Good drugs, bad drugs - relationship with the improved performance of the pharmaceutical industry and intensified war against illegal drugs
Joshua Wolf Shenk on the fractured logic behind America's war on narcotics
To suffer and long for relief is a central experience of humanity. But the absence of pain or discomfort or what Pablo Neruda called "the infinite ache" is never enough. Relief is bound up with satisfaction, pleasure, happiness - the pursuit of which is declared a right in the manifesto of our republic. I sit here with two agents of that pursuit: on my right a bottle from a pharmacy; on my left a bag of plant matter bought last night, for about the same sum, in a New York bar from a group of men who would have sold me different kinds of contraband if they hadn't sniffed cop in my curiosity and eagerness. This being Rudy Giuliani's New York, I had feared they were undercover.
Fear and suspicion, secrecy and shame, the yearning for pleasure, and the wish to avoid men in blue uniforms. The drug wars - which, having spanned more than eight decades, require the plural - are palpable in New York City. In Washington Square Park Giuliani erected ten video cameras that sweep the environs 24 hours a day.
Several times a month I walk through that park to the pharmacy, where a doctor's slip is my passport to another world. Here, altering the mind and body with powders and plants is not only legal but even patriotic. Among the souls wandering these aisles, I feel I have kin. But I am equally at home, and equally ill at ease, among the outlaws. I cross back and forth with wide eyes. What I see is this. From 1970 to 1998 the inflation-adjusted revenue of major pharmaceutical companies more than quadrupled to $81 billion, 24 per cent of that from drugs that affect the central nervous system and sense organs. Sales of herbal medicines now exceed $4 billion a year. Meanwhile the war on other drugs escalated dramatically. Since 1970 the US federal anti-drug budget has risen 3,700 per cent and now exceeds $17 billion. More than 1.5 million people are arrested on drug charges each year, and 400,000 are now in prison. These numbers are just a window on to an obvious truth: we take more drugs and reward those who supply them; we punish more people for taking drugs and especially punish those who supply them.
The drug wars and the drug boom are interrelated, of the same body. The hostility and veneration, the punishment and profits, come from the same beliefs and the same mistakes.
To the more sober-minded among us, it is a source of much consternation that drugs, alcohol and cigarettes are so central to our collective social life. It is hard to think of a single social ritual that does not revolve around some consciousness-altering substance. ("Should we get together for coffee or drinks?") But drugs are much more than a social lubricant - they are the centrepiece of many individual lives. When it comes to alcohol, cigarettes or any illicit substance, this is seen as a problem. With pharmaceuticals it is usually considered healthy. Yet the dynamic is often the same.
It begins with a drug that satisfies a particular need or desire maybe known to us, maybe not. So we have drinks or a smoke or swallow a few pills. And we get something from this, a whole lot or maybe just a bit. But we often don't realise that the feeling is inside, perhaps something that with effort could be experienced without the drugs or, perhaps, as in the psychiatric equivalent of diabetes, something that we will always need help with. Yet all too often we project upon the drug a power that resides elsewhere. Many believe this to be a failure of character. If so, it is a failure in which the whole culture is implicated. A recent example came with the phrase "pure theatrical Viagra", widely used to describe a Broadway production starring Nicole Kidman. Notice what's happening: sildenafil citrate is a substance that increases blood circulation and has the side effect of producing erections in men. As a medicine, it is intended to be used as an adjunct to sexual stimulation. As received by our culture, though, the drug becomes the desired effect, the "real thing" to which a naked woman on stage is compared.
Not long after his second inauguration, President Clinton signed a bill earmarking $195 million for an anti-drug ad campaign - the first instalment of a $1 billion pledge. The ads, which began running last summer, all end with the words "Partnership for a Drug Free America". The driving force behind the Partnership is a man named James Burke - and he is a peculiar spokesman for a drug-free philosophy. Burke is the former CEO of Johnson & Johnson, makers of various over-the-counter and prescription medications. The philanthropic arms of other pharmaceutical companies, such as Merck, Bristol-Myers Squibb and Hoffman-La Roche, have also made sizeable donations.
I resist the urge to use the word "hypocrisy", from the Greek hypokrisis, meaning the acting of a part on stage. I don't believe James Burke is acting. Rather, he embodies a contradiction so common that few people even notice it - the idea that altering the body and mind is morally wrong when done with some substances and salutary when done with others. The Partnership's formula is to present a problem - urban violence, date rape, juvenile delinquency - and lay it at the feet of drugs. "Marijuana," says a remorseful-looking kid, "cost me a lot of things. I used to be a straight-A student, you know. I was liked by all the neighbours. Never really caused any trouble. I was always a good kid growing up. Before I knew it I was getting thrown out of my house."
This kid looks about 17. The Partnership couldn't tell me his real name or anything about him except that he was interviewed through a New York drug-treatment facility.
In the 19th century now-illegal substances were commonly used in medicine, tonics and consumer products. A new era began with the federal Pure Food and Drug Act of 1906, which required the listing of ingredients in medical products. Then the 1914 Harrison Narcotic Act, ostensibly a tax measure, asserted legal control over distributors and users of opium and cocaine.
On the surface this may seem progressive, the story of a still-young nation establishing commercial and medical standards. And there was genuine uneasiness about drugs that were intoxicating or that produced dependence; with the disclosure required by the 1906 act, sales of patent medicines containing opium dropped by a third. But the movement for prohibition drew much of its power from a far less savoury motive. "Cocaine," warned Theodore Roosevelt's drug adviser, "is often a direct incentive to the crime of rape by the Negroes." As David Musto reports in The American Disease, the prohibitions of the early part of the century were all, in part, a reaction to inflamed fears of foreigners or minority groups. Opium was associated with the Chinese. In 1937 the Marijuana Tax Act targeted Mexican immigrants. "I wish I could show you what a small marijuana cigarette can do to one of our degenerate Spanish-speaking residents," a Colorado newspaper editor wrote to federal officials in 1936. Even the prohibition of alcohol was underlined by fears of immigrants and exaggerations of the effects of drinking. On the eve of its ban in 1919 a radio preacher told his audience: "The reign of tears is over. The slums will soon be a memory. We will turn our prisons into factories, our jails into storehouses and corncribs. Men will walk upright now, women will smile and the children will laugh."
But the federal authorities, temperance advocates and bigots had reached too far. Whereas alcohol (like coffee and tobacco) has been a demon drug in other cultures, in western societies its use in medicine, recreation and religious ceremonies stretches back thousands of years. Most Americans had personal experience with drink and could measure the benefits of Prohibition against the violence (by gangsters and by Prohibition agents, who, according to one estimate, killed 1,000 Americans between 1920 and 1930) and the deaths by "overdose". After Franklin Roosevelt lifted Prohibition, subsequent generations knew that the drug, though often abused and often implicated in crimes, violence and accidents, differs in its effects depending on the person using it. With outlawed drugs no such reality check is available. People who use illegal drugs without great harm generally stay quiet.