Shoot Out the Lights:
The failure of objective reason to frame the response to drug realities

 

 

 

Abstract

 

Since the dawn of civilisation, man has used herbs, plants and minerals to change the way he feels, in ritual and recreation. Some of these substances have become accepted, even valued within our cultures whilst others (usually those used by the outsider, the foreigner, the incomer) have been demonised and regarded with dread and awe. This paper provides a brief history of drug use and trends in European drug use and mythology and explores the changes in policy which have come about often by accident. The paper also discusses the notion of harm reductionist methodology and examine its historical significance.  Finally the paper considers the direction in which world drug trends and current policy protocols are likely to lead us.

 

 

 

Drugs Demonology

 

Inglis (1975) has noted the odd division of drug use typology between nomadic and settled peoples.  From the earliest times, he argues, nomadic peoples have used what we would nowadays describe as psychedelic or hallucinogenic drugs (mushrooms, leaves, cactus buds etc.) which could be picked from trees or plants in passing, or dug from the earth in their wild state.  By contrast, settled peoples have been able to comfort themselves with drugs (alcohol, opium etc.) which require extensive cultivation and preparation.  Furthermore, nomadic peoples, he argues, with their largely shamanic systems of worship, have treasured hallucinogenic drugs for their visionary and mind-altering properties in ritual ceremonies and rites of passage.

 

Settled peoples, on the other hand, have viewed such substances (and the users of such substances) with deep suspicion, even fear.  The drugs used by settled peoples have achieved a higher level of integration; partly because of their integration into the social process (as an agricultural crop, a processable raw material, a marketable commodity) and are thus largely stripped of their religious significance and viewed more as an aid to leisure or labour (depending upon the perceived properties of the drug).

 

Here perhaps lies a clue to the reasons why our responses to drug use (and, incidentally to nomadic peoples) are often illogical and hysterical.  The folklore of settled civilisations with regard to nomads or gypsies is filled with images of enchantments and illusions and the seduction of it's women.  Travelling people - and by extension immigrants from other cultures - bring with them strange and unsettling practices and substances which, unless fiercely resisted, might fundamentally undermine existing social structures.

 

Indeed some have argued (Peele, 1985; Inglis 1975) that drugs are only regarded as drugs when they are introduced into cultures which have no tradition of using them and there is some evidence (Yates, 1984; Szasz 1974) that, where drugs are imported in this way, the individuals using them experience their effects quite differently to the way they are experienced within their "home" cultures.

 

Thus our modern day attitudes to drugs are perhaps influenced more by a belief in possession by devils and fear of the outsider that any intellectual analysis of relative risk.  Drugs (those we have made illegal) are used by incomers, often with the deliberate intention of corrupting the morals of the weakest in our society; our young and our women.  By contrast, our own drugs (those we are used to and which remain, broadly speaking, legal) are not regarded as drugs at all.  Alcohol, tobacco, caffeine are seen as relaxing aids to labour or leisure and, with the exception of alcohol, are not popularly associated with criminal activity.  It is a long and dishonourable tradition which has not gained any maturity through its longevity.

 

For most of this century (and earlier) the association between drug use and the sexual offences has been a recurrent preoccupation.  Anecdotal information though, whilst extensive, is usually unsupported by any empirical evidence.

 

During the economic depression in 1880's America, as whites for the first time competed for jobs with Chinese "immigrants", William Randolph Hearst, owner of the San Francisco Examiner, ran a series of "yellow peril" articles loosely connected by the common elements of inscrutable Chinese criminals, opium-induced depravity and white virgins led astray (Carroll & Noble, 1977).  Few proofs were offered to substantiate the claims made, which appear to have been a crude attempt to engender fear and distrust of the Chinese community.  Chinese immigration to the USA was outlawed in 1892.

 

Meanwhile, on the east coast of America, in response to the abolition of slavery and a similar competition for jobs, white Southern politicians and others began a similar campaign of hatred and disinformation.  Dr. Christopher Koch, a virulent anti-drugs campaigner of the period claimed: "Most of the attacks on white women in the South are the direct result of a cocaine-crazed Negro brain" (Shapiro, 1988). The New York Tribune  in 1903 reported claims from police officers in Asheville, North Carolina that they had been unable to stop a "Negro in a cocaine frenzy" even with a direct shot in the heart at point-blank range.  As a result of these stories, a number of Southern States police forces were issued with heavier calibre firearms (Shapiro, op cit).

 

These stories find an uncomfortable echo in the evidence of Los Angeles policemen in 1992; on trial for the use of excessive force in apprehending the young black man, Rodney King.  At least one officer informed the court that force had been necessary since officers believed that King had taken PCP and they were concerned for the safety of a woman police officer who was present at the scene.

 

In the UK, the story was much the same, with lurid novels by Sax Rohmer about the "yellow devil" Fu Manchu, and reports of 'real life' corruption of white women by Chinese owners of opium dens and brothels in the popular press.

 

During the inquest on the death of the actress Billie Carleton of a reported cocaine overdose, and the subsequent trial of her associate, Reggie de Veulle, newspapers widely reported the involvement of London's artistic demi-monde in cocaine- and morphine-crazed 'pyjama parties'.  Reports contained veiled references to homosexuality (de Veulle was bisexual) and other, unspecified, unnatural sexual practices.  'Violation' and white slavery was hinted at in many of these reports and once again, the key ingredients were evil 'men of colour', illegal drugs, young white women, and unspecified "lewd and libidinous" behaviour (Kohn, 1992). 

 

To what extent these reports were based on fact is now difficult to ascertain, but other studies at the time - notably the evidence reported by the Committee on the Use of Cocaine in Dentistry, 1916 - concluded that the taking of drugs such as cocaine was not a particularly widespread problem (Berridge 1984).

 

In more recent times, a number of drugs have been associated with cases of sexual molestation.  Newspaper reports in the 1960's on the use of cannabis by Afro-Carribbeans and Africans (again with hints of jazz-fueled sexual frenzy and a predilection for young white women) were influential in the UK Government's decision to alter drugs legislation to include the use of premises for smoking the drug.  Most recently, the UK Government moved to restrict possession of the "date-rape drug" Rohypnol in response to a flurry of newspaper reports claiming that rapists had deliberately 'spiked' the drinks of their victims beforehand.  This action was taken despite action taken by the manufacturers to reformulate the drug to make it easily detectable and the failure of the Forensic Science Service to find any trace of Rohypnol in any of the 16 rape cases they examined (ISDD, 1998).

 

Finally, alcohol has been long associated with sexual molestation; both in terms of fuelling the sexual aggressivity of the perpetrator and in lowering the inhibitions of the victim.  Alcohol is also highlighted as a factor (perpetrator only) in cases of childhood sexual abuse (Finkelhor et al, 1986).  Interestingly, although there is evidence that one of the long-term outcomes of such abuse may be an adult 'career' in drug dependence (Wilson 1997), other drugs are not as yet reported as influencing the perpetration of such offences.

 

In all of these cases, stretching back a century and more, there is little or no evidence of any causal relationship between intoxication and the committing of offences of sexual molestation.  This does not, however, appear to undermine the racist, sexist demonology which appears to lie behind much of our response to drug problems in society.

 

 

 

Freak Out!

 

The other enduring strand to popular conceptions of drug use is that of enchantment.  Drugs can "take over the mind" leaving the user incapable of rational thought. 

 

Certainly, these ideas have their origins in the shamanistic use of drugs in religious ritual, but they have been compounded by developments in philosophical and psychoanalytic thought in the past 100 years.

 

At the end of the 19th Century, Sigmund Freud, the father of psychoanalysis, began experimenting with the use of cocaine.  Freud was an enthusiastic advocate of cocaine, recommending it both to colleagues and patients.  But his enthusiasm gradually turned to dismay as he recognised his own dependence on the drug.  Freud was one of the early experimenters to explore the possibility of opening the door to the subconscious through the use of drugs (Stephens, 1993)

 

This use of drugs to expand the mind was not an experiment restricted to the emerging fields of psychoanalysis and psychiatry.  In the early part of this century, Havelock Ellis and a small group of writers and friends were experimenting with mescaline; an experiment which echoed the use of cannabis by Baudelaire and other French intellectuals in the previous century (Inglis, 1975)

 

By the 1930's, psychiatrists were using a wide range of drugs - opiates, cocaine, mescaline, cannabis and barbiturates - in the treatment of a number of mental disorders.  The process, known as narco-analysis, usually involved intravenous injection of the chosen drug in order to induce a cathartic state during which the psychiatrist would attempt to use psychotherapeutic techniques in order to unearth the hidden origins of the patient's trauma.  The model appeared to produce its best results in the treatment of neuroses (and, later, during the war, with the treatment of shell-shock) where repressed memories were indeed uncovered.  Interestingly, though, one of the major drawbacks was the sporadic and unpredictable return of the catharsis, often many months later; a phenomenon later to become familiar with LSD-users as 'flashbacks' (Mellechi, 1997)

 

In 1943, Albert Hofmann, a research chemist with Sandoz in Switzerland, launched LSD on an unsuspecting world.  Hofmann had synthesised the drug some five years earlier but, for reasons which remain unclear, returned to his earlier work to discover that he had invented the most powerful psychedelic know to man (Hoffman, 1997)

 

By this time, a number of psychiatrists were using mescaline in an attempt to prove the biological origins of schizophrenia.  Amongst these were the Scottish psychiatrist, Humphrey Osmond who in the early 1950's was experimenting with the administration of mescaline to writers and philosophers including: Harry 'Ghost Hunter' Price, former president of the Society for Psychical Research; Aldous Huxley, whose book The Doors of Perception  (1985) became the bible of the 60's LSD generation; and Christopher Mayhew MP who went on to become the chairman of the mental-health charity, MIND.

 

By the late 1950's though, the landscape was beginning to change irreversibly.  A growing awareness of, and concern over, drug taking, was to about to make make the self-administration of any drug a decidedly suspect activity.  Furthermore the leaking of the great LSD experiment out to the 'lay' public was to result in a mass experiment with LSD among young people in the 1960's and that in turn, would so discredit the drug itself that conducting serious research became almost impossible.  By the end of the 1960's, the use of LSD in psychiatric medicine had all but disappeared (Sandison, 1997).

 

In the 1950's though, all this was yet to come.  Huxley, clearly enjoying his reputation as the eccentric English philosopher in Los Angeles, continued his correspondence with Osmond and continued to recruit volunteers for the 'great experiment'.  Amongst these were artists writers and film stars (including, unbelievably, Cary Grant).  Osmond sent Al Hubbard to Huxley in 1955.  Al Hubbard was the eccentric president of a uranium company.  He had an enormous amount of money; an unquenchable belief in the power of psychedelics to reveal the 'spirit world'; and a seemingly endless supply of LSD.  With Hubbard's arrival in Los Angeles, the LSD experiment gathered speed.

 

Amongst the recruits was the young American author, Ken Kesey.  Unlike the elitist Huxley, Kesey was keen to share the LSD experience with everyone.  Kesey began to spread the word amongst the emerging beatnik community in San Francisco.  By the mid-60's, Kesey had refined the Kool Aid Acid Test; mixing the music of the Grateful Dead with copious amounts of free LSD and a basic light show (Stephens, 1993)

 

In the early 1960's, on the other side of the continent, a young psychology professor at Harvard, named Timothy Leary, began to experiment with LSD in a study which, up until then, had been examining the therapeutic uses of psilocybe mexicana.  Within a very short time, Leary was to publicly advise the youth of America to: "Turn on, tune in and drop out".  True to his advice, Leary dropped out of Harvard and established the Castalia Foundation (later to become the International Federation for Internal Freedom) at Millbrook.  There he played host to the Scottish psychiatrist and 1960's luminary, R. D. Laing.

 

Laing was at that time collaborating with Alex Trocchi (author of Cain's Book)  and William Burroughs ( author of Junky)  on a book to be entitled Drugs of the Mind.  Laing and Leary hit it off at once although the book never progressed beyond lengthy discussions, often under the influence of LSD.  By 1965, Laing too, had dropped out (of the Tavistock Clinic and his other medical appointments) and was conducting LSD therapy sessions at his private clinic in Wimpole Street.

 

Around the same time, the confidence trickster and self-proclaimed 'astral traveller', Michael Hollingshead, returned to London to establish the World Psychedelic Centre in a luxurious Belgravia apartment.  Hollingshead had introduced Leary to LSD and had almost single-handedly achieved the conversion of the respected Harvard professor into 60's beat guru.  Once back in the UK, Hollingshead quickly attracted a coterie of LSD apostles including; Paul McCartney, Roman Polanski, Donavon, Eric Clapton, Mick Jagger etc.

 

Within months the LSD revolution had begun in the UK.  Some early apostles of the centre, growing increasingly concerned with Hollingshead's unscrupulous behaviour established Gandalf's Garden in World's End, Chelsea.  Here an elite group of devotees experimented with a variety of hallucinogens, including MDMA (ecstasy).  But by this time, LSD had become the undisputed market-leader and little came of these experiments.  Meanwhile, Hollingshead, with mounting debts fled to Nepal from whence he returned to establish a short-lived ashram on Cumbrae named the 'Pure Light'.

 

Throughout the 1970's, LSD maintained a discreet presence in the UK although it had disappeared from orthodox medical practice when it was incorporated into the Dangerous Drugs Act 1967.  However, the legacy of LSD in the 60's is discernible in the popular press coverage of the issue of drug use at rave events; with their descriptions of "trance-like dancing" and glassy-eyed staring".  The overblown urban mythology of the 60's, with it's tales of LSD 'trippers' leaping out  of windows whilst believing they could fly or attempting to peel off their skin whilst believing they were oranges, is thankfully, long gone.  But a certainly legacy does remain; the flickering flame kept alive by journalists eager for a titillating story and defence lawyers anxious to produce a mitigation for their client's behaviour.

 

 

 

Drug Trafficking - A Trade with Global Dimensions

 

The final thread to the popular belief about drugs is that not only is it a problem that is brought into our culture from outside; which produces madness and mania in its users; but that somehow it can be stopped - by increasing penalties, stopping immigration, hitting the 'Mr. Bigs' etc.

 

Drug use and the illicit trade in both drugs themselves and their precursors (the chemicals used to create/synthesise those drugs) has become a major global problem.  The United Nations Drug Control Programme (UNDCP) estimates that the blackmarket in various drugs accounts for 8%  of world trade - more than cars or the world trade in iron and steel. (UNDCP, 1998)

 

Opium

Between 1985 and 1996, production of opium tripled.  In 1996, there were an estimated 280,000 hectares (690,880 acres) given over to opium production estimated at 5,000 metric tonnes.  One third of this crop would be consumed as opium.  The UNDCP estimates that 300 metric tonnes of blackmarket heroin are produced annually.

 

The two main cultivation areas are the Golden Triangle (Lao People's Democratic Republic, Myanmar, Thailand & Viet Nam) and the Golden Crescent (Afghanistan, Iran & Pakistan).  Most of the heroin produced in the Golden Triangle comes from Myanmar (formerly Burma) and is destined for the USA.  Most of the heroin produced in the Golden Crescent comes from Afghanistan and is destined for Western Europe.

 

Production of heroin is also increasing in Colombia (where it is controlled by the cocaine cartels), India, China, Mexico and the Middle East.  There are also fears that the emerging Central Asian republics - particularly Uzbekistan, Tajikistan & Kyrgyzstan - will become involved.

 

Coca

Between 1985 and 1996, production of coca doubled.  In 1996, there were an estimated 220,000 hectares (543,620 acres) given over to coca production about 50% of which was in Peru.  Peru, Bolivia and Colombia between them account for approximately 98% of world coca cultivation.  The UNDCP estimates that 300,000 metric tonnes of coca were produced in 1996.  This would have resulted in the synthesis of 1,000 metric tonnes of blackmarket cocaine.

 

Amphetamine Type Stimulants (ATS)

Between 1978 and 1993, the UNDCP estimates that production of ATS (including ecstasy) increased ninefold.  This was equivalent to a 16% increase each year.  (Estimates include legitimate ATS diverted into the blackmarket).  So far, most of the illicit laboratories which have been discovered have been in the USA and Western Europe.  However, production is increasing in Eastern European countries; particularly Poland.  There is also evidence of production of ephedrine-based stimulants in Kazakstan and Kyrgyzstan.

 

Cannabis

Increasingly the trend is towards domestic supply; particularly in Western Europe.  There is more likelihood of opportunistic smuggling of cannabis than is the case with the other blackmarket drugs.  Countries involved in large-scale production include: the USA, Republic of South Africa, Morocco, Mexico, Jamaica, Pakistan, Colombia.  Production is also increasing in the Central Asian Republics of the Commonwealth of Independent States.

 

Trafficking

Most of the trafficking in blackmarket drugs is now in the hands of a small number of criminal organisations (including the Colombian Cartels, the Triads, the Yakuza, Cosa Nostra, La Cosa Nostra and various Soviet Mafia groups). There is an increasing trend in many of these organisations to increased 'vertical integration'.  That is to say, controlling all aspects of the production and distribution system in order to maximise profit and offset occasional losses in the more difficult stages of distribution.  This development has been particularly marked in the cartels controlling the distribution of South American cocaine.  The UNDCP estimates that profit margins (taking into account the cost of seizures, bribes etc.) are as follows: ATS - 240%; cocaine - 300%; heroin - 100%.

 

Alternative Crops

Many of the organisations who control cultivation and production are almost feudal in structure and effectively 'own' the peasants who cultivate the base product reducing the possibilities for encouraging cultivation of other crops.  Where alternative crops have been grown, farmgate prices are rarely able to compete with those for the illicit crop.  In South America, cultivation of rubber or macadamia nuts would potentially result in farmgate prices somewhat higher than those for cocaine but there is a long 'lead in' time (10 - 15 years) before full productivity can be achieved.

 

Global Consumption	% World Population	People (million)
Heroin & other Opiates	0.14	8.0
Cocaine	0.23	13.3
Cannabis	2.45	141.2
Hallucinogens (LSD)	0.44	25.5
ATS (Ecstasy)	0.52	30.2
Sedatives	3.92	227.4
Tobacco	20.00	1,159.0
Alcohol	50.00	2,897.7

 

As Inglis (1975) remarked in his seminal work The Forbidden Game, "the genie is out of the bottle now".  Whatever we do in the coming millennium, forcing it back into the bottle is not an option.

 

 

 

A New Lexicon for the Same Old Response

 

'Normalisation', 'harm reduction', 'recreational drug use'.  A bewildering array of new terms have been coined in the addiction field in the past two decades.  Often they are used, or misused, as if they were theoretical constructs designed to aid our understanding of the dependence phenomenon instead of simply a convenient descriptive for what we do; what we fail to understand.  All are to some extent euphemisms through which we seek to reassure ourselves that forcing the genie back into the bottle is not what we are about; not what we ever thought we could achieve.

 

Currently, much attention is being directed towards the use of so-called dance drugs by a new group of drug users apparently entirely separate for the injectors of previous generations.  The trend towards the so-called "recreational" use of ecstasy and other stimulant drugs in association with attendance at dance events can be traced culturally to the  Northern Soul phenomenon of the '70's - a cult music-and-drugs tradition which remained resolutely underground; and upon which, orthodox drug treatment services made no significant impact.

 

Scientifically, the term recreational can be traced to the late 1970's and the work of addiction theorists such as Zinberg (1984) and Peele (1985).  In the UK, a monograph by Yates (1979) entitled Recreation or Desperation discussed the possibility that any drug might be "normalised" (that is acquire a normal use-profile giving an even distribution of experimenters and social users with a smaller, a-typical group of dependents) given a wide enough availability.  Thus, in cultures where there is little or no access to alcohol, those who drink are less likely to have normal drinking patterns or normal personality profiles.  Where alcohol is readily available, the typical characteristics of the drinking population is likely to be more normal.

 

The paper argued that the abnormal use profile of heroin might be as much to do with the lack of availability as the drug itself.  The argument seemed to be supported at that time by the recruitment into heroin use (particularly by smoking) of large numbers of young people who appeared to show little evidence of social dislocation or emotional disturbance commonly associated with heroin addiction.

 

This possible 'normalisation' of heroin users, it was argued would require significant changes in the responses of drug treatment services.  Up until that time, most treatment interventions had been predicated upon an assumption that drug users attending services would inevitably be emotionally scarred by their experience and require a therapeutic intervention which adequately responded to the need for psychic healing.  If, however, significant numbers of those attending services were not damaged in this way, then services would need to adopt a more cognitive methodology which took a consumer advice approach to the problem and offered skills-based solutions.

 

However, it appears clear now, that what was being observed at that time was the inevitable result of a dramatic fluctuation in the market.  If in any market, there is a sudden increase in availability, there is likely to be a corresponding increase in experimentation in the product.  This will be particularly so where an existing, familiar product becomes available in a more attractive form.  This last point is clearly relevant to the influx of Middle Eastern smoking heroin at that time which effectively broke down the injection taboo (Griffiths et al, 1994).

 

However, such experimentation is likely to be relatively short-lived.  In the market career of any product, early users will either move to alternative products or no product at all, or will become confirmed users.  This appears to have been what happened in this instance.  A sudden increase in the availability of heroin in a smokable form brought in a flood of social or recreational users who were consequently more representative of the wider community.  Re-examination of this group has shown that the majority moved on to the use of other drugs - notably ecstasy - in a relatively short space of time.  Of the remainder, a smaller number have become daily users (usually by injection) whilst some have ceased to use illicit drugs at all.

 

Meanwhile, the expected influx of 'normalised' heroin users into drug treatment services failed to materialise.  Indeed there is some evidence that some indices, such as evidence of child sexual abuse histories have actually increased amongst the service-presenting population (Wilson, 1998).

 

Recreation or Desperation was published at a time when the movement against the disease model was at it's height.  Publications from the drug field at that time routinely dismissed the relevance of drug type or chemical composition.  Over the past 5 years, however, this process has begun to be reversed.  The importance of drug type has been reasserted and there is a widespread recognition that some drugs - heroin, tobacco and rock cocaine are excellent examples - are by their very nature liable to show abnormal use profiles.

 

Harm reduction, on the other hand is a new description for a practice which has, arguably been in existence for at least a century (Velleman & Rigby, 1993).  The English Inebriate Acts (Berridge, 1999) made provision for the appointment of a guardian to protect the inebriate from himself.  In 1926, the so-called Rolleston Committee reaffirmed the appropriateness of doctors treating addiction to morphine or heroin by prescription of those drugs; either in reducing amounts or, in some circumstances, over the long term. (Berridge, op cit)

 

In the UK in the 1960's the establishment of a specialist treatment service (particularly in London) meant a further reaffirmation of the Rolleston pronouncements.  Statutory NHS services prescribed heroin and other drugs (Glatt et al, 1965).  The emergent voluntary sector provided clean injecting equipment, injecting rooms, (Turner, 1994) nutritional advice and instructions on dealing with overdoses (Yates, 1992).

 

 

 

Conclusion

 

Although, then, harm reduction as a concept is not new, its rebirth in the past two decades has attracted great criticism from a number of quarters mainly because it is now more visible and widespread.  The extensive use of methadone, for instance, has been decried by some (Yates, 1992) since it appears, on its present scale, to represent more a mechanism of social control than an individual therapeutic intervention.

 

Moreover, some have also pointed out that such substitute medications may not be either available or acceptable for other forms of drugs use - stimulant use, multi-drug use etc.

 

The arguments against harm reduction appear to centre around two basic problems.  Firstly morality.  Can it be morally justified to appear to condone the use of illicit drugs and does this not 'send out the wrong message" to people using illicit drugs or to people considering whether to use them.  Secondly, there is the problem of leakage.  Can we guarantee that apparently complicit messages intended for those already using will not be seen by those not yet using and be seen by them as an inducement or invitation.

 

Some work has been undertaken on this latter issue.  Gilman (1989) tracked the distribution of a comic-style health pamphlet called Smack in the Eye, which was intended for a readership of currently injecting drug users.  Little evidence was found of 'leakage' outside the intended target group, but it should be noted that this was an extremely small study and satisfactory replication in a wider context might not be possible.

 

Finally, it has to be noted that harm reduction approaches have, of necessity been limited by the legal context and by public perception and acceptability of the work.  Given the current situation, with an escalating availability of illicit drugs, a less obviously damaged user group and an increasing acceptability of some drugs by some sections of the community, the sustainability of these constraints cannot be guaranteed.

 

There is already some evidence of changes in public opinion - particularly with regard to the acceptability of cannabis.  The increasing impetus to consensus legislation across Europe will inevitably lead to a further re-examination of the legal framework and it is possible that a Europe-wide consensus on drug legislation would be more resistant to American pressure which has been a central driving force in the shaping of international convention for the best part of a century (Inglis, 1975).

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