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The Effects of Drug Legalization

The following is an excerpt form "Ain't Nobody's Business If You Do", by
Peter McWilliams. It is a discussion between William F. Buckley, Jr. and
Professor Gazzaniga (The Andrew W. Thompson Jr. Professor of Psychiatry
[Neuroscience] at Dartmouth Medical School) which was originally published
in the February 5, 1990, issue of the National Review.





Buckley: It is said that the drug crack is substantively different from
its parent drug, cocaine, in that it is, to use the term of Professor van
den Haag, "crimogenic." In other words a certain (unspecified) percentage
of those who take crack are prompted to--well, to go out and commit mayhem
of some kind. Is that correct?

Gazzaniga: No, not in the way you put it. What you are asking is: Is there
something about how crack acts on the brain that makes people who take it
likelier to commit crime?

Let's begin by making it clear what crack is. It is simply cocaine that
has been mixed with baking soda, water, and then boiled. What this
procedure does is to permit cocaine to be smoked. Now any drug ingested in
that way-- i.e., absorbed by the lungs--goes more efficiently to the
brain, and the result is a quicker, more intense experience. That is what
crack gives the consumer. But its impact on the brain is the same as with
plain cocaine and, as a matter of fact, amphetamines. No one has ever
maintained that these drugs are "crimogenic.'

The only study I know about that inquires into the question of crack
breeding crime reports that most homicides involving crack were the result
NOT of the use of crack, but of dealer disputes. Crack did not induce
users to commit crimes. Do some crack users commit crimes? Of course.
After all, involvement in proscribed drug traffic is dangerous. Moreover,
people who commit crimes tend to use drugs at a high rate, though which
drug they prefer varies from one year to the next.

Buckley: You are telling us that an increase in the use of crack would not
mean an increase in crime?

Gazzaniga: I am saying that what increase there would be in crime would
not be simply the result of the pharmacology of that drug. Look, let's say
there are 200,000 users/abusers of crack in New York City--a number that
reflects one of the current estimates. If so, and if the drug produced
violent tendencies in all crack users, the health-care system would have
to come to a screeching halt. It hasn't. In fact, in 1988 the hospitals in
New York City (the crack capital of the world) averaged only seven crack-
related admissions, city-wide, a day. The perception of crack-based
misbehavior is exaggerated because it is the cases that show up in the
emergency rooms that receive public notice, and the whole picture begins
to look very bleak. All of this is to say: when considering any aspect of
the drug problem, keep in mind the matter of selection of evidence.

It is prudent to recall that, in the past, dangerous and criminal behavior
has been said to have been generated by other drugs, for instance
marijuana (you remember "Reefer Madness"?). And bear it in mind that since
cocaine is available everywhere, so is crack available everywhere, since
the means of converting the one into the other are easy, and easily
learned. It is important to note that only a small percentage of cocaine
users actually convert their stuff to crack. Roughly one in six.

Buckley: Then would it follow that even if there were an increase in the
use of crack, the legalization of it would actually result in a decrease
in crime?

Gazzaniga: That is correct.

Buckley: Isn't crack a drug whose addictive power exceeds that of many
other drugs? If that is the case, one assumes that people who opt to take
crack do so because it yields the faster and more exhilarating
satisfactions to which you make reference.

Gazzaniga: That is certainly the current understanding, but there are no
solid data on the question. Current observations are confounded by certain
economic variables. Crack is cheap--

Buckley: Why? If cocaine is expensive, how can crack be cheap?

Gazzaniga: Cocaine costs $1,000 per ounce if bought in quantity. Once
ounce can produce one thousand vials of crack, each of which sells for $5.
The drug abuser is able to experience more drug episodes. Crack being
cheap, the next high can come a lot more quickly and since there is a down
to every up, or high, the cycle can become intense.

So yes, crack is addictive. So is cocaine. So are amphetamines. The
special punch of crack, as the result of going quickly via the lungs to
the brain, may prompt some abusers to want more. By the way, it is the
public knowledge that crack acts in this way that, as several studies
document, causes most regular cocaine users to be cautious about crack.
The casual- to-moderate user very clearly wants to stay in that category.
So, all you can say is that there is a *perception*, widely shared, that
crack is more addictive. Whether it is, isn't really known. One thing we
do know is that crack does not begin to approach tobacco as a nationwide
health hazard. For every crack-related death, there are three-hundred
tobacco-related deaths. Another example of hyperbole is the recent claim
that there were 375,000 "crack babies" born last year; how could that
possibly be, when the government (the National Institutes on Drug Abuse)
informs us that there were only 500,000 crack "users" last year?
Exaggeration and misinformation run rampant on this subject.

Buckley: Well, if crack were legally available alongside cocaine and, say,
marijuana, what would be the reason for a consumer to take crack?

Gazzaniga: You need to keep your drug classifications straight. if your
goal were, pure and simple, to get high, you might try crack or cocaine,
or some amphetamine. You wouldn't go for marijuana, which is a mild
hallucinogen and tranquilizer. So, if you wanted to be up and you didn't
have much time, you might go to crack. But then if it were absolutely
established that there was a higher addiction rate with crack,
legalization could, paradoxically, diminish its use. This is so because if
cocaine were reduced to the same price as crack, the abuser, acknowledging
the higher rate of addiction, might forgo the more intensive high of
crack, opting for the slower high of cocaine. Crack was introduced years
ago as offering an alluring new psychoactive experience. But its special
hold on the ghetto is the result of its price. Remember that--on another
front--we know that 120- proof alcohol doesn't sell as readily as 86
proof, not by a long shot, even though the higher the proof, the faster
the psychological effect that alcohol users are seeking.

Buckley: Is there evidence that the current consumption of drugs is
restrained by their illegality? We have read that ninety million Americans
have experimented, at one time or another, with illegal drugs. Would more
than ninety million have experimented with them if drugs had been legal?

Gazzaniga: I think illegality has little if anything to do with drug
consumption--and, incidentally, I am certain that far more than ninety
million Americans have at some point or other experimented with an illegal
drug.

This gets to the issue of actual availability. Drugs are everywhere,
simply everywhere. In terms of availability, drugs might just as well be
legal as illegal. Now it has been argued that legalization will create a
different social climate, a more permissive, more indulgent climate. It is
certainly conceivable, primarily for that reason, that there would be
greater initial use--the result of curiosity. But the central point is
that human beings in all cultures tend to seek out means of altering their
mental state, and that although some will shop around and lose the powers
of self-discipline, most will settle down to a base rate of use, and a
much smaller rate of abuse, and those rates are pretty much what we have
in the U.S. right now.

Buckley: Then the factor of illegality, in your opinion, does not weigh
heavily? But, we come to the critical question, if ninety million (or
more) Americans have experimented with the use of drugs, why is drug abuse
at such a (relatively) low level?

Gazzaniga: If you exclude tobacco, in the whole nation less than 10 per
cent of the adult population "abuses" drugs. That is, 9 to 12 million
adult Americans abuse drugs. That figure includes alcohol, by the way, and
the figure remains fairly constant.

Consider alcohol. In our culture alone, 70 to 80 percent of us use
alcohol, and the abuse rate is now estimated at 5 to 6 per cent. We see at
work here a major feature of the human response to drug availability,
namely, the inclination to moderation. Most people are adjusted and are
intent on living productive lives. While most of us, pursuing that goal,
enjoy the sensations of euphoria, or anxiety reduction, or (at times)
social dis- inhibition or even anesthesia, we don't let the desire for
these sensations dominate our behavior. Alcohol fills these needs for many
people and its use is managed intelligently.

It is worth nothing that the largest proportion of this drug is sold to
the social drinker, not the drunk, just as most cocaine is sold to the
casual user, not the addict. Now, early exposure to alcohol is common and
inevitable, and youthful drinking can be extreme. Yet studies have shown
that it is difficult to determine which drunk at the college party will
evolve into a serious alcoholic. What is shown is that the vast majority
of early drinkers stop excessive drinking all by themselves. In fact, drug
use of all types drops off radically with age.

Buckley: Wait a minute. Are you telling us that there is only a 10 per
cent chance that any user will become addicted to a drug, having
experimented with it?

Gazzaniga: The 10 per cent figure includes all drugs except tobacco. The
actual risk for abuse for some drugs is much lower. Consider last year's
national Household Survey (NHS) which was carried out by the National
Institutes on Drug Abuse.

Gazzaniga: It is estimated that some 21 million people tried cocaine in
1988. But according to the NHS only three million defined themselves as
having used the drug at least once during each month preceding their
interview. Most of the three million were casual users. Now think about
it. All the cocaine users make up 2 per cent of the adult population, and
the addicts make up less than one quarter of 1 per cent of the total popu-
lation. These are the government's own figures. Does that sound like an
epidemic to you?

Buckley: But surely an epidemic has to do with the rate at which an
undesirable occurrence is increasing. How many more cocaine users were
there than the year before? Or the year before that?

Gazzaniga: The real question is whether or not more and more Americans are
becoming addicted to something. Is the rate of addiction to psycho- active
substances going up? The answer to that is a flat no. Are fads during
which one drug becomes more popular than another as the drug of abuse?
Sure. But, when one drug goes up in consumption, others go down. Heroin
use is down, and so is marijuana use. That is why the opiate and marijuana
pushers are trying to prove their purity--so they can grab back some of
their market share, which apparently they have done for heroin in New York
City.

But having said that, you should know that the actual use of cocaine and
all other illicit drugs is on the decline, according to the NHS. The just-
published National High School Survey carried out by the University of
Michigan reports that the same is true among high-school students. Crack
is used at such a low rate throughout the country that its use can hardly
be measured in most areas.

Buckley: Well, if low addiction rate is the rule, how do we come to terms
with the assertion, which has been made in reputable circles, that over 40
per cent of Americans fighting in Vietnam were using heroin and 80 per
cent marijuana?

Gazzaniga: Stressful situations provoke a greater use of drugs. Vietnam
was one of them. But what happens when the soldiers come home? That point
was examined in a large study by Dr. Lee Robbins at Washington University.
During the Vietnam War, President Nixon ordered a study on the returning
vets who seemed to have a drug problem. (Nixon didn't know what he was
looking for, but he was getting a lot of flak on the point that the was
producing a generation of drug addicts.) Dr. Robbins chose to study those
soldiers returning to the U.S. in 1971. Of the 13,760 Army enlisted men
who returned and were included in her sample, 1,400 had a positive urine
test for drugs (narcotics, amphetamines, or barbiturates). She was able to
re- test 495 men from this sample a few months later. The results were
crystal clear: Only 8 per cent of the men who had been drug positive in
their first urine test remained so. In short, over 90 per cent of them,
now that they were back home, walked away from drug use. And all of them
knew how to get hold of drugs, if they had wanted them. Incidentally, Dr.
Robbins did a follow-up study a couple of years later on the same
soldiers. She reported that there had not been an increase in drug use.

Buckley: Aha! You are saying that under special circumstances, the use of
drugs increases. Well, granted there was stress in Vietnam. Isn't there
also stress in American ghettos?

Gazzaniga: If you live in poverty and frustration, and see few rewards
available to you, you are likelier than your better-satisfied counterpart
to seek the escape of drugs, although the higher rate of consumption does
not result in a higher rate of addiction. Virtually every study finds this
to be the case with one possibly interesting twist. A recent Department of
Defense study showed that drug use in the military was lower for blacks
than for whites, the reverse of civilian life. (It is generally agreed
that the military is the only institution in our country that is
successfully integrated.) In short, environmental factors play an
important role in the incidence of drug use.

Buckley: So you are saying that there are social circumstances that will
raise the rate of consumption, but that raising the rate of consumption
doesn't in fact raise the rate of addiction. In other words, if 50 per
cent of the troops in Vietnam had been using crack, this would not have
affected the rate at which, on returning to the U.S., they became
addicted. They would have kicked the habit on reaching home.

Gazzaniga: That's the idea. Drug consumption can go up in a particular
population, fueled by stress, but the rate of addiction doesn't go up no
matter what the degree of stress. Most people can walk away from high drug
use if their lives become more normal. Of course, the stress of the ghetto
isn't the only situation that fuels high drug consumption. Plenty of
affluent people who for some reason or another do not find their lives
rewarding also escape into drugs.

Buckley: If it is true, then, that only a small percentage of those who
take crack will end up addicted, and that that is no different from the
small percentage who, taking one beer every Saturday night, will become
alcoholics, what is the correct way in which to describe the relative
intensity of the addictive element in a particular drug?

Gazzaniga: That is an interesting question and one that can't
satisfactorily be answered until much more research is done. There are
conundrums. Again, it is estimated that 21 million people tried cocaine in
1988. Yet, of those, only 3 million currently use it, and only a small
per- centage are addicted. As for crack, it is estimated that 2.5 million
have used it, while only a half million say they still do, and that figure
includes the addicted and the casual user. Some reports claim that as many
as one half of crack users are addicted. As I have said, crack is cheap,
and for that reason may be especially attractive to the poor. That is a
non- pharmacological, non-biological factor, the weight of which we have
not come to any conclusions about. We don't even have reliable data to
tell us that crack creates a greater rate of addiction than, say, cocaine.
My own guess is it doesn't. Remember that the drug acts on the same brain
systems that cocaine and amphetamines do.

Buckley: To what extent is the addictive factor affected by education?
Here is what I mean by this: Taking a drug, say heroin or cocaine or
crack- -or, for that matter, alcohol--is a form of Russian roulette, using
a ten- cartridge revolver. Now, presumably, an educated person, concerned
for his livelihood, wouldn't take a revolver with nine empty cartridges
and one full cartridge, aim it at his head, and pull the trigger. But
granted, decisions of that kind are based on ratiocinative skills. And we
have to assume these skills don't exist even among college students. If
they did, there would be no drinking in college, let alone drug taking.
Comments?

Gazzaniga: Most people perceive themselves as in control of their destiny.
They do not think the initial exposure will ruin their lives, because of
their perceived self-control, and they are right. Take the most difficult
case, tobacco--the most highly addictive substance around. In a now
classic study, Stanley Schachter of Columbia University formally surveyed
his highly educated colleagues at Columbia. At the same time, he polled
the working residents of Amagansett, a community on Long Island where he
summered. He first determined who were ongoing smokers, and who had been
smokers. He took into account how long they had smoked, what they had
smoked, and all other variables he could think of.

It wasn't long before the picture began to crystallize. Inform a normally
intelligent group of people about the tangible hazards of using a
particular substance and the vast majority of them simply stop. It wasn't
easy for some, but in general they stopped, and they didn't need treatment
programs, support programs, and all the rest. Dr. Schachter concluded,
after this study, that it is only the thorny cases that show up at the
treatment centers, people who have developed a true addiction. For those
people, psychological prophylactics, including education, are of little or
no value. Yet it is these people that are held up as examples of what
happens when one uses drugs. This is misleading. It creates an unworkable
framework for thinking about the problem. Most people can voluntarily stop
using a psychoactive substance, and those people who do continue to use it
can moderate their intake to reduce the possibility of health hazards.
This is true, as I say, for most substances, but I repeat, less true for
tobacco because of its distinctively addictive nature. The people who
unwisely continue to use tobacco tend to smoke themselves into major
illness even though they are amply warned that this is likely to happen.

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TANSTAAFL
Columbus, OH
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