Illegal Drugs

THE HARM DONE

Drugs Cause Many Problems, But They Need To Be Kept In Perspective

IN A former warehouse under Manhattan bridge in New York, now home to a
therapeutic community run by Phoenix House, 42-year-old Michael talks sadly
of the cost of 30 years on heroin and crack cocaine. "I couldn't see
further than the next bag of dope. I was hustling, shoplifting and getting
high. I couldn't deal with people. I have a 14-year-old son that I could
never look after."

Michael has now been voluntarily at Phoenix House for four months, learning
how to cope with others and with himself. He is well-dressed, articulate
and eager to escape. The desire to be a decent father to his son, coupled
with the skills training and accommodation that Phoenix House provides, may
be just what he needs to kick his habit, get a job and rejoin the human
race. Gabriel has a tougher job ahead: he has been in a clinic in Tijuana,
just south of Mexico's border with the United States, after spending 14 of
his 30 years on methamphetamines. His mother, who once threw him out for
stealing from her, found him ragged and emaciated, and persuaded him to go
for treatment at one of Mexico's very few professionally run clinics. Now
sleek and handsome, he is off drugs. But he will struggle to find work, and
will return to live in the same community where his addiction began.

Many people take drugs because they get pleasure from them. To those who
prefer a glass of burgundy and a cigar, that may seem hard to understand.
It is, however, improbable that so many people would spend so much money on
voluntarily eating, smoking or sniffing drugs if doing so brought them
nothing but misery.

That said, though, abusing drugs undoubtedly wrecks many lives. Once people
become truly dependent, it can take them years to break the cycle. As with
cigarettes, the pleasure then consists mainly of avoiding the pain of
giving up. But the vast majority of drug users end up like neither Michael
nor Gabriel. They go through a period when drugs form part of their lives,
and then they move on. Peter Cohen, of the Centre for Drug Research at the
University of Amsterdam, followed a sample of cocaine users whom he
describes as typical. After ten years, 60% had become completely abstinent
and 40% remained occasional users. "Most drug users ultimately stop," he
says. "Drugs no longer fit their lifestyle. They get jobs, they have to get
up early, they stop going to the disco, they have kids."

The dangers of drugs should not be underestimated, but nor should they be
exaggerated. With the exception of heroin, drugs contribute to far fewer
deaths among their users than either nicotine or alcohol. In America, for
instance, tobacco kills proportionately more smokers than heroin kills its
users, and alcohol kills more drinkers than cocaine kills its devotees.

Consuming a drug is rarely the only cause of death. More often, the user is
taking some extra risk. That is true even for heroin. The European
Monitoring Centre for Drugs and Drug Addiction (EMCDDA), which collects and
analyses European statistics, reports that the mortality rate for people
who inject heroin is two to four times as high as that for non-injectors,
mainly because of the danger of contracting HIV or hepatitis from dirty
needles.

"Acute deaths related solely to cocaine, amphetamines or ecstasy are
unusual," says the EMCDDA in a recent report, "despite the publicity they
receive." Dr van Brussel, the addiction care expert, agrees: "We have about
100 deaths a year from heroin addiction in the Netherlands," he says, "but
only one or two from cocaine." Even though much of the world's ecstasy
passes through the Netherlands, the country has only one death a year of a
person with ecstasy in his bloodstream. Even then, it is rarely clear that
ecstasy (MDMA) alone is the killer. According to Charles Grob, a professor
at the UCLA School of Medicine, people who take MDMA incur health risks
mainly if they are already unfit. He recalls one man, who had experienced
no previous problems with ecstasy, whose blood pressure began to rise
alarmingly after taking it. It transpired that he had stayed at a friend's
house, and used an asthma inhaler because he was allergic to his friend's
cat. It was the combination of substances that had caused the trouble.

Even drugs that do not kill people may still hurt them. More and more
evidence suggests that drugs may affect brain activity. Some even hint that
marijuana, regarded by its fans as safer than sugar doughnuts (and less
addictive), may do damage. A study recently reported in the American Heart
Association's journal suggested that for middle-aged people the risk of a
heart attack rose by nearly five times in the first hour after smoking
marijuana.

But the overall impression remains that, in the words of the Lancet, a
British medical journal, "It would be reasonable to judge cannabis less of
a threat than alcohol or tobacco...On the medical evidence available,
moderate indulgence in cannabis has little ill-effect on health."

Whereas some drugs harm people's health, some may also do good. Hospitals
still use heroin derivatives to treat pain. They cannot usually prescribe
marijuana, even though a study published by the Institute of Medicine in
1999 suggested that marijuana could help to treat nausea, loss of appetite,
pain and anxiety. In America, such findings have turned medical marijuana

into the main issue in the campaign to soften the law on drugs.

Health apart, drugs cause other kinds of harm--not just to the individual
user but to society at large. Crack cocaine seems to be linked to domestic
violence, marijuana makes workers groggy, no drug is good for motorists.
And some people who use drugs heavily--"chaotic" drug users - are
disproportionately likely to commit crimes. A mere 5,000 of the country's
estimated 25,000 hard-drug addicts are responsible for about half of all
petty crimes committed in the Netherlands, guesses Bob Keizer, drugs policy
adviser to the Dutch Ministry of Health.

Crime and chaos Given the expense of a heavy habit, petty crime is an
obvious income source. However, Michael Hough, director of the Criminal
Policy Research Unit at the University of the South Bank in London,
believes that the link is not simple. Rather, the sort of person who
becomes a "chaotic" drug user is also disproportionately likely already to
be an "acquisitive offender": a thief, shoplifter (the addict's crime of
choice) or burglar. "The preconditions for starting on heroin are to be a
risk-taker, and to have quite a bit of money," he says. He points to a
study of people arrested in Britain, by Trevor Bennett of Cambridge
University, which calculated that the cost of consuming heroin and crack
accounted for 32% of criminal activity.

Where drug use directly harms society, government is right to intervene.
But the best way to protect society is not necessarily to ban drugs. If
that were the right course, governments would begin by banning alcohol,
which causes far more aggression and misbehaviour than any other substance,
licit or illicit. Instead, governments everywhere pursue tougher policies
against drugs, some of which are more harmful than the drugs themselves.

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