CHAPTER SEVEN
Solutions
‘I start from the presumption that nature is all that there is and gravitate towards scientific explanations of phenomena … Was it possible that a single psychedelic experience — something that turned on nothing more than the ingestion of a pill or square of blotter paper — could put a big dent in such a worldview? Shift how one thought about mortality? Actually change one’s mind in enduring ways?’
MICHAEL POLLAN, HOW TO CHANGE YOUR MIND, 20181
The longevity of the drug war has surprised many of its most fervent opponents. Even though it’s been a catastrophic failure in reducing drug supply and usage, its benefit to political and law-enforcement elites should never be under-estimated. For these reasons, alternatives to the war on drugs have never been more relevant. How to access illicit substances in the face of prohibition, the beneficial uses of psychedelic drugs, and what a legalised and regulated market could look like are three areas that deserve examination.
As long as the drug war continues to ravage communities in the West and drug-producing nations in South America, Asia, and Africa, resistance to its twisted logic is necessary. This isn’t a signal to consume more drugs, but rather an acknowledgement that a regulated and legalised system is the best way to improve health and reduce crime.
~
The explosion of the dark net — online, mostly anonymous, crypto-markets — has provided a new frontier in selling and procuring drugs. It has allowed consumers to browse countless stores to find what they’re looking for, usually without exposing themselves to law-enforcement threats or gang violence. I’ve checked out some of these websites, many based in Australia and Europe, and seen every drug imaginable on sale, from heroin to fentanyl. I could order the drug, and it would arrive at my home or office within a matter of days or weeks. The vast bulk of the product reaches the intended customer, with police only intercepting a small fraction of it.
Research released by criminologists in 2017 found that Australia had more online drug vendors per capita than any other country, apart from the Netherlands. Vendors sold opioids and ecstasy,2 and more than one-quarter of the dark net’s methamphetamine market was facilitated by Australian online dealers. Prices for drugs varied greatly, but Australian vendors often charged more for products than their overseas counterparts, meaning much of their market was domestic.
One of the researchers behind the study was Dr James Martin, associate professor in criminology at Swinburne University in Australia, who argued that there were positive signs revealed by the study. He wrote that dark net consumers usually purchased higher-quality drugs than those sourced from traditional places, and had greater knowledge of the drugs’ composition.
There was one huge caveat, however. ‘Unfortunately, crypto-markets are unable to resolve the worst, intractable systemic drug violence in source countries such as Mexico’, Martin wrote. ‘In the absence of a legal market for these drugs, this violence will continue unabated, much as it has since the beginning of the war on drugs.’3 The dark net did little to stop the brutality around the production of drugs in Africa, South America, or elsewhere.
The dark net entered the public consciousness with the Silk Road marketplace, run from 2011 until 2013 by Dread Pirate Roberts, later exposed as American citizen Ross Ulbricht. He was found guilty in 2015 of narcotics trafficking, money laundering, running a criminal enterprise, and computer hacking, and was sentenced to life in prison without the prospect of parole. Before his sentencing, Ulbricht told the court that Silk Road was ‘supposed to be about giving people the freedom to make their own choices’ as an expression of his libertarian values.
But it had all gone horribly wrong, as prosecutors alleged that he had paid money to have six people killed (although the murders were never carried out). Dozens of drug sellers on Silk Road were prosecuted globally after Ulbricht was imprisoned. The US government and those involved with Silk Road who evaded detection eventually tried to sell some of the hundreds of millions of dollars of bitcoin that they recovered or kept after the site was shut down.
The US government argued that closing down Silk Road was a necessary step in tackling illegal drugs. After the verdict was announced, the Manhattan US attorney, Preet Bharara, said that, ‘Ulbricht was a drug dealer and criminal profiteer who exploited people’s addictions and contributed to the deaths of at least six young people. Ulbricht went from hiding his cybercrime identity to becoming the face of cybercrime and as today’s sentence proves, no one is above the law.’
James Martin, some of whose work was used by the Ulbricht defence team, unbeknownst to him, told me that Silk Road was pioneering, and for that reason the US government had to crush it because it was an ‘overtly politically, subversive act’ to sell illegal drugs on such a large scale. ‘I think it really highlighted the limitations of state power’, he said, because it took years of high-cost investigations by the FBI, DEA, and Europol to get Ulbricht. ‘Terrorists and paedophiles get a lighter touch [prison sentence] than Ulbricht, and his biggest crime was making a fool of the whole system of drug prohibition.’
Ending Silk Road was only a momentary victory for US officials, because many similar sites blossomed soon after. Martin welcomed this as a positive development. ‘The dark net does offer this kind of unexpected third way where at least some of the harms associated with the drug-trade can be ameliorated’, he said. ‘Street dealing is typically the riskiest part of a drug-supply chain. The reason for that is because drug dealers need to have some minimal level of public exposure to get customers.’
Martin’s research offered unique insights into the drug-trade, whereas its traditional trafficking methods made it close to impossible to track. Via encrypted chats, many online sellers shared details about their motivations with Martin and his colleagues, detailing their financial returns as well as their deliberate subversion of what they viewed as absurd drug laws.
While nations from Australia to the US maintained a tough prohibitionist strategy against drugs, the dark net was a buyer’s market rather than a seller’s market. Interested parties had thousands of options to browse through, even able to check online reviews of products on their very own trip advisor. As in the legit world, selling bad drugs would generate poor reviews. There was still no guarantee of quality, unless the drugs were tested on arrival — toxic fentanyl was being sold to consumers with sometimes deadly results — but reviews gave users a sense of what the seller was offering. Drug samples were also sometimes given to ‘drug critics’ as a way to boost a seller’s reputation and sales. Some suggestions were emerging that dark-net dealers might develop an effective and safe method of testing drugs themselves to reduce the risks of consumption for users. Increasing numbers of people were also buying legal prescription drugs on the dark net because they couldn’t get the drugs they believed they needed to treat their medical conditions.
Some dark-web operators stopped selling fentanyl in 2018, fearing that its potency and toxicity might attract the attention of law enforcement. A 2019 study by the Australian National University found that fentanyl was being sold on the dark net, but that 99.7 per cent of the listings on various dark-net sites were not of the deadly drug.
In a study released in Addiction journal in 2017, Martin challenged his own belief that the dark net would necessarily reduce violence associated with the drug-trade. Although there was evidence that proved such reductions would be ‘modest’ — because ecstasy and cannabis were the biggest sellers online, and the drugs that were least associated with violence — ‘the demographic characteristics of cryptomarket users may also exclude those market participants who are typically most vulnerable to systemic violence (eg sex workers, rough sleepers).’4
Some of the more entrepreneurial dark-net sellers used the language of ethical drug taking in their advertising. It was impossible to verify the accuracy of their claims, and it was unlikely that drug sellers had the ability to completely avoid the destructive supply chain that was inevitable in the production of drugs such as cocaine, but some clearly believed it was an effective tool to attract business. One advertisement read:
We are a team of libertarian cocaine dealers. We never buy coke from cartels! We never buy coke from police! We help farmers from Peru, Bolivia and some chemistry students in Brazil, Paraguay and Argentina. We do fair trade!
Another one read:
This is the best opium you will try, by purchasing this you are supporting local farmers in the hills of Guatemala and you are not financing violent drug cartels.5
Martin acknowledged that the dark net was open to abuse — such as doxing, fraud, hacking and sellers stealing funds — but ‘to date, not a single instance of physical, intra-market violence between cryptomarket drug-traders has been recorded. This fact is likely to be of no small comfort to those who increasingly choose to buy and sell illicit drugs online, and the absence of violence associated with online drug-trading may be a significant factor driving its growth in years to come.’
The attitude of law enforcement towards the dark net was still evolving, he said. Officials knew it was impossible to shut down all websites selling illicit drugs, just like they could never arrest their way into a drug-free society, but cryptomarkets presented an existential challenge to the normal ways of policing drugs with busts and surveillance. Online drug markets were undeniably less harmful than the traditional drug-trade, so the public interest would be best served by allowing these sites to remain open (a view not shared by all police). One of the biggest dark-net sites, Dream Market, closed in 2019 amid rumours that the DEA or FBI had caused its failure.
Martin said that the dark net also presented an ideological challenge to the drug war, because the rhetoric for decades about illicit substances emphasised the violence that inevitably occurred. But with Silk Road and others, Martin explained, they were ‘just a bunch of nerds. You’ve got these guys who are sitting behind a computer. You’ve got no violence. You’ve got no scary people hanging around corners or hanging around schoolyards or any of the other sort of symbols of drug-war propaganda. It’s pretty difficult to scare people with that.’
~
Beckley Park is a beautiful old property situated 30 minutes from the centre of Oxford in England. Down muddy tracks, past lush, green fields and old farmhouses, I visited on a glorious, crisp sunny day. Founded by Amanda Feilding in 1998, Beckley Foundation pushes for global drug reform and the scientific study of psychoactive substances.
I spent the day with Feilding, in her mid-70s, and discussed her life-long quest to normalise the use of psychedelic drugs and cannabis to help people in mental need. She was passionate and knowledgeable, clearly frustrated by the slow pace of drug reform. She believed that LSD, mushrooms, and cannabis should be a central part of treating depression and mental-health problems.
Evidence was building to support her thesis. Two 2016 studies — one at Johns Hopkins University and the other at New York University — showed that a single dose of psilocybin (magic mushrooms) could have immediate, lasting, and profound effects on cancer patients dealing with depression and anxiety. An earlier study found that cancer sufferers who faced imminent death felt more comfortable with this outcome after taking psychedelics. Another study at Johns Hopkins University from 2014 found that taking magic mushrooms helped 80 per cent of participants end their nicotine addiction.
Beckley’s grand house, parts of which dated back hundreds of years, surrounded by a moat and perfectly manicured hedges near fighting swans in the lake, made for a curious setting to the serious and revolutionary message she was pushing. She told me that although she had befriended many rich people — including some in the tech world — who talked positively about using psychedelics and how it helped their creativity, very few were willing to put up money to support scientific research into the drugs’ perceived health benefits.
Feilding told me that, after decades of psychedelic drugs being demonised and dismissed, science could restore its rightful place in society and show with evidence that mind-altering drugs would help the world. ‘Science is the kind of new religion’, she said, as other religions had become less respected in the West.
Due to the drugs’ illegality and the widespread belief that working with them would harm careers, only a few brave souls engaged in this issue, though it was becoming far less controversial to research these drugs. Feilding had to play the long game, pushing for change over decades. Only in the last years had it become more socially acceptable to advocate for these drugs, but her frustration with the slow progress of change was palpable. Feilding wasn’t a trained scientist, but understood much of the science around psychedelic drugs and its properties.
She had launched a for-profit cannabis business, Beckley Canopy Therapeutics, to capitalise on the booming legal marijuana business and to develop cannabis-based medicines. She hoped to put some of the profit generated by this business into more scientific research on psychedelics.
Feilding had had an interest in mystical experiences from a young age. Her godfather had become a Buddhist monk, which gave her a taste for global adventures. She left school at 16 because she didn’t ‘like the constrictions and not being allowed to learn what I wanted to learn, but I always self-educated pretty compulsively. I got the best tutor in the world in religions and Arab studies.’
She started smoking cannabis at Oxford University in 1960, and tried LSD for the first time in 1965. ‘I found my mission in life’, she said. ‘I had kind of a visionary spirit. My mother was Catholic, my father was agnostic, so I had a bit of both. I dreamed of doing great things for the world. One of my dreams was watering the desert. And then I came across this knowledge [about the benefits of psychedelic drugs].’ To this day, Feilding wanted people to have access to these drugs and to the science that supported its use. ‘I’m not against recreational use at all. I’m against recreational misuse.’
The Beckley Foundation was born from an idea that Western societies, including Britain, had copied US drug policies for the wrong reasons. We were a ‘lapdog’, she said. ‘I started the Beckley Foundation to build a scientific evidence base, to share why the policies of criminalisation and prohibition were causing much more harm than they were solving. You need to deal with the drugs individually, and psychedelics and cannabis cause very few harms. The harm is mainly caused by prohibition.’
Feilding’s vision was a future where psychedelic drugs weren’t viewed as a novelty but as part of a vital way of life. ‘In an ideal society, there would be retreat centres’, she told me. ‘Places in the country where people can go and have people around who are experienced guides [with drugs] to help the traumatised in bad situations — experiencing altered states with the intention of self-improvement.’ Psychedelics or cannabis could help people with Parkinson’s disease and PTSD.
LSD was discovered by Swiss scientist Albert Hofmann in 1938 — he was the first man to take an acid trip in 1943 — but the drug only entered popular consciousness in the 1960s. He spent his life opposing the drug’s prohibition. He took it himself because he saw it as a ‘sacred drug’ and argued that, ‘I see the true importance of LSD in the possibility of providing material aid to meditation aimed at the mystical experience of a deeper, comprehensive reality.’ Hofmann was aware of the drug’s danger if not used in a well-controlled, professional psychiatric setting, but remained a committed advocate for its therapeutic benefits.
For decades, Feilding’s advocacy was restricted to a small audience, but in the last decade public attitudes and scientific research had evolved; psychedelic drugs were no longer viewed as an evil that had to be restricted. ‘I’d like my legacy to be to integrate the possibility of altered states into society, because I think they are valuable to the human’s survival’, she said. ‘What we find noble in humans, including bravery — these compounds can help bring that out.’
The Beckley Foundation regularly featured in the British conversation about drug reform. In 2011, the organisation co-ordinated a public letter in The Guardian and The Times that declared the ‘war on drugs’ a failure and pushed for an end to prohibition. It was signed by current and former leaders of Colombia, Guatemala, and Mexico, countless Nobel Prize winners, and many others.
Feilding had worked with one of Britain’s leading scientists in the psychedelic field, Dr Robin Carhart-Harris, who was head of Imperial Psychedelic Research Group at Imperial University. (Imperial opened the world’s first psychedelic research centre in 2019.) Carhart-Harris often partnered with Dr David Nutt, the famous British neuropsychopharmacologist. At his home in Oxford, Carhart-Harris told me that he had long believed that there was a need for rigorous scientific studies on psychedelic drugs to give them credibility in the wider community. He was shocked to learn that there had never been a brain-image study with LSD until he released one in 2016. It was possible to prove with evidence that LSD was fundamentally changing how humans viewed the world.
Carhart-Harris said at the time:
We observed brain changes under LSD that suggested our volunteers were ‘seeing with their eyes shut’ — albeit they were seeing things from their imagination rather than from the outside world. We saw that many more areas of the brain than normal were contributing to visual processing under LSD — even though the volunteers’ eyes were closed. Furthermore, the size of this effect correlated with volunteers’ ratings of complex, dreamlike visions.
Our brains become more constrained and compartmentalised as we develop from infancy into adulthood, and we may become more focused and rigid in our thinking as we mature. In many ways, the brain in the LSD state resembles the state our brains were in when we were infants: free and unconstrained. This also makes sense when we consider the hyper-emotional and imaginative nature of an infant’s mind.6
Carhart-Harris explained that there was still much that humans didn’t understand about the brain, but psychedelic drugs ranging from ayahuasca [an Amazonian hallucinogenic brew] to LSD had the possibility of reshaping consciousness. He imagined a world in the not-too-distant future where a patient visited their local doctor, explained they had depression, obsessive-compulsive disorder, addiction, an eating disorder, phobia, a speech impediment, or chronic pain, and, instead of prescribing an anti-depressant, the doctor would say that there was a viable alternative. Carhart-Harris imagined a doctor saying to the patient: ‘There is this other treatment model, but it requires something of you. It’s not just about passively giving you medicine. You have to go into this treatment willing to engage. If you’re interested, I can refer you to this clinic that’s called the Psychedelic Treatment Clinic.’
It would take a week or longer at a psychedelic spa to be given certain psychedelic drugs, under professional supervision, along with access to healthy food, teaching, and yoga, and at the end of the process the person would, hopefully, be vastly improved, if not cured. Carhart-Harris was critical of many psychoanalysts working today whom he viewed as not being open to using psychedelic drugs with their clients. ‘They’re almost in this religion rather than in scientifically directed method and practice’, he said.
Carhart-Harris admitted that psychedelic retreats would be difficult to support in a public health-care system without a major shift in government thinking, although the Food and Drug Administration in the US was changing its views. In 2016, it allowed final trials on ecstasy for PTSD patients before possible legalised prescription use of the drug from 2021. Such treatment would be principally available to those who had private health care; it would likely be inaccessible to most people in the non-Western world, who barely had access to decent health care, let alone a psychedelic spa. Take Honduras, the Philippines, or Guinea-Bissau. Carhart-Harris acknowledged that this was a major problem and there should be a concerted effort to not keep these medical advances just for Western patients. There was a risk of creating an ‘elitist division’, he said, when only the wealthy, connected, or highly educated could access the drugs.
The New Yorker magazine ran feature stories on the use of ayahuasca in Brooklyn and Silicon Valley.7 ‘The drug of choice for the age of kale’ was the headline on its 2016 story. Novelist Ayelet Waldman gained publicity in 2017 after admitting to micro-dosing LSD, using small amounts of the drug to manage her depression (although it can also help to improve creativity). The Beckley Foundation and Imperial College London started the world’s first scientific study into micro-dosing in 2018. The practice exploded in Silicon Valley from 2010, with the use of small amounts of LSD or magic mushrooms allowing for hours of intense concentration, and it soon crossed over into more popular use.
These kinds of stories didn’t mean that the drugs weren’t helping people, but the benefits needed to be more widely shared than just with elites on the American coasts. Public attitudes were shifting rapidly. A YouGov poll in 2017 found that nearly two-thirds of Americans were keen to try psychedelic drugs if they were proven to help with their condition. The level of education determined a person’s belief in the drugs. Fifty-three per cent of respondents supported medical research into psychedelic drugs, but this increased to 69 per cent for people with graduate degrees.
During the years I spent researching this book, I started seeing more articles in the mainstream press from PTSD sufferers who swore that ecstasy had saved their lives. The illegality of the drug undoubtedly affected its use and popularity for medical purposes (but this has had little impact on its widespread recreational use).8 Although I’ve never been an evangelist for psychedelic drugs, I’ve become convinced that the West’s obsession with anti-depressants is a fundamentally unhealthy way to manage life. If psychedelic drugs can even partially ameliorate the pain that’s convinced so many people to pop anti-depressants, it’s surely a path worth exploring.
The growing acceptance of psychedelics, and the possibility of them becoming more widely available, also raised issues about the privatisation of knowledge and production — similar to the concerns being expressed about the legal cannabis industry. Activists worried that companies would steal the wonders of the drugs for their financial benefit; I saw little debate around the for-profit corporate medicalisation of psychedelics, but it seemed like a necessary conversation.9
Looking much further into the future, with artificial intelligence likely to dominate the 21st century, I asked Carhart-Harris about the possibility of giving psychedelic drugs to robots if they were depressed. The character Marvin, the paranoid android, in Douglas Adams’ book The Hitchhiker’s Guide to the Galaxy was prone to depression and boredom; I thought he was a prime candidate for psychedelics. Carhart-Harris found the idea intriguing, and said that, ‘If we create them [robots] in our image, then they’ll suffer like we do.’
Zachary Mainen, from the Champalimaud Centre for the Unknown in Lisbon, told a conference in New York in 2018 that intelligent robots, like humans, might need anti-depressants because ‘an autonomous AI will need to have its own interests and its own goals, and if those are thwarted it will be angry or sad in the sense of the same type of reactions that animals and people have’.10
Despite the scientific successes, and a growing body of evidence that proved the health benefits of some psychedelic drugs, Carhart-Harris was cautious. ‘I should be more conscious of the runaway enthusiasm that’s happening now [around psychedelic drugs], and just keep that in check a bit’, he said. He worried that some of the therapy that used these drugs wasn’t grounded in well-researched science. ‘What is the therapy, because it’s not something that looks that familiar to me. It’s not cognitive behavioural therapy, as I understand it. It’s not even psychoanalysis, as I understand it. It’s its own thing. What is that? That’s a completely legitimate question, because it needs to be better documented and manualised so that others can understand the model and then replicate it and test it. You can’t just assume that the model that you’re using, which is left over from the 1960s, is the right one.’
Many of the teachings and mentorships that influenced this movement, from the 1960s until today, came from people with a mystical bent. ‘As a secular scientist, I need to think carefully about that’, Carhart-Harris said.
Many of the people I spoke to about psychedelic drugs stressed that they wanted to avoid what they viewed as the mistakes made by the 1960s generation. The message back then, personified by psychedelic drug preacher Timothy Leary, was to ‘drop out of high school, drop out of college, drop out of graduate school.’ The effect was a successful government campaign to demonise the drugs, and decades of wasted years when valuable scientific studies could have occurred. Today, the target audiences for advocates aren’t hippies but the political and medical elites, to show them how valuable the drugs are. As the libertarian Reason magazine put it in 2017, the message is clear: ‘Stay in school. Apply for research grants. Design clinical trials. Show your work. Evangelize, yes, but with a new audience in mind — not the counterculture, but the Man himself.’11
The US Drug Enforcement Administration (DEA) had placed MDMA on its Schedule One list in 1985, making it illegal to manufacture, sell, buy, or prescribe it. A Democrat from Texas, Lloyd Bentsen, had pushed the DEA to act after a spate of medical emergencies related to the drug. Nonetheless, one year later, a DEA administrative judge, Francis Young, concluded that the DEA had been mistaken and that MDMA should be a Schedule Three drug, allowing it to be prescribed by doctors. ‘The overwhelming weight of medical opinion evidence received in this proceeding concurred that sufficient information on MDMA existed to support a judgment by reputable physicians that MDMA was safe to use under medical supervision,’ Young argued. ‘No evidence was produced of any instances where MDMA was used in therapy with less than wholly acceptable safety.’ His view was ignored.12
The practical application of psychedelics is a live issue today. Dr Ingmar Gorman is a New York-based psychologist who has researched the use of supervised ecstasy in the treatment of PTSD. He has also focused on using such drugs to treat substance abuse (a 2017 study published in the Journal of Psychopharmacology found that LSD and psilocybin helped people reduce their dependence on opioids). He was committed to the concept of MDMA becoming a recognised and accepted form of medicine.
Many decades ago, including in the US, doctors and psychiatrists used to take the same drugs as their patients, including psychedelics, to give them an insight into their effects. In the course of his research, Gorman interviewed these older doctors, and they agreed that it gave them a unique understanding into the use and applicability of psychedelic drugs under a carefully controlled scientific setting.
William A. Richards, a psychologist at the Johns Hopkins School of Medicine in Maryland, said that it was a ‘perfectly rational thing for a professor to give LSD or psilocybin to a graduate student’ in the 1960s, such was the normality of dishing it out to doctors and psychologists.13
Many doctors who advocated psychedelic drugs for treatment, personal growth, and insight spoke of the possibility of one drug-taking session having the potential of changing an individual’s life. Some patients talked about taking these drugs as ‘rebooting the brain’.14
Richards told New Statesman that, ‘People may only receive the drug once and experience its effect for four to six hours but the benefit comes from the memory of that experience and how it changes your view of yourself, other people and the world.’15
Gorman’s primary focus was on helping people with severe PTSD who were treatment-resistant, meaning that psychopharmacology and other psychotherapy didn’t work: soldiers and people who had experienced war, torture, or sexual abuse. Jessi Appleton had been violently sexually assaulted when she was young, and had participated in the MDMA trial for PTSD set by up one of the US’s leading groups advocating for psychedelic drugs, the Multidisciplinary Association for Psychedelic Studies (MAPS). She wrote in 2017 that, ‘My MDMA sessions allowed me to process my past traumas and learn to live a life with compassion and self-love.’16 Nonetheless, there were growing stories of sexual assaults occurring in the psychedelic community, which too often received little public attention. A #MeToo reckoning was required.
Although Gorman wanted MDMA to be more widely available as a medically provided treatment for trauma than it currently was, he worried about its overuse because not enough was known about its long-term effects. ‘People can be very vulnerable when they’re on these drugs’, he said. ‘My fear is that there could be some kind of negative consequence to willy-nilly prescription of psilocybin [mushrooms] or MDMA.’ Instead, he wanted these drugs to be better integrated into normal medical treatment.
What motivated Gorman to continue his work was seeing the tangible results of patients using psychedelic drugs. ‘Therapy with MDMA is kind of like driving a Ferrari’, he explained. ‘People refer to psychedelic therapy as accelerated therapy. I could use psychiatric terms to describe it, but it’s like night and day. It’s a transformation. From somebody who cannot smile, who doesn’t have the joy in their life, to somebody who then has that, and it’s incredibly motivating. It’s moving. To be able to release that control, it’s something that in therapy, without these drugs, can take decades. You see it over the period of three months [with ecstasy].’
It wasn’t just ecstasy that provided potentially huge benefits to patients. Ketamine was also being tested to treat alcohol addiction (and it was proven to help some people with depression and anxiety). Elias Dakwar, a professor of clinical psychiatry at Columbia University in New York, led ketamine tests on patients with substance-abuse problems. ‘The thinking on ketamine’s effect on depression is that it reverses depression-related adaptation through neuroplasticity’, he told Vice Motherboard in 2016. What he meant was that the brain became more open to creating new connections, and could stop old and unhealthy patterns of behaviour. Therapy with the drug held open the possibility of improving lives.17
Growing numbers of doctors wanted the option of using ketamine, because they had so few other medical ways to stop highly disturbed and distressed patients intent on suicide. Ketamine can be that powerful. Although the US FDA approved a ketamine-like nasal spray for release on the market in 2019 — to be made by pharmaceutical giant Johnson & Johnson — many doctors expressed reservations over the haste with which the product was approved, considering its still unknown long-term effects. Nonetheless, it’s surely worth using judiciously on the 25 per cent of patients with depression who don’t respond to current drugs.
Dakwar conducted a study on the use of ketamine to treat crack cocaine addiction. Early, unfinished results showed that the craving for cocaine was reduced with the use of small amounts of ketamine. If successful, ketamine could be used to rewire the brain to be less attracted to drugs such as cocaine and others like it that caused personal and societal damage if abused.18
Dakwar told me that despite the benefits of some psychedelic drugs, he did not support the full legalisation of them, because they required a ‘medical context for administration. The risks associated with irresponsible use, which unfortunately we might predispose to if they’re so freely available, are just so grave. There’s potential psychosis that persists beyond the experience.’
These concerns led to the opening in New York in 2017 of the first US therapeutic facility for users of psychedelic drugs. Andrew Tatarsky, founder and director of the Centre for Optimal Living, said that the growth in experimentation with these drugs convinced him to open a space in which reliable information could be obtained about the opportunities and risks associated with them.
The Psychedelic Education and Continuing Care Program was another US-based initiative that aimed to both educate the wider public about the use of such drugs and reduce any harm. This movement was moving into the mainstream, with growing numbers of university students researching psychedelic science and better understanding the properties and possible benefits of the drugs. There was also a focus on getting more women and minorities involved in the movement.
~
What a legal and regulated drug market would look like is one of the great questions of our age, because no country has ever tried it. Throughout this book, I’ve included ideas, suggestions, and insights from drug takers, experts, academics, and politicians around the world about how it could be done, and why they think it’s the most sensible way to tackle widespread drug use and misuse.
And yet it’s only relatively recently that the public conversation in the US has momentously shifted, from why the drug war has been disastrous and should end to how this could be done. Growing anger over mass incarceration and increased support for legal cannabis have generated enough heat to lead the new conversation.
‘Depending on how the issue is framed’, an American writer on the drug war, Dan Baum, argued in 2016, ‘legalisation of all drugs can appeal to conservatives, who are instinctively suspicious of bloated budgets, excess government authority, and intrusions on individual liberty, as well as to liberals, who are horrified at police overreach, the brutalisation of Latin America, and the criminalisation of entire generations of black men. It will take some courage to move the conversation beyond marijuana to ending all drug prohibition, but it will take less, I suspect, than most politicians believe.’19
I would quibble with Baum’s characterisation of conservatives and liberals — many conservatives and liberals, especially since 11 September 2001, accepted vast government and corporate surveillance over their lives with little protest, and takers of cocaine rarely thought about the harm it caused to South American nations — but his overall point was correct. It’s unimaginable that every nation in the world would suddenly legalise all drugs one day and that the drug war would simply end. Some countries would take incremental steps, such as starting with the legalisation of cannabis, and then potentially become open to further ideas leading to full legalisation. Others could follow the Portugal model, and decriminalise.
Let’s imagine, with hard facts, what a different world could look like. We must consider the best ways to minimise harm in a legalised drug environment. Abuses and crime will occur; mental-health problems may ebb and flow, depending on access to proper treatment and medication; and it’s possible that problematic drug use could worsen. A utopian legal and regulated drug market — a world where billions of citizens use substances responsibly — won’t happen. Advocates of a different system must think through what could go wrong, to try to lessen any harmful consequences from the first day when strong and weak drugs are prescribed legally by a doctor and bought online, over a store counter, or at a pharmacy.
The evidence from Portugal is encouraging: troubled drug use has declined since 2001, and the state has spent huge amounts of money on treatment for any problems that have occurred since decriminalisation. Nonetheless, the outcome of legalisation in a larger country such as the US, Britain, or Australia is unclear. Demand for drugs remains sky-high across the globe, so for many experts the question is therefore clear: how can harm be mitigated?
Mark Kleiman, a professor of public policy at New York University, opposed the drug war for decades, and told Harper’s Magazine that he believed the evidence pointed to a likely increase in problematic cocaine use after legalisation, roughly equivalent to the number of alcoholics in the US (around 17.6 million people). He feared that the government wouldn’t spend enough on treatment to help. The result, he argued, could be higher numbers of troubled cocaine and alcohol users. ‘A limit to alcoholism is you fall asleep’, he said. ‘Cocaine fixes that. And a limit to cocaine addiction is you can’t sleep. Alcohol fixes that.’20
Even if Kleiman was correct — and there was no way to know with certainty until a country legalised all drugs — this didn’t mean that a responsible state shouldn’t move to end the far-worse system of prohibition, and aim to minimise harm in a regulated environment. Decades of hard evidence have proved the damage done by trying to police personal habits, with the enrichment of organised crime and the prevalence of associated ills an unavoidable by-product of the drug war.
A minority of people abuse alcohol chronically, but making it illegal is unthinkable. Instead, a rational society finds ways to warn people of the risks of excessive drinking, and offers treatment for those who fall between the cracks (although few nations achieve this successfully). Likewise, in a legalised drug market there would need to be tight controls over access, distribution, taxes, advertising (ideally, none at all), and care for anybody who didn’t manage their drug habit properly. It’s wildly irrational to imagine that every young person would start shooting up heroin at school if the drug suddenly became legal (and data from Portugal showed that overdoses and HIV infections dropped hugely after decriminalisation was instituted).
No legal market should encourage people to take drugs — in fact, the dangers associated with them should be made plain — and yet the widespread recreational use of such substances can’t be discounted. Many of the problems that do occur in the recreational drug market are due to drugs that are mixed with deadly chemicals, or to the street violence that comes with drug dealing. A legal drug market would control the chemical composition of the drugs. The dark net or shady dealers could still sell unsafe drugs, but the prevalence of this activity would decline.
Anybody who wanted to take ecstasy at a party, for example, would know where to find clean, tested pills. Young people would be taught not to take them excessively — in lessons that should start in high school — and a legal market would allow scientists to far better understand the long-term effects of drug use. This research is currently highly restricted because the substances are illegal.
Steve Rolles is a senior policy analyst of drug policy with the Transform Drug Policy Foundation in Britain, and he’s one of the most informed thinkers on the subject. In 2019, he released the world’s first book on how to regulate cocaine and other stimulants. He explored the viability of consumer cocaine products such as energy drinks, lozenges, and gum, and whether the general public would use them if they were regulated and produced safely.
His 2017 book, Legalising Drugs: the key to ending the war, laid out a clear path towards a sustainable and sensible drug policy. ‘Working towards reducing harm would shift the focus of policy from reducing use per se to reducing problematic use (in other words, use that creates significant negative impacts for the user or those around them)’, Rolles wrote.21
US writer Dan Baum argued that there had to be a state monopoly over drug distribution; otherwise, the profit motive would corrupt the process. ‘That the government should profit from a product it wants to discourage could be seen as hypocritical but that’s the way things stand with tobacco, alcohol, and gambling’, he wrote.22 He advocated that state funds, as in Portugal, be directed to helping troubled drug takers, producing education campaigns aimed at dissuading the use of drugs, and establishing a range of services (from public infrastructure to health care) from tax income.
Baum could foresee that criminal networks that today make huge amounts of money from the drug-trade would diversify their interests into other nefarious areas, such as illicit goods or kidnapping, to recover the lost revenue from the legalisation of drugs. But law enforcement should target these groups, and, using the proceeds of legalisation, would have greater funds to do so. Harvard economist and director of economic studies at the libertarian think tank the Cato Institute, Jeffrey Miron, estimated in 2019 that local, state, and federal US governments could reap a US$106.7 billion annual windfall from the legalisation of all prohibited drugs. This huge sum would be derived both from tax revenue and law-enforcement savings.
Although public opinion has shifted radically in many Western nations towards supporting cannabis legalisation, it remains a minority view that all drugs should be legalised and regulated. Despite the Global Commission on Drugs finding in 2016 that the banning of drugs has had ‘little or no impact’ on drug use globally, there was still a long way to go to convince a sceptical public to back an end to prohibition. I heard this scepticism across the globe. After all, as this book shows, it wasn’t the rich who suffered in the drug war. It was the poor and minorities, so it was these groups (and those with the most limited voices in our political and media systems) who would disproportionately benefit from an end to prohibition. On this issue, I can’t claim to be an objective journalist, weighing up the pros and cons of legalisation, when I’ve witnessed the debilitating effects of prohibition. I’m happy to be called an advocate for new and safer ways to address drug use and abuse.
Rolles envisaged various ways to regulate drug supply. The most serious drugs, such as injectable heroin, would be prescribed by a medical practitioner and could only be taken in a supervised facility. Pharmacies could offer drugs such as ecstasy to interested users and sell it to them in non-branded packaging. Licensed outlets could sell drugs carrying a lower level of risk, such as magic mushrooms and cannabis, with buyers allowed to consume them on the property. International, national, and local laws would need to change and adapt to the new drug regime to work.
The advantages of this system were clear, Rolles explained:
Legalised and regulated drugs will be of known quantity and potency, will come with dosage and safety information from the vendor and on the packaging. They are also more likely to be consumed in safer, supervised environments that encourage more responsible using behaviours. We have to move beyond the historical preoccupation with reducing the prevalence of use and have a pragmatic focus on reducing risky use and overall harm.23
No country would adopt these measures overnight; it would be a gradual process of removing the litany of prohibitionist legalisation, policing, and attitudes. Yet, from what I’ve heard and seen, I believe that it’s the most sensible way to end decades of wasted resources and ruined lives on a war that will never be won. Continuing with prohibition does nothing to address the ballooning profits of criminal groups, or the many deaths from dirty drugs. Legalisation and regulation could transform the way in which we view drugs — from being a danger having to be controlled to providing an opportunity to establish a safer society.