CHAPTER 1
DRUGS—A LONG AND VARIED HISTORY

Humans have experimented with narcotic and hallucinogenic plants since before recorded history, discovering their properties as they tested plants for edibility or were attracted by the odors of some leaves when these were burned. Ancient cultures used narcotic plants to relieve pain or to heighten pleasure; they used hallucinogenic plants to induce trance-like states during religious ceremonies. Natural substances, used directly or in refined extracts, have also served simply to increase or to dull alertness, to invigorate the body, or to change the mood.

TYPES OF NARCOTICS

Opium

In medicine, and as defined by the Drug Enforcement Administration (DEA), the term "narcotic" refers to opium, opium derivatives, and semi-synthetic substitutes. The word itself comes from the Greek word "torpor," a synonym for lethargy, which in this context means indifference to pain, hardship, and suffering. A plant named Papaver somniferum is the main source of natural narcotics. Records from Mesopotamia (5000-4000 b.c.e.) refer to this plant, the poppy flower. The ancient Greek and Egyptian societies used extracts from the opium poppy to quiet children, among other things. The Greek physician Galen prescribed opium for headaches, deafness, epilepsy, asthma, coughs, fevers, "women's problems," and for melancholy moods. Hippocrates (c. 400 b.c.e.), widely considered the father of modern medicine, used medicinal herbs, including opium. In those days, opium cakes and candles were sold in the streets. The Romans undoubtedly learned of opium during their eastern Mediterranean conquests.

The Islamic civilization preserved the medical arts after the decline of the Roman Empire and by the tenth century had established trade and an interchange of medical knowledge between Persia, China, and India. Laudanum—an alcoholic solution ("tincture") of opium—was introduced by Paracelsus in the sixteenth century and came to be widely used in Europe during the next two hundred years. In the early 1700s a professor of chemistry at the University of Leiden in the Netherlands discovered that a combination of camphor and tincture of opium, called paregoric, was an excellent pain reliever.

In the eighteenth century the British Society of Arts awarded prizes and gold medals for growing the most attractive Papaver somniferum. By the nineteenth century many babies in the United Kingdom were being soothed to sleep with a sleeping preparation containing laudanum. British Prime Minister William Gladstone (1809-98) put laudanum in his coffee so that he could speak better in front of Parliament. British writers Samuel Taylor Coleridge and Elizabeth Barrett Browning were addicted to opiates like laudanum, while author Charles Dickens calmed him-self with opium.

The famed British trader William Jardine considered the sale of opium "the safest and most gentleman-like speculation I am aware of." At the height of the opium trade, the "noble house" of Jardine and his partner had eighteen well-fitted opium clipper ships and fourteen receiving ships along the Chinese coast to help unload opium shipments.

Perhaps because so few other painkillers and therapeutics were available until the nineteenth century, there appears to have been little real concern about excessive use of opium in many parts of the world. An exception was China: in 1729 the Manchu dynasty (1644-1912), in an attempt to discourage the importation and use of opium in that country, passed laws directing that opium dealers be strangled.

Since Great Britain then held a monopoly on the importation of opium into China, the British fought to keep their highly profitable trade. The British defeated the Chinese in the Opium War (1839-42) to guarantee their right to continue to sell opium to the Chinese people. The illegal opium trade that developed in China to avoid tariffs (extra costs imposed by the government) led to gangsterism—not unlike the growth of the crime underworld in the United States when the sale of alcohol was banned during Prohibition (1920-1933).

In 1803 Friedrich Wilhelm Sertürner, a German pharmacist, discovered how to isolate the alkaloid morphine, the primary active agent in opium. Morphine is ten times more potent than opium. The name comes from Morpheus, the Greek god of sleep. In 1832 Pierre-Jean Robiquet, a French chemist, was the first to isolate codeine from opium, another alkaloid but milder than morphine; it came to be used in cough remedies. The development of the hypodermic needle in the early 1850s made it easier to use morphine. It became a common medicine for treating severe pain, such as battlefield injuries. During the American Civil War, so many soldiers became addicted to morphine that the addiction was later called "soldier's disease."

The most potent narcotic hidden within opium, and thus within the poppy, was heroin, first synthesized in 1874 by C. R. Alder Wright at St. Mary's Hospital in London. The medical potential of the drug was not fully realized for another twenty-four years. In 1898 Heinrich Dreser published his findings in Germany on the physiological consequences of what was then still known as diacetylmorphine. The Bayer Company in Eberfeld, Germany, began to market the drug as a cough remedy and painkiller under the brand name Heroin, the word derived from the German word for "heroic," intended to convey the drug's power and potency ("History of Heroin", Office on Drugs and Crime, United Nations, http://www.unodc.org/unodc/bulletin/bulletin_1953-01-01_2_page004.html). The drug was an instant success and was soon exported to twenty-three countries.

Coca

Coca, formally Erythroxylum coca, is a small tree native to tropical mountain regions in Peru and Bolivia; its leaves hold the alkaloid cocaine. The ancient South American rite of burying coca with the dead dates back to about 3000 b.c.e. In ancient times the deceased were buried in a sitting position, wrapped in cloths and surrounded by pottery containing artifacts, maize, and bags of coca to sustain them on their way to the afterlife. Even then, the Incas knew that cocaine, extracted from coca leaves, was capable of producing euphoria, hyperactivity, and hallucinations. After the Spanish conquest, coca was grown on plantations and used as wages to pay workers. The drug seemed to negate the effects of exhaustion and malnutrition, especially at high altitudes. Many South Americans still chew coca leaves to alleviate the effects of high altitudes.

In the 1850s Paolo Mantegazza, an Italian doctor, came to value the restorative powers of coca while living in Lima, Peru. In the late 1850s he published a book praising the drug, which led to interest in coca in the United States and Europe. At that time in Europe the chemist Angelo Mariani extracted cocaine from coca leaves; cough syrup and tonics holding drops of cocaine in solution became very popular ("Mariani's Coca Wine" and "Dr. Mariani's French Tonic"). Pope Leo XIII awarded Mariani a medal for his invention. Thomas Edison, President William McKinley, Jules Verne, and H. G. Wells were among those praising the product (Arthur C. Gibson, Freud's Magical Drug, Los Angeles: University of California, http://www.botgard.ucla.edu/html/botanytextbooks/economicbotany/Erythroxylum/index.html). William Hammond, U.S. surgeon general under President Abraham Lincoln, was impressed with the drug, but most doctors were unsure. Popular response, on the other hand, was very favorable, as extracts from coca leaves appeared in wine, chewing gum, tea, and throat lozenges.

A developing temperance movement helped fuel the public's fondness for nonalcoholic products containing coca. In the mid-1880s Atlanta, Georgia, became one of the first major American cities to forbid the sale of alcohol. It was there that pharmacist John Pemberton first marketed Coca-Cola, a syrup that then contained extracts of both coca and the kola nut, as a "temperance drink."

Most doctors of the time generally felt uncomfortable with cocaine. They were not alone. In 1914, when Congress outlawed the sale of narcotics (with the Harrison Narcotic Act), cocaine, although a stimulant rather than a narcotic, was bundled in legislatively with opium and its derivatives. The government considered cocaine a social danger—particularly among southern African-Americans—rather than a physically dangerous drug.

Hallucinogens

Hallucinogens are drugs that have the ability to alter people's perceptions, sensations, and emotions. Naturally occurring hallucinogens derived from plants have been used by various cultures for magical, religious, recreational, and health-related purposes for thousands of years. For more than two thousand years Native American societies often used such hallucinogens as the psilocybin mushroom of Mexico and the peyote cactus of the Southwest in religious ceremonies. The religious use of peyote has been a matter of legal controversy. Federal law made its use illegal but granted states the right to make exceptions. Several states, including Arizona, Texas, and New Mexico, have allowed its use in certain circumstances, such as when it was used by Native Americans in "bona fide religious rites" or by those who were members of theNative American Church. In 1990 the Supreme Court decided the First Amendment did not guarantee this right, only permitted it. Three years later Congress reinstated the right by overturning portions of the court's decision with the Religious Freedom Restoration Act of 1993 (RFRA). In 1997 the Supreme Court ruled that the RFRA was unconstitutional. Later, a number of states began to allow peyote use under limited conditions.

Although scientists were slow to discover the medicinal possibilities of hallucinogens, by 1919 they had isolated mescaline from the peyote cactus and recognized its resemblance to the adrenal hormone epinephrine (or adrenaline). Research was also done on hallucinogens, particularly the synthetic hallucinogen lysergic acid diethylamide (LSD), for possible use in psychotherapy and treating alcoholism during the 1950s and 1960s, with debatable results.

Cannabis

Cannabis is the term generally applied to the Indian hemp plant Cannabis sativa from which marijuana, bhang, ganja, and hashish are derived. Bhang is equivalent to the U.S.-style marijuana, consisting of the leaves, fruits, and stems of the plant. Ganja is prepared by crushing the flowering tips of cannabis and collecting a resinous paste; ganja and hashish are the same thing, and more potent than marijuana and bhang (Arthur C. Gibson, "The Weed of Controversy" Los Angeles: University of California, http://www.botgard.ucla.edu/html/botanytextbooks/economicbotany/Cannabis/index.html). Cannabis dates back more than five thousand years to central Asia and China; from there it spread to India and the Near East.

Cannabis was highly regarded as a medicinal plant used in folk medicines. It was long valued as an analgesic, topical anesthetic, antispasmodic, antidepressant, appetite stimulant, antiasthmatic, and antibiotic. But by the mid-twentieth century its use as a "recreational drug" had spread, eclipsing its traditional medicinal uses. According to the Almanac of Policy Issues ("Drug Trafficking in the United States," http://www.policyalmanac.org/crime/archive/drug_trafficking.shtml, May 2004), smoking marijuana is by far the most common illicit drug-using activity in the United States. Its medical uses are not forgotten, however, and one argument for the legalization of marijuana is to ease the suffering of patients with cancer, glaucoma, and a number of other conditions.

AVAILABILITY OF DRUGS

In late nineteenth century America it was possible to buy, in a store or by mail order, many medicines (or alleged medicines) containing morphine, cocaine, and even heroin. Until 1903 the soft drink Coca-Cola contained cocaine. The cocaine was later removed and more caffeine (already present in the old drink from the kola nut) was added. Pharmacies sold cocaine in pure form, as well as many drugs made from opium, such as morphine and heroin.

Beginning in 1898 heroin became widely available when the Bayer Company marketed it as a powerful cough suppressant. According to the U.S. Government Office of Technology Assessment ("Technologies for Understanding and Preventing Substance Abuse and Addiction: Appendix A, Drug Control Policy in the United States—Historical Perspectives," http://www.drugtext.org/library/reports/ota/appa.htm), physician prescriptions of these drugs increased from 1% of all prescriptions in 1874 to 20-25% in 1902. These drugs were not only available but also widely used, with little concern for negative health consequences.

Cocaine, heroin, and other drugs were taken off the market for a number of reasons. A growing awareness of the dangers of drug use and food contamination led to the passage of such laws as the Pure Food and Drug Act of 1906 (PL 59-384). Among other things, the act required the removal of false claims from patent medicines. Medical labels also had to state the amount of any narcotic ingredient the medicine contained and whether that medicine was habit-forming. A growing temperance movement, the development of safe, alternative painkillers (such as aspirin), and more alternative medical treatments contributed to the passage of laws limiting drug use, although these laws did not completely outlaw the drugs.

In addition to health-related worries, by the mid- to late 1800s drug use had come to be associated with "undesirables." The term usually included poor Americans, often African-Americans and immigrants, especially from southern Europe and Asia, who were arriving in ever greater numbers in the United States.

In the United States especially, narcotic use was thought to be confined to the poor and disadvantaged, while evidence of use among the wealthier classes was overlooked. When drug users were thought to live only in the slums, drug use was considered solely a criminal problem; but when it was finally recognized in middle-class neighborhoods, it came to be seen as a mental health problem.

By the turn of the century, the use of narcotics was considered an international problem. In 1909 the International Opium Commission met to discuss drugs. This meeting led to the signing of a treaty two years later in the Netherlands, requiring all signatories to pass laws limiting the use of narcotics for medicinal purposes. After nearly three years of debate, Congress in 1914 passed the Harrison Narcotic Act (PL 63-223), which called for the strict control of opium and coca.

REGULATING DRUGS

The passage of the Harrison Narcotic Act reflected, in part, a growing belief that opium and cocaine were medicines to be taken only when a person was sick (and then only when prescribed by a doctor). In addition, many people were beginning to believe that these drugs caused insanity or led to crime, particularly among foreigners and minorities. For example, opium use was strongly associated with Chinese immigrants. Many Americans also believed that cocaine affected African-Americans more powerfully than it did whites, surmising the drug frequently incited the minority group to violence.

"The Cocaine Habit," an article published in 1900 in the Journal of the American Medical Association (vol. 34), claimed that southern African-Americans were the major purchasers of an inexpensive form of cocaine known as the "5-cent sniff." Because temperance laws had led to an increase in the price of alcohol, it was thought that many poor Americans, especially African-Americans, were turning to less expensive drugs. In addition, many observers claimed that the "drug-habit menace" had led to increased crime, particularly among African-Americans.

During the 1920s the federal government regulated drugs through the U.S. Treasury Department. In 1930 President Herbert Hoover created the Federal Bureau of Narcotics, headed by Commissioner of Narcotics Harry J. Anslinger. For the next thirty-two years, Anslinger, believing all drug users were deviant criminals, vigorously enforced the law. Marijuana, for example, was presented as a "killer weed" that threatened the very fabric of American society.

Marijuana was believed to have been brought into the country and promoted by Mexican immigrants and then picked up by African-American jazz musicians. These beliefs played a part in the passage of the 1937 Marijuana Tax Act (PL 75-238), which tried to control the use of marijuana. The act made the use or sale of marijuana without a tax stamp a federal offense. Since by this time the sale of marijuana was illegal in most states, buying a federal tax stamp would alert the police in a particular state to who was selling drugs. Naturally, no marijuana dealer wanted to buy a stamp and expose his or her identity to the police. (The federal tax stamp for gambling serves the same purpose.)

From the 1940s through the 1960s, the Food and Drug Administration (FDA), based on the authority granted by the 1938 Food, Drug, and Cosmetic Act (52 Stat. 1040), began to police the sale of certain drugs. The act had required the FDA to stipulate if specific drugs, such as amphetamines, barbiturates, and sulfa drugs, were safe for self-medication.

After studying most amphetamines and barbiturates, the agency concluded that it simply could not declare them safe for self-medication. Therefore, it ruled that these drugs could only be used under medical supervision—that is, with a physician's prescription. For all pharmaceutical products other than narcotics, this marked the beginning of the distinction between prescription and over-the-counter drugs.

For twenty-five years, undercover FDA inspectors tracked down pharmacists who sold amphetamines and barbiturates without a prescription and doctors who wrote illegal prescriptions. In the 1950s, with the growing sale of amphetamines, barbiturates, and, eventually, LSD and other hallucinogens at cafés, truck stops, flophouses, and weight-reduction salons, and by street-corner pushers, FDA authorities went after these other illegal dealers. In 1968 the drug-enforcement responsibilities of the FDA were transferred to the U.S. Department of Justice.

WAR IS DECLARED

From the mid-1960s to the late 1970s, the demographic profile of drug users changed. Previously, drug use had generally been associated with minorities, lower classes, or young "hippies" and "beatniks." During this period, drug use among middle-class whites became widespread and more generally accepted. Cocaine, an expensive drug, began to be used by middle- and upper-class whites, many of whom looked upon it as a nonaddictive recreational drug and status symbol. Drugs also become much more prevalent in the military, as they were cheap and plentiful in Vietnam.

While drug use gained wider acceptance in some circles, other sectors of the public came to see drugs as a threat to their communities—much as, forty years earlier, alcohol had acquired a negative image, leading to Prohibition. Drugs not only symbolized poverty but were associated with protest movements against the Vietnam War and the "establishment." Many parents began to perceive the widespread availability of drugs as a threat to their children. By the end of the 1960s such views began to acquire a political expression.

When he ran for president in 1968, Richard Nixon included a strong antidrug plank in his law-and-order platform, calling for a "War on Drugs." As president, Nixon created the President's National Commission on Marihuana and Drug Abuse—but ignored its findings, which called for the legalization of marijuana (Marihuana: A Signal of Misunderstanding, Report of the National Commission on Marihuana and Drug Abuse, March 1972, http://www.cognitiveliberty.org/news/schafer.htm). (Marihuana is a variant spelling of marijuana.) Since that time the U.S. government has been waging a war on drugs in some form or another. In 1973 Congress authorized formation of the Drug Enforcement Administration to reduce the supply of drugs. A year later the National Institute on Drug Abuse (NIDA) was created to lead the effort to reduce the demand for drugs and to direct research and federal prevention and treatment services.

Under the Nixon, Ford, and Carter administrations, federal spending tended to emphasize the treatment of drug abusers. Meanwhile, a growing number of parents, fearing that their children were being exposed to drugs, began to pressure elected officials and government agencies to do more about the growing use of drugs. In response, NIDA began widely publicizing the dangers of marijuana and other drugs once thought not to be particularly harmful.

The Reagan administration favored a strict approach to drug use and increased enforcement efforts. The budget to fight drugs rose from $1.5 billion in 1981 to $4.2 billion in 1989. By the end of the Reagan administration, two-thirds of all drug-control funding went for law enforcement and one-third went for treatment and prevention. First Lady Nancy Reagan vigorously campaigned against drug use, urging children to "just say no!" The Crime Control Act of 1984 (PL 98-473) dramatically increased the penalties for drug use and drug trafficking.

CRACK COCAINE

Cocaine use increased dramatically in the 1960s and 1970s, but the drug's high cost restricted its use to the more affluent. In the early 1980s cocaine dealers discovered a way to prepare the cocaine so that it could be smoked in small and inexpensive but very powerful and highly addictive amounts. The creation of this so-called crack cocaine meant that poor people could now afford to use the drug, and a whole new market was opened up. In addition, the AIDS epidemic caused some intravenous (IV) drug users to switch to smoking crack to avoid HIV exposure from sharing needles.

Battles for control of the distribution and sale of the drug led to a violent black market. The easy availability of sophisticated firearms and the huge amounts of money to be made selling crack and other drugs transformed many areas of the nation—but particularly the inner cities—into dangerous places.

The widespread fear of crack cocaine led to increasingly harsh laws and penalties. Authorities warned that crack was instantly addictive and spreading rapidly, and they predicted a subsequent generation of "crack babies," or babies born addicted to crack because their mothers were using it.

HEROIN GETS CHEAPER, PURER

The dangers associated with crack cocaine caused changes in the use of heroin in the 1990s. Many reported deaths from heroin overdosing had lessened the drug's attraction in the 1980s. In addition, heroin had to be injected by syringe, and concerns regarding HIV infection contributed to the dangers of using the drug. In the 1990s an oversupply of heroin, innovations that produced a smokable variety of the drug, and the appearance of purer forms of the drug restored its attractiveness to the relatively small number of people addicted to "hard" drugs. It was no longer necessary to take the drug intravenously—it could be sniffed like cocaine—although many users continued to use needles.

THE WAR GOES ON

The Anti-Drug Abuse Act of 1988 (PL 100-690) created the Office of National Drug Control Policy (ONDCP), to be headed by a director—popularly referred to as the "drug czar"—who would coordinate the nation's drug policy. Federal budget documents indicate that spending for drug control rose from $4.2 billion under President Ronald Reagan to $12.2 billion in the last year of the elder President George Bush's term. As was the case during the Reagan administration, the monetary split was roughly two-thirds for law enforcement and one-third for treatment and prevention. By 1990 every state that had once decriminalized the use of marijuana had repealed those laws.

When he took office in 1993, President Bill Clinton cut the ONDCP staff from 146 to twenty-five, while at the same time raising the director of the ONDCP to cabinet status. Clinton called for one hundred thousand more police officers on the streets and advocated drug treatment on demand. White House budget documents indicate that in 1998 drug-control spending totaled $16.1 billion, with the split remaining at about two-thirds for law enforcement and one-third for treatment and prevention.

Taking office in 2001, President George W. Bush promised to continue national efforts to eradicate illegal drugs in the United States and abroad. On May 10, 2001, Bush appointed John Walters the new drug czar. Together they pledged to continue "an all-out effort to reduce illegal drug use in America," according to the White House news release announcing the appointment. Their proposed goals included increased spending on treatment, intensified work with foreign nations, and an adamant opposition to the legalization of any currently illegal drugs. The Bush administration also wove its antidrug message into its arguments for invading Afghanistan. While Bush's case was built primarily on the notion that Afghanistan's Taliban leaders had harbored terrorist Osama bin Laden, he regularly referred to Afghanistan's role as the world's biggest producer of the opium poppies from which heroin is made.

Over the course of Bush's first term, White House budget documents indicate that federal spending on drug control grew from $9.8 billion to $12.1 billion (it is important to note that in the mid-1990s, changes were made in the list of expenditures included in this tally, making it difficult to analyze historical drug control spending trends), with treatment still accounting for just under one-third of the total.

Questioning the War on Drugs

By 2005 there was considerable controversy surrounding the necessity and effectiveness of the war on drugs. Decades of effort have led to large numbers of people serving prison sentences for manufacturing, selling, or using drugs. And yet the illegal drug trade continued to thrive. Many liberal critics have argued that a different approach is necessary. Even some prominent conservatives and Bush allies, including commentator William F. Buckley and former Secretary of State George Schultz, had begun to question whether illicit drugs were an enemy worth waging war against, especially such a costly war during a time of rapidly rising federal budget deficits.