Doris told me how she finally reached ground zero. ‘I’d come into work late and say the lock broke off the door, or the dog just died, or my aunt is sick. Every kind of excuse you could think of. I was looking for a way out but I didn’t know a way out. I felt like I was going to die strung out on drugs. I never prided myself on being suicidal, but one day I just got tired of the living. “God,” I started to think, “I just don’t want to live no more.”’
It can take many years for compulsive drug users to decide to quit. I remember asking Louis what he did when he hit rock-bottom. He told me that he found a trapdoor. In the early stages of a drug epidemic, there isn’t much that can be done to reduce drug use because users have yet to develop serious problems. But as the crack epidemic in the United States waned, its last embers proved susceptible to intervention, not by law enforcement, but by treatment providers. It is not easy to reduce or stop the compulsive drug use of long-term heroin, crack or methamphetamine users. A study conducted in the United States in 1994 found that only 13 per cent of hard-core drug users who received help were able to reduce their use substantially, or kick it entirely.39
This may seem a demoralizingly low success rate, but it is far higher than that achieved by arresting, jailing, disenfranchising, and un-employing drug addicts. A study by the RAND Corporation in 1994 found that to achieve a 1 per cent reduction in cocaine consumption in the United States, the government could spend an additional $34 million on drug-treatment programmes, or twenty-three times as much ($783 million) on trying to eradicate the supply of cocaine from Colombia.40 Despite this vindication of the efficacy of drug-treatment programmes, provision in the United States is woefully inadequate. Over a million Americans were thought to need treatment for cocaine abuse in 1998, but in the previous four years only 250,000 of them had actually received it.41
America’s problematic drug users are more likely to find themselves drying out in prison than in a treatment programme. Drug courts have been heralded as an effective alternative to incarceration, but they put users who want to get help in the Kafkaesque position of having to get themselves arrested in order to be treated. This is a bitter irony considering the vehemence with which the United States government has prosecuted its war on drugs. The drug treatment mandated by the courts is often a throw-back to the twelve-step programme first devised by Alcoholics Anonymous, a method based on repenting for the harm the user has done to other people, finding a substitute for drugs in spiritual belief, and abstaining from drugs entirely. ‘I had twenty years of programmes,’ Doris told me. ‘“Heal! Demon, come out!” I had all that, and none of it worked. You can’t make people do anything. They have to be ready. One day I surrendered to what they call “the high cost of low living”, and decided that I wanted to change my life. My boss helped me get clean, and once I saw the clean side of living, I started to think “hey, maybe it’s not so bad.”’
Drug treatment has come a long way from its origins in exorcism. Contemporary programmes focus less on the drug itself, and more on encouraging drug users to question their compulsive behaviour, so as to recognize and resist ‘the euphoric recall’. ‘Narcotics Anonymous tell you to stay away from “people, places and things”, Doris explained. ‘Don’t go to places where you know drugs are. Get a watch. When I first came back to the neighbourhood after getting clean in a programme, people would say “Doris! How ya doing?” They thought I was going to say “alright, where’s the red cap? Where’s the coke?” But I’d look at my watch and say “aw shit! I gotta go!” It works if you work it, but even now, with twenty years clean, I still make meetings. It’s where my friends are, people like me. They say that baseball players dream of baseball. Well, I’m a drug addict, so I dream of drugs. But I’m not like a newcomer to it, you know? The obsession has been lifted.’
Jerry, a former methamphetamine user and treatment programme graduate from Chico, California, told me where he thought the roots of compulsive drug use lay. ‘A lot of people feel lonely, you know? So they seek companionship, sometimes in a very unhealthy way, via drugs and alcohol. You have to ask yourself “OK, what can I do?” First off, I can change the way I perceive being lonely. It’s not such a bad thing. How can I develop some support, some friendships, so I feel a part of things, and have some purpose in my life? We treat drug dependency as a symptom of a lack of coping skills. You start to learn how to deal with anger and frustration without having to run and numb yourself with drugs and alcohol. How to deal with loss and grief, and relationship issues. How to communicate effectively. A lot of the guys have never had to manage money or be responsible for their actions. So we focus on changing thinking patterns, changing our environment, and really developing some sober living skills.’
But as Louis told me, drug treatment can only work when its providers recognize the drug user’s right to define their problem for themselves. ‘It is one thing to be using recreationally, another thing to be self-medicating, and another thing to be on a suicidal track.’ For the many people whose drug-taking is a response to trauma, depression or hopelessness, being told to stop taking drugs is not always the best way to reduce the harm they are doing to themselves. ‘Crack users are stigmatized, marginalized and criminalized, but really, the harm is caused more by society’s attitudes than by the drug in and of itself. My drug use has changed as I’ve realized that it is possible to be a productive member of society and still be a drug user. You need some kind of base, a sense of responsibility for yourself and your relationships. The self has to be in place, and then the self can make choices. Once you have that, you can enjoy the experience of smoking crack, without the would-have-beens, could-have-beens or should-have-beens. If you fail to plan, you plan to fail. It’s a quaint saying, but I believe there’s some truth to it.’
Kenneth is a former crack user and dealer from Dothan, Alabama. ‘While I was inside God gave me a vision of the Ordinary People’s Society, to go out to the ordinary people who were overlooked or outcast, the homeless, the drug addicts and the prisoners who were despondent just like me, and to clean up where I had messed up. I thought about how my mother would always leave me a key, no matter how bad I was, and how she would always have food prepared for us. When I got out of prison, I went back to the same ’hood in Dothan where I had sold drugs. There was a pizza shop across from the mall where my mother used to work and the Puerto Rican guy there would give me the pizzas that he was going to throw away at the end of the night. I would go to the crack-houses that I knew in the area and I would pass the pizzas out, because I knew that when we were out there doing drugs we didn’t eat and that if they ate, it would diminish their drug use, and stop them from robbing and stealing and shooting people.’
The Ministry of Health of the Netherlands has said that ‘the Dutch policy assumes that it is not possible to completely quash drug consumption through government policies. Partly because of this belief…government policy discourages drug consumption. For those who continue to consume drugs, there is a wide range of measures in place to manage potential social and health problems associated with drug use.’ The Netherlands has only a quarter of the UK’s population and considerably fewer drug users, but its government spends twice as much as Westminster on preventing and treating drug abuse.42 Of the 30,000 opiate addicts in the Netherlands, 15,000 receive some kind of treatment.43 In terms of drug use per head, the Netherlands is in the same league as Germany and France, at a considerably lower level than the United Kingdom, and half or even a third of the levels seen in the United States.44 That the Netherlands is famously liberal in its attitudes to drug use, while the United States is among the most punitive of all countries, suggests that drug policy has very little influence on the number of people who use drugs. In fact, cannabis consumption in the Netherlands went down after the laws were liberalized, which could be taken to mean that forbidden fruit loses its taste once we’re allowed to eat it.
The Dutch approach is to be commended, but real change will only come when people develo
p a more nuanced understanding of what propels compulsive drug use. Drug-treatment professionals have long said that the best drug abuse prevention programme ever invented is gainful employment. It is all too easy to imagine that a crack or cocaine addiction is a curse to be exorcized, when it is usually only an accomplice to existing chaos. Doctors, health visitors and social workers try to limit the damage to individuals and communities, but they are clearing up the mess rather than getting to the root of the problem, which is invariably nourished by long-neglected social and personal problems.45
In the absence of public understanding and political will, the vacuum is being filled by improvements in medical technology. A new treatment for compulsive cocaine users is expected to become available in 2009, what might be called the Clockwork Orange approach to breaking stubborn thought-patterns. The biotechnology company Xenova has developed a therapeutic vaccine for the treatment of cocaine dependence which induces antibody responses to the drug. In trials, most drug users who took cocaine within six months of being given Xenova’s vaccine reported a reduction in the euphoric effects of cocaine. The drugs had finally stopped working.46
10
Legalization
Not that which goeth into the mouth defileth a man; but that which cometh out of the mouth, this defileth a man.
Matthew 15: 11
The demand for cocaine comes from two sources: recreational users and problematic users. At present, neither seems amenable to intervention by law enforcement or drug education specialists. Those most likely to be put off drugs by a spell in prison face minuscule odds of being arrested.1 As Alan said, ‘the police have to worry about the bigger things going on. Let’s face it—a couple of ad agency twats taking a bit of coke are not doing any harm to anybody, are they?’
Meanwhile, those least likely to be dissuaded from using drugs by a prison term are those most likely to be given one. Most regular crack users are unable to hold down a job, much less one that allows them to indulge a £100-a-day crack habit. As a result, nearly all crack users finance their drug-taking through crime. Up to 80 per cent of America’s thieves are thought to be hard-core drug users, and every year they steal goods worth £3.75 billion. The illegal market in drugs also binds compulsive drug users to other criminal activities. Most crack users are poor, many are in debt to their dealers, and are either threatened or beaten when they cannot pay those debts. Half of the women who regularly use crack in London are prostitutes. Almost two thirds of heavy crack users have spent time in prison, and more than half of prison inmates report that they used drugs while there.2
But the links between hard drugs and crime, however stubborn, can be broken if the drugs can be made cheaper and more accessible. In Switzerland, prescription programmes that have been doing just that for the past ten years have been instrumental in reducing the number of crimes committed by drug addicts by up to 90 per cent and doubling the numbers able to sustain full-time employment.3
In thinking about the crimes committed by compulsive drug users, and the extent to which police and public health officials can do anything about them, it should be clear that the illegal marketplace is the worst possible arena for affecting change. The prohibition of drugs actually sustains problematic drug use and creates drug addicts. One reason is that the heaviest and most troubled drug users prove to be the best customers. Twenty-two per cent of cocaine users in the United States account for 70 per cent of total consumption. Their suppliers have every interest in encouraging compulsive consumption, and much less interest in supplying occasional, recreational cocaine users. Consequently, ambitious drug dealers congregate wherever there are likely to be compulsive users—in other words, where the poorest, most neglected and hopeless people live.4
Drug abuse is assumed to make people criminally violent, but a closer look shows most instances of drug-related violence to be a consequence not of drug use, but of the criminalization of drug use. In 1988, at the height of the crack epidemic that swept through New York City, there were 414 murders in the city. In police reports, more than half of those killings were described as ‘drug-related’. This might lead one to think that being high on cocaine played a big role in making people murderous. Mental health problems, social deprivation and strong pharmaceuticals will always be a potent brew, but in fact none explain the violence of the drugs business. Just eight of those murders were committed by people under the influence of crack or cocaine; 85 per cent of drug-related killings would be better described as ‘money-related’: committed in order to get money to buy drugs, in disputes between drug dealers and their customers or in territorial disputes between rival dealers.5
The prohibition of drugs has created drug neighbourhoods, drug dealers and drug violence. Steven Soderbergh’s film Traffic, released in 2000, was the first time that Hollywood had tried to get to grips with the failures of the war on drugs. The action moves between Mexico, where corruption stymies the government’s attempts to curtail the smuggling business, and Washington D.C., where the drug tsar is forced to reconsider his belligerent anti-drugs talk when he realizes that his daughter has developed a heroin habit. One scene in particular brilliantly encapsulates the process by which drugs have become such a major employer of young men in the United States. The drug tsar appears to blame the (black) inner city for (white) suburban drug problems, but is quickly pulled up short by a friend of his daughter, who tells him that ‘right now, all over this great nation of ours, 100,000 white people from the suburbs are cruising around downtown, asking every black person they see “you got any drugs? You know where I can score some drugs?” Think about the effect that has on the psyche of a black person. Bring 100,000 black people into your neighbourhood, and they’re asking every white person they see “you got any drugs?” Within a day everyone would be selling: your friends, their kids. Here’s why: it’s an unbeatable market force, man. A 300 per cent mark-up. You can go out on the street, make $500 in two hours, come back and do whatever you want to do with the rest of your day. You’re telling me that white people would still be going to law school?’6
Drug use, whether light or heavy, is common to all classes and ethnicities in the United States, but middle-class and suburban abuse of drugs, whether legal or illegal, is more readily concealed so it is easier to disregard. The difference between uptown and downtown drug markets is one of economics. Suburban drug dealing is more likely to be part of a partying lifestyle, in which drugs are mainly sold by word-of-mouth through contacts at work, in pubs and bars, and at gigs and raves. In the suburbs, there are no stable, drug-selling locales, and drug dealers are much less likely to have employees. Inner-city drug dealing will always be more chaotic than suburban drug dealing because dealers and buyers are less likely to know one another, there is more through traffic and turnover is higher. Dealers have to take to the streets to attract customers, where they are more likely to run into the police and rival dealers, which only increases the likelihood that events will turn violent. People who don’t live in inner-city neighbourhoods might equate visible drug-dealing with actual drug use, but rates of drug dependency are only slightly higher in the inner-city than elsewhere, and many who live there see drug dealers, rather than users, as the primary problem.7
Eighty per cent of the cocaine in the United States is consumed by white people, yet police operations and drug-treatment programmes have focused on poor, inner-city neighbourhoods, typically inhabited by minority populations.8 This focus on visible drug sales rather than actual drug abuse has turned the campaign for a drug-free America into a daily struggle for control of neighbourhoods in which drug sales have become a mainstay. Although black Americans make up just 12 per cent of the population and 13 per cent of drug users, and arrest rates for other crimes are pretty similar for minorities and whites alike, African-Americans make up 38 per cent of those arrested for drug offences and 59 per cent of those convicted for drug offences.9
In fact, young white Americans are more likely to take illegal drugs than young black or
Hispanic Americans. Seventeen per cent of young whites report having tried drugs, mainly marijuana, compared to 13 per cent of black Americans. Only 2.6 per cent of teenagers had tried cocaine in 2003, but the rate was four times higher for white teenagers than it was for black teenagers.10 Ted tried to explain why this might be. ‘Rates of drug use are considerably higher among affluent white folk than among poor minority folk because drugs cost money. Black and Hispanic drug users are much more likely to be in touch with their families, and vastly more likely to go to church, so they’re more likely to hear that drug use is bad, degrading and sinful, and much less likely to hear that drug use is liberating or rebellious. There is no black Keith Richards, you know?’ So why should it be that despite such abstemious beginnings, 9.7 per cent of adult African-Americans use illegal drugs compared to 8.5 per cent of adult Caucasian-Americans?11 When you look at who is smoking crack, you see that 46 per cent of them are white, 36 per cent of them are black and 11 per cent of them are Hispanic. Crack has never found a following outside the most run-down inner cities of the world, and the breakdown of the racial origins of crack smokers tallies closely to the racial mix of the most neglected neighbourhoods of the United States.
The British Crime Survey last asked questions about ethnicity in 1996, so there is no way of knowing whether black Britons are more or less likely to use drugs than their white counterparts, but if the 1996 survey is anything to go by, black people are marginally less likely to use illegal drugs than white people.12 The number of black people serving prison sentences for drug offences is disproportionately high, but there are disproportionately high numbers of black people serving time for all kinds of offences in the UK’s prisons because black communities are subject to much higher levels of policing than other neighbourhoods. Black Britons are less likely to be cautioned, more likely to be charged with an offence and, once in court, more likely to be sent to prison than the white majority. The linchpin for this racial bias is the stop and search powers that Parliament ceded to the police under the Misuse of Drugs Act 1971.
Cocaine Nation Page 30