Jimi Hendrix, John Belushi, Kurt Cobain - Essay Example

Jimi Hendrix. John Belushi. Kurt Cobain. These icons of American popular culture share the dubious distinction of dying young, at the height of theirpopularity, and from the direct or indirect use of heroin, among other legal and illegal drugs. Heroin and other so-called "hard drugs" have torn their way through the ranks of musicians, actors, supermodels and artists. Heroin use stretches back thousands of years and continues today, despite severe restrictions and penalties and the risk of contracting AIDS or other deadly diseases. The illegal juice of the opium poppy funds terrorism and fuels deadly turf wars in American inner cities, despite billions spent by the U.S. each year in interdiction efforts. Nevertheless, in 2004, the National Survey on Drug Use and Health (NSDUH) reported about 166,000 heroin users in the United States, out of more than 19 million people age 12 and over who reported using an illicit drug within the past month (SAMSHA report, section 1.4). Chronic heroin users may resort to stealing, prostitution and other crimes to pay for their habit. New users turn to snorting and smoking the drug, giving them less of a high but also carrying less of a stigma and avoiding the telltale track marks. The tenacity of heroin's hold on humanity begs the question: Would the United States be better off if heroin -- or some form of poppy-derived opiate -- were legalized Would it be best to let the government, or approved non-governmental organizations and charities, handle maintenance and long-term treatment of heroin users, with the goal of curing them of their addiction The experience in other countries, coupled with medical evidence, shows that it is certainly worth exploring some form of legalization that removes the criminal profit motive and focuses on reducing demand for drugs by treating drug use as a public health concern, rather than a crime. Since Richard Nixon declared war on drugs in 1973, the United States has spent billions in a losing cause trying to eradicate the use of "illegal" drugs in America. For the 2007 fiscal year alone, the Bush administration requested $12.7 billion for federal drug control efforts (National Drug Control Strategy, 2006, 1), a figure that doesn't begin to cover state and local law enforcement, court, prison and health care costs, or more esoteric costs such as lost productivity in the workforce. This paper focuses on the potential benefits and risks of partial legalization of heroin -- which, along with cocaine, particularly crack cocaine, probably faces the highest stigma of all illicit drugs. However, the same problems that make heroin so reviled, including its addictiveness and potential for harming the user, are what make heroin an ideal test case for "controlled legalization" along a medical/public health model. Rather than continuing to fight a war that cannot be won, the United States should beat a strategic retreat -- and seek a true victory elsewhere, looking to actually solve the problem by acknowledging the medical and psychological reasons for drug use in the first place. Then, the nation could focus on addressing those issues head on, without apology, and with an eye on continuous improvement for the betterment of its citizens and communities. Legalization in any form is seen by many as a moral failure. The thinking is, if something is "wrong," it is wrong not to stop it or outlaw it. It has proven difficult, however, in almost a century of legislation, to curtail the use of drugs like heroin, cocaine and marijuana. Instead, the laws have created a pervasive and profitable black market controlled by criminals, who pocket the cash while the American taxpayer foots the bill. Legalization in some form, with the intent of controlling demand, could go a long way toward eliminating criminal trafficking, deaths and overdoses due to impure/too pure product and the spread of deadly diseases such as AIDS and hepatitis. Refocusing heroin as a sign of a medical condition, not a criminal or moral failing, would bring users into treatment where they could seek help for any underlying problems that may have driven them to drug use in the first place. With more individuals seeking treatment, pharmaceutical companies would have the financial incentive to develop new drugs to treat their problems, such as better maintenance drugs, better drugs for depression and other conditions related to neurochemical imbalances. Finally, legalization would not prevent anti-drug education; in fact, it would free up billions of dollars now spent on law enforcement that could be redirected toward the treatment and prevention efforts. Heroin is classified by Inciardi as a "semisynthetic narcotic" in the same category as legal substances Dilaudid and Percodan/oxycodone (60).[NOTE, CHAPTER 3] Its chemical name is diacetylmorphine, which gives a clue as to its origin in morphine, a natural narcotic that comes from Papaver somniferum L. -- the opium poppy. Other narcotic drugs, such as Demerol, Methadone and Darvon, are synthetic relatives with widespread, though regulated, pharmaceutical use. These chemicals are all related to natural substances produced within the human body, known as endorphins. Like their illegal and prescription cousins, endorphins both control pain and produce euphoria, such as the "runner's high." This has led some scientists, such as Smith and Tasnadi, to consider whether opiate use and addiction have a rational and useful biological basis (2). Opium use was recorded in Mesopotamia some 4,000 years ago, as well as by the ancient Greeks. Popular opium-based patent medicines were widely used by Americans until the early 1900s, when two major pieces of legislation were passed. First, in 1906, came the Pure Food and Drug Act, which sought to curb the use of addictive opiates and dangerous additives in patent medicines by requiring medicines to have ingredient lists on their labels. The revelation of the high percentage of opiates, cocaine and alcohol in these products caused many Americans to stop using them (Inciardi, 1992, p. 15) [NOTE, in chapter 1]. Cocaine and opiates became controlled substances in 1914 with the passage of a federal law commonly known as the Harrison Act. Later court cases would affirm that it was illegal for a physician to prescribe an opiate to treat narcotic addiction, and though a subsequent case overturned that position in 1925, by then, Prohibition (of alcohol) was in full swing and many physicians were unwilling to treat addicts regardless. Later maintenance programs, involving a synthetic and more stable opiate known as methadone, would largely be overseen by public health agencies and clinics, rather than private physicians in a doctor-patient relationship. That's the American experience. But legalization and treatment-based strategies are not without precedent. For many years in England, opiate addiction was treated as a private matter between doctor and patient, and the number of users was low, author and film producer Mike Gray reports in his pro-legalization work "Drug Crazy: How We Got Into This Mess and How We Can Get Out." The emergence of the drug subculture among younger users in the 1960s dramatically increased the number of users in England as it did in the United States, and pressure from the United States has prompted sporadic regressions into a more crime-based model -- with the accompanying costs of law enforcement and incarceration (153). Several other European nations, including the Netherlands and Switzerland, have undertaken various forms of a treatment-based strategy in dealing with heroin users. These countries, Gray reports, witnessed a drop in criminal activity as the street trade decreased. The European experience has formed the basis for a popular notion among legalization supporters in the United States, a concept known as "harm reduction." Former Baltimore mayor, federal prosecutor and current Howard University Law School Dean Kurt L. Schmoke, an advocate, describes harm reduction in the Dutch experience as "a balanced approach to drug abuse that emphasizes treatment and minimizes risk to both the community and the drug user" that is heavy on services and education (qtd. in Staley, xv). The United States can look to these experiences for guidelines, gleaning insight from both the successes and the failures. Given that heroin is a potentially dangerous substance, the utmost care must be taken to ensure that it is manufactured, dispensed and monitored. As Schmoke notes, an array of services for users needs to be in place. It is highly likely that, given differences in social norms and attitudes, an American model would need to be different from its European counterparts. Racial, ethnic and socioeconomic differences among users would have to be considered when developing services and educational programs, as racial minorities in America, as described by Gray in several contexts, have radically different experiences with drug use, and criminal penalties, from that of whites (47, 110). Drug use among teenagers is a significant concern, and parents' fears, often stoked by the media, would need to be addressed if any treatment-based legalization program is to work. By nature, teens are experimental and often fail to recognize the consequences of their actions. Heroin use among teens, according to NSDUH, is low, although use of prescription narcotics such as Percodan/oxycodone is more prevalent and on the rise (SAMHSA report, Section 2). Americans tend to view youthful drug use as a critical social failure, so care would need to be taken when dealing with teenage users and their behavior patterns. Since this would be a public health model, heroin users by definition need treatment, regardless of age. The government's own statistics belie the notion that teenagers are ripe for seduction by heroin use if it is legalized, according to the Office of National Drug Control Policy's 2004 update. The top five substances abused by teenagers -- the so-called "gateway" drugs -- are: Marijuana, prescription painkillers, hallucinogens, Ecstasy and cocaine (13). Heroin is not a beginner's drug, but something graduated to later. Decisions would need to be made for users age 21 and over about whether a medical diagnosis of a prior addiction would be necessary. In the most significant Swiss study, for example, Gray notes that only users with a significant history and at least two failed attempts at other rehabilitation methods were included in legal heroin treatment programs (164). Although a significant source of funding could come from money previously used to fight the criminal drug trade, the program would have start-up costs and millions of dollars would have to be committed to it. Users who are able may be required to pay a portion of their income to cover costs, such as an insurance co-pay system used in health maintenance organizations. However, this should be watched carefully to make sure that payment does not become a barrier to treatment, which is the ultimate aim. Whatever restrictions are set on the program, they must be based on rational, scientific and medical realities of heroin addiction and abuse -- all with the aim of harm reduction for the users and all Americans alike. Flexibility and response to changing conditions needs to be built into the system as well. Of course, this is only a partial legalization strategy. It is not perfect. As with any substance, there will be those who seek to get around the legal avenues of distribution. The same problem occurs with cigarettes and alcohol, generally due to government-imposed taxes and tariffs making it cheaper to buy off the back of a truck than through a legitimate establishments. However, it is believed it will provide a significant benefit in the form of harm reduction, in terms of drug-related crimes, criminal profitability and the spread of diseases. One significant question will likely persist, and that is whether legalization will, on its own, create new addicts. The European studies, as recounted by Gray, tend to support eventual stabilization in the user population, absent other factors. He quotes British psychiatrist Dr. John Marks, who ran a successful maintenance clinic in the 1990s in northern England that was eventually shut down due to pressure from embarrassed U.S. authorities, that the demand curve for "forbidden fruits" is U-shaped (159). When drugs and alcohol are either prohibited or openly available, consumption goes up. Finding that balance in between leads to less addiction. That may take time, and mistakes will inevitably be made. Learning from those mistakes is the key. If the politics of fear-mongering can be successfully removed from the equation, there is a good chance that a successful, balanced, American public health model for controlling heroin abuse can be found. That will never happen, however, under current policies and with current attitudes. It cannot be determined if legalization will create any additional addicts of any age than those already being created by the black market system in existence today. The fact that not every question can be answered in advance is no reason to avoid legalization, or any public policy for that matter. There are always downsides and unanswered questions and to wait for all the answers would simply bring society to a standstill. The most important consideration is the ultimate cost-benefit analysis: Do Americans as a society gain more with controlled legalization than we do with criminalization No one will ever know if we never try. Works Cited Gray, Mike. Drug Crazy: How We Got Into This Mess and How We Can Get Out. New York: Random House, 1998. Inciardi, James A. The War on Drugs III: The Continuing Saga of the Mysteries and Miseries of Intoxication, Addiction, Crime and Public Policy. Boston: Allyn and Bacon, 2001. Office of National Drug Control Policy, National Drug Control Strategy Update, March 2004. 23 February, 2006. Office of National Drug Control Policy, National Drug Control Strategy FY 2007 Budget Summary, February 2006. 24 February, 2006. Staley, Sam. Drug Policy and the Decline of American Cities. New Brunswick, NJ: Transaction Publishers, 1992. Read More