the street or break into cars. We do not see the drug users who hold down a job, pay the rent or the mortgage, and support a family. In the absence of evidence to the contrary, people naturally assume that most illegal drug users are like the ones they notice, who are apt to be the least discreet and most antisocial. This is like assuming that the wino passed out in a gutter is a typical drinker.

Hmmm. So, how many users are, you know, addicts?

That's actually a hard question to answer, given the difficulty involved in asking people about their drug consumption habits. In fact, when prohibitionists talk about vast armies of addicts, they're talking about something they just don't know. Let's turn to psychologist, lawyer and drug researcher Stanton Peele for an idea of how many cocaine users just can't put the stuff down:

One way to calculate the number/percentage of addicts is to compare those who have ever taken a drug with those who currently take it with those who currently take it daily (or nearly so). Of course, many regular, daily users wouldn't be classified as addicts (like the physician described by Zinberg and his colleagues who for decades injected morphine daily, but did not use on weekends and vacations, without ever increasing his dosage or undergoing withdrawal -- see Meaning of Addiction, Chapter 1).

Unfortunately, you can't get government statistics on daily use. The most frequent use calculated in the Substance Abuse and Mental Health Services Administration's (SAMHSA) National Household Survey on Drug Abuse is 51 or more times in the prior year, or an average of once weekly (or more), which would obviously include many users who are not addicts.

The 1995 Household Survey found that of 3.7 million cocaine users in the last year, 1.2 million used on average at least once a month and 600,000 used at least weekly on average. Although these 600,000 would not qualify as clinical addicts, Drug Czar Barry McCaffrey wants to claim these and more.

Hmmm ... so the number of addicted cocaine users actually falls below the government's measurement threshold.

Well, what about heroin? that's nasty stuff, right? Surely we have an idea of how many heroin addicts there are. Well, we can kind of guesstimate. Wrote Sullum for Reason magazine in 2003:

The National Household Survey on Drug Abuse indicates that about 3 million Americans have used heroin in their lifetimes; of them, 15 percent had used it in the last year, 4 percent in the last month. These numbers suggest that the vast majority of heroin users either never become addicted or, if they do, manage to give the drug up. A survey of high school seniors found that 1 percent had used heroin in the previous year, while 0.1 percent had used it on 20 or more days in the previous month. Assuming that daily use is a reasonable proxy for opiate addiction, one in 10 of the students who had taken heroin in the last year might have qualified as addicts.

One in ten? How does that compare with perfectly legal alcohol? Well, according to the National Institutes of Health:

A 1994 study of drug use and addiction in the U.S. showed that more than 90 percent of Americans have experimented with alcohol, and about 70 percent drink at least occasionally. About 15 percent of those who experiment become alcohol-dependent at some point in life. This compares to a dependency rate of 25 percent in those who experiment with smoking tobacco, and around 4 percent in marijuana smokers.

So, it's pretty clear that the vast majority of people who consume any intoxicant do so without developing dependency and, in fact, may well enjoy benefits from their consumption, since they presumably value the pleasure, stress-reduction and other qualities found in intoxicants. On the other hand, a few users of any intoxicant will have problems, whether their drug of choice is legal or illegal.

So, even if you don't believe that people have an inherent right to choose what to put into their own bodies (I obviously do), the "problem" of legalization isn't as simple as whether it "will lead to more use." For every abuser who suffers problems, there may be nine users who enjoy benefits. Increased use may, in balance, be a good thing since the evidence suggests that most of that use will be moderate.

All things considered, you still may conclude that prohibition, with its militarized policing, erosion of the Fourth Amendment, soaring costs and high rate of defiance (breeding disdain for the law) is a worthwhile venture. But I think Jacob Sullum makes a strong case that the drug use that prohibitionists want to stamp out is not an unalloyed evil.



Anonymous Brandyjack said...

May I suggest, you get a copy of the LaGuidia Report, circa 1940, New York City. Concerning the new idea of drug prohibition.

June 7, 2008 6:18 PM  
Blogger J.D. Tuccille said...

You mean this?

It's an interesting document, essentially saying that marijuana (or "marihuana," as in the report), just isn't that scary -- and seems like fun.

June 7, 2008 6:44 PM  
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March 18, 2009 11:53 PM  

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