In the course of writing this book, I have been asked several times what alternative or alterations I would propose to drug prohibition. My conception of the historian’s role is epistemological, not prescriptive: to describe the past as best I can, not translate it into blueprints for the future. Historians labour to show by what processes, accidents and misunderstandings we got where we are. This is quite different from showing the way forward. Asked how we might do so, the best response might be the celebrated words of the London cabbie: ‘I wouldn’t start from here.’
If the war on drugs is not being won – and clearly, anyone who is prepared to write that it has been going on for two hundred years does not believe it is – is legalization the answer? Is there at least a blank-slate response, if blank slates ever existed in human affairs? There can be no single reply. What to do with drugs depends on a society’s given tolerance for risk balanced against its regard for individual freedom, its ability to enforce norms and the associated costs. Drugs are dangerous, some more than others. Certain activities are also dangerous, though we tolerate and even celebrate them. Mountaineering, for example. Mountain climbing in selected American locations causes six hundred deaths per million people.1 Fatalities from cocaine, including crack, oscillate between 350 and 700 per million in the USA and Europe.2 Paragliding in Germany has been measured at 460 deaths per million, and climbing Mount Everest at 15,600. Where should the limit be set? Should paragliding be banned? Certainly it would be a shame, as it must be fun – but then, so probably is playing with cocaine. Rather than set artificial red lines, I will therefore keep my closing observations to the past, and limit them to three.
The first is that supply suppression has not worked. Of course, there have been successes. The dismantlement of the French Connection is one. The effective elimination of diversion in India and Turkey are two more. Thailand has managed to get rid of its poppy fields. China under the CCP was able to solve its opium problem. The historian James Windle has rightly highlighted a few more such successes, all incidentally confined to opiates. Both India and Turkey, however, were helped in that they were vetted as official suppliers of opium to the pharmaceutical market. Thailand only triumphed as the country was economically transformed, and even then its illicit drug industry simply moved next door. China eliminated opium through totalitarian measures that might not be practicable in the country itself today, let alone elsewhere.
But the key obstacle has been that, as drug production is pushed down in one place, it resurfaces in another. The outsized economic incentives created by prohibition ensure it does so, as Friedman warned in his 1972 Newsweek piece. In this context, moreover, it is worth noting that harm reduction offers no solution. Only liberalization can remove the incentives to trafficking – and the associated violence. Maintenance policies, by establishing legal sources alongside the black market, can undercut illicit dealers and take their customer base, or part of it, away from them. This, though, is but a half measure, especially as maintenance applies only to opiates: addiction provides the medical rationale for making maintenance distributions, and there is no such thing as marijuana or Ecstasy maintenance. One question this leaves hanging is whether some supply-suppression efforts offer better returns than others. My hunch is that crop eradication and similar actions are especially useless. Probably law enforcement works best when it is deployed closest to home. I leave the point to criminologists, who are better equipped to make it.
The second observation I wish to volunteer is that the criminalization of the drug user has been a monumental historical blunder. There is a philosophical question at stake: should someone go to jail, or even be given a criminal record, for having done something harmful only to him- or herself ? But condemning users, the evidence shows, is also wasteful. Compare incarceration rates on drug offences in the USA and in the EU, then look at their respective drug-use incidences. The USA incarcerates something like five times more people, yet its population uses more drugs across almost every category. Portugal is right. Imprisoning drug users keeps them away from healthcare, and it only makes the problem worse. The criminalization of the drug user, never intuitive, was the fruit of particular historical circumstances. It made its grand entry in The Hague, where it was informed by colonial paternalism on the one hand and Qing desperation on the other. It also owed something to prevailing medical views. But addiction and the theories behind it have served the user shockingly poorly. As a medical category, addiction was theorized with the aim of healing. It became the excuse for punishing. Had vice notions of addiction prevailed, I cannot help thinking, they would have produced less punitive governance models, perhaps in the style of those that apply to prostitution or gambling.
Third, and finally, it is time to recognize that the illicit drugs as a group are a historical category, and not a scientific one. They are all fallen medicines, but their original applications as medicines varied widely. From a blank-slate perspective, each would warrant being regulated completely differently. It is not just that they are addictive in different ways, and some not at all. The risks associated with them bear no comparison one to another. Based on recent data produced by the American agency NIDA, for example, annual fatalities per thousand heroin users stand at a rate of 7.3. For cocaine this is 0.7.3 For amphetamines the rate is yet lower, and for hallucinogens or marijuana it is basically nil. Such divergent levels of risk ought to justify different regulatory regimes. The legalization of cannabis in a handful of countries and American states recognizes this fundamental difference with respect to one widely consumed drug. Lumping together illicit drugs also impedes research into their medical uses. This book has discussed the late resurgence of medical marijuana, but other drugs are potentially concerned. Research shows that some psychotropics (psilocybin, LSD, MDMA) may be of value in treating otherwise intractable mental illnesses. The UK’S Advisory Council on the Misuse of Drugs, for one, has recommended that they be rescheduled accordingly. This has been denied, ostensibly because it would clash with the treaties.
The Opium Wars were the original sin of drug prohibition. The drug-control system grew from an attempt to remedy their evils. Other drugs were later grafted into this system from administrative or political convenience: in chronological order, cocaine, marijuana, hallucinogens and amphetamines. Commonly labelled narcotics, they were placed together on the neat ladder that were the drug-control schedules. They had in common with opium that they had once been medicines, but they were otherwise fundamentally different. Regulation, had history followed a different course, might have reflected these differences in nature. Such has not been the case: these fascinating yet fraught substances became and have remained opium’s orphans.