On Drugs

 A Sumerian tablet dated to 5,000 years ago. It records the payment of a worker with beer.

A Sumerian tablet dated to 5,000 years ago. It records the payment of a worker with beer.

Around 200,000 years ago, anatomically modern humans emerged from our progenitors. Only much later—approximately 50,000 years ago—would our forebears demonstrate abstract thought and the suite of other traits that we now consider fundamental to our species. Thus spake Homo sapiens. For the vast majority of prehistory, humans lived in small groups, foraging and hunting whatever sustenance their surroundings provided. People only began to settle down with the advent of agriculture, a mere 10,000 years ago. This revolution would dramatically alter the course of history, with early farmers serving as harbingers of the modern era. Agrarian societies began to develop stratified social hierarchies, which in turn required the development of increasingly complex political structures. Hunter-gatherers had operated in relatively egalitarian groups, but the moment we began counting our sheep, the seeds of inequality were sown. The greater relative productivity of agriculture also freed some individuals to develop new skills and created new divisions of labour. One skill that was soon developed was fermentation, now practicable given the glut of food that was available. Evidence for the earliest alcohol production appears immediately after the rise of agriculture. It seems to have been as popular then as it is now: upon developing the first written language, the Sumerians began etching clay tablets with references to Ninkasi, their goddess of beer. They would also be the first to record opium use. While the Sumerians may have been the first group with the capacity to record their activities, they were not alone in their indulgence: archaeological evidence indicates that early humans readily consumed any drug they encountered. Drug use has been with humanity from the start, and our infatuation with intoxication hasn't waned since.

Despite our longstanding enthusiasm for substance use, it is undeniable that drugs can have terrible consequences for individuals and societies. As such, authorities have sometimes sought to control drug use, variously invoking religious or ethical creeds, levying taxes, or imposing outright prohibition. Murad IV, an Ottoman sultan in the 17th century, imposed the death penalty for the consumption of coffee, tobacco, and alcohol. Taking an unusually hands-on approach, he would dress in rags and go slumming to uncover offenders. Upon finding some unlucky reprobate enjoying an illicit beverage, the sultan would cast off his disguise and decapitate the poor individual on the spot. Though this is appalling by modern standards, it is made more so by the fact that the sultan was himself an alcoholic; he managed to develop cirrhosis of the liver and die by the age of 27. While few today would abide the sultan's edict banning coffee, fewer still would condone the outright murder of drug users. Yet most states do criminalize drug use, and generally impose punitive measures of some form. Given the status quo, one would be forgiven for assuming that drug prohibition is the historical norm. One would be mistaken. While intoxicants have been occasionally proscribed throughout history, the near-universal prohibition of drug use is an aberration particular to the last century. As we mark this puritanical centenary, it is worth examining the historical rationale for the imposition of drug prohibition. Due to its role as global hegemon, the drug policy of the United States is of particular relevance; the perspectives of last century's Americans have shaped the world we live in today. Other countries also embraced prohibition, but America has been unique in its international influence.

 An American opium den.

An American opium den.

For millennia, drugs were ingested in total ignorance of their pharmacology. Following the technological progress of the Industrial Revolution, systematic scientific inquiry set the stage for advances in chemistry and a growing understanding of epidemiology. The first pharmaceuticals appeared in this era, often with ancient drugs like opium, cannabis, and coca as the active ingredients. By the 19th century, opium was commonly found in the homes of North America, primarily in a tincture known as laudanum. At a time when most women led quietly desperate lives, laudanum was prescribed for menstrual cramps or general maladies, leading to high rates of addiction. Meanwhile, the use of morphine during the American Civil War was so prevalent that addiction to it became known as the "soldier's disease". Even infants were medicated with opiates, often simply to induce sleep. In the waning years of the 19th century, diacetylmorphine was developed by Bayer, the makers of Aspirin. It was marketed as a cough suppressant, and sold over the counter. Today, we still commonly refer to the drug by its original brand name: Heroin.

Given the remarkable frequency of opiate abuse in the 19th century, it seems unsurprising that the first U.S. law prohibiting opium use was passed in 1875. What is surprising is that the target of this law was not drug addiction, but the growing Chinese community of San Francisco. The discovery of gold had brought hundreds of thousands of people to California during the 1850s. Opium dens had become commonplace in San Francisco, and they were primarily operated by Chinese migrants. It was explicitly stated by the city's lawmakers that their legislation was meant to prevent white people from patronizing such establishments and socializing with Chinese people. In particular, the worry was that white women would engage in sexual activities with Chinese men. As opium dens spread across the country, so did such concerns. In 1909, Congress passed the first national law prohibiting opium use. Smoking, the method of ingestion favoured by Chinese users, was prohibited; injecting and drinking the drug, as white users preferred to do, remained legal until 1914.

 A 1914 New York Times article detailing the dangers of so-called negro cocaine fiends. Click   here   to read the full article.

A 1914 New York Times article detailing the dangers of so-called negro cocaine fiends. Click here to read the full article.

Heroin is to opium as cocaine is to coca leaves. The leaves had been consumed by indigenous people for thousands of years before European colonization, but cocaine was not produced until the pharmacological boom of the 19th century. The drug quickly became widely used, to the point that pure cocaine was available for purchase in the Sears catalog. It was popular with labourers due to the energy, pain relief, and endurance it provided. At the time, manual labour was one of the few opportunities available to many black Americans, and the drug eventually came to be associated more generally with the black community. The overt racism of the era is evidenced by newspaper reports claiming that black cocaine users were imbued with superhuman strength, invulnerability to bullets, and predatory sexual desires (as seen in the New York Times article pictured above). Against a backdrop of antebellum prejudice and Jim Crow laws, cocaine became illegal in 1914.

By now, the trajectory of cannabis will be unsurprising. After millennia of traditional use, cannabis became a common ingredient in early pharmaceuticals, often serving to relieve pain or nausea. These tinctures had few side effects and lacked addictive potential. However, at the beginning of the Mexican Revolution in 1910, a wave of migrants entered the southern United States. They brought customs that were unfamiliar to the existing population, including the smoking of marijuana. Though many Americans might have gladly quaffed a cannabis tincture, they would have been unlikely to understand that marijuana was the same drug. Anti-immigrant sentiments were commonplace, and all manner of crimes would be ascribed to marijuana-impaired Mexicans. American states began to ban the drug's use in 1915.

 The disposal of alcohol during Prohibition in America.

The disposal of alcohol during Prohibition in America.

While racist sentiments clearly contributed to the institution of drug prohibition in North America, it is also true that the moral zeitgeist of the age was generally aligned against intoxicants, given that the production of alcohol was criminalized by governments in Canada and the United States during this period. In Canada, prohibitionist laws were imposed by the provinces, creating a patchwork of legality. However, in the United States the federal government imposed nationwide prohibition in 1920. The cultural impact was so profound that the era is simply referred to as Prohibition. Alcohol consumption did decrease during this period, though not without a cost. Bootlegging quickly emerged to fill the gap left by legitimate businesses, and the black market came under the control of violent criminals; between 1920 and 1921, homicides, thefts, burglaries, and assaults all dramatically increased in frequency in American cities. Gangsters soon realized that it was preferable to smuggle hard liquor over other forms of alcohol, as there was greater profit by volume. The consumption of spirits surged as beer drinkers turned to whisky. In an effort to prevent bootleggers from obtaining and selling industrial alcohols, the federal government mandated that they be poisoned with deadly methanol. This failed to stop the gangs from distributing it; it is estimated that as many as 10,000 people were killed after unknowingly consuming poisoned alcohol. Eventually the government would capitulate. Faced with the ascendancy of organized crime and a general disregard for the law, Congress repealed Prohibition in 1933.

A century has passed since the beginning of our experiment with prohibition in North America, yet the scene is eerily familiar. Violent criminals are enriched by the black market. Drugs are increasingly concentrated and dangerously tainted. People are dying. Déjà vu. In fact, the situation today is much worse than in the past. Innocent people from Mexico to Afghanistan fall victim to the internecine warfare of drug traffickers. Billions of dollars are spent combating drug use, yet overdose deaths are greater than ever before. Brutal global cartels amass enormous wealth, while countless non-violent users sit in prison. The war is lost; drugs won. Why have we failed to accept this reality? Some would argue that many drugs are too dangerous to be legal. If this was a genuine concern, cigarettes and alcohol—two leading causes of death—would also be illegal today. The truth is somewhat darker, and echoes the prejudice of a century ago: we have tolerated the war on drugs because it has primarily targeted the marginalized and spared the privileged. Both alcohol and drugs were once prohibited. Alcohol was commonly consumed by the cultural majority, so its prohibition was repealed. Drugs have been associated—generally undeservedly—with people of colour, disadvantaged communities, and counterculture movements, so their prohibition has persisted. However, things may soon change. The bulk of our society has been largely insulated from the drug war for many decades, but as the sun set on the 20th century, the chickens were coming home to roost.

A victim of drug violence in Mexico. Credit: Fernando Brito

Our culture is awash in opiates, much as it was a century ago. As then, prescription drug abuse is common. The late '90s saw a rapid increase in prescriptions of synthetic opioids such a hydrocodone and oxycodone, commonly known by brand names like OxyContin, Percocet, and Vicodin. Between 2000 and 2010, the number of Canadians using prescription opioids tripled. While the drugs are vital to chronic pain management, they are also widely abused. Drug overdoses are now the primary cause of unnatural death in the United States and Canada, with opiates accounting for the vast majority of cases. Overdose deaths have increased overall, but in the last few years a particularly lethal drug has surged to the fore: fentanyl. Most of the people that have been killed by fentanyl never intended to use the drug; they intended to use another drug, but consumed a tainted product. This opioid is now appearing across North America, but it has already been particularly damaging in British Columbia for several years. In 2012, fentanyl was involved in 4% of the 269 overdose deaths in the province. So far in 2017, there have been over 1100 overdose deaths. Fentanyl accounts for 81% of them.

North America is in the midst of an unprecedented drug overdose epidemic. This is common knowledge, so there is no need to belabour the point. However, there is an uncomfortable truth that does need to be expressed: this crisis represents the inevitable culmination of drug prohibition. The media frequently reports that fentanyl is present in all manner of illicit drugs, and that it is 100 times more potent than heroin. Yet they typically fail to connect the dots: the reason fentanyl is present in all manner of drugs is precisely because it is so potent. Much as whisky was easier to smuggle than beer, fentanyl is easier to smuggle than other substances. By trafficking in a particularly potent drug, dealers are simply maximizing their profit in a black market system. It is prohibition that is killing people; fentanyl is just how it is killing people. Ironically, the deadly nature of the drug may help undo prohibition in the end. Recent deaths have revealed another uncomfortable truth: all sorts of people are doing drugs. It only takes a few grains of fentanyl to kill, so recreational drug users are frequent casualties. Overdoses were once something that happened to gaunt figures in alleyways; now they happen to friends and family. It seems that fentanyl has brought the drug war home.

 Drug overdose deaths in British Columbia, 1991-2017

Drug overdose deaths in British Columbia, 1991-2017

I started this post earlier in the year, writing the bulk of it all at once, then leaving it to languish. During that pause, my father died. I didn't have a conventional relationship with him, so the experience was not as jarring as it would be for many. Nonetheless, I found myself reexamining the relationship that we did have. I recount this here because my father was a drug addict. I only know the broad strokes of his life, and the few memories I have with him are from my childhood. I recall a day when he pulled out some of his mugshots to show me. After my interest in those had faded, he rolled up his sleeves to show me some tattoos he had received in prison. His arm now bare in front of me, he pointed to the pit of his elbow. Running his finger along a mass of scar tissue, he asked, "Do you know what this is from?" I shook my head. "This is from shooting drugs."

Looking back, I can't help but be somewhat bemused by my father's display that day. In the past, when I reflected on the incident, it seemed to be an awkward attempt at bonding by a man that was uncomfortable being a parent. However, after my father died, I considered something that had not come to mind before: I believe that he showed me those things because he saw himself as a criminal and an addict. This might not seem surprising, given that he was both. I mean to say that I believe those titles wholly defined him in his own mind. They would also define him in my mind. My father had his demons, and it is likely that he would have struggled even absent his addictions. However, I can't help but wonder what his life might have been if he had seen himself differently, less bound to his failings. Maybe I could have known him in another way. Maybe not. What is certain, is that our society reinforces the stigma of addiction with every arrest, turning struggling people into criminals. It is time to try something new. It's time to end prohibition. Not just for those with the problem, but for their mothers, fathers, sons, and daughters.

Thanks for reading.

Samuel WilsonComment