FINE LINES

The most frustrating part of the interminable debate about the "war on
drugs" is the word "drugs." Strictly speaking, after all, there is no war
on drugs in this country; there is a war on some drugs.

America boasts a vast legitimate pharmaceutical industry, and personal
expenditures on its products go up every year. Very, very few of us go even
a week without taking some kind of drug, be it an over-the-counter cold
medicine, a doctor-prescribed medication, or a self-medicated legal
substance--a cigarette, a shot of tequila, a double espresso, a McFlurry.
And the variety and sophistication of these substances are growing as fast
as their use. Do you remember the day when you could simply ask for a cup
of coffee and no further elaboration was required? The salient question
behind the "drug" war, then, is not simply the usual
libertarian-authoritarian conundrum.

It's much simpler: What is the criterion that makes one drug the object of
a "war" in which millions are incarcerated for illegal use and another drug
the object of a vast marketing machine through which millions are regularly
sold to and hooked? The more you think about the question, the more elusive
the answer becomes. Once upon a time, medicine was relatively
unsophisticated. The few medicinal drugs there were saved lives or cured
obvious debilitating illnesses; the few recreational drugs there were gave
people pleasure or excitement or oblivion and were regulated on an ad hoc
but vaguely sane basis. In a puritanical culture, drugs that were extremely
pleasurable, physically harmful, and highly addictive--opium, cocaine,
heroin--were banned. Drugs that were mildly pleasurable, slightly
unhealthy, and less addictive--caffeine, nicotine, alcohol--were milked for
profit and tax revenues. Few pretended this scheme was entirely
coherent--permitting addictive, destructive booze while banning
nonaddictive, benign pot made no real sense--but it seemed a practical
balance between the right to personal pleasure and the need for social
calm. The one attempt to be coherent, Prohibition, proved the dangers of
consistent logic in social policy. And then technology had its way. It
seems to me that the last decade or so has largely invalidated whatever
sanity lay behind this practicable scheme. Our deeper understanding of the
chemical effect of even a candy bar has made us think about everything we
consume in pharmacological terms. (You can partly thank the Food and Drug
Administration's labeling for that.) And our ability to take pharmaceutical
substances and alter them in minuscule ways has further blurred the
distinction between "good" and "bad" chemicals. The result is a hopelessly
contradictory scheme in which fat-drenched hamburgers--partly responsible
for heart disease, our leading cause of death--are celebrated, while
marijuana, consumed with little harm by millions, is stigmatized to the
point of incarceration. And these are the easy cases.

Further up the chemical-sophistication ladder, the ironies only multiply.

Take the designer drug Ecstasy. "E" is now classed in the same group of
illegal drugs as heroin.

But as recently as the 1980s it was completely legal; Merck patented it in
1914. E works by flooding the brain for a few hours with serotonin, the
"happy" chemical, a substance our body naturally produces but in much
smaller and more consistent amounts.

Now compare Prozac. Prozac and its sister and successor drugs help regulate
the production of serotonin for people with suppressed or unstable
serotonin levels.

The effect of such drugs is far less intense than that of Ecstasy--and the
method by which serotonin is released and moderated is far subtler.

But the substance being manipulated is the same. Indeed, people who
regularly take Prozac tend to find that E barely affects their mood at all.
Their serotonin problem is already fixed. Yes, there are differences in
degree here, and some in kind. Long-term, persistent use of Ecstasy has
been correlated with depression. But long-term use of Prozac may affect the
structural composition of the brain as well. Neither is clearly dangerous
unless taken in massive doses.

Both are designed to make people "happier." What rationale is there in
making one drug illegal and marketing the other to literally millions every
year? Similarly, Starbucks profits by marketing coffee, a legal substance
that addictively wires people for hours on end. Health-food stores sell
stronger versions of speed in the form of pills and even chocolate.

There are no laws preventing anyone from drinking ten double espressos or
downing several packets of No-Doz. But one sniff of a much more
concentrated methamphetamine--which might actually be less damaging to your
body--can land you in jail. Similarly, you can get a dose of Xanax from
your doctor and feel extremely mellow within half an hour; or you can take
two puffs of pot and be a felon.

Likewise, you can buy a drug from a vitamin store--androstenedione--to
boost your own production of testosterone, or you can get a packet of
testosterone gel on the black market (as thousands of teenage jocks do) and
risk a criminal record.

A growing number of "medicinal" drugs also have high "recreational" street
value: painkillers like Vicodin, downers like Valium, uppers like Ritalin,
and anesthetics like Ketamine. My point is not that there is no sense at
all in these distinctions. Clearly, crystal meth is more potent, more
addictive, and easier to take than ten triple espressos.

Clearly, excessive steroid use can wreck people's livers in ways that even
massive use of legal androstenedione won't. But we're dealing here with
degree as much as kind. And as the sophistication of pharmaceuticals
develops exponentially each year, the lines we draw between legal and
illegal, between stigmatized and accepted, will become more and more
arbitrary. In exactly the same way, the very definition of "health" is up
for grabs. Do most people take Prozac for their mental health or their
sense of well-being? Is there a moral difference between taking Xanax to
get some sleep and smoking a joint?

If someone wants to take modest amounts of anabolic steroids to look good
and feel sexy, why should that be illegal when a legal, multibillion-dollar
industry is aimed at achieving the same effects with the stone-age
technology of swallowing creatine, eating steak, and pushing pieces of iron
up and down? Similarly, human growth hormone was developed to accelerate
the growth of stunted children.

It's now popular among retiring baby-boomers who enjoy its rejuvenating
effects on their bodies and minds.

But the boomers often have to fake weight loss and impotence to get it legally.

Why shouldn't retirees have access to it--not because they have an actual
physical ailment but because they want to enjoy to the fullest what's left
of their lives?

Isn't aging the ultimate physical ailment? I wish I knew the answer to
these questions; to me they seem the ones we need to confront.

The war on soft drugs is built on such logical sand that it cannot be
sustained forever--just as the once-clear distinction between health and
pleasure is now disintegrating, and only our residual cultural puritanism
is propping it up. In a country dedicated to the pursuit of happiness,
where happiness is reducible to a chemical, surely the "war on drugs" will
not be the only casualty of this development.