Milk of Paradise

by Lucy Inglis

  By the time Richards was taking the apomorphine cure, drugs, and particularly heroin, had become associated with a new generation of musicians. Jimi Hendrix and Janis Joplin died in 1970, both aged twenty-seven. The official cause of Hendrix’s death was a barbiturate overdose, but he was a regular user of both heroin and hashish. Joplin was a heroin addict, whose use escalated alarmingly when she was stressed or unhappy. Bob Dylan claimed, perhaps untruthfully, to have been both a heroin addict and a prostitute, in interviews in the 1960s. Of his heroin addiction, he told the BBC that ‘I kicked a heroin habit in New York City [when he was involved with the Beat movement] . . . I got very, very strung out for a while, I mean really, very strung out . . . I had about a $25-a-day habit and I kicked it’.26 This may or may not be true, but the drug culture that arose from the Beat movement encouraged experimentation and breaking the shackles of society’s expectations. Even popular journalism changed for good with the arrival of the American drug-taking titan Hunter S. Thompson, who used heroin to counteract the vast quantity of cocaine he used daily, as well as the mescaline he also enjoyed. He seemed to live in a state of perpetually intoxicated chaos, and when he committed suicide aged sixty-seven, in 2005, had his ashes fired from a cannon at his funeral. Yet he appeared to have few regrets. Where the Buffalo Roam, a film of 1980 based on Thompson’s own autobiographical stories, attributed to him the line, ‘I hate to advocate drugs, alcohol, violence, or insanity to anyone, but they’ve always worked for me.’

  In the last half of the twentieth century there was a sea change in the way society, particularly American society, viewed and used recreational drugs. Thompson’s life was so extreme it approached parody, but the interview recorded between Burroughs and Bowie had highlighted a moment of wider change in narcotic culture. For Burroughs, ‘junk’ was an essential part of his lived experience, which eventually fuelled and was inextricably linked to his creativity, true of the other beats with their intoxicants of choice. For David Bowie, it was a personal pitfall that had ultimately threatened calamity. For Keith Richards, it was part of a lifestyle. In the following decades, many musicians wrote about the experience of heroin, ranging from Lou Reed with his ‘Perfect Day’, Pink Floyd and the dreamily expansive ‘Comfortably Numb’, The La’s with the deceptively cheerful ‘There She Goes’, to Iggy Pop’s looming withdrawal symptoms in ‘Lust for Life’. For many, the greatest song written about the experience of heroin addiction and its attendant mental and physical torments was the 1994 release of ‘Hurt’ by American band Nine Inch Nails. In the same year, Kurt Cobain of the grunge band Nirvana was found dead of a self-inflicted gunshot after failing to overcome his heroin addiction, which he used to temper stomach pain (possibly itself the result of his heroin use), and depression.

  The death of Kurt Cobain brought the realities accompanying chronic heroin dependence into the open for a new generation, and also reinforced the connection between opiates and the temporary relief from fear and anxiety.

  From John Leigh in the 1780s, to Sertürner’s work in 1804, chemists and pharmacists had worked diligently upon isolating the active compounds present in opium latex, aware that these drugs had an effect on the human nervous system, one that had the dual action of allaying pain and anxiety, but they did not fully understand why. The boom in recreational drug use of all kinds across the Western world in the 1960s made official bodies keener than ever to discover the mechanisms of opiates and their synthetic counterparts, opioids, but it wasn’t until 1973 that a rebellious graduate student finally arrived at the answer.

  Candace Pert was born in 1946 in Manhattan. She was due to enter Johns Hopkins School of Medicine in Baltimore as a graduate researcher in pharmacology in 1970 when she broke her back in a horse-riding accident. The subsequent effect morphine had upon both her brain and her body inspired a lifelong career in researching the connections between the two. Working under Solomon Snyder, she neglected her authorized work on insulin receptors to focus upon the effects of opioids on the brain, and in 1973 ordered the materials she would need to conduct her own experiments, including morphine and brain tissue. (Receptors are proteins in the brain to which molecules or short peptides are designed to bind specifically, comparable to the way a key fits into a lock, effectively blocking out pain and discomfort.) The morphine was labelled with a radioactive atom that made it traceable when it bound itself to the brain matter. Preferring to work when the laboratory was empty, Pert brought her five-year-old son Evan with her on a Friday night so that she could conduct her experiment in peace. When she returned to work on Monday morning, the radioactive atom pathway had identified the first known opioid receptor in the human brain.

  Two years later, in 1975, a pair of researchers in Scotland, Hans W. Kosterlitz and John Hughes, identified encephalin, the first of the endorphin family to be discovered and one of the peptides which act in the brain as painkillers, manufactured by the central nervous system and the pituitary gland. Physical exercise, breastfeeding, voluntary sexual intercourse and laughter all produce endorphins in humans.

  In 1978, as a result of these findings, Snyder, Kosterlitz and Hughes shared the Albert Lasker Award for Basic Medical Research, which frequently precedes the award of the Nobel Prize. Pert, however, was excluded, owing to her status as a graduate student and, many felt, including Pert herself, her gender. She wrote a sharp protest letter to Science magazine in January 1979, stating that ‘I played a key role in initiating this research and following it up’. Snyder credited Pert in his acceptance speech: ‘I am honored that the Lasker Foundation has chosen this year to recognize the field of opiate receptor and opiate-like peptide research . . . Among the many people who contributed to this area, my own special thanks go to Candace Pert who, as a graduate student, identified the opiate receptors in my laboratory.’27 In an ongoing campaign, Pert refused to stand aside and let a senior associate take the credit for her work, scotching one of the most promising careers of the century, in terms of research into analgesics. An embittered Pert went on to have a groundbreaking career in peptide research, and after her death in 2013 in Potomac, Maryland from the complications of heart failure aged sixty-seven, Snyder remembered her in a tribute in the New York Times as ‘one of the most creative, innovative graduate students I have ever mentored’.28

  And Behold, A Pale Horse: HIV

  One of the peptide therapies Candace Pert hoped to develop was Peptide T, designed to block the action of Human Immunodeficiency Virus. She was unsuccessful, largely due to the mutable nature of HIV itself. It is an extraordinarily adaptable disease, with a virus body one-sixtieth the size of the human red blood cell. The rapid spread amongst intravenous drug users in the early 1980s was cause for alarm, although this new disease appeared to primarily manifest in the sexually active members of the gay community of the coastal continental United States.

  The 1925 outbreak of malaria had deterred many in the Middle East from injecting heroin, but the same had not been true in America, and the country that had happily supplied so many mail-order syringe kits for a century was inevitably going to suffer. HIV-1, the primary manifestation of the disease that leads to AIDS, emerged in the 1920s in the Belgian Congo, but did not begin to spread widely in the USA until 1981. The mysterious death of a fifteen-year-old boy, Robert R[ayford], in St Louis in 1969 is one of the few indicators that AIDS was present in the USA before the epidemic that began in 1981. Rayford had never travelled, and those treating him speculated that he had been involved in sex work. The first confirmed case in Europe came in 1976, when Norwegian sailor and truck driver Arne Vidar Røed, known as Arvid Noe, his wife and eight-year-old daughter, died in quick succession after being diagnosed the previous year.

  HIV is a particularly cunning virus that can lie dormant when untreated for more than a decade before it emerges as a crippling immune condition that renders the host helpless in the face of bacterial infections, skin cancers and respiratory ailments. Its sudden dominance in the coastal United States homosexual ma
le community, at a time when gay pride had asserted itself as a social and political force, was interpreted by many as a form of divine justice. That it also infected the intravenous drug-using population only reinforced this belief. Since the Second World War, America had also undergone a long and undignified debacle involving blood transfusions from and within the armed forces, where hepatitis B and C were rife, transmitting the disease within the ranks and to civilians. The hypodermic needle was rapidly becoming tainted with the association of sickness rather than cure.

  When AIDS emerged as an issue amongst the prostitutes of the San Francisco Tenderloin district in 1985, the mainstream media seized upon the issue. It was no longer simply a homosexual problem, it had passed into the straight male population via the disease vector of sexual intercourse and needle-sharing. Silvana Strangis was one of the first reported San Francisco prostitutes to exhibit the symptoms of AIDS, most likely contracted from her pimp, Tony, who was a fellow heroin addict as well as her sexual partner, and in the advanced stages of the disease. At the time, more than 98 per cent of the San Francisco AIDS cases were homosexual men, and it had been easy to dismiss the disease as a gay problem, but ‘Suddenly there were children with AIDS who wanted to go to school, labourers with AIDS who wanted to work, and researchers who wanted funding, and there was a threat to the nation’s public health that could no longer be ignored.’29

  This public-health issue formed the bedrock of a new White House campaign against drugs. Drawing deeply upon America’s well of sentimentalism, Ronald and Nancy Reagan founded the Just Say No campaign, targeting ‘this cancer of drugs’ upon American soil. The Christian message of the Reagan campaign against drugs is clear, coupling an ‘unyielding and inflexible’ attitude to drug use with the steaming righteousness accompanying such phrases as ‘We Americans have never been morally neutral against any form of tyranny.’30 The sudden coincidence between the Just Say No campaign and the spread of HIV to the heterosexual male population in 1985–6 is remarkable, representing the governmental response to the spread of the disease to what was perceived as the mainstream population.

  The sense of immunity from illness that had come with the widespread usage of penicillin had lasted a scant five decades before a new sexually transmitted, blood-borne virus arrived to haunt the West, and HIV/AIDS comprised ‘a disease that from its first days was as much a social as a medical problem’.31 The inability to acclimatise to a new cultural reality regarding alternative sexuality and drug use left the Reagans calling upon the nobility of the Second World War dead as a reason not to use drugs in their White House address of 1986.

  In the USA in 1990, 10 per cent of intravenous drug users who volunteered for testing returned a positive result for HIV.32 Yet, five years after the Reagan campaign, there was still little practical advice for people living and sleeping with an IV heroin user or sex worker. ‘Just Say No’ wasn’t quite as simple and effective as it first appeared. Randy Shilts, the determined and eloquent journalist who wrote the definitive text on the early years of the epidemic in San Francisco, And The Band Played On, died aged forty-two from AIDS complications. ‘It is a tale that bears telling’, he wrote, ‘so that it will never happen again, to any people, anywhere.’33

  The stigma of HIV became irretrievably entangled with American stigmas against homosexuality and also drug addicts. The rapidity of the spread of HIV amongst the high-risk homosexual populations of San Francisco and New York, who were now increasingly mobile in a new era of cheap air travel, was genuinely terrifying, yet the prejudice against this relatively small subset of the American population grew out of all proportion. A huge gulf remains even in Shilts’s measured writing, specifically between the homosexual and intravenous drug-using communities, each of whom blamed the other for spreading HIV. Heroin use was suddenly associated not with smoking or snorting, but the process and ritual of injecting, tainting the user and further separating them from society. The studies which were conducted into HIV also focussed on the racial background of those carrying HIV, with black and Hispanic drug users and prostitutes targeted as not more vulnerable, but more ignorant to the reality of HIV infection. The association of Latin and black Americans with danger to society re-emerged with a vengeance less than a century after Harrison, despite the evidence for the fastest vector of infection being the white, male homosexual population. Extensive studies by the National Center for Health Statistics upon the pregnant Latina population commenced, highlighting religious superstition and lack of safe-sex practice. The enemy was not so much a mysterious and parasitic disease as a type of person.

  As the AIDS epidemic came to pass, the methadone programmes gained popularity: a safe oral daily dosage, administered in a supervised environment, seemed the perfect way to stop Americans turning to the hypodermic. Heroin had become inextricably linked to a soiled street life of prostitution, hustle, and the instant gratification of a $10 high.

  Throughout the 1960s and 70s, the peak of street heroin usage, a series of utopian initiatives to combat global opium farming had been introduced. The Royal Project in Thailand, initiated by King Bhumibol in 1969, was and remains one of the world’s most successful opium-poppy replacement projects. In the northern highlands of Thailand, which had been taken over by the opium trade from Burma, the hill tribe people were struggling to survive. On the Thailand–Burma border, the elephants used for the logging trade were routinely drugged with opium to render them docile. The Royal Project, which aimed to replace opium cultivation with market gardening, has offered rehabilitation for humans and animals alike, but has also created a series of model villages more suited to tourist visits than to the needs of the communities who had previously farmed opium to survive. The divide between those engaged in heroin use, and those who grew opium for a living, is widening constantly.

  The Royal Project succeeds because of the sheer amount of money involved, and because of the late King Bhumibol’s philanthropic commitment. Similar projects have been initiated in Afghanistan, namely the growing of almonds by Californian farmers as a replacement for the opium poppy, but Afghanistan is simply too dangerous, and the irrigation infrastructure too irregular, for such projects to work. Crop replacement remains the ideal solution to opium farming in some of the world’s poorest places, but it requires huge amounts of money and a support network. As the farmers of Afghanistan have realized repeatedly, growing melons is foolhardy if there are no roads on which to take them to market, or the market has been bombed out of existence.

  Crop-replacement initiatives are, in the main, vanity projects for philanthropists. The displaced Akha people, now numbering some 80,000 in Chiang Mai and Bangkok, would profit from such projects more than the imported workers who farm them currently. In 2007, the Thai government passed a law curbing the people’s access to fertile farmland, claiming it instead for the queen under the Community Forest Act, curtailing the traditional Akha way of life still further. Many of the young non-literate Akha women entered the Thai sex trade, unable to survive otherwise. The mountain existence they had been raised to, one of monthly ancestor and spirit veneration, slash and burn agriculture, and opium smoking or eating, was replaced with sex work, cheap heroin, AIDS and social ostracization. The parallel existence of the Royal Project and the systematic theft of the Akha way of life typifies the hypocrisy of current opium farming replacement schemes. The Akha people are now left to beg on the streets of Chiang Mai and Bangkok, sell their bodies, or commit to remaining in their homeland in ‘simple lives of unremitting tedium, enlivened by two things: addiction to opiates and being used as a tourist attraction’.34

  A Return to the Fragrant Harbour

  Hong Kong, the opium-trading centre created on a barren outcrop in the Pearl River Delta, has gone from strength to strength. While Afghanistan probably still claims the title in terms of endemic corruption, Hong Kong takes the crown in terms of revenue, and quasi-legitimate infrastructure. The founding of the Hongkong and Shanghai Banking Corporation (HSBC) in 1865 made i
t possible to channel credit and liquid funds from the opium trade into other shipping and mercantile businesses. No longer confined to Hong Kong Island, British, American and Australian companies took over Kowloon, and 235 more tiny islands in the delta, creating a sprawling mass of high-rises and a financial industry unrivalled anywhere in the world.

  Hong Kong’s population increased dramatically when Mao Tse-tung created the People’s Republic of China in 1949, as hundreds of thousands of Chinese decided to avail themselves of Hong Kong’s privileges of extraterritoriality, and the opportunities for free trade available there – or, as the English translation of a Chinese history of the area states, ‘the familiarity of the entire region to achieve economic gains by illegal means’.35 The economic hierarchy of Hong Kong lends itself to organized crime in a unique way: the series of laws and bylaws brought in under British rule coupled with institutionalized corruption in the police force and judicial system meant that, from the 1930s onwards, Hong Kong became not only a settlement built on the opium trade, but the focus of global heroin trafficking. Largely, this is due to the borderless nature of Greater China, making Hong Kong the financial funnel of a country that takes up approximately 3,657,765 square miles of territory and has a conservative population estimate of 1.5 billion. It is a vast territory, embracing extreme climates: Kashgar, in north-west China, is lucky to see four inches of rainfall a year, while Canton can have as much as thirteen. As with the Pashtuns of Afghanistan and the Was and Akhas of Burma, many different peoples straddle official borders, all of whom conduct business between themselves and outlying tribes. This tribal business structure was echoed in the early Triad societies of Hong Kong, which was taken over in the early twentieth century by one of the Green Gangs. The Green Gangs assimilated with the criminal chiu chau gangs of Hong Kong and the original secret societies of the seventeenth century to form one solid mass of incestuous corruption three centuries later, pushing drugs and cash through the Pearl River Delta on an unprecedented scale.