Last month, the U.S. Food and Drug Administration announced its intention to lower the nicotine content of cigarettes to, ideally, “minimally or nonaddictive” levels. Public health advocates celebrated the decision; on the other hand, Big Tobacco investors began dumping shares at the prospect of supplying an ever-more-elastic demand.
Cigarette critics and capitalists alike belong to what Richard DeGrandpre calls the “cult of pharmacology,” a system of belief that dominates American drug discourse. Rooted in modernist faith in understanding the world through scientific approach, by the early twentieth century many considered drug experience to be a straightforward process of brain and body chemistry, without regard for concepts we might recognize today as set and setting. Historically contingent forces divide drugs into “angel” and “demon” categories, but their effects are similarly reduced to biological mechanism: “‘soul’ was reinterpreted as ‘mind,’ and ‘spirit’ was reinterpreted as ‘biochemistry.’”
But cults are given to blind faith, so it is worth considering the extent to which substances are to blame for problem use.Read More »
In response to Donald Trump’s sniffly debate performances over the last month-and-a-half of the 2016 presidential campaign, the Twittersphere erupted in wild speculation that the alleged billionaire had prepared with lines other than his taking points. “Notice Trump sniffling all the time. Coke user?” ventured Howard Dean, former chair of the Democratic National Committee, one-time presidential candidate, and, not incidentally, licensed medical doctor. Others consulted drug authorities, of a sort. Self-described cocaine “expert” Carrie Fisher told a curious fan that she “ABSOLUTEY” thought Trump appeared like a “coke head.”
While Trump probably doesn’t toot key bumps before going onstage, it is worth considering in a serious way what a potential future commander-in-chief believes about an issue near and dear to Points readers: drug policy. What follows is an attempted breakdown of Trump’s position on the three key topics mentioned above. I say “attempted” because, like with most things, his often contradictory stance on drugs is characteristically hard to pin down.
Sitting for an interview on the O’Reilly Factor in February, Trump displayed some surprising compassion for others after host Bill O’Reilly called medical marijuana a “ruse”: “But I know people that have serious problems and they did that, they really – it really does help them,” Trump professed.
He didn’t offer any clarifying details but said that he was “in favor of it a hundred percent.”
Still toeing the small-federal-government line of the party that gave him its nomination, Trump similarly left recreational weed for states to decide. I think.
During a debate last summer, he opined that “[regulating marijuana] is bad. Medical marijuana is another thing, but I think it’s bad and I feel strongly about that.” When pressed by the moderator about states’ rights to set their own policy, he verbally shrugged: “If they vote for it, they vote for it. But they’ve got a lot of problems going on right now in Colorado – some big, big problems.” (Again, no specifics.)
Later, at the same rally he proclaimed medical a state issue, he softened his tone. “In terms of marijuana and legalization, I think that should be a state issue, state-by-state.”
Notably, during the cultural hysteria of the crack epidemic, Trump supported full legalization. “We’re losing badly [bigly?] the War on Drugs. You have to legalize drugs to win that war. You have to take the profit away from these drug czars.” When pressed about his 1990 statement last year, Trump must have misremembered. “I said it’s something that should be studied and should continue to be studied. But it’s not something I’d be willing to do right now. I think it’s something that I’ve always said maybe it has to be looked at because we do such a poor job of policing. We don’t want to build walls. We don’t want to do anything. And if you’re not going to do the policing, you’re going to have to start thinking about other alternatives. But it’s not something I would want to do.”
Trump calls the problem of opioid addiction “tremendous.”
He may very well believe that his proposed wall on the U.S.-Mexico border will stem the tide of heroin into the states, but traffickers are responding to demand cultivated domestically.
As much as I try to stay up on my drug news, sometimes people scoop me. This most recently happened last month when I received an article with a fantastically understated title: “Groundbreaking Treatment could be the End of Cocaine Addiction.” It was certainly enough to make a skeptical drug historian smile (and chuckle at the layered humor of Yahoo Finance covering anything related to the stockbroker’s culturally purported substance-of-choice).
The vaccine, named dAd5GNE, combines parts of a common cold virus with a particle molecularly similar to cocaine, triggering an immune response against both. “Once immune cells are educated to regard cocaine as the enemy,” Crystal explains, “it produces antibodies, from that moment on, against cocaine the moment the drug enters the body.” The idea is to neutralize cocaine particles before they pass the blood-brain barrier, blunting their effects. This is a key distinction among addiction medications like methadone, which partially block opioid receptors once drugs like heroin cross over.
Crystal concedes that the process may not reliably pan out for humans. Years ago, his team observed vaccinated rats appearing less hyperactive after cocaine use than non-vaccinated rats, and the isolated antibody absorbing cocaine particles in a test tube, but scaling up is not necessarily linear. “We need to find out if the vaccine will cause enough anti-cocaine antibodies to be produced so that it works in humans, too.”
Crystal’s cautious optimism is not reflected in articles like the one my friend shared (though author Melody Hahm is considerably more measured in the main text). Once Crystal began experimenting on primates after mice, an article from The Fix invited readers to “[i]magine that cocaine addiction could be eradicated, poof, with a simple vaccine. [Crystal] now thinks his team has actually figured out a very clever trick to make that dream a reality.” A recent article in the New York Post calls the treatment a potential “saving grace” for addicts.
Poof! The drug historian continues smiling. In the early 1960s, scientists Vincent Dole and Marie Nyswander began using the synthetic opioid methadone to treat heroin addiction. Soon, journalists began proclaiming the drug as the “magic bullet” solution to the nation’s growing heroin problem. (But not without reason; the uniquely favorable conditions of early methadone trials, which featured rigorous screening processes for applicants and included staggered patient cohorts in cumulative retention data, produced impressive results: anywhere from 71 to 94 percent of users ceased criminal activity, found steady employment, and/or enrolled in college.) But heroin addiction was most prevalent in poor, high-stress urban neighborhoods characterized by racial discrimination in housing and employment. Methadone didn’t alter the scene much in places short on opportunity and long on reasons to use and sell dope. For decades, critics have credited the drug with simply perpetuating social conditions that give rise to drug use in the first place.
dAd5GNE may face similar charges. It doesn’t eliminate craving for cocaine, it just reduces the drug’s effect. Research suggests cocaine must occupy at least 47 percent of a dopamine transporter to produce a characteristic high and Crystal’s vaccinated primates never reached levels above 20 percent. But committed human addicts may accidentally overdose trying to bridge the gap, assuming they stick with the vaccination booster regiment at all, while polydrug users have an easier workaround. In any case, neither the setting or consequences of cocaine use on a social or individual level will probably change much. And, like its opioid-blocking counterparts, the cocaine vaccine gets us no closer to answering questions about addiction’s natured and (or?) nurtured etiology.
However, the vaccine has one major advantage over most opioid maintenance therapies: it has virtually no addictive potential. Twelve-step adherents and other abstemious interests liken methadone maintenance to substituting one drug – read: addiction – for another. Opioid replacement drugs can induce a mild euphoria, create physical tolerance, and even be fatal at certain dosage thresholds, which, at least theoretically, are non-issues for vaccine boosters administered weeks apart.
However, this treatment is not for everyone who does cocaine. The vast majority of users enjoy it as a fun or utilitarian stimulant without adverse outcomes. Many have no desire to stop. But even for problem users hoping to quit, the cocaine vaccine may go the way of methadone, Antabuse, and nicotine patches: magic bullets for some, stopgaps for others, nothing for most. (Assuming, of course, that trials confirm dAd5GNE is viable for human use.) But for anyone who earnestly desires to break patterns of destructive behavior, here’s hoping for more poofs in the future than the past.
Public service announcements of the War on Drugs have long been lampooned, and for good reason. Nonetheless, many have accepted such advertisements as a relatively benign, if irritating, collateral consequence of watching network television. Not unlike obnoxious pitches for ShamWow, we shrug our shoulders, chuckle, and move on. As rates of drug abuse have only increased throughout our long War on Drugs, we know that anti-drug PSA’s are at best an ineffective tactic and a poor use of taxpayer’s money. A closer look at anti-crack PSA’s in the Crack Era suggest that drug warrior TV spots were hardly benign. In many ways, this anti-drug effort proved to be socially irresponsible, misleading, and quite possibly, counterproductive.
If TV news of the period had not made it abundantly clear, PSA’s of the period reaffirmed popular assumptions that crack was an urban nonwhite problem which threatened to spill into suburban districts and victimize white youth. Despite the reality that crack was indeed an urban problem, the target audience of most PSA’s appear to be white suburban youth—potential victims. A litany of mainstream white celebrities offer their voices to variations of the same message; beware or the dangerous pusher and “just say no.” Kirk Cameron advises youth, “Come on, say no to drugs.” Bruce Willis also invokes the “just say no” tagline in his PSA, reminding children sternly to “be the boss” and make their own decisions. In the same year (1987), Willis appeared in a series of advertisements for Seagram’s Liquor clad in a white Miami Vice suit with multiple women on his arms. The tagline of the Seagram’s advertisement: “This is where the fun starts.”
In addition to offering an oversimplified message for drug avoidance most spots also advance the myth that one-time crack use kills. Just ask Pee-Wee Herman, “It’s the most addictive kind of cocaine and it can kill you. So every time you use it you can risk dying. Doing it with crack isn’t just wrong, it could be dead wrong.” Before he took to talking to chairs in public, Clint Eastwood also joined the fray as he channeled his best Dirty Harry. “You see this cute little vial here, that’s crack, rock cocaine, the most addictive form. It can kill you.” As with a series of PSA’s geared against crack, the postscript of the spot reads “Don’t even try it. The thrill can kill.” Brat Packer Ally Sheedy appeared in the same line of ads reminding Breakfast Club fans again “crack kills.” Other ads feature an undertaker and a businessman’s funeral, purportedly all casualties of crack. This myth marred the period, advanced most prominently by the overdose of basketball star Len Bias. Unfortunately, Bias was hardly a first-time user, nor did he overdose on crack, but rather, high-grade cocaine.Read More »
EDITOR’S NOTE: The Harrison Narcotics Act of 1914 turns 100 years old tomorrow. The new federal law regulated traffic in opiates and cocaine and produced lasting effects for US and international drug policy (you can read the full text here). Today, four celebrated scholars offer 100-word reflections on first 100 years of the Harrison Act.
Recent Points inductee Kyle Bridge devoted some of his M.A. research to drug use trends and crime rates in Jacksonville, Florida. Here he presents a modified and abridged version of his work.
Since at least the early twentieth century, as regular Points readers will know, many Americans have associated illicit drug use with criminality or otherwise deviant behavior. This holds especially true in the last fifty years of U.S. history, and some politicians have made significant hay with the issue. Combating drug abuse was a prominent plank in Richard Nixon’s 1968 platform. “Narcotics are a modern curse of American youth,” he claimed in a campaign speech, and in his first term the President committed to an “all-out assault” on what he labeled “public enemy number-one.” National worries were based on a legitimate correlation: in 1969 users made up a significant portion if not the majority of criminal perpetrators in metro areas including Los Angeles, the District of Columbia, New York, and Boston.
As a student of history and lifelong Jacksonville resident (actually Callahan, a small town just north of the city), I was curious about the local dynamic of this association, and how it changed over time. The Jacksonville public regarded drug use with an unsurprising wariness, similar to Americans nationwide. Still, policing drug use warranted little attention in local politics until around 1995, almost a half-decade after crime rates peaked during the crack epidemic. In fact new attention to drug use surfaced three years into what would become an almost entirely consistent twenty-year crime decline. By the turn of the millennium, the drug arrest rate had jumped to 1,115.18 per 100,000, almost doubling rates from the height of the crack epidemic (never higher than 689.62).
This past weekend alcohol and drug scholars across the globe descended upon London’s School of Hygiene and Tropical Medicine to learn from each other about what they know best, alcohol and drugs. The interdisciplinary conference does much to encourage scholarship across lines of disciplinary specializations, but also, the nation-state. Below please find assorted notes from my time abroad:
Perhaps most noted for his work Andean Cocaine, Paul Gootenberg gave a keynote speech addressing the concept of blowback. Entitled “Controlling Cocaine? 1900-2000,” Gootenberg began with what might be considered an obvious truth for drug historians—that is, that if read from an historical perspective, the term “drug control” is an oxymoron. Throughout the 20th century, drug control often perpetuates the antithesis of control. Drug control efforts by the United States have bred more chaos, more illicit trade, more use, and worst of all, more violence. In supporting his claim, Gootenberg examined the ways in which United States efforts to control the global supply of cocaine produced various unintended consequences.
Originally an economic historian by trade, Gootenberg makes good use of global commodity chains to explain the story of cocaine and attempts at its control. In framing the long history of cocaine commodity chains and blowback, Gootenberg broke down the century into several distinct phases, each with specific unintended consequences. In the first forty years of the 20th century, particularly after 1914, the United States attempted to push anti-cocaine measures onto the international agenda. During this period, Andean trafficking in cocaine remained relatively benign, marginal, and nonviolent. Between 1948 and 1973, cocaine came to be increasingly criminalized as illicit networks began to shift outward from the Andean region in response to FBN attempts to crush production in the region. A pivotal moment in cocaine commodity chain development passed in 1960 when traffickers were exiled under the Cuban Revolution. These exiled traffickers quickly became a Pan-American Network of traffickers, thereby expanding the commodity network for cocaine traffic. Still though, Gootenberg carefully noted, the trade remained small and fairly peaceful through 1970. Read More »
“I think that if you say something three times out loud, people take it as fact. And also, I think there are certain ideas that people want to believe, that really fit in with cultural stereotypes, and it’s hard to get rid of those”– Claire Coles
A friend recently posted a Retro Report video about the crack baby myth on my facebook page with the comment, “you called this, like, a year ago.” Another friend emailed me the link and a note, “always ahead of the game, you are.” While I appreciate my friends’ propers, I should point out that people have been debunking the crack baby myth for over twenty years. The correction just can’t seem to stick. If I called anything, it’s that sad fact: we just can’t let go of the crack baby.
As I argued before, one reason why we can’t let go of this myth is that it has the structure of a conspiracy theory, one in which the conclusion is sacrosanct even if the evidence is not yet identified. We have such agile, creative minds, and we really want the crack baby to be real because it has the ring of truthiness. Just the other day, a friend tried to grok the crack baby that wasn’t and concluded that crack still did something – even if that was just to stand in for all the other awful consequences of using crack and, of course, it’s true: some of those awful consequences can have very damaging effects on a human being. I had to agree: in that way, yes, one could say that there is such a thing as a crack baby.
This is not the first time the New York Times has run a story about what it called (in 2009) “The Epidemic That Wasn’t.” A cynic might wonder if maybe debunking the myth has become almost as good a story as the crack baby him or herself, even if it does require a journalistic mea culpa. Perhaps this is a second reason for the persistence of the crack baby myth: saying there is no crack baby makes for some great copy.
When I began researching grassroots responses to crack-cocaine I found myself—albeit naively—both surprised and confused by heavy-handed, aggressive calls for more policing and harsher sentencing from working and middle class black urbanites. Was this unique to the period? Did this represent a specific and different response to the marketing invention of crack? Moreover, I found myself asking: What motivated calls to stigmatize and scapegoat members of their own local communities? Why would local leaders deliberately attract negative attention to their already beleaguered districts, thereby further perpetuating negative stereotypes regarding the debasement of inner-city culture? Where were the progressive voices calling for moderate, rational, public health responses?
In earlier posts, I have begun to explain this reaction through the lens of black-lash. Much like working class white ethnics before them, working and middle-class blacks responded to what they deemed destructive and dangerous changes to their neighborhood and organized in efforts for reform to “take back their streets”. Steeped in the language of victimhood and citizenship, these local activists made battles over crime and drugs battles of good versus evil. The war against pushers, panhandlers, pimps and hoodlums would be about protecting the decent, innocent citizens held captive in their own neighborhoods. Finally, black-lash—much like white backlash—came to be motivated in part by a perceived threat to group progress. Working and middle class blacks viewed youth and street culture manifested by the drug trade as a clear threat to gains made under the Civil Rights Movement.
Recently, the use of the term black-lash has given me some pause for two reasons. First, black-lash is less clearly and directly motivated by race. The increasing significance of class in the post civil rights era makes such a term less useful. More significantly, black-lash is not unique to the Crack Era. The new work of Michael Javen Fortner clearly suggests that such sentiment existed in the 1970s as Harlemites fought vociferously against the increasing presence of heroin and crime in their neighborhoods. This suggests that black-lash existed less as a reactionary impulse, and more as an enduring, but understudied class fissure within the black community. With that said, let’s take a closer look at the roots of black-lash in the late 1960s and early 1970s to better assess the utility of the term “black-lash” as an explanatory tool. Read More »
Starting Monday, we’ll present a series of excerpts from the book, paired with a scholarly reflection on the excerpt. We’re pleased to have four notable scholars of drugs and addiction contributing to the series, starting with Eric Schneider. Monday, we’ll run an excerpt from “Teddy”–whose involvement with “dope” began in Harlem during World War Two. Tuesday, we’ll publish Eric’s reflection on Teddy’s history. And so on…
I’m particularly pleased to have organized this series, because of how much Addicts Who Survived has meant to me since I first read it (not long after the initial publication). I can still remember working on the early history of cocaine, and coming across an account from “Curtis” describing how he obtained cocaine from a drugstore at the age of nine–in 1913. It is hard to describe the impact of reading his account in 1990 or so, at a time when few people even remembered that cocaine had once been legal, much less had access to testimony about that moment in time. I wish that Addicts Who Survived had prompted more such oral history projects. For now, we can simply celebrate this particular accomplishment. Here’s a portion of what “Curtis” had to say, below.–Joe SpillaneRead More »