Chasing the Scream: The First and Last Days of the War on Drugs

by Johann Hari

If you can prescribe opiates for back pain, why can’t you prescribe them ...

Why did the prescription drug crisis radically accelerate in the past decade?

people are given much more powerful opiates than Oxycontin and Vicodin day in, day out.

For example, the diamorphine—heroin—you will be given if you have a knee replacement is a really powerful opiate, agreed by doctors to be around three times more powerful than Oxycontin, and you will often take it for a long time as you recover. Yet—as we saw before, and has been proven beyond doubt—this almost never turns people into addicts.

Why are there sudden moments when large numbers of people, scattered across different bathrooms and barrooms, suddenly pick them up and swallow them compulsively, all at once?

Outbreaks of drug addiction have always taken place, he proved, when there was a sudden rise is isolation and distress—from the gin-soaked slums of London in the eighteenth century to the terrified troops in Vietnam.

Has anything happened in the United States in the past decade that could be the deep driver of t...

The American middle class had been painfully crumbling even before the Great Crash produced the worst economic crisis since the Great Depression. Ordinary Americans are f...

That, Bruce’s theory suggests, is why they are leaning more and more heavily on Oxycontin and...

All those stressed-out moms hooked on Vicodin and all those truck drivers hooked on Oxycontin have been seeing their incomes shrink and their abilities to look after their families wither for years as their status and security in American society shrivel away.

Vicodin and Oxycontin do contain chemical hooks, and those do play some role in the addiction.

Remember the evidence from earlier, about how just 17 percent of tobacco addiction is caused by the chemical hooks in the drug? Given that tobacco is the most addictive drug, we would expect at most that the chemicals in Oxycontin play—at worst—a similar role in causing Oxycontin addiction.

Why are so many people starting with Oxycontin and Vicodin and ending up using heroin?

This conveyor belt from prescription drugs to more potent stuff has been well documented—nobody can deny it—and at first it seems to refute everything I learned in Switzerland.

The crisis is so severe in Vermont, for example, that the governor in 2014 dedicated his entire State of the State address to the surge in heroin use, and it was widely claimed ...

This effect is called “the iron law of prohibition.”

The day before alcohol prohibition was introduced, the most popular drink in the United States was beer, but as soon as alcohol was banned, hard liquor soared from 40 percent of all drinks that were sold to 90 percent.

People responded to a change in the law by shifting from a milder drink to a stronger drink.

it didn’t change their tastes. It changed something else: the range of drinks that were offered to them.

When you are smuggling a substance into a country, and transporting it in secret, “you have to put the maximum bang in the smallest possible package,” he writes.

Imagine secretly transporting a trunkload of beer across the United States. You will be able to get, say, a hundred people their drink for the night. But load the same trunk with whisky, and you will be able to get a thousand people their drink for the night. So you’re going to smuggle the whisky—and when your drinkers come into your speakeasy, that’s all that you will be able to offer them, along with even more toxic drinks like Billie Holiday’s favorite, White Lightning, a booze so strong that even hard-core alcoholics would turn it down today.

Prohibition always narrows the market to the most potent possible substance. It’s the iron law.

The harder you crack down, the stronger the drugs become.

Many drug users want and prefer the milder forms of their drug—but they can’t get them under prohibition, so they are pressed onto harder drugs.

Almost everyone who is addicted to Oxycontin, and gets cut off by their doctor, wants to carry on using Oxycontin. But under prohibition, it’s really hard to get a mild opiate like Oxy, and pretty easy to get a hard opiate like heroin.

That’s how prohibited markets work: it’s the iron law.

On the streets, Oxy is three times more expensive than heroin—way beyond the price range of most addicts. So, he told me, they “switch to heroin, just because of the economics of it.”

The war on drugs makes it almost impossible for drug users to get milder forms of their drug—and it pushes them inexorably toward harder drugs.

in Brownsville, Brooklyn, the state spends one million dollars for every five people it arrests and convicts of midlevel drug offenses:

What João did in Portugal was to use all that money in a very different way.

the vast majority of the people he sees here are using drugs “just because they like it. They do not have a problem with it, they just do it because it makes them feel good. In those cases they don’t actually need treatment [or] imprisonment. They might eventually need to be careful, but they don’t need a medical doctor or a jailer or a legal intervention.”

“You can stop using drugs for a while, but if you don’t solve the problems you have in your mind, things will come back. We have to work [on] the trauma in your life, and only then can you change the way you deal with it.”

Over your year and a half being treated here for addiction, the team will try to build a safe, trusting environment where you can do something you have been running away from for years—express your emotions, and tell your story truthfully.

The last time João moved with his family, he hired a moving company that was established with the help of his department. Ten recovering addicts came together to form a cooperative, and the state lent them the money to buy a truck at a very low interest rate. His wife had been nervous, but the guys did a perfect job, João says with pride. Of course, he adds, in that cooperative of ten, “some of them will relapse,” but now “the others are protectors. They will help to deal with that problem. They will insist: go to your doctor, go now, as soon as possible, try to stop again, then you can work with us again. They as a group protect themselves.”

After the drug war, we will make it easier to employ recovering addicts, with subsidies—because we understand this will keep them from relapsing more effectively than the threat of being caged.

there is strong scientific evidence that persistent cannabis use affects how adolescent and teenage brains develop, and can permanently lower their IQ.

It has turned out, it seems, that strengthening people’s internal resistance to drugs works a lot better than trying to terrorize them away from drugs with force.

We all want to protect children from drugs. We all want to keep people from dying as a result of drug use. We all want to reduce addiction.

And now the evidence strongly suggests that when we move beyond the drug war, we will be able to achieve those shared goals with much greater success.

In the United States alone, legalizing drugs would save $41 billion a year currently spent on arresting, trying, and jailing users and sellers, according to a detailed study by the Cato Institute.

If the drugs were then taxed at a similar rate to alcohol and tobacco, they would raise an additional $46.7 billion a year, according to calculations by Professor Jeffrey Miron of the Department of Economics at Harvard University.

That’s $87.8 billion next year, and every year. For that money, you could provide the Portuguese style of treatment and social reconnec...

Prohibition—this policy I have traced across continents and across a century—consists of endlessly spreading downward spirals. People get addicted so we humiliate and shame them until they become more addicted. They then have to feed their habit by persuading more people to buy the drugs from them and become addicted in turn. Then those people need to be humiliated and shamed. And so it goes, on and on.

after the drug war, the state helped people to get better, and then those people helped more people to get better, and then they helped still more people to get better—and so the downward spiral of the drug war has been replaced by a healing ripple that spreads slowly out across the society.

Like the French Resistance, the Tupamaros were organized into different “pillars,” all operating separately—so that if one pillar was captured, the movement would live on.

Mujica had just been elected president of Uruguay. He announced that he would not be moving into the Presidential Palace. He would be staying right here, in his shack, for his full five-year term. He would be giving 90 percent of his income to the poor and living on $775 a month. And as for the presidential limousine—no, thanks. He would take the bus.

In Uruguay, the president is sworn in on inauguration day by the most popularly elected senator. That senator was Lucia.

Timothy Leary. He was the most famous face of 1960s drug legalization, a Harvard professor who dropped out to preach that everybody should take drugs and sail away on the trip that would finally bring Western civilization crashing down.

Leary evangelized on a cascade of TV shows that he was the founder of a new religion, with cannabis and LSD as its sacraments. These drugs should, he said, be given to twelve-year-olds so they can “fuck righteously and without guilt”—and to prove the point he gave them to his own young teenage children, even as they went slowly insane.

“Please wake up,” Leary’s daughter wrote to him in letters while he swallowed more tabs than Pac-Man. “You are destructive and evil.” She later dissolved into insanity and committed suicide. Leary had already...