A Sale of Two Toxicities

Originally submitted to a Latin American Studies course in April 2012. Flaws: egregiously conflates MDMA with the “methamphetamine” that makes up the MA half of its abbreviation (the statement containing the conflation in question is true, but requires further documentation); mentions coca leaves in a section where powdered cocaine would be more appropriate; relies on some dated sources (though for their specificity/breadth/depth they were the most current compendia available); in places is underdeveloped in argumentation based on statistics; generally approaches, perhaps, too many facets of an enormous issue without quite the required plethora of examples and explorations. What is really needed, probably is an updated version of the amazing Consumers’ Union tome – many hundreds of pages long – heavily relied upon for this essay. Acknowledgments go to my housemate for providing me with the book containing the fact about Escobar and to an economics professor for speaking in his micro course about the theories and realities of competition and monopoly as well as the supply curves of heroin, thus providing some of my inspiration for this topic.

“Drug” is one of those words in language like “love” and “good” whose monosyllabic directness and discursive ubiquity belies an extremely relativistic and contentious interpretability. Drugs can have positive and negative effects, can be a public safety menace and vital to social healthcare practices, can be addictive, prescribed in daily doses, used as needed or as desired on special occasions, and can be a means to escape reality or to recover stability within it, so it is difficult to conceive of a human activity or human-consumed substance that could not be deemed a drug by falling into one of these categories. This malleability of meaning is important to bear in mind when examining the twin mammoth entities to which most conversational consensus has affixed the label of “drug industry.” As the definition of a drug itself is somewhat arbitrary, any justification made for the distinction between legal and illegal drugs should not go unquestioned. While the illegal industry of trafficking scheduled drugs is naturally framed for the public eye by legislators and sanctioned commentators as a destructive scourge, in contrast to the advocacy of institutional treatments using legal pharmaceuticals through frequently televised and printed endorsements, the reality of the two businesses is much more complex. Not only are the specific effects of drugs on their users often at odds with general perception, variances in methods and effects of regulation have paradoxical consequences, appearances of particular business models imply a defiance of popular economic parlance and traditional views, and ultimate societal impact in many cases runs contrary to – or is much more complicated than – common beliefs. Communities all across the world, and especially in Latin America, where many of the world’s fiercest drug wars are being fought, witness a broader picture of international drug policies that prompts a serious reconsideration of current enforcement tactics and philosophy.

Widespread use of illegal drugs in the United States is typically cause for fear, dismay and often sensationalistic hyperbole among the public. Heroin and crack-cocaine usage patterns are described as epidemics, and even state/city-legalized medical marijuana dispensaries (and, in 2012, substance-free institutions for cultivational/economic marijuana education) are targeted by federal police forces for raids and shutdowns. However, since at least as far back as 1972, those who study these illegal substances find surprisingly little justification in the drugs’ effects for the predominant attitude toward them. A Consumers Union report on legal and illegal drugs found that the overall effects of heroin on the body and mind of the user are “amazingly bland:” psychoses, mental deterioration and brain damage are no more common among addicts than other people (Brecher 25-27). Effects of illegal substances on childbirth, though a common element of disapproving discourse, are often vastly overstated and attributable to other factors in the lives of drug users. Poverty and malnutrition can readily account for the alleged symptoms of “addicted” babies born to heroin users (Brecher 29-31); for so-called “crack babies,” a 1998 report found that “‘we have few data to warrant the alarm that grew out of earlier reports, often fueled by the media, of the possible devastating effects of prenatal cocaine-exposure’” (Mundell). Though it is commonplace in films and on television shows to hear of characters dying from heroin overdose, there is no paper in scientific literature that attributes an overdose as cause of death to a heroin addict; any coroners’ reports which so attribute heroin overdose more precisely mean “death from unknown causes after injecting heroin” (Brecher 106). In fact, the Consumers Union report suggests that most supposed deaths from heroin overdose are the result of combinations of alcohol or barbiturate use with heroin intake, combinations generally avoided out of common sense and experience by most addicts until being convinced of the “heroin overdose” explanation for death (Brecher 111).

Other substances which are also outlawed but have somewhat less feared of a public image are similarly overstated with regard to their negative effects. Among marijuana users, there have been no recorded deaths due to toxicity, no indication of the supposed “amotivational syndrome” which is “now generally discounted,” no effect on fertility, natal chromosomes or genetic codes, and no mental impairment demonstrated that leads to increased danger when performing tasks such as operating a motor vehicle except when other drugs (such as alcohol) are involved (“Chapter 4”). There is no evidence that marijuana causes psychoses or other such adverse mental reactions, nor is there conclusive evidence that it creates physical dependencies (Brecher 460-461). Chewing coca leaves, or drinking tea or other beverages derived therefrom, is no “more damaging to mind or body than the drinking of coffee or tea” (Brecher 271). Psychedelics are often cause for horror stories in the media and government statements, but there too the deleterious effects appear vastly overstated beyond proportion. The Consumers Union report states of peyote that “one bad reaction per 70,000 ingestions” is “probably overestimated” (Brecher 342). The Dutch Coordination Centre for the Assessment of New Drugs found in a 2000 report that using hallucinogenic mushrooms “does not, on balance, present any risk to the health of the individual” (Netherlands). LSD has a more popular and storied history, its use preceding on some occasions (though not proven to cause) severe seizures, but similarly, “experts in the fields of hallucinogens and forensic toxicology are doubtful that LSD could be the sole cause of someone’s death. The scientific literature on the subject is just too scant” (Weeks). Even with ecstasy (MDMA) and other methamphetamines, though there is ongoing scientific inquiry as to their neurotoxicity, “serious acute adverse effects seem rare” and long-term changes in behavior “have been seldom detected and are fairly subtle when they are found” (Baggott). While there are obvious health risks involved in using illegal drugs, and research is still taking place to find further information, current data and research indicates that much less alarm is appropriate among the populace than that which is typically fomented.

In sharp contrast to the relatively mild effects of the feared drugs mentioned above, those substances which are legal and infrequently labeled “drugs” have comparatively startling, well-documented and scientifically accepted negative consequences. While it is “crack babies” or heroin-addicted infants that seem to generate the greatest amount of terror in news reports, a 1978 paper on fetal alcohol syndrome – “specific patterns of growth deficiencies, facial features and brain damage” among babies born to alcoholic mothers – described it as “’the most frequently known teratogenic [i.e. creating fetus malformation] cause of mental deficiency in the Western world’” (Gelernter). Smokers of tobacco “‘have two or three times as many premature babies… one in five of babies lost would have been saved if their mothers had not smoked’” (Brecher 233). Long-term physical and mental impairments and deaths of adults caused by tobacco and alcohol are uncontroversial, incontrovertible and likewise far beyond anything attributed to illegal substances. Alcohol addiction – unlike opiate addiction – is decidedly detrimental to the brain, leading to intellectual and emotional deterioration, convulsions and psychosis (Brecher 26). Also unlike opiate addiction, alcoholism “is utterly destructive to the human mind;” 22% of male first admissions to state mental hospitals in 1964 were alcoholics, 29% of general hospitals’ medical-surgical wards’ consecutive male admissions identified problem drinkers, 40% of all arrests in 1965 were for being drunk in public or DUI, and large percentages compose the perpetrators and victims of homicide, including the majority of stabbings, beatings and shootings in Philadelphia (Brecher 261-262).

Conclusive evidence says cigarette-smoking is by far the most important cause of lung cancer, and a major factor in coronary heart disease, chronic bronchitis, emphysema, and other serious conditions; “[f]rom 250,000 to 300,000 smokers a year go right on dying prematurely as a result of their smoking” (Brecher 232-243). Caffeine, generally regarded as mild and socially mundane, produces desirable effects similar to cocaine/amphetamines, with the same side effects of withdrawal, agitation, and negative symptoms as those other drugs (Brecher 199-206). When “‘[c]igarette smoking is unquestionably more damaging to the human body than heroin,’” (Brecher 25), no substance except tobacco “known to man is used with such remarkable frequency” (223), “70% of adolescents who smoke more than one cigarette “continue smoking for the next 40 years” (224), and “even in schools where marijuana use is widespread, alcohol remains the major drug problem among high-school seniors” (428), clearly the priorities and formulations of drug legality are subject to something other than informed, rational analysis of the drugs themselves.

While few believe that tobacco and alcohol are suitable for treating medical conditions, the drugs which are manufactured by pharmaceutical corporations to do so carry a certain authority and weight due to the important role they are given within hospitals and in everyday treatments. However, many serious side effects are caused by substances which are endorsed by national regulatory agencies and prescribed by the very people assigned to protect public health, often in shocking excess of anything wrought by illegal drugs. Thalidomide, a drug manufactured and sold between 1957 and 1961 by a German pharmaceutical company to treat (among other things) morning sickness, resulted in 10,000 birth defects internationally, in which infants were born with “flippers” for arms and legs, in many cases dying (Law 95). Vioxx, an antiarthritic drug sold by Merck between 1999 and 2004 to at least 2 million people – receiving $2.5 billion in sales in 2003 – was found to double users’ risk of heart attacks and strokes (Angell 265). 15 in 1000 suffered these “side effects,” leading to a “death toll equivalent to two or three jumbo jets falling out of the sky every week” (Law 91-101). Cyclooxygenase-2 inhibitors such as Vioxx “have probably caused tens of thousands of heart attacks and strokes among the millions of people who have taken them regularly” (Angell 276). These and other legal drugs specifically intended to treat physical ailments have physical consequences that in their profound destructive force largely overshadow those problems on the body associated with illegal substances.

In the field of psychiatry, too, drugs which are regulated and advocated by the most esteemed public health institutions to improve the mental lives of patients can have terribly contradictory results. Certain antidepressants have been found to exacerbate depression and other mental health problems; Eli Lilly, the maker of Prozac, was forced to settle a lawsuit pertaining to the 1989 shooting of 20 people – with eight killed, including the gunman – by Joseph Thomas Wesbecker, who had been prescribed the drug by a psychiatrist (Law 110). One medical expert even goes as far as saying that “‘[e]very single school shooting can be traced to the use of [SSRIs]’” – the class of medication to which Prozac and other drugs like Paxil belong (Law 112). Following an outcry in the United Kingdom, instructions for the latter – marketed there as Seroxat – was quickly and tremendously revised by GlaxoSmithKline from a 1-in-500 risk for withdrawal to a risk of 1-in-4 (Law 116). Crimes of this gravity, and drastic perception shifts in safety of this kind, are foreign to the respective influence and research of illegal drugs.

Journalist and author John G. Fuller notes of aspirin, one of the most commonplace drugs, that in 1972 no label contained warnings for the blood loss, gastrointestinal bleeding or ulceration it was even then known to cause, and that it “is the leading cause of drug-induced, accidental, fatal poisoning in children” (271), and goes on to say of pharmaceuticals that there are “15,000,000 hospital visits each year from drug side effects” (298). To emphasize the current difference in negative incidences between the types of drugs from the two industries, in 2009, 77.1% of 4.6 million U.S. drug-related emergency room visits involved the use of pharmaceuticals (including almost 50% for those “taken as prescribed”), compared with 22.1% involving illicit drugs, much of which is probably included in the 14.7% involving alcohol and “other drugs” – statistics for alcohol use alone are not recorded and are assumed to be much greater (“InfoFacts”). The same report shows that hospitalizations due to pharmaceuticals, whether used as prescribed or not, have increased at a rate faster than that of total drug-related hospitalizations over a five-year period, indicating that legitimately manufactured substances are an increasingly greater risk. Fuller makes reference in his 1972 book to a well-known muckraking book from the 1930s, stating of the largely unmitigated ability on the part of large corporations to essentially experiment on the public, “Today, nearly forty years later, the situation is worse, not better” (10). Based on the continuation of frequent, serious and apparently expanding health concerns resulting from legal substances, it seems accurate to update his statement for the forty years that have now passed since his work.

Perhaps the most disheartening part of the damaging effects wreaked by legal and legitimized pharmaceuticals is the failure and corruption of the regulatory apparatus tasked with ensuring proper treatment and protecting the public from potential dangers. According to Fuller, 85% of a sample of 400 of over 100,000 over-the-counter drugs “have not shown adequate evidence to be considered ‘effective for their intended use’” by the National Academy of Sciences (NAS) (276). A more recent study of SSRIs found that 56% of users were taking the drugs for conditions not approved by the FDA (Law 105). One Dr. Burack, an authority on pharmacology and internal medicine, tells Fuller of the interference of big business on pricing, efficacy and regulation: “‘The question is not should we abolish brand names and use generic names, but when?… I think it’s obvious that the top echelons of the FDA [Food and Drug Administration] are controlled by the pharmaceutical companies’” (299). Even prominent regulators, some belonging to the same board that found so many drugs ineffective, are subject to double dealings: “One NAS panel head has admitted to being on the payroll of three giant drug corporations: SmithKline & French, Burroughs Wellcome, and Merck, Sharpe & Dohme. This is a financial conflict of interest he never saw fit to divulge to the FDA” (Fuller 301). Lest the fact that Fuller published his book in the 1970s lead to the suspicion that his findings are outdated, findings from post-2000 research bolster his evidence and provide even more flagrant examples of compromised regulatory practices.

The highest levels of the executive and legislative branches of the United States government are closely intertwined with the influence – and often, the direct presence – of major pharmaceutical companies. George H. W. Bush held a seat on Eli Lilly’s board of directors and Donald Rumsfeld served as CEO and presiding chairman of G.D. Searle between his work within political administrations (Angell 202). While Bush and Rumsfeld are noted Republicans, President Obama, a Democrat, is also intimately linked to the industry. Peter Schweizer describes prominent sources of his funding: “[A]mong President Obama’s biggest financial backers are precisely the Big Pharma companies who benefit from the mandate.  Sally Sussman, head of government affairs for Pfizer, is one of his biggest campaign bundlers.” The mandate to which Schweizer refers is the recent requirement that insurance companies cover contraceptives, of which Pfizer offers several varieties, while the president’s health care reform bill – which expands the amount of those insured by 30 million – produces similar business gains for all manner of pharmaceuticals. In 2002, the industry spent $91 million on lobbying legislators, with more than one lobbyist per Congressman (Angell 198); since Obama took office, it has spent $695 million – an average of roughly $230 million per year of his term – which is in excess of the combined efforts of financial institutions and gas and oil companies (Schweizer).

Pharmaceutical industry spending and influence in the US and elsewhere covers all levels of society, however, not merely the lawmakers and executors. Companies now pay fees of $310,000 per new drug application to the FDA, which amounts to a full half of its evaluation center’s budget, and over the decade following the initiation of this practice a record thirteen different drugs were withdrawn from the market for causing hundreds of deaths (Angell 209). In 92% of FDA hearings, at least one member has a financial conflict of interest, and in 55% this is true of half or more members (Angell 210); in the case of the previously mentioned Vioxx, four of six members – including the chairman – of the advisory committee meeting that approved it had a conflict of interest (269). This problem is international: the CEO of the UK’s Medicines and Healthcare products Regulatory Agency stated in 2004 that the MHRA was “100% funded by industry,” and an estimate for Sweden’s equivalent regulatory board is 95% (Law 98). With regard to the knowledge of practicing physicians, Angell declares that “[t]here is no question that [the industry] influences educational content (250). The money spent on lobbying politicians is relatively trivial in comparison to that spent on drug promotion among physicians, which recently approximated $5.5 billion per year, more than all US medical schools spend to educate students (Law 90-91). Effectively all of the most trusted and responsible authorities on drug use and regulation in industrialized nations are recipients of funds from the pharmaceutical industry, rather unlike the industry of the much-maligned illicit drugs that appear to bear the brunt of “public menace” criticism.

Certainly not exempt from its own version of lobbying is the general purchasing public, which frequently watches, hears and reads the many advertisements of legal drug manufacturers – though these are often produced at an equivalent expense with other, potentially more important, routes for spending, and with the help of disingenuous tactics. Vioxx, for instance, featured in an advertising campaign costing $160 million, a sum of money much greater than a trial testing side effects would have been (and, as Angell notes, not even close to the sum spent marketing the drug to physicians) (271). On multiple occasions, seemingly innocuous interviews of celebrities on television talk shows and news programs feature endorsements of pharmaceuticals in the context of regular conversation, and the famous figures receive payment for such “stealth ads” without disclosing the fact (Angell 117). Studies and articles on drugs which are reported in journals and mass media outlets are sometimes prepared by the very companies producing the drugs, which then pay supposed academic “authors” to sign them (Angell 159). Even the “free” samples so common to doctors’ offices and dispensed readily to patients are not genuinely free, since their actual cost is merely added to the ultimate price of the drug in the marketplace (Angel 115). Again, the general populace is typically subject to one-sided ringing endorsements, both in the news and in commercials, from only one of the two drug industries, so the incongruity between realities and public attitudes is understandable.

In Latin America, where battles against illegal drug trafficking have long been waged, regulation of legally permitted and institutionalized pharmaceuticals appears even more unscrupulous because regulation is often much less stringent. Milton Silverman describes in 1976 – though since the domestic situation has remained the same or worsened since the aforementioned works on 1970s American policy, continuation of trends elsewhere seems probable – the relatively lax standards of Central and South American national policies with regard to legal drugs: “In Colombia, at least until recently, government control of information supplied by the [pharmaceutical] companies to physicians has been minimal. A similar situation has long existed in Ecuador. Practically no control over medical advertising and promotion has been exercised by the Central American countries” (4). Health benefit claims of drugs are overstated and risks are underplayed, just they are in the developed world, but many which require a doctor’s prescription in the US and Europe are often sold over-the-counter in Latin Americans without any such requirement (Silverman 6). Similar to the common product disclaimer that a particular item is “known to the state of California to cause cancer,” many pharmaceuticals seem to have negative effects only known to the United States or industrialized countries, though dissimilarly no such warning is given to Latin American users.

Chloramphenicol, whose usage is restricted in the US for serious infections when other drugs fail because of the risk of blood diseases, is promoted as having many more possible uses for Latin American countries, with few or no warnings/adverse reactions mentioned (Silverman 10-11). In Mexico, 1 in 1000 admitted to pediatric hospitals for over 48 hours w/ aplastic anemia had taken chloramphenicol, and 30% died within 2 months of diagnosis (Silverman 128). Indomethacin, an antiarthritic drug produced by Merck, is known to be toxic with many side effects, which occur in 35-40% of patients and subsequently lend the drug few indications (drug-treatment-justifying illnesses) in the US; however, many more indications are listed in Latin America, even for “fever” (Silverman 35-37). Antidepressants also come with much more warning in the US, as possible effects include birth defects and heart attacks, but which go unmentioned in Latin American countries. (Silverman 78-80). These drugs are of the same types as those described earlier that have occasionally produced horrendous results, but differences in international standards allow for greater leeway in promotion of sales in different markets. “The power of governments over multinational corporations in the developing nations is exceedingly weak and ineffective” (116), Silverman summarizes, as not only is the health care system much less regulated in Latin America, so are the legal and economic systems.

“Country of origin” laws prohibit the sale of pharmaceuticals within Latin America that are not approved by the regulating bodies of the countries in which the drugs are manufactured, but US companies can skirt this restriction using a technique whereby a product removed from the domestic market by the FDA can be sold in Latin America by simply opening a plant there: the drug’s country of origin is no longer the US, so its sale is permissible (Silverman 117). In Latin America “‘it is unthinkable for anyone to sue a doctor for malpractice. Physicians in these countries do not carry malpractice insurance,’” and therefore companies are not sued for death or injury as they would be in first-world countries (Silverman 118-119). Transnational drug companies, Silverman adds, use unfair trade practices to boost their net gains from Latin America: “Overpricing imports and underpricing exports are good ways to repatriate more profits than the local government allows,” and foreign sales increased 1000% over the 20 years between 1955 and 1974 to $5 billion (119-120). The lobbying of physicians seems even more extreme in Latin America than in the US: there is, according to Silverman’s 1976 findings, a roughly 1-to-3 ratio of visitadores (drug salesmen) to physicians in Central America and Mexico, and the visitadores are paid more than the average physician (122). Silverman states that ‘“U.S. manufacturers would be put to shame if the U.S. public knew how they were promoting their products in Latin America” (131).

One of the more interesting aspects of the public and official attitude toward the legal and illegal drug trades is the notable discrepancy between ideologically affirmed beliefs in free trade and competitive markets and the effective consequences of distinct policies relating to the two industries. While the term “cartel” is almost reflexively attached to illegal drug gangs, it is actually the pharmaceutical industry that appears far more anticompetitive and able to monopolize its products. Illegal drug trafficking deals largely with goods that are natural resources (coca leaves, marijuana, opium poppies, mushrooms, etc.), and as a result, in economic terminology, the production side of the industry at least has few “barriers to entry,” meaning “competition will not be reduced” (“Policy”). Marcia Angell finds that, by contrast, the pharmaceutical industry contains significant barriers to entry that fuel its vast profits: “Instead of being a free market success story, it lives off government-funded research and monopoly rights” (20). Few people on the street have access to the laboratories and research capabilities, and where there are such “insurmountable” barriers to entry, “[c]onsumer welfare can obviously suffer” from “monopoly-level pricing” (“Policy”); indeed, the Federal Trade Commission documented anticompetitive behavior in the industry in 2002 (Angell 190).

Drug corporations are able to achieve uniquely astronomical levels of profit largely because of the ability to patent and monopolize their widely sold chemical products. The passage by the US Congress of the 1984 Hatch-Waxman Act enacted a series of laws extending from eight years to fourteen “monopoly rights for brand-name drugs. Exclusivity is the lifeblood of the industry because it means that no other company may sell the drug for a set period,” even though it “flies in the face of all [of Big Pharma’s] rhetoric about the free market” (Angell 9-10). There are many commonplace tactics employed to extend even these significant privileges: companies may receive a series of exclusive patents on the same drug for different uses, even when those uses are not FDA-approved; performing tests with children results in an additional six months of exclusivity; lawsuits brought by generic companies prompt a 30-month delay of the monopoly as the case is heard, and if successful the suing company receives its own 6-month period of exclusivity for being the first to bring charges, which is occasionally cause for collusion between a large corporation and a particular generic brand (Angell 179-183). In addition, pharmaceutical companies are opposed to relaxation of patent law in Third World for HIV/AIDS medications, thereby maintaining larger revenues (Angell 206-207).

These revenues and profits set the legal drug industry well apart from most of the rest of big business. Prescription drug profits stand at $200 billion a year domestically and $400 billion worldwide, the “most profitable in the United States – by a long shot” since the early 1980s – and these values only reflect direct sales to consumers, meaning they do not include drugs administered in hospitals, nursing homes, or offices (Angell 3-5). Prescription medications gain 18% profits on sales, compared with a median value of 3.3% for all other Fortune 500 companies, above even commercial banking (13.5%); the combined profits for the 10 drug companies listed were greater than the profits for all the other 490 firms combined in 2002 (Angell 11). According to rudimentary economic theory, however, “[i]n competitive markets, a company will make zero economic profits in the long run;” other firms will enter the arena to sell the same product and eventually eliminate all revenues above what is needed to keep the business operating (“Perfect”). Evidently drug companies (like other consistently profitable businesses) are far from competitive, giving credence to Fuller’s claim that “[i]n all the major industries, free enterprise is a farce” (303). The reality that such profiteering overlooks, according to Fuller, is that a small array of generic drugs is sufficient for 99% of patients who come to a doctor (299).

The lucrative gains within black-market drug business are essentially guaranteed by virtue of methods of international enforcement policy, which has memorable historical precedence. Prohibition of alcohol in the US in the 1930s was totally ineffective and harmful, creating powerful violent syndicates (Brecher 265-266); now, in fighting to destroy the foreign syndicates of those drugs which are still prohibited, many smaller and harder-to-detect groups have been created (Youngers 7). Because opiates like heroin create physical addictions, demand for such drugs is “inelastic – prices have no effect on consumption;” what attempts to control smuggling of such drugs, then, actually do “is to discourage an increase in the supply and thus to help maintain high prices” (Brecher 93-94). Any financial “loss due to interception of smuggled consignments remains trivial in comparison to the total markup” (Brecher 303). Law enforcement limitation of amphetamine production prevents market saturation (thus keeping its price elevated) and feeds the market for cocaine, which grew “‘by leaps and bounds’” during the amphetamine crackdowns of the 1960s (Brecher 302-305); furthermore, at least at the time of Fuller’s book, “[n]early 40 percent of the amphetamine pill production in the [US] cannot be accounted for” (274). US enforcement strategy, if not in service of illegal drug trafficking organizations, demonstrates incredibly uninformed judgment about their economics which supports the industry rather than undoing it.

This “overwhelming proportion of anxiety and concern on a very small corner of the drug scene” not only helps to reinforce that corner but to further harm those with much lesser power, including those for whom it is assumedly waging the drug war (Brecher 480). In a remarkable statement, the Consumers Union report definitively asserts that it is policy that does the greatest harm to illegal drug users: “By far the most serious deleterious effects of being a narcotics addict in the United States today are the risks of arrest and imprisonment, infectious disease, and impoverishment – all traceable to the narcotics laws, to vigorous enforcement of those laws, and to the resulting excessive black-market prices for narcotics” (Brecher 22). Support is indirectly given to the largest suppliers, as government surveillance allows established importers to give tips that catch newcomers and maintain current distribution and price controls (Brecher 93). While the stated goal of much enforcement is to limit supply and therefore usage of particular substances, domestic levels of cocaine (as well as heroin) increased such that prices dropped for both during the 1980s (Youngers 8). Enforcement of possession, which focuses on lowest-level offenders, imprisons a large amount of the populace and comes at a cost far greater than any possible benefit, effectively serving as part of the problem (Brecher 468).

Minorities within the US, who have historically had difficulties with assimilation and equal treatment, are frequently the effective targets of antidrug legislation and enforcement. “Prior to the Marijuana Tax Act,” James and Johnson state, “‘poor, segregated minority groups, especially Mexican-Americans and urban Negroes, used marijuana’s consciousness-expanding properties as an economical euphoriant;’” its production being far cheaper (and, in the case of Mexican-Americans, more agriculturally familiar) than the fermentation of alcohol (60). Antimarijuana legislation was opposed from the beginning by the Journal of the American Medical Association, but greater factors than health risks led to the criminalization of a popular substance among minorities (Brecher 417). Investigative journalist Gary Webb’s landmark report on the introduction of crack cocaine into American inner cities in the 1980s found that the initial chief supplier was funneling profits toward the Central Intelligence Agency-supported Contra forces fighting against the Sandinistas in Nicaragua, thereby supporting both the illegal cocaine industry in Colombia and the newfound drug habits of minorities in urban ghettos, “as black America is still struggling with [crack’s] poisonous side effects.” This development likely fostered the current trends toward minority involvement in the illegal drug trade: “Retail distribution and sale of cocaine in New York City are controlled by Latino and African American gang members under eighteen years of age” (James 125). Modern popular television serial dramas ranging from CSI to The Wire and recent films like Precious and Pariah capture the resulting hardships and ravaged environments experienced by poor minorities, which is encouraging in its recognition but potentially alarming in its expected, increasingly commonplace, presentation.

Socioeconomic effects of the drug war upon Latin American countries are unfortunately much more extensive and profound than most related concerns within the United States. Political violence and corruption as well as social and environmental damage (such as aerial fumigation of Colombian coca crops, the spray of which carries over into communities and diverse and endangered natural habitats like national parks) are negatively impacted by enforcement strategies that favor militarization of security forces over economic aid (Youngers 8). Bolivian farmers, for instance, are often economically dependent on farming subsistence levels of coca, and do not feel that they can trust government promises to replace eradicated crops, while economic aid from the US is typically contingent on strict enforcement of coca eradication, a common situation throughout South America that generates unrest and violence (Youngers 177-178). Furthermore, these efforts appear to be in vain: since the launch of the 1989 Andean Initiative, contrary to stated goals the “global and regional scope of the drug trade has expanded significantly;” coca production has remained steady, with no evidence of meaningful reduction in US cities (Youngers 4-5).

A telling piece of trivia illustrates the vast ironies and contradictions of the worldwide approach to drugs: Pablo Escobar, the onetime notorious leader of Colombia’s Medellín drug empire, “learned how the U.S. markets worked” through a job he held earlier in his life as “a cigarette salesman for Philip Morris in Panama” (Lunde 185). While Escobar was widely feared and hated and died a violent death at the hands of authorities, Philip Morris and its many employees continue openly selling the legal cigarettes that public health officials and investigators acknowledge kill hundreds of thousands of people per year, a toll far beyond even the collateral damages (i.e. deaths largely attributable to illegality) from the drug war. In an absurd paradox, the most highly-regulated and putatively scientifically-supported drugs to which ill patients entrust their lives and wellbeing frequently have “side effects” that put most shunned and untouchable illegal drugs to shame, and it is the illegality of the latter drugs that accounts for most of their negative effects. The deep implications of this are both unnerving and liberating: regulation and policy are not well-reasoned judgments but, on the contrary, the written permissions granted to the powerful to defy reason, which creates an unsettling distrust in authority along with a reinforced trust in direct experience and engagement with life and the community. Were the market truly free within countries and across borders, the unimpeded flow of information would render ridiculous the uninformed pronouncements and decisions of media figures and public officials, and substances with a known and trusted history of relative safety that are easy to produce and distribute would be favored over experimental chemicals whose proper research is blocked and avoided and that are controlled by small groups of people. For while the latter often involves the literal sale of toxicity, the former would immediately cease to exist if it did the same – as there is no framework established by the voice of authority to challenge the findings of everyday people – and thus that officious framework strives more for the sale of illegal drugs as toxicity. There is always much to question and much to learn, and analysis of how the world deals with simple words with far-reaching implications, like “drugs,” serves as a reminder that those eager to provide the simple answers are too often dead wrong.

Works Cited

Angell, Marcia. The Truth About the Drug Companies: How They Deceive Us and What to Do About it. New York: Random House, 2005. Print.

Baggott, Matthew, and John Mendelson. “Does MDMA Cause Brain Damage?” Ecstasy: The Complete Guide: A Comprehensive Look at the Risks and Benefits of MDMA. Ed. Julie Holland. Rochester, VT: Park Street Press, 2001. Erowid. Web. 10 Apr. 2012.

Brecher, Edward M., et al., eds. Licit & Illicit Drugs: The Consumers Union Report on Narcotics, Stimulants, Depressants, Inhalants, Hallucinogens, and Marijuana – including Caffeine, Nicotine, and Alcohol. Boston: Little, Brown, 1972. Print.

“Chapter 4 Toxic Effects of Cannabis and Cannabinoids: Review of the Evidence.” House of Lords Select Committee on Science and Technology Ninth Report 4 Nov. 1998: n. pag. Erowid. Web. 10 Apr. 2012.

Fuller, John G. 200,000,000 Guinea Pigs. New York: G.P. Putnam’s Sons, 1972. Print.

Gelernter, Carey Quan. “Research Uncovered Fetal Alcohol Syndrome.” San Diego Union Tribune 18 Jan. 2007: n. pag. Erowid. Web. 10 Apr. 2012.

“InfoFacts: Drug-Related Hospital Emergency Room Visits.” National Institute on Drug Abuse. National Institutes of Health, May 2011. Web. 10 Apr. 2012.

James, William H. and Stephen L. Johnson. Doin’ Drugs: Patterns of African American Addiction. Austin: University of Texas, 1996. Print.

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