Chasing the Scream: The First and Last Days of the War on Drugs (70 page)

18
Elizabeth Young, “The Needle and the Damage Done,”
Guardian
, August 20, 1994.

19
Linnet Myers, “Europe Finds U.S. Drug War Lacking in Results,”
Chicago Tribune
, November 2, 1995.

20
Gray,
Drug Crazy
, 158. John Marks, “To Prescribe or Not to Prescribe,”
Mersey Drugs Journal
(September/October 1987): 5.

21
I first learned this from an excellent series of articles and a documentary
The Truth About Heroin
, by the British journalist Nick Davies, in 2001.

22
Ed Bradley, “Success of Britain’s Addict Treatment Program,”
60 Minutes
segment, December 27, 1992, CBS News transcript.

23
Anslinger archives, box 1, file 8.

24
Will Self,
Junk Mail
, 92.

25
Sally Woods, “Heroin and Methadone Substitution Treatments,” unpublished Ph.D. thesis, Liverpool John Moores University, 2005.

26
Young, “Needle and the Damage Done.”

27
Myers, “Europe Finds U.S. Drug War Lacking.”

28
Edward Pilkington, “The Smack Doctor,”
Guardian
, October 26, 1995.

29
Ibid.

30
Self,
Junk Mail
, 91.

31
Bradley, “Success of Britain’s Addict Treatment Program.”

32
Ibid.

33
See Self,
Junk Mail
, 94.

34
Gabriele Bammer and Grayson Gerrard, eds., “Heroin Treatment: New Alternatives. Proceedings of a Seminar held on 1st November 1991, Ian Wark Theatre, Canberra,” National Center for Epidemiology and Population Health.

35
Davenport-Hines,
Pursuit of Oblivion: A History of Narcotics
, 275, 282.

36
A good discussion of this subject is found in Harald Klingemann, “Natural Recovery from Alcohol Problems,” chapter 10 of
The Essential Handbook of Treatment and Prevention of Alcohol Problems
, edited by Nick Heather. See also Satel and Lilienfeld,
Brainwashed
, 54–56.

37
Self,
Junk Mail
, 93.

38
Miller,
Case for Legalizing Drugs
, 53.

39
Bradley, “Success of Britain’s Addict Treatment Program.”

40
Bulletin on Narcotics
, January–April 1954, 6.

41
Marks, “Paradox of Prohibition.”

42
John Marks, “The North Wind and the Sun,”
Proceedings of the Royal College of Physicians of Edinburgh
, vol. 21, no. 3 (July 1991). Heroin prescription has a considerably better success rate than methadone prescription. In the only randomized heroin and methadone prescription trial, 71 percent of patients given methadone dropped out, compared to just 26 percent of heroin patients. The methadone patients were also far more likely to have committed crimes and to be using their drug heavily. See Woods, “Heroin and Methadone Substitution Treatments,” and Uchtenhagen, “Heroin Maintenance Treatment.”

43
He explains this both in his interview with me (see Russell Newcombe audio) and in Nick Davies’s brilliant documentary
The Truth About Heroin
.

44
Marks, “Paradox of Prohibition.”

45
Marks,
Paradox of Prohibition
, 7. This phenomenon had in fact been noticed before, by another doctor. In the late 1950s in the United States, Dr. Walter Treadway wrote: “It is known that addicted individuals, having acquired a supply, are very apt to dispose of part of it for a consideration, thus assuring their own future purchases. It is also known that these addicted peddlers, or addicted pushers as they are often called, may assiduously endeavor to recruit new addicts, often for the same reason.” See King,
Drug Hang-Up
, 178.

46
Marks, “North Wind and the Sun.”

47
 
Pat O’Hare, “Merseyside, the First Harm Reduction Conferences, and the Early History of Harm Reduction,”
International Journal of Drug Policy
18 (2007), 141–44.

48
http://fair.org/press-release/media-downplay-bigotry-of-jesse-helms/, accessed April 26, 2013.

49
Marks also discusses this here: http://www.runcornandwidnesweeklynews.co.uk/runcorn-widnes-news/runcorn-widnes-local-news/2010/08/19/dr-john-marks-talks-about-the-controversial-harm-reduction-drug-treatment-programme-in-widnes-55368-27086372/, accessed November 28, 2012.

50
Woods, “Heroin and Methadone Substitution Treatments,” 45–46.

51
Marks, “Paradox of Prohibition.”

52
Peter Carty, “Drug Abuse: The End of the Line,”
Guardian
, December 10, 1997.

53
John Marks, “Preventing Drug Misuse,”
Psychiatry Online
, vol. 1, issue 7, paper 2.

54
The history of these street scenes is summarized well in Ambros Uchtenhagen, “Heroin-Assisted Treatment in Switzerland: A Case Study in Policy Change,”
Addiction
, doi: 10.111/j.1360-0443.2009.02741.x.

55
Joelle Kuntz,
Switzerland: How an Alpine Pass Became a Country
, 7.

56
http://www.guardian.co.uk/travel/blog/2007/aug/02/itsillegaltowhatofficer, accessed January 22, 2012.

57
See Holiday,
Lady Sings the Blues
, 137.

58
Joanne Csete,
From the Mountaintops
, 17; Uchtenhagen, “Heroin-Assisted Treatment in Switzerland: A Case Study in Policy Change.”

59
Interview with Dr. Ambros Uchtenhagen. He also describes his mission there in “Heroin-Assisted Treatment in Switzerland: A Case Study in Policy Change.” See also O’Hare, “Merseyside,” 141–44.

60
Csete,
From the Mountaintops
, 18; Uchtenhagen, “Heroin-Assisted Treatment in Switzerland: A Case Study in Policy Change”; Ambros Uchtenhagen, “The Medical Prescription of Heroin to Heroin Addicts,”
Drug and Alcohol Review
16 (1997), 297–98.

61
When I was introduced to Jean by Dr. Rita Manghi and her colleagues at the clinic in Geneva, he agreed to speak on the condition that I do not use his real name or post the audio of the interview online. The reason he gave for this is that his story involved him admitting to criminal acts from before the law was changed—such as drug-smuggling—for which the statute of limitations has not passed. For that reason, this is the only instance where I am not posting the audio for these quotes on the website. The conversations were recorded and the audio has been provided to Bloomsbury. Dr. Manghi also confirmed to the publishers in writing that she introduced me to several patients in her clinic, and they included “Jean.”

62
“Narcotic Addiction,”
Spectrum
magazine, March 1, 1957, 139.

63
The Narcotics Officer’s Handbook
, 79–80.
Anslinger also makes this point in
The Murderers
, 219.

64
Csete,
From the Mountaintops
, 19.

65
Over a three-year period, of the 353 patients leaving the heroin program studied in
Prescription of Narcotics for Heroin Addicts: Main Results of the Swiss National Cohort Study
(Uchtenhagen et al., 6), 83 left to choose an abstinence-based therapy. See Uchtenhagen et al.,
Prescription of Narcotics
, 7.

66
There was a slight language barrier between us, but this is my best understanding of the metaphor.

67
http://www.time.com/time/health/article/0,8599,1926160,00.html, accessed January 22, 2013.

68
Denis Ribeaud, “Long-term Impacts of the Swiss Heroin Prescription Trials on Crime of Treated Heroin Users,”
Journal of Drug Issues
34:163 (2004), 173, doi: 10.1177/002204260403400108, http://jod.sagepub.com/content/34/1/163.

69
Ibid., 188.

70
http://hivlawandpolicy.org/resources/view/753, accessed January 22, 2013.

71
Jurgen Rehm and colleagues, “Mortality in heroin-assisted treatment in Switzerland 1994-2000,”
Drug and Alcohol Dependence
79 (2005), 137–43.

72
Uchtenhagen et al.,
Prescription of Narcotics
, 6.

73
Ibid.

74
Ribeaud, “Long-term Impacts,” 173.

75
Uchtenhagen et al., “Prescription of Narcotics for Heroin Addicts,” 89.

76
Ibid., 94. Woods, “Heroin and Methadone Substitution Treatments,” 33.

77
Csete,
From the Mountaintops
, 16.

78
Ibid., 27-8. Uchtenhagen et al., “Prescription of Narcotics,” 96.

79
At the same time, she tried to champion the legalization of cannabis, but this effort was rejected by the Swiss people.

80
It was Joanne Csete’s brilliant pamphlet that made me realize this.

81
This wording is from Ruth’s memory.

82
Peter Reuter and Robert MacCoun, “Heroin Maintenance: Is a US Experiment Needed?”
One Hundred Years of Heroin
, ed by D. Musto.

83
Privately, she says, he was “really, really” interested in the country’s methadone program.

84
http://www.mapinc.org/newscsdp/v07/n531/a05.html, accessed February 20, 2014.

85
http://www.nytimes.com/2011/02/07/us/07pharmacies.html?ref=prescriptiondrugabuse, accessed February 20, 2014.

86
The strength of opiates is compared in standard medical textbooks using something called an “equianalgesic chart.” See for example http://globalrph.com/narcoticonv.htm and http://clincalc.com/Opioids/ http://www.medscape.com/viewarticle/542574_3. There are several that enable you to compare different opiates and figure out how much more or less of one opiate is equivalent to another. They show the medical consensus that diamorphine (the form of heroin given to patients in hospitals) is considerably stronger than Oxycontin. (All accessed May 14, 2014.) See also the NHS Scotland report “The Management of Pain in Patients with Cancer,” November 2009, 21, published on the NHS website: http://www.palliativecareguidelines.scot.nhs.uk/documents/PAINCANCERREV_BPS_NOV09.pdf, accessed June 20, 2014.

87
Maté,
Hungry Ghosts
, 141.

88
The work of the Nobel Prize–winning economists Joseph Stiglitz and Paul Krugman provides the best documentation of this trend that I know.

89
This discussion of the phenomenon is based both on Gray,
Drug Crazy
, and on my interview with Gray. See also http://www.cato.org/pubs/pas/pa157.pdf, accessed November 20, 2012.

90
http://www.cato.org/pubs/pas/pa-157.html, accessed March 3, 2013.

91
Gray,
Drug Crazy
, 68. http://www.cato.org/pubs/pas/pa157.pdf, accessed November 20, 2012.

92
Gray,
Drug Crazy
, 68.

93
Musto,
American Disease
, 94.

94
Terence McKenna,
Food of the Gods
, 212.

95
Steve Rolles,
After the War on Drugs: Blueprint for Regulation
, 125.

Chapter 16: The Spirit of ’74

1
A good account of the Portuguese revolution is given in chapter 7 of Malcolm Jack’s book
Lisbon: City of the Sea
, and it helped to inform this section.