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JAMES Q. WILSON
James Q. Wilson is Collins Professor
of Management and Public
Policy at the University of
California at Los Angeles. He is the author of Thinking about
Crime (1975), Bureaucracy (1989), and Crime: Public Policies for Crime
Control (2002), the coauthor of Crime and Human Nature (1985), and
the coeditor of Drugs and
Crime (1990). The essay that we
reprint appeared originally in February 1990 in Commentary, a
conservative magazine.
Against the Legalization of Drugs
In 1972, the president appointed me
chairman of the National Advisory Council for Drug Abuse
Prevention. Created by Congress, the Council was charged with
providing guidance on how best to coordinate the national war on
drugs. (Yes, we called it a war then, too.) In those days, the
drug we were chiefly concerned with was heroin. When I took
office, heroin use had been increasing dramatically. Everybody
was worried that this increase would continue. Such phrases as
“heroin epidemic” were commonplace.
That same year, the eminent
economist Milton Friedman published an essay in Newsweek in
which he called for legalizing heroin. His argument was on two
grounds: As a matter of ethics, the government has no right to
tell people not to use heroin (or to drink or to commit
suicide); as a matter of economics, the prohibition of drug use
imposes costs on society that far exceed the benefits. Others,
such as the psychoanalyst Thomas Szasz, made the same argument.
We did not take Friedman’s advice.
(Government commissions rarely do.) I do not recall that we even
discussed legalizing heroin, though we did discuss (but did not
take action on) legalizing a drug, cocaine, that many people
then argued was benign. Our marching orders were to figure out
how to win the war on heroin, not to run up the white flag of
surrender.
That was 1972. Today, we have the
same number of heroin addicts that we had then—half a million,
give or take a few thousand. Having that many heroin addicts is
no trivial matter; these people deserve our attention. But not
having had an increase in that number for over fifteen years is
also something that deserves our attention. What happened to the
“heroin epidemic” that many people once thought would overwhelm
us?
The facts are clear: A more or less
stable pool of heroin addicts has been getting older, with
relatively few new recruits. In 1976 the average age of heroin
users who appeared in hospital emergency rooms was about
twenty-seven; ten years later it was thirty-two. More than
two-thirds of all heroin users appearing in emergency rooms are
now over the age of thirty. Back in the early 1970s, when heroin
got onto the national political agenda, the typical heroin
addict was much younger, often a teenager. Household surveys
show the same thing—the rate of opiate use (which includes
heroin) has been flat for the better part of two decades. More
fine-grained studies of inner-city neighborhoods confirm this.
John Boyle and Ann Brunswick found that the percentage of young
blacks in Harlem who use heroin fell from 8 percent in 1970—71
to about 3 percent in 1975—76.
Why did heroin lose its appeal for
young people? When the young blacks in Harlem were asked why
they stopped, more than half mentioned “trouble with the law” or
“high cost” (and high cost is, of course, directly the result of
law enforcement). Two-thirds said that heroin hurt their health;
nearly all said they had had a bad experience with it. We need
not rely, however, simply on what they said. In New York City in
1973—75, the street price of heroin rose dramatically and its
purity sharply declined, probably as a result of the heroin
shortage caused by the success of the Turkish government in
reducing the supply of opium base and of the French government
in closing down heroin-processing laboratories located in and
around Marseilles. These were short-lived gains for, just as
Friedman predicted, alternative sources of supply— mostly in
Mexico — quickly emerged. But the three-year heroin shortage
interrupted the easy recruitment of new users.
Health and related problems were no
doubt part of the reason for the reduced flow of recruits. Over
the preceding years, Harlem youth had watched as more and more
heroin users died of overdoses, were poisoned by adulterated
doses, or acquired hepatitis from dirty needles. The word got
around: Heroin can kill you. By 1974 new hepatitis cases and
drug-overdose deaths had dropped to a fraction of what they had
been in 1970.
Alas, treatment did not seem to
explain much of the cessation in drug use. Treatment programs
can and do help heroin addicts, but treatment did not explain
the drop in the number of new users (who by definition had never
been in treatment) nor even much of the reduction in the number
of experienced users.
No one knows how much of the decline
to attribute to personal observation as opposed to high prices
or reduced supply. But other evidence suggests strongly that
price and supply played a large role. In 1972 the National
Advisory Council was especially worried by the prospect that
U.S. servicemen returning to this country from Vietnam would
bring their heroin habits with them. Fortunately, a brilliant
study by Lee Robins of Washington University in St. Louis put
that fear to rest. She measured drug use of Vietnam veterans
shortly after they had returned home. Though many had used
heroin regularly while in Southeast Asia, most gave up the habit
when back in the United States. The reason:
Here, heroin was less available and
sanctions on its use were more pronounced. Of course, if a
veteran had been willing to pay enough—which might have meant
traveling to another city and would certainly have meant making
an illegal contact with a disreputable dealer in a threatening
neighborhood in order to acquire a (possibly) dangerous dose —he
could have sustained his drug habit. Most veterans were
unwilling to pay this price, and so their drug use declined or
disappeared.
RELIVING THE PAST
Suppose we had taken Friedman’s
advice in 1972. What would have 10 happened? We cannot be
entirely certain, but at a minimum we would
have placed the young heroin addicts
(and, above all, the prospective addicts) in a very different
position from the one in which they actually found themselves.
Heroin would have been legal. Its price would have been reduced
by 95 percent (minus whatever we chose to recover in taxes). Now
that it could be sold by the same people who make aspirin, its
quality would have been assured—no poisons, no adulterants.
Sterile hypodermic needles would have been readily available at
the neighborhood drugstore, probably at the same counter where
the heroin was sold. No need to travel to big cities or
unfamiliar neighborhoods —heroin could have been purchased
anywhere, perhaps by mail order.
There would no longer have been any
financial or medical reason to avoid heroin use. Anybody could
have afforded it. We might have tried to prevent children from
buying it, but as we have learned from our efforts to prevent
minors from buying alcohol and tobacco, young people have a way
of penetrating markets theoretically reserved for adults.
Returning Vietnam veterans would have discovered that Omaha and
Raleigh had been converted into the pharmaceutical equivalent of
Saigon.
Under these circumstances, can we
doubt for a moment that heroin use would have grown
exponentially? Or that a vastly larger supply of new users would
have been recruited? Professor Friedman is a Nobel Prize—winning
economist whose understanding of market forces is profound. What
did he think would happen to consumption under his legalized
regime? Here are his words: “Legalizing drugs might increase the
number of addicts, but it is not clear that it would. Forbidden
fruit is attractive, particularly to the young.”
Really? I suppose that we should
expect no increase in Porsche sales if we cut the price by 95
percent, no increase in whiskey sales if we cut the price by a
comparable amount—because young people only want fast cars and
strong liquor when they are “forbidden.” Perhaps Friedman’s
uncharacteristic lapse from the obvious implications of price
theory can be explained by a misunderstanding of how drug users
are recruited. In his 1972 essay he said that “drug addicts are
deliberately made by pushers, who give likely prospects their
first few doses free.” If drugs were legal it would not pay
anybody to produce addicts, because everybody would buy from the
cheapest source. But as every drug expert knows, pushers do not
produce addicts. Friends or acquaintances do. In fact, pushers
are usually reluctant to deal with nonusers because a nonuser
could be an undercover cop. Drug use spreads in the same way any
fad or fashion spreads: Somebody who is already a user urges his
friends to try, or simply shows already-eager friends how to do
it.
But we need not rely on speculation,
however plausible, that lowered prices and more abundant
supplies would have increased heroin usage. Great Britain once
followed such a policy and with almost exactly those results.
Until the mid-1960s, British physicians were allowed to
prescribe heroin to certain classes of addicts. (Possessing
these drugs without a doctor’s prescription remained a criminal
offense.) For many years this policy worked well enough because
the addict patients were typically middle-class people who had
become dependent on opiate painkillers while undergoing hospital
treatment. There was no drug culture. The British. system worked
for many years, not because it prevented drug abuse but because
there was no problem of drug abuse that would test the system.
All that changed in the 1 960s. A
few unscrupulous doctors began 15 passing out heroin in
wholesale amounts. One doctor prescribed almost six hundred
thousand heroin tablets — that is, over thirteen pounds — in
just one year. A youthful drug culture emerged with a demand for
drugs far different from that of the older addicts. As a result,
the British government required doctors to refer users to
government-run clinics to receive their heroin.
But the shift to clinics did not
curtail the growth in heroin use. Throughout the 1960s the
number of addicts increased—the late John Kaplan of Stanford
estimated by fivefold — in part as a result of the diversion of
heroin from clinic patients to new users on the streets. An
addict would bargain with the clinic doctor over how big a dose
he would receive. The patient wanted as much as he could get,
the doctor wanted to give as little as was needed. The patient
had an advantage in this conflict because the doctor could not
be certain how much was really needed. Many patients would use
some of their “maintenance” dose and sell the remaining part to
friends, thereby recruiting new addicts. As the clinics learned
of this, they began to shift their treatment away from heroin
and toward methadone, an addictive drug that, when taken orally,
does not produce a “high” but will block the withdrawal pains
associated with heroin abstinence.
Whether what happened in England in
the 1 960s was a miniepidemic or an epidemic depends on whether
one looks at numbers or at rates of change. Compared to the
United States, the numbers were small. In 1960 there were
sixty-eight heroin addicts known to the British government; by
1968 there were two thousand in treatment and many more who
refused treatment. (They would refuse in part because they did
not want to get methadone at a clinic if they could get heroin
on the street.) Richard Hartnoll estimates that the actual
number of addicts in England is five times the number officially
registered. At a minimum, the number of British addicts
increased by thirtyfold in ten years; the actual increase may
have been much larger.
In the early 1 980s the numbers
began to rise again, and this time nobody doubted that a real
epidemic was at hand. The increase was estimated to be 40
percent a year. By 1982 there were thought to be twenty thousand
heroin users in London alone. Geoffrey Pearson reports that many
cities—Glasgow, Liverpool, Manchester, and Sheffield among
them—were now experiencing a drug problem that once had been
largely confined to London. The problem, again, was supply. The
country was being flooded with cheap, high-quality heroin, first
from Iran and then from Southeast Asia.
The United States began the 1960s
with a much larger number of heroin addicts and probably a
bigger at-risk population than was the case in Great Britain.
Even though it would be foolhardy to suppose that ‘the British
system, if installed here, would have worked the same way or
with the same results, it would be
equally foolhardy to suppose that a combination of heroin
available from leaky clinics and from street dealers who faced
only minimal law-enforcement risks would not have produced a
much greater increase in heroin use than we actually
experienced. My guess is that if we had allowed either doctors
or clinics to prescribe heroin, we would have had far worse
results than were produced in Britain, if for no other reason
than the vastly larger number of addicts with which we began. We
would have had to find some way to police thousands (not scores)
of physicians and hundreds (not dozens) of clinics. If the
British civil service found it difficult to keep heroin in the
hands of addicts and out of the hands of recruits when it was
dealing with a few hundred people, how well would the American
civil service have accomplished the same tasks when dealing with
tens of thousands of people?
BACK TO THE FUTURE
Now cocaine, especially in its
potent form, crack, is the focus of attention. Now as in 1972
the government is trying to reduce its use. Now
as then some people are advocating
legalization. Is there any more reason to yield to those
arguments today than there was almost two decades ago?
I think not. If we had yielded in
1972 we almost certainly would have had today a permanent
population of several million, not several hundred thousand,
heroin addicts. If we yield now we will have a far more serious
problem with cocaine.
Crack is worse than heroin by almost
any measure. Heroin produces a pleasant drowsiness and, if
hygienically administered, has only the physical side effects of
constipation and sexual impotence. Regular heroin use
incapacitates many users, especially poor ones, for any
productive work or social responsibility. They will sit nodding
on a street corner, helpless but at least harmless. By contrast,
regular cocaine use leaves the user neither helpless nor
harmless. When smoked (as with crack) or injected, cocaine
produces instant, intense, and short-lived euphoria. The
experience generates a powerful desire to repeat it. If the drug
is readily available, repeat use will occur. Those people who
progress to ‘bingeing” on cocaine become devoted to the drug and
its do not here take up the question of marijuana. For a variety
of reasons—its widespread use and its lesser tendency to
addict—it presents a different problem from cocaine or heroin.
For a penetrating analysis, see Mark Kleiman, Marijuana:
Costs of Abuse, Costs of Control
(Greenwood Press, 217 pp.). [Author’s note.]
effects to the exclusion of almost
all other considerations—job, family, children, sleep, food,
even sex. Dr. Frank Gawin at Yale and Dr. Everett Ellinwood at
Duke report that a substantial percentage of all high-dose,
binge users become uninhibited, impulsive, hypersexual,
compulsive, irritable, and hyperactive. Their moods vacillate
dramatically, leading at times to violence and homicide.
Women are much more likely to use
crack than heroin, and if they are pregnant, the effects on
their babies are tragic. Douglas Besharov, who has been
following the effects of drugs on infants for twenty years,
writes that nothing he learned about heroin prepared him for the
devastation of cocaine. Cocaine harms the fetus and can lead to
physical deformities or neurological damage. Some crack babies
have for all practical purposes suffered a disabling stroke
while still in the womb. The long-term consequences of this
brain damage are lowered cognitive ability and the onset of mood
disorders. Besharov estimates that about thirty thousand to
fifty thousand such babies are born every year, about seven
thousand in New York City alone. There may be ways to treat such
infants, but from everything we now know the treatment will be
long, difficult, and expensive. Worse, the mothers who are most
likely to produce crack babies are precisely the ones who,
because of poverty or temperament, are least able and willing to
obtain such treatment. In fact, anecdotal evidence suggests the
crack mothers are likely to abuse their infants.
The notion that abusing drugs such
as cocaine is a “victimless crime” is not only absurd but
dangerous. Even ignoring the fetal drug syndrome,
crack-dependent people are, like heroin addicts, individuals who
regularly victimize their children by neglect, their spouses by
improvidence, their employers by lethargy, and their co-workers
by carelessness. Society is not and could never be a collection
of autonomous individuals. We all have a stake in ensuring that
each of us displays a minimal level of dignity, responsibility,
and empathy. We cannot, of course, coerce people into goodness,
but we can and should insist that some standards must be met if
society itself—on which the very existence of the human
personality depends — is to persist. Drawing the line that
defines those standards is difficult and contentious, but if
crack and heroin use do not fall below it, what does?
The advocates of legalization will
respond by suggesting that my 25 picture is overdrawn. Ethan
Nadelmann of Princeton argues that the risk of legalization is
less than most people suppose. Over twenty million Americans
between the ages of eighteen and twenty-five have tried cocaine
(according to a government survey), but only a quarter million
use it daily. From this Nadelmann concludes that at most 3
percent of all young people who try cocaine develop a problem
with it. The implication is clear: Make the drug legal and we
only have to worry about 3 percent of our youth.
The implication rests on a logical
fallacy and a factual error. The fallacy is this: The percentage
of occasional cocaine users who become binge users when the drug
is illegal (and thus expensive and hard to find) tells us
nothing about the percentage who will become dependent when the
drug is legal (and thus cheap and abundant). Drs. Gawin and
Ellinwood report, in common with several other researchers, that
controlled or occasional use of cocaine changes to compulsive
and frequent use “when access to the drug increases” or when the
user switches from snorting to smoking. More cocaine more
potently administered alters, perhaps sharply, the proportion of
“controlled” users who become heavy users.
The factual error is this: The
federal survey Nadelmann quotes was done in 1985, before crack
had become common. Thus the probability of becoming dependent on
cocaine was derived from the responses of users who snorted the
drug. The speed and potency of cocaine’s action increases
dramatically when it is smoked. We do not yet know how greatly
the advent of crack increases the risk of dependency, but all
the clinical evidence suggests that the increase is likely to be
large.
It is possible that some people will
not become heavy users even when the drug is readily available
in its most potent form. So far there are no scientific grounds
for predicting who will and who will not become dependent.
Neither socioeconomic background nor personality traits
differentiate between casual and intensive users. Thus, the only
way to settle the question of who is correct about the effect of
easy availability on drug use, Nadelmann or Gawin and Ellinwood,
is to try it and see. But the social experiment is so risky as
to be no experiment at all, for if cocaine is legalized and if
the rate of its abusive use increases dramatically, there is no
way to put the genie back in the bottle, and it is not a kindly
genie.
HAVE WE LOST?
Many people who agree that there are
risks in legalizing cocaine or heroin still favor it because,
they think, we have lost the war on drugs. “Nothing we have done
has worked” and the current federal policy is just more of the
same.” Whatever the costs of greater drug use, surely they would
be less than the costs of our present, failed efforts.
That is exactly what I was told in
1972— and heroin is not quite as 30 bad a drug as cocaine. We
did not surrender and we did not lose. We did
not win, either. What the nation
accomplished then was what most efforts to save people from
themselves accomplish: The problem was contained and the number
of victims minimized, all at a considerable cost in law
enforcement and increased crime. Was the cost worth it? I think
so, but others may disagree. What are the lives of would-be
addicts worth? I recall some people saying to me then, “Let them
kill themselves.” I was appalled. Happily, such views did not
prevail.
Have we lost today? Not at all.
High-rate cocaine use is not commonplace. The National Institute
of Drug Abuse (NIDA) reports that less than 5 percent of
high-school seniors used cocaine within the last thirty days. Of
course this survey misses young people who have dropped out of
school and miscounts those who lie on the questionnaire, but
even if we inflate the NIDA estimate by some plausible
percentage, it is still not much above 5 percent. Medical
examiners reported in 1987 that about 1,500 died from cocaine
use; hospital emergency rooms reported about 30,000 admissions
related to cocaine abuse.
These are not small numbers, but
neither are they evidence of a nationwide plague that threatens
to engulf us all. Moreover, cities vary greatly in the
proportion of people who are involved with cocaine. To get
city-level data we need to turn to drug tests carried out on
arrested persons, who obviously are more likely to be drug users
than the average citizen. The National Institute of Justice,
through its Drug Use Forecasting (DUF) project, collects
urinalysis data on arrestees in twenty-two cities. As we have
already seen, opiate (chiefly heroin) use has been flat or
declining in most of these cities over the last decade. Cocaine
use has gone up sharply, but with great variation among cities.
New York, Philadelphia, and Washington, D.C., all report that
two-thirds or more of their arrestees tested positive for
cocaine, but in Portland, San Antonio, and Indianapolis the
percentage was one-third or less.
In some neighborhoods, of course,
matters have reached crisis proportions. Gangs control the
streets, shootings terrorize residents, and drug dealing occurs
in plain view. The police seem barely able to contain matters.
But in these neighborhoods — unlike at Palo Alto cocktail
parties — the people are not calling for legalization, they are
calling for help. And often not much help has come. Many cities
are willing to do almost anything about the drug problem except
spend more money on it. The federal government cannot change
that; only local voters and politicians can. It is not clear
that they will.
It took about ten years to contain
heroin. We have had experience with crack for only about three
or four years. Each year we spend perhaps $11 billion on law
enforcement (and some of that goes to deal with marijuana) and
perhaps $2 billion on treatment. Large sums, but not sums that
should lead anyone to say, “We just can’t afford this any more.”
The illegality of drugs increases
crime, partly because some users 35 turn to crime to pay for
their habits, partly because some users are stimulated by
certain drugs (such as crack or PCP) to act more violently or
ruthlessly than they otherwise would, and partly because
criminal organizations seeking to control drug supplies use
force to manage their markets. These also are serious costs, but
no one knows how much they would be reduced if drugs were
legalized. Addicts would no longer steal to pay black-market
prices for drugs, a real gain. But some, perhaps a great deal,
of that gain would be offset by the great increase in the number
of addicts. These people, nodding on heroin or living in the
delusion-ridden high of cocaine, would hardly be ideal
employees. Many would steal simply to support themselves, since
snatch-and-grab, opportunistic crime can be managed even by
people unable to hold a regular job or plan an elaborate crime.
Those British addicts who get their supplies from government
clinics are not models of law-abiding decency. Most are in
crime, and though their per-capita rate of criminality may be
lower thanks to the cheapness of their drugs, the total volume
of crime they produce may be quite large. Of course, society
could decide to support all unemployable addicts on welfare, but
that would mean that gains from lowered rates of crime would
have to be offset by large increases in welfare budgets.
Proponents of legalization claim
that the costs of having more addicts around would be largely if
not entirely offset by having more money available with which to
treat and care for them. The money would come from taxes levied
on the sale of heroin and cocaine.
To obtain this fiscal dividend,
however, legalization’s supporters must first solve an economic
dilemma. If they want to raise a lot of money to pay for welfare
and treatment, the tax rate on the drugs will have to be quite
high. Even if they themselves do not want a high rate, the
politicians’ love of “sin taxes” would probably guarantee that
it would be high anyway. But the higher the tax, the higher the
price of the drug, and the higher the price the greater the
likelihood that addicts will turn to crime to find the money for
it and that criminal organizations will be formed to sell
tax-free drugs at below-market rates. If we managed to keep
taxes (and thus prices) low, we would get that much less money
to pay for welfare and treatment and more people could afford to
become addicts. There may be an optimal tax rate for drugs that
maximizes revenue while minimizing crime, bootlegging, and the
recruitment of new addicts, but our experience with alcohol does
not suggest that we know how to find it.
THE BENEFITS OF ILLEGALITY
The advocates of legalization find
nothing to be said in favor of the current system except,
possibly, that it keeps the number of addicts smaller than it
would otherwise be. In fact, the benefits are more substantial
than that.
First, treatment. All the talk about
providing “treatment on demand” implies that there is a demand
for treatment. That is not quite right. There are some
drug-dependent people who genuinely want treatment and will
remain in it if offered; they should receive it. But there are
far more who want only short-term help after a bad crash; once
stabilized and bathed, they are back on the street again,
hustling. And even many of the addicts who enroll in a program
honestly wanting help drop out after a short while when they
discover that help takes time and commitment. Drug-dependent
people have very short time horizons and a weak capacity for
commitment. These two groups —those looking for a quick fix and
those unable to stick with a long-term fix—are not easily
helped. Even if we increase the number of treatment slots — as
we should—we would have to do something to make treatment more
effective.
One thing that can often make it
more effective is compulsion. 40 Douglas Anglin of UCLA, in
common with many other researchers, has
found that the longer one stays in a
treatment program, the better the chances of a reduction in drug
dependency. But he, again like most other researchers, has found
that dropout rates are high. He has also found, however, that
patients who enter treatment under legal compulsion stay in the
program longer than those not subject to such pressure. His
research on the California civil commitment program, for
example, found that heroin users involved with its required
drug-testing program had over the long term a lower rate of
heroin use than similar addicts who were free of such
constraints. If for many addicts compulsion is a useful
component of treatment, it is not clear how compulsion could be
achieved in a society in which purchasing, possessing, and using
the drug were legal. It could be managed, I suppose, but I would
not want to have to answer the challenge from the American Civil
Liberties Union that it is wrong to compel a person to undergo
treatment for consuming a legal commodity.
Next, education. We are now
investing substantially in drug-education programs in the
schools. Though we do not yet know for certain what will work,
there are some promising leads. But I wonder how credible such
programs would be if they were aimed at dissuading children from
doing something perfectly legal. We could, of course, treat drug
education like smoking education: Inhaling crack and inhaling
tobacco are both legal, but you should not do it because it is
bad for you. That tobacco is bad for you is easily shown; the
Surgeon General has seen to that. But what do we say about
crack? It is pleasurable, but devoting yourself to so much
pleasure is not a good idea (though perfectly legal)? Unlike
tobacco, cocaine will not give you cancer or emphysema, hut it
will lead you to neglect your duties to family, job, and
neighborhood? Everybody is doing cocaine, but you should not?
Again, it might be possible under a
legalized regime to have effective drug-prevention programs, but
their effectiveness would depend heavily, I think, on first
having decided that cocaine use, like tobacco use, is purely a
matter of practical consequences; no fundamental moral
significance attaches to either. But if we believe—as I do—that
dependency on certain mind-altering drugs is a moral issue and
that their illegality rests in part on their immorality, then
legalizing them undercuts, if it does not eliminate altogether,
the moral message.
That message is at the root of the
distinction we now make between nicotine and cocaine. Both are
highly addictive; both have harmful physical effects. But we
treat the two drugs differently, not simply because nicotine is
so widely used as to be beyond the reach of effective
prohibition, but because its use does not destroy the user’s
essential humanity. Tobacco shortens one’s life, cocaine debases
it. Nicotine alters one’s habits, cocaine alters one’s soul. The
heavy use of crack, unlike the heavy use of tobacco, corrodes
those natural sentiments of sympathy and duty that constitute
our human nature and make possible our social life. To say, as
does Nadelmann, that distinguishing morally between tobacco and
cocaine is “little more than a transient prejudice” is close to
saying that morality itself is but a prejudice.
THE ALCOHOL PROBLEM
Now we have arrived where many
arguments about legalizing drugs begin: Is there any reason to
treat heroin and cocaine differently from the way we treat
alcohol?
There is no easy answer to that
question because, as with so many 45 human problems, one cannot
decide simply on the basis either of moral
principles or of individual
consequences; one has to temper any policy by a commonsense
judgment of what is possible. Alcohol, like heroin, cocaine,
PCP, and marijuana, is a drug—that is, a mood-altering
substance—and consumed to excess it certainly has harmful
consequences:
auto accidents, barroom fights,
bedroom shootings. It is also, for some people, addictive. We
cannot confidently compare the addictive powers of these drugs,
but the best evidence suggests that crack and heroin are much
more addictive than alcohol.
Many people, Nadelmann included,
argue that since the health and financial costs of alcohol abuse
are so much higher than those of cocaine or heroin abuse, it is
hypocritical folly to devote our efforts to preventing cocaine
or drug use. But as Mark Kleiman of Harvard has
pointed out, this comparison is
quite misleading. What Nadelmann is doing is showing that a
legalized drug (alcohol) produces greater social harm than
illegal ones (cocaine and heroin). But of course. Suppose that
in the 1920s we had made heroin and cocaine legal and alcohol
illegal. Can anyone doubt that Nadelmann would now be writing
that it is folly to continue our ban on alcohol because cocaine
and heroin are so much more harmful?
And let there be no doubt about
it—widespread heroin and cocaine use are associated with all
manner of ills. Thomas Bewley found that the mortality rate of
British heroin addicts in 1968 was twenty-eight times as high as
the death rate of the same age group of nonaddicts, even though
in England at the time an addict could obtain free or low-cost
heroin and clean needles from British clinics. Perform the
following mental experiment: Suppose we legalized heroin and
cocaine in this country. In what proportion of auto fatalities
would the state police report that the driver was nodding off on
heroin or recklessly driving on a coke high? In what proportion
of spouse-assault and child-abuse cases would the local police
report that crack was involved? In what proportion of industrial
accidents would safety investigators report that the forklift or
drill-press operator was in a drug-induced stupor or frenzy? ~We
do not know exactly what the proportion would be, but anyone who
asserts that it would not be much higher than it is now would
have to believe that these drugs have little appeal except when
they are illegal. And that is nonsense.
An advocate of legalization might
concede that social harm—perhaps harm equivalent to that already
produced by alcohol —would follow from making cocaine and heroin
generally available. But at least, he might add, we would have
the problem “out in the open” where it could be treated as a
matter of “public health.” That is well and good, if we knew how
to treat — that is, cure — heroin and cocaine abuse. But we do
not know how to do it for all the people who would need such
help. We are having only limited success in coping with chronic
alcoholics. Addictive behavior is immensely difficult to change,
and the best methods for changing it — living in drug-free
therapeutic communities, becoming faithful members of Alcoholics
Anonymous or Narcotics Anonymous — require great personal
commitment, a quality that is, alas, in short supply among the
very persons —young people, disadvantaged people—who are often
most at risk for addiction.
Suppose that today we had, not
fifteen million alcohol abusers, but half a million. Suppose
that we already knew what we have learned from our long
experience with the widespread use of alcohol. Would we make
whiskey legal? I do not know, but I suspect there would be a
lively debate. The Surgeon General would remind us of the risks
alcohol poses to pregnant women. The National Highway Traffic
Safety Administration would point to the likelihood of more
highway fatalities caused by drunk drivers. The Food and Drug
Administration might find that there is a nontrivial increase in
cancer associated with alcohol consumption. At the same time the
police would report great difficulty in keeping illegal whiskey
out of our cities, officers being corrupted by bootleggers, and
alcohol addicts often resorting to crime to feed their habit.
Libertarians, for their part, would argue that every citizen has
a right to drink anything he wishes and that drinking is, in any
event, a “victimless crime.”
However the debate might turn out,
the central fact would be that 50 the problem was still, at that
point, a small one. The government cannot
legislate away the addictive
tendencies in all of us, nor can it remove completely even the
most dangerous addictive substances. But it can cope with harms
when the harms are still manageable.
SCIENCE AND ADDICTION
One advantage of containing a
problem while it is still containable is that it buys time for
science to learn more about it and perhaps to discover a cure.
Almost unnoticed in the current debate over legalizing drugs is
that basic science has made rapid strides in identifying the
underlying neurological processes involved in some forms of
addiction. Stimulants such as cocaine and amphetamines alter the
way certain brain cells communicate with one another. That
alteration is complex and not entirely understood, but in
simplified form it involves modifying the way in which a
neurotransmitter called dopamine sends signals from one cell to
another.
When dopamine crosses the synapse
between two cells, it is in effect carrying a message from the
first cell to activate the second one. In certain parts of the
brain that message is experienced as pleasure. After the message
is delivered, the dopamine returns to the first cell. Cocaine
apparently blocks this return, or “reuptake,” so that the
excited cell and others nearby continue to send pleasure
messages. When the exaggerated high produced by
cocaine-influenced dopamine finally ends, the brain cells may
(in ways that are still a matter of dispute) suffer from an
extreme lack of dopamine, thereby making the individual unable
to experience any pleasure at all. This would explain why
cocaine users often feel so depressed after enjoying the drug.
Stimulants may also affect the way in which other
neurotransmitters, such as serotonin and noradrenaline, Operate.
Whatever the exact mechanism may be,
once it is identified it becomes possible to use drugs to block
either the effect of cocaine or its tendency to produce
dependency. There have already been experiments using
desipramine, imipramine, bromocriptine, carbamazepine, and other
chemicals. There are some promising results.
Tragically, we spend very little on
such research, and the agencies funding it have not in the past
occupied very influential or visible posts in the federal
bureaucracy. If there is one aspect of the “war on drugs”
metaphor that I dislike, it is its tendency to focus attention
almost exclusively on the troops in the trenches, whether
engaged in enforcement or treatment, and away from the
research-and-development efforts back on the home front where
the war may ultimately be decided.
I believe that the prospects of
scientists in controlling addiction will 55 be strongly
influenced by the size and character of the problem they
face. If the problem is a few
hundred thousand chronic, high-dose users of an illegal product,
the chances of making a difference at a reasonable cost will be
much greater than if the problem is a few million chronic users
of legal substances. Once a drug is legal, not only will its use
increase but many of those who then use it will prefer the drug
to the treatment: They will want the pleasure, whatever the cost
to themselves or their families, and they will resist—probably
successfully—any effort to wean them away from experiencing the
high that comes from inhaling a legal substance.
IF I AM WRONG...
No one can know what our society
would be like if we changed the law to make access to cocaine,
heroin, and PCP easier. I believe, for reasons given, that the
result would be a sharp increase in use, a more widespread
degradation of the human personality, and a greater rate of
accidents and violence.
I may be wrong. If I am, then we
will needlessly have incurred heavy costs in law enforcement and
some forms of criminality. But if I am right, and the legalizers
prevail anyway, then we will have consigned millions of people,
hundreds of thousands of infants, and hundreds of neighborhoods
to a life of oblivion and disease. To the lives and families
destroyed by alcohol we will have added countless more destroyed
by cocaine, heroin, PCP, and whatever else a basement scientist
can invent.
Human character is formed by
society; indeed, human character is inconceivable without
society, and good character is less likely in a bad society.
Will we, in the name of an abstract doctrine of radical
individualism, and with the false comfort of suspect
predictions, decide to take the chance that somehow individual
decency can survive amid a more general level of degradation?
I think not. The American people are
too wise for that, whatever the academic essayists and
cocktail-party pundits may say. But if Americans today are less
wise than I suppose, then Americans at some future time will
look back on us now and wonder, what kind of people were they
that they could have done such a thing?
Topics for Critical Thinking and
Writing
1. Wilson objects to the
idea that using cocaine is a “victimless crime” (para. 24; see
also para. 49). A crime is said to be “victimless” when the
offender consents to the act and those who do not consent are
not harmed. Why does it matter to Wilson, do you think, whether
using illegal drugs is a victimless crime?
2. Wilson accuses Ethan
Nadelmann, an advocate of legalization, of committing “a logical
fallacy and a factual error” (para. 26). What is the fallacy,
and what is the error?
3. Wilson raises the
question of whether we “won” or “lost” the war on heroin in the
1 970s and whether we will do any better with the current war on
cocaine (paras. 30—31). What would you regard as convincing
evidence that we are winning the war on drugs? Losing it?
4. In his criticism of those
who would legalize drugs, Wilson points to what he regards as an
inescapable “economic dilemma” (para. 37). What is this dilemma?
Do you see any way around it?
5. Economists tell us that
we can control the use of a good or service by controlling the
cost (thus probably reducing the demand), by ignoring the cost
and controlling the supply, or by doing both. In the war on
drugs, which of these three economic strategies does Wilson
apparently favor, and why?
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