Saturday, December 19, 2009

Drug-Free Communities?

One of the callers to my television show this week asked what those people like him who wanted to live in drug-free communities should do. I brushed him off by pointing out that every known human society (except for some Arctic groups living in extremely impoverished environments) has used some kind of intoxicant. But then as I was driving home and passed a municipal sign declaring the town to be a “drug- and gun-free zone”, I started wondering what these people mean by “drug-free community”.

They can’t mean it literally. An inspection of their houses would almost certainly turn up aspirin or acetaminophen and some kind of cold or sinus remedy. Most of the houses would have at least one bottle of prescription drugs. The kitchens would have (unless the residents were members of the Latter Day Saints) coffee, tea, chocolate, and cola drinks. Their children are vaccinated and most of them got flu shots this year. When these drug protesters go to the dentist, they are probably grateful for his use of nitrous oxide and the follow-up prescription for Vicodin. The children most likely attend schools where almost ten per cent of the students take stimulants (including the methamphetamine the DEA scares everyone with) to treat some Attention Spectrum Disorder. Their world is far from drug-free.

Perhaps they mean free from dangerous drugs. But that can’t be true either. All of the communities from which my call might likely have come allow the sale of alcoholic beverages in restaurants, clubs, and bars; and cigarettes, beer and wine are sold in their grocery stores and drug stores. Alcohol and tobacco are by far the most dangerous drugs in our society. (And I say “tobacco” rather than “nicotine” because the smoke inhaled from burning the whole plant is much more problematic than is the nicotine it contains.) Tobacco-related illnesses cause over 400,000 deaths each year. Alcohol only kills about 150,000 by alcohol-related illnesses and acute intoxication each year, but it manages to score another 15,000 or so deaths in alcohol-caused car wrecks. These drunk-driving deaths each year total more than the deaths resulting from all of the illegal drugs combined. Alcohol is also the only drug whose consumption has been causally connected to any violent crimes. Aspirin and acetaminophen can’t even reach 1 % of the number of alcohol deaths, and yet they kill more than any of the so-called dangerous drugs. Marijuana has never been shown to have caused a single death, and Switzerland has not had an opiate overdose death in the ten years that the Swiss have been giving heroin to addicts.

Perhaps they are making the lesser claim that they are keeping illegal drugs out of their community. But that claim doesn’t stand up to scrutiny. Making drugs illegal does not make them unavailable. It just makes them more expensive and less pure and makes society more dangerous and corrupt. Stimulants (amphetamines and Ritalin) are now used, legally and illegally, by at least as many people as they were in their legal heydays of the 1960s. The percentage of the population addicted to opioids today is greater than it was before passage of the Harrison Act in 1914. Millions of doses of MDMA – outlawed by a panicked congress in 1986 – are used in the U.S. each week. And marijuana? The government claimed that fewer than 100,000 people used marijuana when it asked congress to outlaw it in 1937. Now the government claims that over 100,000,000 people have used marijuana and that almost 15 million use it at least once a month. These numbers add up to a lot of drugs being used in communities that claim to have banned them.

These statements of “drug-free communities”, whether made as claims of fact or as aspirations for the future, are doomed to be false. The problem is that they all use the term “drug” to refer to harmful chemicals with biological effect. They seem to be creating a dichotomy between drugs and medicines.

The chemicals themselves are neither good nor bad: they just are. Some can be used beneficially; some (often the same ones) can be used detrimentally. The methamphetamine the DEA has been scaring people with for years is the same Methadrine that is prescribed for kids with ADHD and substantially the same as the Dexedrine the Air Force gives to its combat air crews for increased performance. One recent survey showed that twenty per cent of working scientists used these or similar “brain boosters” to improve their work.

Medical practice would be severely hampered without morphine and other opioids to control pain. But heroin (diacetyl morphine) is converted back to morphine in the body. In fact, long-term experienced addicts cannot distinguish between injections of these two drugs. Heroin can be used as a pain killer in some patients who are allergic to morphine.

In addition to heroin, the DEA has many other “evil” drugs in Schedule I, classified as having no significant medical use. Of these, marijuana, LSD, MDMA (ecstasy), mescaline (peyote), and psilocybin (magic mushrooms), among others, have well-documented histories of medical research and use.

Both the drug-free community wishers and the law because they focus on the chemicals instead of the users. The first American drug laws – the Pure Food and Drug Act of 1906 and the Harrison Narcotics Tax Act of 1914 – were reasonably effective in decreasing both drug dependency and harms resulting from drug use. But when alcohol was prohibited in 1920, the emphasis shifted from the users to the chemicals themselves; and the heroin acts of the 1920s started the country down the disastrous road of drug prohibition.

Now is the time to recover from that disastrous, vicious, and corrupting attempt to create drug-free communities, and instead start looking at the users. Now is the time to create communities free from the harms of irresponsible drug users.

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