The “War on Drugs” is doing as well as the war on terror. Just as the latter inflicts massive damage on innocent civilians, creates fertile ground for enemy recruiters, and even provides the arms that are then turned again US soldiers, the former takes its own innocent victims. It exacerbates the consequences of dangerous drugs by turning a chronic disease into a crime. The Sentencing Project reports: “Sentencing policies brought about by the "war on drugs" resulted in a dramatic growth in incarceration for drug offenses. At the Federal level, prisoners incarcerated on a drug charge comprise half of the prison population, while the number of drug offenders in state prisons has increased thirteen-fold since 1980. Most of these people are not high-level actors in the drug trade, and most have no prior criminal record for a violent offense.”
Efforts to stamp out the supply side—as in programs to eradicate the crop abroad or target big pushers and organized crime here have been equally unavailing. Increases in the market price of heroin only bring more entrepreneurs into the market. Decriminalization would probably reduce the criminality and violence associated with the drug trade today, as Milton Friedman among others argued. Nonetheless, unregulated markets will not resolve the issue. Today food and petrochemical giants gain by promoting dangerous and addictive substances and then profit even more by marketing “cures.” Nor do markets measure the high costs of chronic diseases not only to the individual but also to families and colleagues.
The contradictions and moral inconsistencies in the drug war are manifest. Dr. Steven Kassels, Medical Director of Community Substance Abuse Centers and author of the medical-legal mystery thriller Addiction on Trial: Tragedy in Downeast Maine, points out that heroin addiction is analogous in many fundamental ways to type 2 diabetes or to smoking. Diabetes has a genetic component, but is exacerbated by poor habits, including food and exercise choices. In addition “alcohol, nicotine, cocaine, and heroin all create their effects through the same common pathway…The same medication, called naltrexone, is used to curb the craving effects of both alcohol and heroin.” Will power alone, whatever that is, is often equally unavailing against all of these addictions. A physician in Kassels’ novel asks his audience to close their eyes and contemplate only their own breathing for sixty seconds. If they are not able to purge all thoughts—and most are not—“you know the struggles of addiction. It is not mind over matter.”
Though heroin’s fatal victims are unacceptably high—more than are killed in auto accidents in many states—smoking and diabetes take even more. Nonetheless we do not generally characterize smokers like Dick Cheney as “nicotine addicts.” And though we tax their habits we do not jail them. Those fortunate enough to have health insurance are offered programs to help them withdraw from their addictions and alter their lifestyles.
We pay for these moral and medical inconsistencies not only with lives but also with our pocketbooks. Incarcerating one patient costs more than $50,000 a year as compared to $5,000 for outpatient treatment. As Kassels puts in in an op ed in the Bangor Daily News: “Expanded access and funding for treatment makes fiscal sense, regardless of whether we believe addiction is a disease or a weakness of moral character…. putting more “addicts” in jail may make us feel good in the short term but does not solve the problem.”
Part of the power of Kassel’s novel lies in the way he gets at the question of just why social policy persists in these morally questionable and fiscally costly contradictions. The criminality of a drug is determined in part by who is—or is purported to be—the prime user of the drug. In coastal Maine as in many rural and suburban communities, heroin is perceived as an “inner city” drug, with all the racial and economic baggage that term carries. Thus in Kassel’s novel, the character accused of murder in the Maine coastal village bears the twin stigma of being “from away” and, falsely, having introduced heroin into this purportedly pristine community.
In this context, I worry that for some citizens, putting addicts in jail may do more than make them feel good in the short term. It may serve deeply entrenched identity needs. Economic arguments, though important and persuasive to some, may not always prevail. For others, jailing the heroin abuser as a uniquely evil moral reprobate is part of affirming a strongly held coastal Maine collective and individual identity, that of a hard working, sober, self-sufficient community of citizens and workers. Treating outsiders and drugs associated rightly or wrongly with them as uniquely dangerous threats to the community may help repress inner doubts about the sacrifices one made to sustain that identity, its staying power in a world of rapid global change, or deviant desires one may himself have harbored.
This sort of harsh moralism sustains and in turn is sustained by Americans’ sense that they are a special people. As Brown University political theorist James Morone puts it in Hellfire Nation, early Puritans came to a new world to escape the persecution of the Old World, to build a church and society in direct contact with God. Yet paradoxically in a land where all save the Native Americans were from far away and where no one was persecuted, it became hard to build and sustain a coherent identity. Persecution in England also had left the Puritans all the more determined to establish a direct relationship with and dependence on their God and to regard all that differed from that mindset as not merely different but evil. “The Puritans groped back to the tried and true—they found terrible new enemies to define them. The saints constructed their us against a vivid series of immoral them: heretics, Indians, witches. Each enemy clarified the Puritan identity."
This existential dimension of drug politics is well illustrated in the different treatment of powder and crack cocaine, where powder, the favorite of the stock broker set, historically has been treated far more lightly than crack, culturally associated with violent inner city minorities. Drug regulation reflects less the power of the drug and more the political power and prestige of those who are doing the regulation.
Overcoming this resistance is difficult, but probably has to include narratives and policies that address the anxieties and self- hatred of the moralizers. Kassels’ emphasis on how drug use cuts across all strata of society and his vivid portrait of the havoc it inflicts even on the lives of the respected and affluent deeply committed to overcoming their illness is an especially useful point in countering the demonization of citizens with dependency problems. I would add that drug policies cannot be easily dissociated from broader economic issues. A generous universal safety net, with Medicare for all, pension protection, shortening working hours, and employment guarantees might lessen anxieties, allow moralizers to be easier on themselves, and open up new possibilities of personal ad community life. Perhaps our politics would be marred by less resentment of all Medicaid recipients, especially those tarred with the triple stigmas of outsider, poverty, and “addiction.”