A Sociological Perspective on Drugs and Drug Use

Erich Goode, Professor of Sociology at SUNY Stony Brook

From: Drugs in American Society, First Edition, Chapter 1 1972 Alfred A. Knopf, Inc. ISBN 0-394-31323-2 SOCIAL CONTEXT AND HUMAN MEANING What can a sociologist tell us about drug use that we do not already know? If there is anything particularly distinctive about the sociologist's view, it is his emphasis on social context. It might appear that this concept seeped into the public consciousness long ago, that it is a banality. But if this were so, the stupendous blunders committed every day by drug researchers and commentators would not occur. If the concept were really understood, a large part of the drug problem would also be understood. The social context of drug use powerfully influencesindeed, it might almost be said determinesat least four central aspects of the drug reality, aspects that traditionally have been presumed to grow directly out of the chemical and pharmacological properties of drugs themselves, independent of human intervention. These four aspects are drug definitions, drug effects, drug-related behavior, and the drug experience. The sociological perspective stands in direct opposition to what might be called the chemicalistic fallacy the view that drug A causes behavior X, that what we see as behavior and effects associated with a given drug are solely (or even mainly) a function of the biochemical properties of that drug, of the drug plus the human animal, or even of the drug plus a human organism with a certain character structure. Drug effects and drug-related behavior are enormously complicated, highly variable, and contingent on many things. And the most important of these things are social and contextual in nature. In the animal world, it is quite a bit easier to predict what drugs will do. But experiments with rats do not tell us very much about human behavior. This is why social context is so important. One of the central dimensions of all human experience is meaning. No object or event has meaning in the abstract, in a natural state. Rather meaning is imposed, socially fabricatedin short, symbolic. Meaning has two features: it is both internal and external. Meaning is assigned externally to objects or behavior in the process of human collaboration or interaction. But it also resides within the individual: it is arrived at as a result of a private act of choosing on the individual's part. In order for an observer to grasp that internal meaning, he must view the world from the subject's perspective, which inevitably involves empathy. The same behavior, the same phenomenon, the same material reality, can mean completely different things to different people or to the same person in different contexts. Meaning is an ascription. It is superimposed on a phenomenon, a reality. It does not arise naturally. Anything may have multiple meanings, depending on one's point of view. Human action is suffused with meaningjust about everything we do is evaluated, thought about, mulled over, judged, interpreted. Take anythingan object, an act, a thought. Put into two different settings, it will mean radically different things to usperhaps, contradictory thingssimply because of our

variability in interpretations. It is not the thing, the act, the thought, we are reacting to. The same thing quite simply "means" different things; the thing does not generate the meaning we put it there. Consider two scenes: one the boudoir, man and wife alone, engaging in foreplay; the other the examining room of a gynecologist's office, the physician, a man, examining a patient for breast cancer. In both cases, a woman's breasts are being felt. But in one, the behavior is linked with a "script" we refer to as "lovemaking." In the second, it is linked with a different script: a medical examination (Gagnon and Simon 1972). Though the specific acts involved are almost identical in a sheerly physical sense, they "mean" radically different things, and the participants act and react, think and feel, differently as a consequence. Thus they are in fact totally different acts, not because they differ externally but because different interpretations have been brought to them. A large proportion of all assertions about social reality are ideologically imperialistic in naturethat is, an external meaning is imposed on a reality that should be investigated from an internal perspective. For example, many people equate long hair on men with feminization, without first asking what long hair actually means to the person growing it. Rather their point of view is that of an external observer who thinks that long hair should mean something definite and unvarying. A few generations ago anthropologists, armed with psychoanalytic insights, invaded non-Western civilizations and imposed their interpretations on what they saw. Snakes were interpreted as phallic symbols, regardless of what snakes actually meant to the particular cultures involved. Nakedness was given a sexual meaning, in spite of fact that in some societies nakedness has the overwhelming meaning of poverty, and not at all of sexuality. Today many of these ideological biases have been eliminated from most analyses of other civilizations, but they are depressingly routine when it comes to our own. And drugs. How do social definitions, interpretations, and meaning impinge on drugs, drug effects, and drug-related behavior? Are the same drug realities defined and interpreted in vastly different ways? How do contextual features change the relevant characteristics of drug use? An example. Peyote taken by American Indians in a ceremony participated in by adherents of the Native American Church is legal and legitimateeven holy. Yet the same substance, taken by college studentseven for the same purposesis suddenly, magically, labeled a dangerous drug, debilitating and damaging to the user and a threat to society and quite illegal. Another example: heroin and morphine. These two drugs are not very different pharmacologically and biochemically, except that pure heroin is several times as potent as morphine. (In fact, the morphine administered for therapeutic purposes in hospitals is stronger than the heroin sold on the street, since black market heroin is considerably diluted.) An experienced drug addict would probably not be able to discern the difference between comparable doses of heroin and morphine, and a pharmacologist would have to look very, very closely to distinguish the laboratory effects of the two drugs. In short, by "objective" standards they are very nearly the same drug; they do more or less the same things to the tissues of the body. Nonetheless, heroin is declared to have no medical uses whatsoever. It is considered a menace, a killer. Morphine, on the other hand, is regarded as a boon to mankind. It has the stamp of approval from the medical fraternity; it is a valuable therapeutic tool. And yet the roles and medical functions of the two drugs, and hence their social meanings, could easily be reversed. It is not the characteristics of drugs themselves, their pharmacological actions, that generate such contrasting interpretations; rather it is the meanings that have been more or less arbitrarily assigned to them. The sociologist's view of drugs and drug use goes a good deal further than merely recognizing that there are variable interpretations of similar drug realities and drug-related situations. It also emphasizes that the drug experience and drug effects will vary when

different meanings are brought into the drug-taking situation. The one-dimensional, chemicalistic view of drug taking is that humans are basically passive receptors for drug actions, and that when a certain drug is administered a certain effect, or standard set of effects, takes place. This view has been discredited as a general model, but the comments of many drug experts indicate that it is still operative. It is not uncommon to encounter analyses that utilize such concepts as the "complete marihuana intoxication syndrome" (Wikler 1970, p. 324), as if the effects of marijuana were a clinical entity with distinct configurations analogous to an H2O molecule or a cumulus cloud; or the notion that drug users are part of "an abnormal subculture" (Willis 1969, p. 34), as if this could be determined by means of objective, scientific examination. Naturally, some drug effects will be fairly distinct and will not vary a great deal, and there will be widespread agreement on their occurrence. In almost every case the whites of a person's eyes will become bloodshot after he has smoked a sizable quantity of marijuana. A person with a.2 percent blood-alcohol concentration in his bloodstream will not be able to operate a complex piece of machinery as well as he could when sober. Nearly everyone will go through some sort of withdrawal distress after long-term administration of a gram a day of barbiturates. But drug effects with such narrow variability are themselves limited in number; drug effects that are highly sensitive to external conditions and about which interpretations vary enormously are far more common, as well as far more important and interesting to most observers. It is crucial to distinguish between drug effects and the drug experience. What happens in one's mind subsequent to taking a given drug is the outcome of many different factors, not solely a function of specific biochemical reactions. A number of changes take place in the body when a chemical is ingested, and not all these changes are automatically noticed and classified. The subject must be attuned to certain drug effects to be able to interpret and categorize them and thus place them within his experiential and conceptual realms. Otherwise, the effect of a drug may simply be sensed as a vague, unsettling, dizzyish sort of experience. A drug effect has to be interpreted and categorized in order to "happen" internally, in order to be part of one's experiencing of it. Out of many potential "effects" of drugs individuals and drug subcultures (as well as the general society) select several to pay special attention to. Very few hospital patients who are administered morphine experience it as euphoric or pleasurable, yet the illegal street user of morphine experiences euphoria and pleasure from it. Psychedelic drugs taken for religious purposes, after spiritual preparation and training, are typically felt as having a religious impact, yet people who take hallucinogenic drugs simply to get high do not usually report anything like a religious or mystical experience. Drugs only potentiate certain kinds of experiencesthey do not produce them. It is the situation, the social definition surrounding usenot simply the drug's "objective" biochemical effectsthat determines the experiential dimension. Societies define not only the meaning of drugs but also the meaning of the drug experience; these definitions differ radically among different societies and among subgroups and subsultures within the same society. Social groups and cultures define what kind of drug taking is appropriate. They define which drugs are acceptable and which are not. They define who takes drugs and why. They decide what amounts of each drug are socially acceptable. They spell out which social situations are approved for drug use and which are not. They define what drugs do, what their actions and effects on people will be. Right or wrong, each of these social definitions and descriptions will have some degree of impact on actual people in actual drug-taking situations. Each will exert a powerful influence on what drugs actually do. The fact that heroin is attributed with a fantastic power to enslave actually helps to give heroin the power to enslave; the "effect" does not rest

completely within the biochemical properties of the drug (Young 1971, p. 43). The effective role of placebos in medical therapy has been underscored in numerous discussions and research. (As one psychopharmacologist wryly remarked: "The lethal dosage of placebo is unknown" [Claridge 1970, p. 26].) The fact that marijuana tends to have a negative and inhibitory effect on the sexual activity of caged rats and a positive and disinhibitory impact on sex in humans indicates the overwhelming role played by social expectations and definitions.

IDEOLOGY AND CULTURE Because the sociologist studies cultures and societies, ideology and morality, as artificially fabricated productsnot as "natural" and inevitable givens in the universehe is a little more detached from his society's values than are most other members of the society. The sociologist is therefore a little quicker to point out the hidden moral and ideological assumptions behind supposedly "objective" descriptions. What seems to most people to be "reasonable" and "natural" nearly always turns out to be that which is socially approved. If something is condemned as "irresponsible" or "unnatural," this can usually be translated as "potentially disruptive of existing social arrangements and privileges." The way that dominant members of society look at things is supposedly the way things "actually" are. In reality, the dominant view on a given subject (as with nearly every view) is typically shot through with value judgments, with ideological and moralistic assumptions that bear no necessary relationship to the phenomenon in question. Yet such views hide behind a mask of objectivity. This is true even of the views of scientists engaged in research on the effects of drugs. It is true of "experts" who write books and articles on drugs. And it is especially true of medical men who inform the public about the dangerous practice of drug "abuse." Morality and ideology are labeled "science" if two conditions hold: (1) the propounder of a given viewpoint has scientific credentials in the public eye, and (2) the view presented is in line with dominant opinion. Writings on drugs contain innumerable biases, some hidden, many not so hidden. But incredibly enough few readers ever question these biases; rather they assume them to be true and self-evident, a reflection of the "real" world. The dense involvement of all of us in our culture is indicated by our almost blind and uncritical acceptance of these views. Dip into any book on drugs. Glance over the concepts, the definitions, the assertions made. Consider such terms as "unreal sensations," "moral judgment of right and wrong,' "withdraw from reality" (Houser 1969, pp. 15, 43, 12), "demoralizing effect," "good judgment," "bad attitudes," "the needs of... law and society," "detrimental to the individual and society" (Jones, Shainberg, and Byer 1969, pp. 36, 16, 85, 9), "poorly adjusted," "the true meaning of anything," "wholesome family situation," "totally unresponsive to education about the hazards of drugs," "well-adjusted young people" (Byrd 1970, pp. 94, 154, 212). These terms were culled from recent drug texts published by prominent publishing houses and widely read. They all contain moral assumptions about what is right and wrong; and they all reflect the ideological bias that the phenomena so described have fixed meanings in the real world, independent of what anyone thinks of them. But in fact every one of these terms is an expression of prejudices on the authors' part; not one has any meaning in a strictly scientific sense. Naturally, some readers will share these prejudices but some will not. What is a "bad attitude"? Something the author doesn't like? Something

generally condemned by conventional members of society? Can a "bad attitude" be tested empirically? And the terms "adjusted," "poorly adjusted," and "maladjusted." "Adjusted" to what? It is possible to be "adjusted" to Nazism, or to the grosser injustices of our own society. What about "irresponsible"? "Irresponsible" in what sense? And to whom? In an article published in a major medical journal a world-renowned laboratory and clinical scientist and physician noted in appropriately solemn tones that the effects of marijuana are "very, very bad," but that the effects of alcohol are "just bad" (Wikler 1970, p. 324). How fortunate we are to receive such valuable esoteric scientific information! Such terms and expressions assume the abstract correctness of the social system in which we live. Deviations from the system are declared to be scientific errors. These declarations represent what might be called pseudosciencemoral and ideological judgments being represented as science. The strange thing is that this tendency is the rule rather than the exception in the drug field. In the debate over drug use and drug effects, smuggled-in value judgments are extremely common, and they shore up many an otherwise persuasive argument. They are used continually as rhetorical and propaganda devices, to win arguments. Assigning something to the status of that which is natural, reasonable, inevitable, rational, and scientifically true not only serves a propaganda purpose but a repressive function as well. If something is rooted in the natural order, is self-evidently true in a scientific sense, how is it possible to question it? However, if we are to be successful at understanding the nature of the drug reality, it is essential to remain sensitive to this ideological sleight of hand.

THE POLITICS OF REALITY The word "politics" has become attached to a variety of phenomena that were previously thought to be unrelated to the arena of politicsthe "politics of experience," "the politics of consciousness expansion," "the politics of therapy." Implied in any such term is the notion that what becomes taken for granted in any society is, in fact, arbitrary and problematic. We think that, for example, the psychiatrist-patient relationship and interaction is a technical and medical matter in toto, whereas recent thinking in this area has come to the conclusion that ideological, moral, and political considerations are densely woven into the therapeutic process. In a sense, psychiatry becomes a means of upholding one particular ideological view, and repressing others, rather than simply helping to make a patient healthy. Likewise, with scientific definitions of reality we can look at science as an institution which has as its task the verification of a special world-view. The rules of science can be looked at as forensic strategies; facts become wielded as ideological weapons. This view holds that science is deeply involved with ideology, and that the classical view of scientific "objectivity" is completely mythical. The concept of "the politics of reality" is especially important in areas of controversy. An extremely naive and outmoded "rationalist" position on facts is that man is essentially reasonable, and that the truth will win out simply because it is the truth. This point of view assumes that reality has a kind of brute hardness to it. The sociological position is that, more important than simply what is true (whatever this might mean), is what is thought to be true. One of the more fascinating processes to be observed in society is the way in which certain assertions come to be regarded as true. Obviously, different individuals and social groups have different stakes, both ideological and material, in certain definitions of what is

true. Thus gaining acceptance of one's own view of reality, of what is true, is an ideological and political victory. Science has become the basic arbiter of reality. Almost no one aside from the scientistand even then usually only the specialist within a given fieldhas any direct contact with the empirical phenomena scientists describe. The fact that the earth revolves about the sun "makes sense" only when interpreted through specialists; almost no one who believes it has ever tested it for himself. In this sense, scientific truth is not very different from religious truth: we accept it as an act of faith. In any dispute, we not only want to be morally right, whatever that might entail; we also want to be empirically and scientifically correct. Nothing has greater discrediting power than the assertion that a certain statement has been "scientifically disproven." Generally we search-about for evidence to "prove" our value judgments. If we believe marijuana use to be morally reprehensible, we want to back up our position with "objective" facts to show that we are also empirically correcthence the claim that marijuana is physically or psychologically damaging. Almost no one who believes that marijuana use is immoral also believes that it is harmless; almost no one who views marijuana use with moral indifference regards marijuana as damaging (though many feign moral indifference, simply to make their empirical view more credible). We shop around for evidence in much the same way that we trundle through a supermarket, selecting here and there. Facts are manipulated, wielded as bludgeons, employed as rhetorical devices. Presenting facts in the drug area is more like making a case than searching objectively for evidence. Any phenomenon is far more complicated than it appears at first blush. We have been taught to perceive only a small portion of the almost infinite number of experiences taking place before us. Philosophers call this process of selective perception attending. We attend to certain kinds of facts and ignore others. "Seeing" is also "not seeing." Whenever a certain observation is made, a sociologically relevant question would be not only "Is it true?" but also "Why stress this observation rather than another equally valid one?" Thus almost any conceivable discussion of the harmfulness or relative harmlessness of marijuana could be presented validly, with extensive documentation, simply by attending to one segment of the marijuana reality and ignoring others. In medical terms marijuana is harmfuldamaging and dangerousto some people under certain circumstances, according to some definitions of harm, at certain dosage levels, in some moods and psychological states. But marijuana is also relatively harmless medicallyfor most people, most of the time, at the potency levels generally available, and so on. There is enormous leeway, then, in presenting different views of a phenomenon, especially one as controversial as drug use. We are ultimately interested not in highly concrete facts but in generalizations from the facts. ("Is marijuana harmful?" "Does marijuana lead to heroin?" "Does marijuana debilitate driving skills?") Since so many different things can and do happen to so many different individuals, the gates are open to pick and choose those facts that are compatible with our own views. One of the central concerns of this book will be an exploration of the politics of reality in the area of drug use.

THE HIERARCHY OF CREDIBILITY The concept of "the hierarchy of credibility" (Becker 1967a) is especially important in any area of human behavior where "experts" abound. It refers to the fact that some people especially those in socially responsible positionshave more power to define what is true than others do. Yet some of the most prestigious, well-known, and credible drug

"experts" have never done any research on the subject, and their pronouncements make it clear that they are ignorant of the latest research. Legitimacy and credibility bear a scant relationship to actual expertise, if that is defined by participation in firsthand research or by a detailed and up-to-date knowledge of that research. From time to time the American Medical Association has issued statements purporting to describe to physicians, as well as to the public at large, the dangers of marijuana use. These statements have been construed by both groups as crystallizations of scientific and expert truth, solidly based on hard evidence. They have been labeled "studies" and "reports," yet they are not based on any research that members of the AMA might have clone, or on research that the AMA might have commissioned, or indeed on any research at all. The American Medical Association's articles on "Marihuana and Society" (American Medical Association 1968) and "Dependence on Cannabis (Marihuana)" (American Medical Association l968) have been cited in thousands of anti-marijuana tracts as definitive proof of the drug's harmfulness, yet they contain little more than a mixture of quite outdated assertions and blatantly biased value judgments. Inevitably, in any controversy we run into the problem of whose word to accept as valid. It is possible in any debate to attack the credentials of anyone with whom we disagree and to accept those of someone we agree with. Through this winnowing process, an artillery of authorities can be assembled to make it appear that we are "right" about our views. But credentials can be weighed in very different ways. To the public a hospital administrator, the head of a government agency, or a member of a national medical committee has better "credentials" than an independent medical or scientific researcher whose work may be known only to a few thousand specialists. To these specialists the hospital administrator may be an ignoramus. It usually turns out that those in positions of social responsibility, those who have credibility and legitimacy, can also be counted on to say something relatively safe and essentially protective. They as well as the public see their role as that of upholding dominant ideological views. They act as a kind of filtering device for the findings of various independent researchers, accepting those findings that fit in with dominant views and ignoring or attacking those that do not. For instance, the fact that a clear majority of all scientific researchers favor some form of legalization of marijuana is unknown to the publicbut the fact that officials of the AMA, the federal government, and the World Health Organization would oppose such a move probably is known to the public and is considered proof that it would be unwise.[1] The concept of "the hierarchy of credibility" becomes crucial when we consider that credible spokesmen have been known upon occasion to proclaim utter nonsense, yet their statements are taken seriously by a large proportion of the public. On March 6, 1971, Dr. Wesley Hall, the newly elected president of the American Medical Association, was quoted by United Press International as saying that a study completed by the AMA left "very little doubt" that marijuana caused a considerable reduction in sex drive. Dr. Hall noted that a thirty-five-year-old man might find his sex drive diminished to that of a seventy-year-old man if he used marijuana, and he hinted that certain evidence demonstrated that marijuana caused birth defects. (This was an extremely clever statement, incidentally, containing as it does what is probably the most dreaded fear of man and woman respectively.) Dr. Hall also suggested that forthcoming findings would help to reduce the level of marijuana use in the country (Drugs and Drug Abuse Education Newsletter 1971). His statement received considerable coverage by the media and was quickly broadcast across the country. About three weeks after the statement was made, Dr. Hall said that he had been misquoted, but he added, in an interview:

I don't mind... if this can do some good in waking people up to the fact that, by jingo, whether we like to face it or not, our campuses are going to pot, both literally and figuratively.... If we don't wake up in this country to the fact that every college campus and high school has a problem with drug addiction, we're going down the drain not only with respect to morality, but. .. the type of system we're going to have (Drugs and Drug Abuse Education Newsletter 1971, pp. 6, 7). Dr. Hall said that he was "deeply concerned with the fact that kids 18 years old are going to have the vote," because they are "in favor of legalization of marijuana and even ... the harder drugs." In relation to drug use in Las Vegas, he commented: "They have 7,000 kids there on drugs.... Somebody better wake up and do something about it instead of talking about the authenticity of a final report which might or might not be out yet." Attacking NIMH's report on marijuana, Dr. Hall said: "Some people are a little bit hesitant to stick out their neck until they have proof positive." Commenting on his own role, he explained: "The AMA states that marijuana is a dangerous drug, that it should not be legalized, and that every physician should do everything in his power to alert the folks to the dangers of marijuana, and this is one thing I'm trying to do." When asked whether misleading statements such as his own might damage the credibility of the AMA, Dr. Hall said: "I'm tired of these phrases about the credibility gap. We're talking about the morality of the country... and respect for authority and decency" (Drugs and Drug Abuse Education Newsletter 1971, p. 7). The entire episode bears crystal-clear testimony to most of the sociological concepts discussed in this chapter. It is readily apparent that Dr. Hall does not like marijuana use; as he sees his job, he must assemble a damaging argument to convince the public of what he wants it to believe. And given the AMA's legitimacy in most Americans' eyes, it is entirely possible to perform this feat. It is also clear that Dr. Hall is untroubled by such technicalities as evidence, facts, and datawhat he wants is good, solid propaganda, regardless of what the facts say. The truly amazing thing is that the AMA can continue to be believed after such an episode. But such is the power of the hierarchy of credibility; in fact, the AMA is and will continue to be taken seriously by most Americans. The power of the hierarchy of credibility is also demonstrated in an anti-marijuana tract distributed recently by the Ambassador College Press. The pamphlet, entitled "New Facts About Marijuana," claims that marijuana is more dangerous and damaging than any other drug, and that it is the "number one narcotic drug" because "the effect on chromosomal organization... from its first use posits permanent effects through generations.... Very few fatal diseases are ever transmitted to subsequent generations as both dominant and recessive. They are either one or the other. But marijuana addiction is transmitted to subsequent generations in both ways, dominant and recessive." These statements were made by a Dr. Louis Sousa of St. Ditmas Hospital in Paterson, New Jersey, and were supposedly presented at a conference of geneticists at Oxford University. Several interested observers (Fiedler 1971; Wittman 1971) checked on the validity of these facts. They discovered that (1) Louis Sousa was not a physician but a laboratory technician; (2) the paper in question was never delivered at a conference of geneticists at Oxford; (3) Sousa was discharged from St. Ditmas about five or six years before the pamphlet was distributed; (4) Sousa has subsequently left the country, under indictment for perjury on another matter. But notice the manipulation of the symbols of legitimacyattributing Sousa with a medical degree when he has none, invoking the prestige of Oxford Universityin an effort to

convince readers of the pamphlet that marijuana must indeed be harmful. If such an impeccable authority claims genetic damage, how could it be false?

WHAT IS A DRUG? After emphasizing the ideological biases hidden in most analyses of the drug reality, it is now possible to attempt several crucial definitions, utilizing these insights as a basis. To be adequate, any definition should perform the following functions: (1) it should group together all the things that share a given relevant trait and (2) it should set apart those things that do not share that trait. What is the defining trait that all drugs share? And what separates a drug from something that we cannot properly call a drug? Most of us believe that all drugs have some intrinsic property that automatically classifies them as drugs. Even the experts assume that the category "drug" is based on a natural pharmacological realitythat a drug must be something or do something that makes it part of a natural, organic, and chemical entity. Yet any search for a purely pharmacological definition of drugs would be fruitless. No formal, objective characteristic of chemical agents will satisfy both criteria of an adequate definition simultaneously. There is no effect that is common to all "drugs" and that at the same time is not shared by "nondrugs." Some drugs are powerful psychoactive agentsthey influence how the mind works; others have little or no impact on mental processes. Some drugs have medicinal properties; others have no medical value at all. Some drugs are toxicthey require very small amounts to kill living beings; the toxicity of other drugs is extremely low. Some drugs build tolerance very rapidlyincreasingly higher doses are required to achieve a constant effect; others do so slowly or not at all. Some drugs are "addicting"they produce a physical dependence; others are not. There is no conceivable characteristic that applies to all substances considered drugs. The classic definition of a drug to be found in nearly every introduction to pharmacology is "any chemical substance that affects living protoplasm." Unfortunately this widely adopted definition is far too broad to be of real usea glass of water fits the definition, as does a bullet fired from a gun, a cold shower, a meal, a cup of coffee, aspirin tablets, or even this book. When we turn to the social definition, we find that the concept "drug" is a cultural artifact, a social fabrication. A drug is something that has been arbitrarily defined by certain segments of society as a drug. Although all substances called drugs do not share certain pharmacological traits that set them apart from other, nondrug substances, they do share the trait of being labeled drugs by members of society. What this means is that the effects of different drugs have relatively little to do with the way they are conceptualized, defined, and classified. The classification is an artificial one; it resides in the mind, not in the substances themselves. But it is no less real because it is arbitrary. Society defines what a drug is, and the social definition shapes our attitudes toward the class of substances so described. The statement "He uses drugs" calls to mind only certain kinds of drugs. If what is meant by that statement is "He smokes cigarettes and drinks beer," we are chagrined, since cigarettes and beer are not part of our stereotype of what a drug is, even though nicotine and alcohol are certainly drugs by at least one criterionthey are both psychoactive. Thus there is a popular conception of drugs (mainly illegal drugs) and a psychopharmacological definition (psychoactive drugs) that are somewhat independent of one another. A given chemical substance may be a drug within one definition or sphere of

interest but not another. Substances such as primaquine, primadone, prinadol, priodox, priscoline, and privine have important medical uses and are described in reference works on therapeutics. Yet it would not occur to the man on the street that any of these substances were drugs. Other substances such as peyote, kava-kava, betel nuts, coca leaves, and Amanita muscaria are used by certain tribal peoples, but they would not appear anywhere in a work on therapeutic medicine. Penicillin has been one of the most valuable drugs in medical therapy in human history, but it is not used illicitly on the street. Alcohol is a drug in a psychoactive sense, but not if we were to adopt conventional society's definition: a man who drinks liquor does not think of himself as a drug user, and he would rarely be so defined even by nondrinkers. Nothing is a drug according to some abstract formal definition, but only within certain behavioral and social contexts. Which substances we elect to examine in any discussion of drugs is always arbitrary and depends entirely on our purposes. Therefore when anyone speaks or writes of drugs, whether layman or professional, physician, sociologist, journalist, or politician, he is referring to a social and linguistic category of entities, not to a natural or pharmacological category. Thus the claim that the "willingness of a person to take drugs may represent a defect of superego functioning in itself" (Fink, Goldman, and Lyons 1967, p. 150) means simply that individuals who ingest substances that society has arbitrarily chosen to label "drugs" supposedly share certain neurotic personality traits, traits not generally shared by those who ingest substances to which society does not assign the label "drugs." This distinction is crucial, and cannot be ignored. One discussion points out that "nothing is a drug but naming makes it so" (Barber 1967, p. 166). Common substances such as ink, soap, gauze bandages, iron, and salt are considered drugs within certain medical contextsthat is, they are considered to have therapeutic utility and are used to heal, or for diagnostic purposes. ... almost anything can be called a "drug." There is nothing intrinsic to any physical or biological substance that makes it a drug or does not. The same substance can be called a "drug" in one social context and called something else in another. For example, the ink that is used in fountain pens is not a drug when used in that way, but it may legally be defined as a drug if it is used as a diagnostic agent in connection with anti-fungal materials which are also defined as drugs.... When we look at drugs in a generalized and comprehensive way, what we see is that it is not so much the substance of a material that makes it a drug, but rather some particular social definition (Barber 1967, p. 2).

WHAT IS A NARCOTIC? The term "narcotic" has been used in two radically different ways in our society. The popular and legal definition has been "any illegal drug." When a drug seizure is made by the police, newspapers will proclaim: "Police Confiscate Narcotics." Many state statutes define marijuana as a narcotic. Medically, pharmacologically, and scientifically, however, the term "narcotic" means a chemical substance that dulls the body's sensitivity to pain; this function is called "analgesia." Thus narcotics serve an important medical and therapeutic function. But they are also pharmacologically addictingthat is, they produce an actual physical dependency in both animals and man. Within this definition only a very narrow

range of drugs may properly be called narcotics, and these are discussed in Chapter 6. Why should confusion arise between the popular and the medical definitions of narcotics? Why should the law, government figures, and the man in the street think of narcotics as "illegal drugs," while the scientist and the physician define them as "painkilling drugs"? And why should government officials stoutly defend the unscientific definition? Several years ago Donald Miller, chief counsel for the Bureau of Narcotics and Dangerous Drugs, a subunit of the Department of Justice, stated: "So far as I can see, I do not think it is irrational to legally define marihuana as a 'narcotic drug' " (Miller 1968, p. 55). Elaborating on the categorization, Miller noted: Despite some physiological differences in the effects of the drugs in the opium family and marihuana, the inclusion of marihuana in the statutory definition of "narcotic" is not constitutionally improper. The word "narcotic" is commonly used to designate drugs having the consciousness-altering characteristics of marihuana, i.e., stupor, mental lethargy, marked alterations of mood, and possible physiological harm (Miller 1968a, p. 93). Actually, the defenders of classifying marijuana as a narcotic have an ideological and propagandistic purpose in mind. "Narcotic" has become a kind of code worda discrediting labelfor a drug whose use is (supposedly) "bad" for the user. In the view of the propagandists, attaching such a labeleven if it is absurd from a scientific point of viewmakes it easier to persuade the public that the drug is in fact harmful and dangerous. The scientific definition of a narcotic ("painkiller") is relegated to minor importance, and the moral meaning ("bad") is given a center stage position. Apparently there is a fear on the part of propagandists that removal of the label "narcotic" from marijuana would imply that it is not in fact dangerous. Notice the clear political overtones of this labeling process in the following statementthe reaction of Representative Charles Wiggins, a Congressman, to the statement made by a physician, Sidney Cohen, that marijuana is not medically or pharmacologically a narcotic: You say quite positively marihuana is not a narcotic. It is not, but only because medical science has chosen to define a narcotic in a fairly narrow sort of way. What I am fearful of, Doctor, is that those who listen to the words, "marihuana is not a narcotic" will not be medical doctors at all, but will rather be just ordinary people who will read into that that it is not dangerous. Now you do not mean that, do you? [my emphasis] (Pepper 1970, p. 13) It is easy to see from this quote the great hold that definitions have on men's minds; it is also clear that our way of defining something has immense ideological implications. Science and politics interpenetrate one another at crucial junctures, and it will be one of the tasks of this book to explore these connections. It should be clear that the popular and legal definition of the term "narcotic" has very little to do with the pharmacological and scientific definition. We will encounter this phenomenon frequently.

DRUG ADDICTION AND DEPENDENCE In the early 1960s, the World Health Organization, in an effort to devise a new terminology that would apply to the "abuse" of all drugs, not just addicting drugs, adopted the term "drug dependence." According to WHO "drug dependence" is ... a state of psychic dependence or physical dependence, or both, on a drug, arising in a person following administration of that drug on a periodic or continued basis. The characteristics of such a state will vary with the agent involved, and these characteristics must always be made clear by designating the particular type of drug dependence in each specific case.... All of these drugs have one effect in common: they are capable of creating, in certain individuals, a particular state of mind that is termed "psychic dependence." in this situation, there is a feeling of satisfaction and psychic drive that require periodic or continuous administration of the drug to produce pleasure or to avoid discomfort (Eddy et al. 1965, p. 723). Under the new terminology, each drug has its own characteristic type of dependence: there is a "drug dependence of the morphine type," a "drug dependence of the cannabis [marijuana] type," a "drug dependence of the alcohol type," and so on. In other words, the new terminology is a definition, or a series of definitions, by enumeration, for it was felt that no single term could possibly cover the diverse actions of the many drugs in use (or "abuse"). In reality, however, the new definition, as well as the accompanying elimination of the term "addiction," is without any utility and confuses more than it clarifies. Its intent is patently ideological in nature: to make sure that a discrediting label is attached to as many widely used (or "abused") drugs as possible. Under the old terminology, it was not possible to label a wide range of drugs as "addicting." As in the "narcotics" controversy, it was necessary to stigmatize such substances as marijuana with a term that sounded very much like "addicting" but that also had a ring of truth to it. In other words, the scientists and physicians who created the new terminology were being employed as propagandists to convince the layman that nonaddicting substances were just as "bad" for him, that he would be just as "dependent" on them as on any truly "addicting" drug, and that the repeated use of both arose out of a compulsion. Under the new terminology, drugs and patterns of drug use that are really radically different are linked together to appear similar in important respects. If we wish to adopt a less propagandistic stance toward the terms "psychic" or "psychological" dependence, it is necessary to abandon them altogether. The difference between psychic dependence and classic addiction (that is, physical dependence) is the following. If you take or are administered a truly addicting drug such as heroin, morphine, or any of the barbiturates in sufficient doses over a long period of time, you will become addictedthat is, your cells will crave the drug, and if the drug is discontinued, you will undergo withdrawal sickness It does not matter what you think, what ideas and attitudes you have about the use or effects of the drug, your cells will still crave that drug. (Even if you have not been told that you are being given the drug you will experience discomfort, although you will not attribute your discomfort to the drug.) In contrast, if you take or are administered a nonaddicting drug such as marijuana over a period of time, nothing essentially will happen to you when you are "withdrawn" from the drug. It is impossible to

induce addiction to marijuana. Now some individuals do use nonaddicting drugs such as marijuana regularly and frequently. But to say that marijuana "causes" a psychic dependence is meaningless. Medical "authorities" label continued (or even sporadic) marijuana use as "dependence" for the simple reason that they cannot understand why anyone should want to use it at all. It is not the properties of marijuana that "cause" a psychic dependence; rather it is the personality structure of certain individuals who happen to use it frequently. It is the individuals that bear looking into, not the drug. It is illogical to attempt to explain something that is variable (some users smoking marijuana heavily and some infrequently) in terms of something that is constant (the drug supposedly producing a psychic dependence). Eliot Freidson, a sociologist, has labeled psychic dependence "the overwhelming product of psychiatric scholasticism"; in a letter to the editor of Trans-action magazine, Freidson commented on the "psychic dependence" of marijuana: "What does this phrase mean? It means that the drug is pleasurable, as is wine, smoked sturgeon, poetry, comfortable chairs, and Trans-action. Once people use it, and like it, they will tend to continue to do so if they can. But they can get along without it if they must, which is why it cannot be called physically addictive" (Freidson 1968, p 75). The point is that psychic dependence means the use on a continued basis of anything that certain medical figures disapprove of. The key word here is disapprove, since the use of other substances that these medical figures do not disapprove of is not labeled a dependency. An addicting drug makes cells dependentit makes them "crave" that drug. When a pharmacologist says that a drug such as morphine or alcohol produces a physical dependence, he means simply that body cells respond in a certain way to continued administration of these drugs. However, it would be completely improper to say that as a direct consequence of this cellular response humans become addicted to the drugs in question. Whether humans do in fact become addicted is dependent largely on social and psychological factors. Nonaddicting drugs do not produce a biochemical dependence in animal cells. Whether or not they lead to continued use is also a social and psychological matter, but continued administration of a nonaddicting drug cannot be equated with a dependence, physical or psychic. A person who has taken high-quality heroin several times a day over a period of time is un4uestionably physically dependent on heroin. A person who smokes marijuana several times daily is displaying a pattern that is a manifestation of something going on in his mind and in his social milieu, and it has little to do with marijuana as a drug. It should be clear, then, that there are two quite separable components in the addictiondependence equation: one is the direct physical action of the drug; the other is how people respond, behaviorally, to the physical action. One component does not translate automatically into the other. The knowledge of what a drug does to the human body does not explain what humans will do in relation to the drug in question. The basic fallacy of the World Health Organization's new terminology is its reductionism that is, its assumption that the biochemical properties of a drug determine the behavioral reality in relation to that drug. If the old definition of addiction is understood as a strictly biochemical description, then it contains some validity, although with serious flaws. But the new terminology is completely invalid, because it is trying to deal with the social dimension by absorbing, distorting, and underplaying what is in fact the central feature of drug taking.

DRUG ABUSE Physicians commonly employ the term "abuse" to refer to the use of a drug outside a medical context; this is the official definition of drug abuse given by the American Medical Association. The term, however, conveys a moral rather than a scientific judgment. Since "abuse" clearly connotes something negative or bad, to employ the term is to discredit and stigmatize drug use rather than to understand or describe it. Those who use the term declare that nonmedical drug use is invariably harmful, without first investigating whether it is in fact so or what constitutes harm in the first place. "Abuse" puts forth the claim that only physicians should be permitted to administer drugs. But since the term "drug" is a social and not a medical concept, such strictly medical claims are inconsistent. One never hears of "medically unsupervised" use (and therefore "abuse") of alcohol, even though alcohol has effects similar in many ways to those substances that physicians feel they ought to control or veto. By the AMA definition, any use of marijuana, regardless of its medical consequences, constitutes abuse, since the drug is not approved for medical purposes by most, and by the most credible, physicians. Purposes such as euphoria, pleasure, relaxation, or mind transformation are considered illegitimate. As "abuse" is used in context, however, it conveys the distinct impression that something quite measurable is being referred to, something very much like a disease, a medical pathology, a sickness in need of a cure. Thus the term simultaneously serves two functions: it claims clinical objectivity, and it discredits the phenomenon it categorizes. "Abuse" announces to the world that the nonmedical taking of drugsactually, only certain types of drugs, since legal drugs such as alcohol are magically exempt from the definition (and thus the medical definition is a passive and curious reflection of the legal situation)is undesirable, that the benefits obtained from illegal drugs are counterfeit, and that they are in any case outweighed by the hard rock of medical damage. But since the weighing of values is a moral and not a scientific process, we are able to see the ideological assumptions built into the term Furthermore, the linguistic category demands verification. By labeling anything "abuse," it becomes necessary to prove that the label is valid. The term so structures our perceptions of the phenomenon that it is possible to see only "abusive" aspects in it. Therefore data must be collected to "demonstrate" the damages of nonmedical drug use. In such ways do science and medicine become the handmaidens of morality and politics.

DRUG EFFECTS AND THE DRUG EXPERIENCE The prevalence of ideology in the drug realm is exemplified by the unwillingness of most observers, including physicians and scientists, to attempt a systematic investigation of the reality of drug use from the point of view of the user. This unwillingness is typically verbalized in a rhetoric of objectivitythe user is inevitably biased and hence cannot tell us anything about the phenomenon of drug use. This position confuses "objective" and "subjective" effects, and tends to ignore the drug experience. The fact is that no one except the drug taker is capable of reporting the nature of the drug experience; thus it is absolutely essential to elicit his descriptions. At the same time, we are totally at the mercy of those descriptions. Traditional behaviorists surmount this dilemma by completely ignoring internal states, judging them to be too ephemeral and subject to distortion and error to be reliable. Clinicians, at least of the psychoanalytic school, resolve the dilemma by assuming

that overt descriptions and statements by drug users represent some deeper hidden meaning that only the psychoanalyst can understand and interpret. But if we wish to put together a complete picture of the drug reality, we cannot afford to be so restrictive. How can we utilize descriptions by subjects of the drug experience without becoming a victim of such distortions as might obtain from reliance on this type of data? A few examples will highlight this "objective-subjective" dilemma. Recent laboratory experiments have shown that, contrary to the opinions of most users and nonusers alike, marijuana does not cause dilation of the pupils of the eyes (Weil, Zinberg, and Nelsen 1968). The traditional behavioral scientist will cite this finding as an example of how even experienced users will believe the myths about marijuana, and hence as further proof that it is risky to accept the "subjective" word of drug users about any aspect of the drug reality. However, there are different levels of the drug reality. The presence or absence of some external drug manifestations (such as pupil dilation) can be verified objectively. Other drug effects are located purely within the subjective realm and are beyond the reach of traditional scientific instruments; in order to explore them we must ask the drug user to recreate the subjective and expressive character of the drug "high." It would be absurd to claim that science can "disprove" the reality of a drug experience as it can the occurrence of a certain physiological effect. Rather the two are in totally different realms. For example, marijuana users often claim that they can hear music more acutely under the influence of the drug (Halikas, Goodwin, and Guze 1971; Tart 1971; Hochman and Brill 1971). However, researchers have been unable to verify this in laboratory experiments: under the influence of marijuana, the activity of perceiving and reporting on auditory stimuli is not significantly different from normal (Caldwell et al. 1969). The traditional laboratory scientist will feel that this disproves the users' claims, and he will view it as evidence of the distortions inherent in reasoning from subjective reportsas well as evidence for relying exclusively on laboratory findings accumulated by trained scientists. However, to conclude that the drug user is simply an untrustworthy guide through the dark wood of fact would be hasty and simple-minded. To understand the subjective impact of sense stimuli, we have to abandon the strict laboratory approach. Users report overwhelmingly that their identification with, involvement in, appreciation of, and enjoyment of music under the influence of marijuana are heightened, that the experience of listening to music becomes richer and more exciting when they are high. This is not a question of a "misperception"the user's experience is in fact the perception itself, and the perception is the phenomenon to be measured. The subjective grasp of the experience is the very reality itself. Similar observations may be made with regard to time. Under the influence of marijuana, users commonly report that time appears to pass very slowly, that it is elongated, and they consistently overestimate the amount of time passing (Tart 1971; Goode 1970; Hochman and Brill 1971; Halikas, Goodwin, and Guze 1971). Now there are a number of different ways of approaching time. To the laboratory scientist, time is a fixed quantum that can be divided into infinitely reproducible segments of equal magnitude. Thus the researcher would say that the marijuana user, under the influence of the drug, estimates the passage of time incorrectly. But this conception is not relevant to the dimension of meaning, to the quality of time as experienced. By looking at the marijuana users' experience as a "distortion," the laboratory scientist is imposing his own views on the reality and is attempting to disprove the validity of the perception itself. The fallacy of the strict behaviorist approach is the substitution of the observer's perspectivethat of the scientist for that of his subjects. It is the failure to take the role of the other, to see the world as the subject sees it.

This discussion should not be construed either as a glorification of what the subject feels to be true or as an affirmation of the position that subjective feelings cannot be studied at all. As David Matza, a sociologist of deviant behavior, has pointed out, attempting to grasp the "subject's definition of the situation ... does not mean the analyst always concurs with the subject's definition of the situation; rather, his aim is to comprehend and illuminate the subject's view and to interpret the world as it appears to him" (Matza 1969, p. 25). The subjective view is not necessarily "right"whatever that might mean regarding one or another propositionbut it does merit understanding on its own ground, and for that purpose its truth or falsity in strictly empirical terms is more or less irrelevant. Because many subjective feelings have no "scientific" or empirical validity, traditional positivistic pharmacology and behaviorist psychology have avoided levels of experience conveyed by the subject through language, through explanations of what he feels. This barrier is now breaking down, and an expanded conception of what science can deal with is emerging. Subjective feelings can be studied "objectively"that is, it is possible to attempt an understanding of the world as it appears to the subject, and to accomplish this "scientifically." There is no contradiction here. What the subject feels and says he feels is a field of data that can be investigated by means of the traditional canons of scientific method. Throughout this book, I will attempt to walk the fine line between these two perspectives. In short, instead of adopting the narrow and arbitrary conventions of traditional behaviorism, ignoring verbal statements and self-descriptions of feelings and experience as irrational or epiphenomenal, I am suggesting that a truly scientific approach toward reality would be to accept them as one dimension of phenomena under study. To exclude subjective states from scientific scrutiny is as arbitrary as thinking of them as the only legitimate version of reality.

NOTES 1. In a survey of drug researchers (Clark and Funkhouser 1970), 59 percent favored making marijuana legally as restricted as alcohol; in contrast, only 9 percent felt this way about LSD. (back)

REFERENCES American Medical Association. 1967. "Dependence on Cannabis (Marihuana)." The Journal of the American Medical Association 201: 368-371. ---. 1968. "Marihuana and Society." The Journal of the American Medical Association 204: 1181-1182. Barber, Bernard. 1967. Drugs and Society. New York: Russell Sage Foundation. Becker, Howard S. 1967. "History, Culture, and Subjective Experience: An Exploration of the Social Bases of Drug-Induced Experiences." Journal of Health and Social Behavior 8: 163-176.

---. 1967a. "Whose Side Are We On?" Social Problems 14: 239 247. Byrd, Oliver E., ed. 1970. Medical Readings on Drug Abuse. Reading, Mass.: AddisonWesley. Caldwell, Donald F., et al. 1969. "Auditory and Visual Threshold Effects of Marihuana in Man." Perceptual and Motor Skills 29: 755-759. Claridge, Gordon.1970. Drugs and Human Behaviour. New York: Praeger. Clark, Walter H., and Funkhouser, G. R. 1970. "Physicians and Researchers Disagree on Psychedelic Drugs." Psychology Today 3 (April 1970): 48-50, 70, 72-73. Drugs and Drug Abuse Education Newsletter. 1971. "AMA Official's Pot Shots Disputed; Taken Out of Context, But I Don't Mind." 2 (March 1971): 6-7. Eddy, Nathan B., et al. 1965. "Drug Dependence: Its Significance and Characteristics." Bulletin of the World Health Organization 32: 721-733. Fiedler, William R. 1971. "Pot and Perjury." Playboy November 1971: 80. Fink, Paul J. Goldman, Morris J., and Lyons, Irwin. 1967. "Recent Trends in Substance Abuse: Morning Glory Psychosis." The International Journal of the Addictions 2: 143-151. Freidson, Eliot. 1966. "Ending Campus Drug Incidents." Trans-action 5 (July-August 1968): 75, 81. Gagnon, John H., and Simon, William. 1972. The Social Sources of Sexual Conduct. Chicago: Aldine. Goode, Erich.1970. The Marijuana Smokers. New York: Basic Books. Halikas, James A., Goodwin, Donald W., and Guze, Samuel B. 1971. "Marihuana Effects: A Survey of Regular Users." The Journal of the American Medical Association 217: 692694. Hochman, Joel S., and Brill, Norman Q. 1971. "Marijuana Use and Psychosocial Adaptation." Unpublished manuscript. Houser, Norman W. 1969. Drugs: Facts on Their Use and Abuse. Glenview, III.: Scott, Foresman. Jones, Kenneth L., Shainberg, Louis W., and Byer, Curtis O. 1969. Drugs and Alcohol. New York: Harper & Row. Matza, David. 1969. Becoming Deviant. Englewood Cliffs, N.J.: Prentice-Hall. Miller, Donald E. 1968. "What Policemen Should Know About the Marihuana

Controversy." International Narcotic Enforcement Officers Association Annual Conference Report 8: 52-56. ---. 1968a. "Marihuana: The Law and Its Enforcement." Suffolk University Law Review 3: 81-96. Pepper, Claude, chairman. 1970 Marihuana: First Report by the Select Committee on Crime. Washington, D.C.: U.S. Government Printing Office. Tart, Charles T. 1971. On Being Stoned: A Psychological Study of Marijuana Intoxication. Palo Alto, Cal.: Science and Behavior Books. Weil, Andrew T., Zinberg, Norman E., and Nelsen, Judith M. 1966. "Clinical and Psychological Effects of Marihuana in Man." Science 162: 1234-1242. Wickler, Abraham. 1970. "Clinical and Social Aspects of Marihuana Intoxication." Archives of General Psychiatry 23: 320-325. Willis, J. H. 1969. Drug Dependence. London: Farber and Farber. Wittman, Barry. 1971. "Pot and Perjury." Playboy May 1971: 65. Young, Jock. 1971. The Drugtakers. London: Macgibbon and Kee.

Drugs and the Law

Erich Goode, Professor of Sociology at SUNY Stony Brook
From: Drugs in American Society, First Edition, Chapter 7 1972 Alfred A. Knopf, Inc. ISBN 0-394-31323-2 In this and the next chapter I shall argue that: (1) Drug laws are passed and enforced independently of their stated goals of deterrence, rehabilitation, and public safety. I submit that instead they are passed and enforced for ideological and moral reasons, not "rational" ones. (2) The drug laws are ineffective. The deterrent effect, which was at best only partial in the past, is swiftly breaking down and will probably prove even less effective in the future. Rehabilitation has always been a complete failurethe prison system has served to perpetuate drug use, not to cure the users. Public safety has actually suffered because of the drug laws. (3) The drug laws probably do more total damage to societyin terms of agreed-upon criteria of harmthan they prevent. Ironically and tragically, it is the law and its enforcement that is principally responsible for the size of the addict population, for the recent increase in addiction, and for a majority of the most harmful features of drug use and the drug scene. Finally, I submit that to the extent that a shift is coming about in law enforcement vis--vis drugs, this represents an ideological shift far more than a realization that the drug laws have not "worked." If a large cross section of the public were asked to give the reasons underlying the existence and enforcement of the drug laws, by far the most common response would be that the populace must be protected from the harm that drugs do to individual users, as well as to society in general. A deterrence-and-containment policy is seen as motivating the legal mechanism. Even the well-informed layman and the expert hold to this view: Most laws are instituted to protect society, or to protect the individual. Laws concerning drugs fit into this legal framework. For example, narcotics are outlawed because their continued use can cause physical and mental debilitation of the individual and lead to crime against society. Obviously, society must have laws governing the distribution and use of dangerous drugs... (Uhr and Uhr 1970, p. 112). However, the closer we examine the laws, and drug use, the less tenable this position becomes. Presumably, the more dangerous a drug is (or potentially dangerous, if significant numbers of individuals were to use it), the more vigorous will be the legal attempts mobilized to prevent its use; a drug whose potential for damage is low would presumably be far less likely to fall within the orbit of criminal law. In actual fact, there is almost no relationship whatsoever between harm, potential or actual, and the existence of drug laws and efforts at law enforcement. There are, of course, many different ways of measuring the "damage" that a drug does or might do. Joel Fort has elaborated a scheme of dimensions of "hardness," which takes into account mainly brain and organic damage, insanity, addiction, violence, accidents particularly vehicularand obviously death (Fort 1968; Fort 1969, pp.98-99). These are

"nonpolitical" dimensions, since nearly everyone would agree that they do constitute damage or harm; on this point at least there should be no controversy. In terms of Fort's scheme, the first category of hardness would include the most "dangerous" drugs currently in use: alcohol, barbiturates, amphetamines, nicotine (in cigarettes), and probably cocaine. Any individual who is a heavy, chronic, long-term user of any one of these drugs stands an extremely high chance of damaging his body and mind. In addition, all the drugs in the group except for cocaine are very commonly used; thus the actual rates of damage are high. The second category of hardness would include drugs whose damage potential is moderate, relative to the first five agents, given frequent, long-term use:- all the narcotics (because of the possibility of overdosing and the very real specter of addiction, as well as the pangs of withdrawal) and the hallucinogens (because of the possibility, however small, of temporary psychosis). The third category would include drugs that, given current medical and pharmacological knowledge, appear to cause fairly infrequent and relatively superficial damage: caffeine, aspirin, and marijuana.[1] This is not to say that these drugs are completely "safe"no drug, no chemical agent of any kind, is completely safe, and that includes water. There are as many as a thousand aspirin poisonings each year, mainly of young children who swallow massive doses, as well as some resulting from suicide attempts. About 0.2 percent of the population develops idiosyncratic pathological responses to aspirin, such as skin rashes. (A physician told me of a patient whose skin fell off in sheets after ingesting aspirin.) And the knowledge of how aspirin works pharmacologically is, as with marijuana, more or less lacking (Fort 1969, pp.25, 41, 141). However, aspirin is typically used with no damage whatsoever to the user. Yet of the five extremely damaging drugs, alcohol and cigarettes are readily available to anyone above a certain agein any quantity, without restraint; amphetamines and barbiturates are available by prescription (and are very commonly and heavily used by prescription for largely nonmedical or pseudomedical reasons); and cocaine is completely criminalized. Of the moderately dangerous drugs, the narcotics and the hallucinogens, possession of both is a crime, although illegalization efforts are more heavily concentrated on the former than on the latter. Of the relatively harmless drugs, caffeine and aspirin are readily available, and marijuana is completely criminalized. Possession of even a small quantity of marijuana (a quarter of an ounce in some jurisdictions), as well as any sale or transferincluding handing someone a joint that is being passed around a circle of friends constitutes a felony, punishable by a prison sentence ranging up to life imprisonment. In at least one stateRhode Islandthe minimum penalty for the sale of marijuana to a minor is thirty years' imprisonment; the maximum is life. The severity of this penalty is surpassed only by that for first-degree murder and treason; it is a harsher penalty than that for rape, second-degree murder, arson, and armed robbery. (A separate but related question is whether or not these penalties are carried out. But the symbolic and attempted deterrent functions of the severity of the law cannot be ignored.) The Rhode Island penalties are not leftovers from an earlier, less enlightened age; rather they are the product of a revision in the penal codes instituted in 1962. Now, if we wish to claim that selling a twenty-year-old college student a couple of joints of marijuana is more damaging to him that murdering him without intent, we may safely argue that the penalties are consistent with damage. But such a contention is ludicrous, and the position is completely untenable. Thus instead of an intimate and causal connection between damage and the law, what actually exists is an extremely loose, almost nonexistent relationship. Society does not construct laws to protect itself or the user from the damage that a drug will, or could, inflict. Yet most people think that that is why the laws against drug use exist and are enforced. And legislators and law enforcement officers no doubt believe that they create and uphold drug

laws because drug use is "dangerous." The "empirical" argument about damage is superimposed on an essentially moral and ideological beliefthe assumption that use of certain drugs is wrong, evil, and undesirable, and should be outlawed. But in reality this is a rationalization, a shaky scaffoldingand it has little or nothing to do with the existence of the laws or their enforcement. The whole relationship between the harmfulness of drugs and drug laws is but one example of the ambiguity of law in general. Some forms of crime outlawed by society and routinely enforced obviously do harm some members of society, along some agreed-upon definition of harm. Murder is one such example. But many forms of criminal behavior perhaps most forms of criminal behaviorharm no one, not even the perpetrator of the crime. (Unless performing the act itself is declared to be harmful. Homosexuality is one example of a "victimless" crime; but some will claim that homosexuality is itself harmful, and given this premise there is no possibility of arguing with the charge.) Moreover, many forms of behavior that are extremely destructive to society and to many of its individual members are quite legal. The record of damage due to alcohol consumption is probably without equal in the history of drug use, but the restrictions placed on the drinker are fairly liberalhe may destroy himself in private but not in public. Warfare, to choose a nondrug example, is always catastrophic, but most politicians make no attempt to render it illegal instead they have always made the refusal to destroy human life in combat a criminal act, under the claim that such killing is for the good of everyone involved. Faulty design and manufacture of products certainly cause thousands more deaths each year than, say, sex crimes, yet politicians and the public become incensed over the latter and are comparatively indifferent about the former. Even the toothless consumer protection laws now in effect were enacted only as a result of the efforts of a few vigorous crusaders, and not by any means as a result of public or official acknowledgment of the potential and actual harm presented by dangerous products. In sum, the view that laws are passed and enforced as a result of the "objective" danger presented to society by the prohibited behavior is not only extremely naive but fallacious. Behind the passage of every drug law in existence is a well-organized and effective lobby that has convinced lawmaking bodies and agents of social control that drug use is in fact a menace to public safety and health. In no instance have medical, pharmacological, psychological, or sociological researchers been asked to prepare a thorough evaluation of the potential or actual dangers of the various drugs so swiftly criminalized. Often, as in the case of the Federal Marihuana Tax Act, the only "evidence" to justify the passage of drug laws has been presented by those who undertook to get the laws enacted in the first place. Howard S. Becker has coined the term "moral entrepreneurs" to describe those highly committed individuals who take it upon themselves to disseminate their views to the public and to make sure that their own version of right and wrong becomes law for all (Becker 1963, pp. 147-163). The moral entrepreneur is an ideological imperialistit is his position that what he believes must also be right for everyone and that anyone doing what he disapproves of must be punished by the might of the law, by the state, by society as a whole. The existing rules do not satisfy him (or hersome of the most influential moral entrepreneurs in history have been women, such as Carrie Nation, the alcohol prohibitionist) ... because there is some evil which profoundly disturbs him. He feels that nothing can be right in the world until rules are made to correct it. He operates with an absolute ethic; what he sees is truly and totally evil with no qualification. Any means is justified to do away with it. The crusader is fervent

and righteous, often self-righteous (Becker 1963, pp. 147-148). Naturally, all moral entrepreneurs believe that what they want to see passed into law is good for others and not merely a crystallization of their own personal views and prejudices. Thus anti-marijuana crusaders do not see themselves as imposing their ideology and morality on the public. Rather they see themselves as doing good, as helping others, as lifting up the drug user to see the error of his ways, as protecting society from the damage that drug use can do to humanity. (But then, as Camus said, the welfare of humanity is always the alibi of tyrants.) In short, the passage of laws is basically a nonrational process that represents an ideological, moral, and political victory of some segments of society over others. Laws are sometimes, even often, a reflection of majority sentiment, but this is not a necessary condition for their passage. Public sentiment and outrage is a useful resource for the moral entrepreneur in his battles. (Most of the state laws criminalizing marijuana possession were pushed through without any fanfare whatsoever.) Likewise, expert documentation and testimony may be useful in the battle to get laws passed, but they too are not essential. As noted earlier, a majority of experts doing research on marijuana use favor the decriminalization of the drug (Clark and Funkhouser 1970), and more and more researchers are turning to this view. Of course, it is always possible to hand-pick "experts" in drug research to present views that are already favorable to official opinion. Even when a full range of views from the scientific community is elicited on a given issue, ignoring the views of the majority is a simple matter. The Nixon administration dismissed The Report of the Commission on Obscenity and Pornographythe most thorough and well-documented study ever conducted on the subjectin just such a manner. Likewise, President Nixon stated publicly that whatever the findings and recommendations of the National Commission on Marihuana and Drug Abuse, he would never legalize marijuana. Such commissions are used primarily as rhetorical devicesthey are useful insofar as they can shore up some official view; if they cannot serve such purposes, they are buried. Thus it is utterly nonsensical to claim that because a nation has passed or enforces a certain law outlawing some behavior, the behavior in question must be harmful to the populace. Yet many observers have made just this assertion. Edward Bloomquist, for instance, claims that the Nigerian government's enactment of harsh legislation against cannabis possession demonstrates the drug's harmful effects on the vigor of a developing nation (Bloomquist 1971, pp. 23-24). (The penalties in another developing nation, Iran, are particularly harsh for drug sellers. Dealers are shot on public television, and TV sets are placed in village squares so that everyone can see these important events. But just what this demonstrates with regard to the effects of the drugs in question is not clear.) The classic statement exemplifying this fallacy was written by a South American physician, Pablo Oswaldo Wolff, who observed that, in regard to cannabis: "All civilized countries have included in their protective legislation a prohibition of the use of Cannabis for enjoyment purposes, because the social and criminal danger to which it can give rise at any time is of immense gravity" [my emphasis] (Wolff 1949, p. 49). A more contemporary observer, Director of the Essex, New Jersey, County Youth and Economic Rehabilitation Commission, echoes Wolff's sentiment: "Why is it that marijuana is the only drug that is outlawed in every civilized country of the world?" (Lordi 1968, p. 163). Three "health" experts make the same observation with regard to drugs in general. The drug laws, they state:

... have been enacted to protect society. Legal controls such as quarantines, isolation, and penalties have always been necessary to stop the spread of various diseases and illnesses. Since the best evidence supports the view that compulsive drug abuse is an indication of an emotional illness in an individual, society is justified in insisting on some type of regulation on the manufacture, distribution, and use of drugs. Such regulation can be viewed as a part of preventative medicine (Jones, Shainberg, and Byer 1969, pp. 69-70). The bizarre Alice-in-Wonderland quality of this statement becomes pointedly clear when we realize that (1) most users of illegal drugs are not, and never become, "compulsive" drug users, yet they are just as liable to arrest as those who are; (2) the conclusion that because (some) drug users are emotionally sick they should be punished and incarcerated is not only illogical but cruel and treacherous; (3) drug users are subject to penalties regardless of whether they do, will, or can "spread" their drug habits to othersthe isolated drug user is still breaking the law; (4) drug laws and law enforcement may not even be effective in dealing with the problems they are designed to solve. The above quotes illustrate that medical analogies are sometimes employed to shore up the edifice of criminal law. And it is on such nonsense that entire legal edifices are often built. A historical view of social and legal attitudes toward drug addiction can give some perspective on the effectiveness of the drug laws. The social image of the drug addict has turned almost full circle since the second half of the nineteenth century. Addiction to morphine as a result of administration during surgery was common during and after the Civil War, and addiction came to be known as the "soldier's disease," or the "Army disease." Late in the nineteenth century and early in the twentieth many preparations containing addicting substances were available over the counter. Opium and morphine were contained in preparations for headaches, toothaches, menstrual pains, insomnia, nervousness, depression, and just about everything else; they were seen as a kind of panacea for a wide range of ills. Naturally, thousands of people, including many respectable middle class housewives, became addicted as a result. Because of the connection between medical therapy and addiction, the drug addict was viewed as a helpless victim, an unfortunate sick person in need of medical attention (see, for example, Terry and Pellens 1928; Lindesmith 1965, 1968; Duster 1970; Smith 1966). But by the 1920s the public image of the addict had become that of a criminal, a willful degenerate, a hedonistic thrillseeker in need of imprisonment and stiff punishment. Curiously enough, at the same time the public view of many medical afflictions, such as leprosy, epilepsy, and insanity, moved in the opposite direction; these conditions came to be regarded as strictly medical problems rather than as signs of immorality and depravity (Duster 1970, p. 10). Today this trend has begun to reverse itself; among many physicians as well as some segments of the public, addiction is coming to be viewed as largely a medical problem. It is, of course, almost completely impossible to estimate with any degree of precision just how many addicts the freely available over-the-counter narcotic preparations called into being. Figures kept at the time are notoriously unreliable, and estimates range from a low of 100,000 to a high of several million. In 1919 the Treasury Department issued a report claiming that there were approximately a million people addicted to narcotics at the turn of the century. Other estimates, based on extrapolations from a number of local surveys, range from slightly less than a quarter of a million (Terry and Pellens 1928) to just under half a million (Kolb and DuMez 1924). Since it is virtually impossible to check the reliability of these estimates, let us accept the in-between figure, half a million, as roughly

accurate. In the early 1900s, as opposed to the 1970s, it is clear that (1) addiction was largely a consequence of medical problems, rather than related to a search for euphoria and peer-generated excitement; (2) the middle-aged, rather than the young, were addicts; (3) women, rather than men, were more likely to be addicts; (4) whites were more likely to become addicted than blacks; (5) addicts were drawn from the entire social class spectrum, and probably somewhat more from the middle class, rather than primarily from the bottom of the class structure (this tendency is breaking down today, however); (6) addicts came from the entire rural-urban continuum, rather than predominately from very large cities and their suburbs. One drug text presents a two-page graph (supplied by the Bureau of Narcotics) showing the number of addicts in the United States from 1900 to the 1960s (Jones, Shainberg, and Byer 1969, pp. 68-69). The peak is reached early in the twentieth century, just before federal legislation was passed, at about 200,000a not unreasonable figure; this is followed by a sharp drop a few years later, to a low in 1945 of under 20,000 addicts; then a small but significant rise to 1960 is recorded, to approximately 50,000 addicts. Downswings in the chart early in the century follow the enactment of new laws. Really effective reductions, however, did not occur "until the Bureau of Narcotics was established in 1930 to enforce.. . laws and apprehend violators" (Jones, Shainberg, and Byer 1969, p. 67). Many defenders of the existing legal structure viewed the "reduction" in the number of addicts between the inception of the narcotic laws and the end of World War II as evidence that punitive policies were actually an effective deterrent against addiction. In 1948 several physicians employed by the government wrote: "This reduction has been largely due to vigorous enforcement of the Harrison Act and the Federal facilities for the treatment of addicts" (Vogel, Isbell, and Chapman 1948). The view that laws and their enforcement are effective against drug use and addiction is widespread. What, however, are the facts? A close look at the facts actually demonstrates the opposite point of viewthat existing and ongoing drug policies have, from their beginnings to the present, been a contributing factor in worsening the drug problem, that punitive policies and approaches have been an almost unrelieved failure. In December 1914 Congress passed the Harrison Act, which outlawed the sale of overthe-counter narcotic preparations and placed the addict in the hands of the physician. Whatever the intent of the law, it is clear that most addicts simply continued to receive drugs from their physician, on prescription, instead of directly from their local pharmacist. If a physician construed the administration of morphine to a patient to be within the scope of legitimate medical practice, he had the right, within the law, to maintain that addict on morphine. On the face of it, then, the law did not change anything. It was the Supreme Court that drew a restrictive interpretation of the Harrison Act and that decided what was to constitute "legitimate" medical practice; in a series of decisions from 1919 to 1922 the court declared maintenance of an addict to be outside the scope of medical practice and therefore illegal. However, in 1925, in the famous Linder case, the Supreme Court overturned its earlier decisions, declaring addiction per se not to be a crime and paving the way for the legality of maintenance. The court affirmed the decision in 1962, in Robinson v. California. Thus the present punitive policies are a consequence of decisions made by the Supreme Court between 1919 and 1922, decisions that were superseded and reversed by later rulings A good case could therefore be made for the unconstitutionality of present legal policies. Because of police harassment of physicians following the passage of the Harrison Act and the wave of arrests of doctors following the Supreme Court's decisions, most physicians became unwilling to shoulder the legal risks attendant upon treating the addict

and eventually discontinued administering narcotic drugs. One study estimated that in the two dozen years after the Harrison Actand primarily after 191925,000 physicians were arraigned on narcotics-selling charges, and 3,000 actually served prison sentences (New York Academy of Medicine 1963). Thousands more had their licenses revoked. The authorities could not have encouraged the emergence of an underworld traffic in narcotic drugs better even by design. The arrest of physicians during this period took the following form selling drugs was declared illegal, thus driving most physicians out of the practice of treating addicts; the few who continued to do so, whether for idealistic or mercenary reasons, naturally attracted a sizable clienteleand just as naturally were charged with "trafficking" in narcotics. Apparently, the dilemma was at least dimly perceived by some officials, since in 1919 and 1920 forty-four ambulatory clinics were opened with a view toward the rehabilitation and eventual cure of addicts. The programs were highly variable in method and effectiveness. In the New York clinic, which received the most attention and publicity, drugs were handed out more or less indiscriminately to anyone who claimed to need drugs; moreover, through various tricks many addicts were able to obtain much more than their share and to sell what they did not use to other addicts. The New York clinic was investigated by the Bureau of Internal Revenue, and a highly critical report was written of its operations. Muckraking journalists attacked the program; several reporters posed as addicts and discovered that they could receive addicting drugs almost upon demand. A public outcry was voiced; campaigns were launched to close the clinics. All but one of the forty-four clinics had been shut down by 1921, and the project was entirely abandoned by 1923. The program was branded a disastrous failure. Actually, the New York clinic, the object of the most vigorous criticism, was the least well run and most clearly unsuccessful. The clinics in New Orleans and Shreveport, Louisiana, appeared to have been successful in their stated goals: (1) relieving the addict's suffering- (2) offsetting the illegal drug trade; (3) curtailing the spread of addiction and (4) reducing the criminal activity of addicts. These efforts, however, received little public attention. The demise of the public clinics, engineered by prohibitionist officials, was then used by them to galvanize popular sentiment against the strictly medical approach to addiction. The public came to support the view that the addict had to be dealt with punitively, that addiction was a matter for the police and not the physician. Actually, the medical approach was not tried in most clinics; rather simple maintenance, or handing out drugs without any medical treatment whatsoever, was the rule. The more carefully run, medically oriented programs did not convince those in power that a true medical approach could in fact work. Addiction came to be seen as inherently untreatableand inherently criminal. A shift in enforcement came about at almost the same time as the demise of the public clinics. In 1919, the first year of their operation, there were only 1,000 federal arrests on narcotic charges. In 1921, when all but one of the public clinics had closed, there were 4,000 federal arrests. And by 1925 there were over 10,000 arrests (Lindesmith 1965, p. 143). Clearly, then, what happened as a result of the Harrison Act was not a diminution of a once large addict population but the appearance of a totally different population altogether. Far from reducing a problem, legislation and enforcement practices on drugs appear to have created a problem out of whole cloth. The federal laws outlawing the sale of narcotics seem to have created three distinct groups from the existing addict population. The first of these groups represents the majority of the middle class addicts, mostly women; when the supply of opium and morphine was discontinued for the nervous, distressed housewife, she eventually turned to the use of barbiturates, under the care of her physician. What the law did for this segment of the population of addicts was to take the over-the-counter narcotics

away and replace them with sedatives, by prescription. Exactly the same types of people who used narcotics in 1900 are now using barbituratesmiddle-aged, middle-class, white women with various quasi-medical, largely emotional problems that (they feel) can be solved by taking a drug. The laws did absolutely nothing to terminate this class of addicts, who certainly were in the majority in 1900they simply changed the drug to which people were addicted. The second group created by the narcotic laws consists of those addicts who discontinued use altogether. But it is likely that this segment comprised the least addicted of the turn-of-the-century addict population. Thus the legislation probably "helped" only those who were most capable of being helped, and who constituted the least troublesome problem anyway. The third segment of the addict population constitutes the present group of "street" addicts. A certain proportion of the earlier addicts refused to discontinue the use of narcotics, and since they did not, or could not, obtain legally available drugs, they became dependent on an illegal supply and thus automatically joined the ranks of the criminal underworld. It is obvious then, that the first half of the 1920s witnessed the dramatic emergence of a criminal class of addictsa criminal class that had not existed previously. The link between addiction and crimethe view that the addict was by definition a criminalwas forged. The law itself created a new class of criminals. Our confidence in this view is strengthened when we examine the role of the sedatives today. It is interesting that the barbiturates began to be used on a more or less widespread basis about the same time that the narcotic over-the-counter drugs became criminalized. Barbital (whose trade name is Veronal) was discovered in 1903, and phenobarbital (or Luminal) in 1912. The current use of the sedatives, including the barbiturates and the "minor" tranquilizers, certainly outstrips the use of over-the-counter narcotic preparations at the turn of the century. Continued administration of doses that are somewhat larger than the moderate doses commonly prescribed will produce addiction, an actual physical dependence in the user, and that daily use of approximately a gram or two will produce a severe dependence, then there may well be a million sedative addicts in the United States todayusers who would actually suffer severe withdrawal symptoms if their supply of drugs were discontinuedand the large majority of these addicts are taking their drugs legally, under medical supervision. In short, the sedatives of today have become the functional equivalent of the freely available narcotic drugs of the turn of the century. What are some consequences of the punitive approach to addiction? It cannot be doubted that the criminalization of narcotics had the immediate short-run impact of reducing the number of addicts in the population. But what about the long-range effects? To justify their policies, and their right to eminent domain in the drug field, the police wish to convince the public that the post-1914 enforcement practices have brought gains to American society. But like many such propagandistic claims, the argument falls apart on careful scrutiny. A wide range of unanticipated and undesired consequences of the police approach to drugs makes us suspect that had more intelligent policies been pursued, many of the most noxious features of addiction would not exist today. Probably the most important contribution that law enforcement has made to the problem of addiction is the creation of an addict subculture. It is important to emphasize that prior to 1914 no addict subculture of any significance existed in the United States, and there was no inevitable link between narcotic use and crime. There was a small population of opium smokers, consisting primarily of Chinese immigrants and of bohemian, literary, underworld, and demimonde figures who learned the habit from the Chinese. Addicts did not display any special cohesion or loyalty as a group; they possessed no lore concerned

with the acquisition and administration of drugs, no ideology elaborating the qualities of various drug highs, no justification for using drugs, no status ranking unique to the world of addiction, no rejection of the nonaddict world. During the formative 1920s these elements of an addict subculture began to emerge. Alfred Lindesmith has said that by 1935, when he was studying addicts in Chicago, "there already was a subculture without doubt" (Alfred Lindesmith, 1971: personal communication). It was the criminalization of addiction that created addicts as a special and distinctive group, and it is the subcultural aspect of addicts that gives them their recruiting power. Up until the past few years external factors have played a more important role in curtailing the spread of addiction than anything the police have done. Alcohol prohibition (1920-1933) focused the activities of organized crime on the distribution of liquor rather than narcoticsin fact, got organized crime started on a big-business scale. The depression of the 1930s also had a delaying effect on the growth of the addict subculture. And the disruption of drug supply lines during World War II slowed down to a considerable degree the recruitment of new addicts. By the end of the war some experts thought that addiction to narcotics had ceased to be a problem of any magnitude; at that time there were only 20,000 known narcotic addicts in the United States. But starting in 1945, and especially in the late 1960s, addiction began to rise dramatically. It is entirely reasonable to view this rise as largely due to the recruitment powers of a gradually developing subculture of intensely committed addicts. And it was through the efforts of the police and the courts that this subculture came into being in the first place. A second major consequence of the punitive police approach to drugs was the rise in the criminal activity of addicts. The view that addicts are "inherently" criminal is totally without foundation. However, it is clear that addiction and crime are closely related. Almost every addict, aside from the wealthy and those in the medical profession, is also a criminal, engaged in some illegal moneymaking venture. A "slave" (or a legitimate conventional job) does not pay enough to support a heroin habit, but many "hustles" do. "Boosting" (stealing from a store) and burglary are probably the most common forms of theft for addicts, although armed robbery, "snatch and grab" street tactics, and automobile thefts are also common. Most junkies have sold heroin, but they generally do so only on a small scale, since dealing in large quantities requires a greater cash outlay than addicts can scrape together at one time. A number of other hustles, such as pimping and confidence games, are not uncommon, but they require more skill and ingenuity than most people, whether addicts or not, possess. In addition, many successful criminal ventures involving large sums of money require precision and reliability, traits that are alien to the addict because of his overwhelming commitment to his habit. So notoriously unreliable are addicts that most criminal gangs will disassociate themselves from a member of their ranks who is discovered to be an addict. Most female addicts prostitute themselves, although they will also "boost." There is no question, then, that there is an intimate relationship between addiction and crime in the United States. (This is not true in most other nations, and it was not true in this country before 1914.) But it is also important to ask the reasons for the addict's criminal pattern of life. The police, in an effort to justify the existing punitive approach to drug prevention, claim that the typical addict's criminal career began before his involvement with heroin. A former director of the Bureau of Narcotics and Dangerous Drugs has written: "It is generally the criminal who turns to addiction rather than the addict who turns to crime" (Giordano 1966). Supposedly the conclusion to be drawn from this fact is that addiction is a criminal matter, a problem for the police to handle, and not a medical matter at all: "Any intelligent layman who becomes convinced of this fact... will see no solution to a crime problem by providing free drugs to criminal drug addicts. How can they be

expected to live useful, productive lives on narcotics when their lives were enmeshed in crime before they became addicted?" (Giordano 1966). The problem with this position is that it is true but irrelevant, a non sequitur. It is well known that most addicts are engaged in criminal activities prior to addiction and typically have a prior arrest record as well (O'Donnell 1965). This is, however, a fairly recent development. Most of the addicts of a generation ago were addicted before they engaged in criminal activities on a routine basis (Abrams et al. 1968, p. 2147); the transition can be traced to the abortive efforts of law enforcement policies and practices. Moreover, addiction clearly increases the frequency, the rate, and the seriousness of the crimes committed, as well as the likelihood of arrest. It is highly questionable whether any addict would persist in stealing hundreds of dollars of merchandise a day if he did not need to "support" a costly habit. It would be foolish to argue that the urban crime rate would not drop sharply with the institution of some kind of clinic maintenance program. Although the rate of crime for clinic addicts would probably be higher than that of the population at large, it would be far lower than the current rate of addict crime under the police-controlled system. Perhaps the most foolish and erroneous view currently in vogue on the drug question is that embodying the "chemicalistic fallacy"the view that addicts engage in crime because of the biochemical effects of heroin itself. It is seriously entertained in some quarters that as a direct action of illegal drugs the user's "character" is destroyed, he becomes a degenerate, his "morality" declines, and he inevitably turns to crime. It has been well over thirty years since Alfred Lindesmith launched an assault against this "dope fiend mythology," but the myth persists, trailing the wreckage of human life behind it. There is nothing inherent in the molecules of heroin that, when united with the cells of the body, compels the user to go out and commit crimes. The addict does not simply commit crimeshe commits moneymaking crimes. As arrest data show unambiguously, the addict is far less likely to commit crimes of violence, such as assault and rape, and far more likely to commit crimes that lead directly to quick cash. The view that addicts simply commit crimes of all kinds because of the direct action of drugs themselves is a grotesque and archaic point of view and is refuted at once by a look at the facts. If the rehabilitative rationale that is used to justify the drug laws were actually functional, someone who is arrested and punished for a narcotic violation would be unlikely to continue using drugs after his punitive experience. In fact, the opposite is true. In one study of 9,000 addicts in Chicago it was found that 86 percent had been previously arrested on narcotic charges. The authors of the study conclude that there is a "treadmill of addiction," with the same addicts being continually arrested and re-arrested, and with new addicts replenishing the supply from time to time (Abrams et al. 1968, p. 2142). Various studies of recidivism among addicts who have served prison sentencesor who have been detained in government-supported "hospitals"indicate a relapse rate of between 50 and 97 percent (Hunt and Odoroff 1962; Duvall, Locke, and Brill 1963; O'Donnell 1964, 1965; Lindesmith 1968). Most studies show a recidivism rate closer to 90 percent; the rate of relapse for addiction is probably higher than that for any type of crimewith the exception of committing homosexual acts. In many ways prisons serve to intensify the addict's involvement with narcotics, since the majority associate only with other addicts in prison and their major topic of conversation revolves around drugs. The marginally committed narcotics user will find himself associating with, and gradually acquiring the attitudes and values of, the addict subculture in prison. The lesson to be drawn from follow-up studies of addicts released from prisons and federal hospitals is that relapse is overwhelmingly the rule and not the exception. Punishment appears to have virtually no effect on deterring the addict from using drugs after his release. Prison is clearly not the answer.

It is obvious that efforts at criminalizing addiction have failed. Any agency other than law enforcement with such a high rate of failure would be forced to reevaluate its methods of dealing with the problem. Over half a century of failure is a long and dismal record indeed. Since the police are to some degree insulated from criticism, they may safely ignore a factual assault on their methods and may remain unwilling to admit their failure to deal with the problem. An answer to why this society continues to pursue the same unworkable and disastrous policies toward drug addiction would require a volume-length discussion. However, a number of suggestions in this direction can be made. When a form of behavior directed toward a stated purpose fails to achieve its goal, the sensible observer begins to look for unanticipated goals or consequences, for latent rewards or blind spots. I am often asked by my students in criminology, deviance, and delinquency classes if the reason for the inability of society to rid itself of the drug problem is that the police receive large payoffs from organized crime. My feeling is that this explanation is far too facile. It is true that more than a few narcotic squads are involved in drug peddling and receive money directly from the criminal underworld. (During the summer of 1969 fifty out of the 300 agents in the Federal Bureau of Narcotics' New York office were forced to resign in the wake of a scandal exposing widespread drug peddling among law enforcement agents. It is exceptional for such behavior to reach public view but common for it to occur.) In itself, however, this does not account for the continuation of the obviously unsuccessful drug programs in force today, though it might explain why one or another drug peddler is not arrested. I believe that the following factors play a role in insuring that the agents of social control, as well as a majority of the public, will continue to view their efforts as reasonable and efficacious, and to regard any reform of the system as an erosion of justice. (1) The symbolic functions implied by severe penalties play an important role in their continuation, whether or not the penalties are effective. A policy is not only a practical attempt to achieve clearly demonstrable goals; it is also a statement of one's own ideological stance. In the case of drug laws, punishing the wrongdoer affirms one's undaunted opposition to drug use. To take a less severe stance would somehow imply that one approves of taking drugs, that at the very least one tolerates drug use. Savage penalties signify one's desire to do something about the problem, even if the penalties actually achieve the reverse. The polarization of sides on all significant issues produces the need for displaying statements of one's ideology. When the issue of "law and order" becomes crucial, support for the police in all their efforts becomes a watchword for a specific political stand. The outcome of the police efforts is basically irrelevantwhat counts is which side one is on. (2) Ideological considerations limit objective evaluations so powerfully that one is unable to see the destructive effects of one's own actions, or the actions of parties that one supports. The fact that many efforts to stamp out crime actually strengthen it will not be recognized by those who initiate such actions. Policemen will reject the contention that the death penalty does not deter homicideeven though data supporting this assertion are a matter of public recordbecause such a view does not square with their ideology. Moreover, the claim that one has actually contributed to something that society views as repugnant is an extremely uncomfortable thought and will not be readily believed. Thus it is extremely unlikely that anyone involved in pursuing or supporting existing drug policies will actually understand or perceive his impact on the drug problem. It is easier to rationalize and justify one's efforts than it is to attempt to make them really effective. (3) Vengeance is a powerful motive in the desire to punish the deviant and the criminal. Any strict observer of the law and existing morality will perceive an imbalance in the moral

economy; the conformist will feel a sense of "distributive injustice" if the transgressor is not punished, and when he is the conformist has cause for satisfaction. A person who observes the law will feel that he has "paid" much more and has received much less in return than the deviant and the criminal who have managed to beat the system. The desire on the part of the law-abiding citizen to punish the transgressor need not bear any relationship to criteria of "effectiveness," because his punishment becomes seen as an end in itself. (4) Deviance and crime, and deviants and criminals, present a vast resource for social control agencies. It has been noted repeatedly that the agencies whose supposed goal is to stamp out antisocial behavior and to "correct" individuals committing it often do their best to insure that these individuals actually continue that behavior. In prisons, mental asylums, courts, welfare agencies, reformatories, or any one of a dozen correctional institutions, there appears to be almost a self-perpetuating quality to the efforts of social control. But this is not as strange or contradictory as it seems at first blush. Social control agencies derive support from deviance; the deviant is defined as the special area of competence of the agency, which receives public funds for its supposed special competence. Deviance is a domain, a sphere of interest, a "turf," an area of control, power, resources, expertise, and concern; it is a kind of happy hunting ground. Without this domain, the functions of the agencies dealing with it would be dubious. A correctional agency cannot be too successful, for that would eliminate its very reason for being and would involve a scramble to discover another problem area. Dealing with an ongoing problem for decades also gives an agency "seniority" in that areaeminent domain, in the case of the police. The police, then, draw ideological and material sustenance from drugs and drug users. It is not a domain that the police are going to give up easily or willingly. It has profited them too handsomely. The colossal failure of drug policies can in part be attributed to the confusion between intention and effectiveness. Most drug policies are, and continue to be, based on ignorance. Lawmakers do not pay attention to the latest research being done in a given area. The "experts" selected to justify law enforcement policiesselected for ideological and not scientific reasonstypically know little more than the lawmakers themselves. Creators and enforcers of the law are, unfortunately, victims of their own propaganda. They have no idea of what the impact of their efforts will be, largely because they have an erroneous and simple-minded view of the social and psychological realities of the drug scene. Often this ignorance causes more damage than the absence of any policy at all. "The law is an ass," said Mr. Bumble in Dickens' Oliver Twist. In the area of drug use, this appears to be irrefutably the case. Drug laws have not worked. The illegal use of drugs is growing apace. Each new, stiffer law is announced as a more effective instrument in the fight against drug abuse. And each year the number of illegal drug users increases. Yet law enforcement officers will continue to apply the same witless and self-defeating policies, to enforce the same stillborn laws. And the lawmakers will comply by cranking them out without any effort to review the principles on which they rest. Evidence demonstrating the failure of police efforts will be ignored, discounted, and even suppressed. A roster of pseudo-experts will be encouraged and financed by agencies of social control to provide "proof" making present policies appear expedient and reasonable. Efforts to significantly reform the law will be resisted, and more stringent penalties, as well as more police power, will be called for. Nonpunitive methods will be discredited. And because ongoing policies are based on errors of fact and logic and a distorted conception of drugs and drug users, the existing problems will continue to grow and the policies will almost inevitably be abortive. The legal situation in relation to marijuana represents a qualitatively different problem from that of narcotic addiction. While many (although certainly not all) heroin addicts wish

to discontinue the use of heroin, very few marijuana users wish to stop smoking cannabis. The laws criminalizing marijuanadirected, paradoxically, principally and most stringently against sale and possession, and almost not at all against use itselfrepresent what Jerome Skolnick calls "coercion to virtue" (Skolnick 1968). Marijuana use is a classic case of the "crime without a victim"; the user harms no one except himself, and many observers question whether even the user is harmed by the use of marijuana. (Other observers argue that the fact that marijuana use is spread among friendsmuch like a communicable diseaserefutes the claim of a victimless crime. However, the solitary user is just as liable to arrest as is the gregarious, sociable user who "turns on" friends. No one who wields this argument suggests that solitary users should be exempt from the marijuana laws.) Since there is no victim, there is no complainant, no one to report marijuana crimes taking place. While the ratio of detected to undetected murders approximates one to zero, detected to undetected auto thefts one to zero, and detected to undetected rapes approximately one to four, there is something like one detected to several hundred thousand undetected acts of marijuana use, one detected to several thousand undetected acts of marijuana sale, and one detected to at least tens of thousands of undetected instances of marijuana possession. The marijuana user who is arrested is in the tiny minority, whereas the overwhelming majority of street narcotic addicts eventually become arrested during their addiction "careers." There are prison cells to hold only several hundred thousand criminals in the United States, and something like 20 million Americans have tried marijuana, half of them using the drug on a more or less regular basis. Regardless of the wisdom or justice of the laws, of their effectiveness as deterrent devices, or of the relative harm or harmlessness of the drug itself, it must be realized that anyone seriously enforcing the marijuana laws faces enormous strategic and logistical problems. In fact, any reasonable observer would have to say that enforcement of the laws is a complete impossibility. The federal marijuana lawthe Marijuana Tax Actwas passed by Congress and signed into law by President Franklin Roosevelt in 1937. It was ruled largely unconstitutional in 1969 in Leary v. United States because of its double-jeopardy feature in relation to the fifty state laws outlawing the sale and possession (and in some jurisdictions the use) of marijuana. (The federal law did not literally penalize the possession of marijuana; rather it penalized the failure to pay the excise tax of $100 per ounce on the transfer of marijuana. But if one were willing to pay the federal tax and were to fill out the necessary forms, one would have automatically incriminated oneself under the state laws.) The act was replaced on the federal level by the Comprehensive Drug Abuse Prevention and Control Act of 1970. The federal law is, however, far less crucial than the fifty state laws criminalizing marijuana. First of all, the number of arrests on the state level is much greater than the number of federal marijuana arrests. Since 1968 in California alone about 50,000 marijuana arrests have taken place each year, and the total arrests in all the other states is at least triple this figure. The number of arrests at the federal level is minuscule in comparison. Second, arrests at the state level involve primarily users and petty sellers, whereas at the federal level most of those arrested are marijuana sellers, usually of large quantities and often at the importation link of the distribution chain. As recent research has indicated, most state-level marijuana arrests take place as a result of accident a patrolman stumbling upon marijuana in someone's possessionand not of planning. One study reported that the overwhelming bulk of state-level marijuana arrests took place without the work of an undercover agent, without the aid of an informant, and without the use of a search warrant or an arrest warrant (Morton et al. 1968). Over a third of the arrests (45 percent for adults, 36 percent for juveniles) took place in an automobile, and another quarter or so (21 percent of the adults, 35 percent of the juveniles) took place in a public place. These facts indicate the dominant

role of "patrol enforcement" and the almost complete absence of a systematic enforcement strategy in marijuana arrests at the state level. In the study just cited, undercover agents supplied only 3 percent of the adult marijuana arrestees and 7 percent of the juvenile arrestees. The accidental nature of state-level marijuana arrests is clearly a source for the feelings of distributive injustice among those arrested. Another feature of the state marijuana laws (also likely to produce resentment) is their enormous variability. Nebraska has the most lenient state law. For possession of a pound or less of marijuana the Nebraska law calls for a penalty ranging from a nominal fine of $ I to seven days' confinement in a county jail and/or a fine up to $500, plus compulsory attendance in a "drug education" course. For possession of more than a pound, the law calls for confinement of from six months to a year and/or a $500 fine. Of all the states, Texas has the most severe penalties; its law calls for imprisonment of from two years to life for the possession of marijuana! It might be reasoned that such a barbaric penalty could never be imposed today; unfortunately for some, sentences of thirty to fifty years were actually handed down in the state of Texas in the late 1960s and early 1970s. By what set of criteria should the effectiveness of the marijuana laws be judged? There are at least five basic functions supposedly served by the marijuana laws and their enforcement: (1) deterrence, (2) rehabilitation, (3) public safety, (4) vengeance, and (5) symbolic representation. The first three of these are instrumental goalsmeasures can be set up to determine whether or not they have in fact been achieved. The last two are symbolic or ideologicaland beyond the reach of empirical tests. The deterrence function can perhaps be measured by comparing the current popularity of marijuana with that of alcohol. The fact that there are "only" 20 million or so marijuana users in comparison with 80 to 100 million drinkers of alcohol (these are overlapping groups, of course) suggests that some degree of deterrence has in fact taken place. But, this trend is swiftly breaking down. Various studies indicate that the rate of increase in the number of college students who have tried marijuana is approximately 1 percent every one or two months. If the present pattern continues, it is highly likely that by the 1980s marijuana will be the drug of choice among the under-thirty segment of the American population. (Alcohol is still the most popular drug among the young.) In this sense, the deterrence aspect of the marijuana laws has been, and will increasingly be, a failure. No follow-up studies have been done of the impact of law enforcement on arrested marijuana users. However, it is known that the number arrested is a minuscule percentage of the total population of users, and that users who are sent to jail are a small proportion of all arrested users. Most marijuana arrest cases are either dismissed, granted parole without a jail or prison sentence, released, or acquitted. If law enforcement were pursued vigorously, and if jail sentences were the norm, the deterrence and the rehabilitation functions of the law could be tested properly, but the marijuana laws have become similar to others that are fitfully, unequally, and irrationally applied and enforced. Thus, given the relatively small number of marijuana users who ever serve a sentence, the rehabilitation function can be said to be almost completely null and void. The public safety issue is clearly contingent on deterrence. The reasoning is that since the laws prevent millions of citizens from using marijuana less damage is done to the body social, because less of the drug is consumed and fewer people are being harmed. The issue is also contingent on three other factors: (I) whether marijuana is in fact dangerous and damaging; (2) the lack of substitution of marijuana for other drugs, such as alcohol; and (3) the lack of damage to society obtaining under the present situation. The majority of the studies summarized in Chapters 2 and 3 suggest that on the issue of the harmfulness of the drugsocial, psychiatric, and medicalmarijuana appears at present to be no more

damaging than commonly accepted household substances. Moreover, nearly all the studies claiming damage to moderate or heavy users have not produced convincing evidence (see, for example, Kolansky and Moore 1971; Campbell et al. 1971; Kew, Bersohn, and Siew 1969; Talbott and Teague 1969; Isbell and Jasinski 1969). If such evidence is to be found, the future awaits it; it has not been turned up at this writing. The question of marijuana substitution is also not easily resolved. The anti-marijuana forces have argued that the fact that many marijuana users also drink demonstrates that substitution does not occurand that instead of only one problem we will have two if the marijuana laws are relaxed. The pro-cannabis forces argue that if marijuana were decriminalized, less alcohol and more marijuana would be consumed, and since the medical damages of alcohol considerably outweigh those of marijuana, less total damage would occur to users and to society. The "anti" argument is couched in the form of X plus Y (damage as a consequence of alcohol use plus damage as a consequence of marijuana use); X plus Y is clearly greater than X alone. The "pro" side holds that what really occurs is X plus Y minus Z (the damage prevented as a consequence of converts from alcohol to marijuana). Actually, the fact that marijuana users also drink alcohol does not invalidate the substitution thesis, since there is no way of knowing how much they decrease their intake of alcohol after smoking marijuana. It is possibleeven likelythat the level of alcohol use among marijuana smokers is higher than that of the general population and that users reduce their alcohol consumption after smoking marijuana. The substitution thesis is being tested by a number of physicians who are suggesting and implementing marijuana use in their therapy as a cure for alcoholism (see, for example, Mikuriya 1970, 1971). Dr. Jordan Scher suggests that a large-scale study should be made on the feasibility of a substitution program. Marijuana, Scher writes, "is not very noxious physically," whereas alcohol, especially among alcoholics, is associated with "frequently psychopathic and violent, combative, and destructive features," is "responsible for 50 percent of automobile and plane accidents, killing 50,000 and maiming and injuring about five times this many annually, and for 50 percent of all arrests for whatever reason." Dr. Scher writes that in regard to legalization, "I am not really sure I am in favor of this idea," but "it may come about in the not too distant future" (Scher 1971, p. 972). In spite of all the arguments for and against the decriminalization of marijuana, the fact remains that these "logical" issues are probably of little consequence in the debate. Marijuana is illegal because most of the public, as well as those in power, are ideologically opposed to its use, because it is a symbol for many other activities and beliefs that are also condemned, and because there is a connection in the minds of many people between marijuana use and belief in a politically and morally unconventional ideology. The medical argument is added to the moral and ideological sentiments to make the anti-marijuana stance appear to be reasonable and rational. The eventual acceptance and decriminalization of cannabis will come about as a consequence of the following factors: (1) the rhetorical and forensic skills of the pro-marijuana lobby in outpropagandizing their opponents; (2) their tactical, organizational, and strategic abilities; (3) the conversion of millions more Americans as a consequence of having tried the marijuana experience; and (4) the gradual dying off of a generation with a restrictive world view and the coming into power of a generation that finds the marijuana experience ideologically acceptable. Marijuana's "objective" properties will play a very minor role in this process.

NOTES 1. Documentation of this assertion would require a book-length presentation. The scheme, however, agrees with Fort's. There is at least one methodological difficulty, and that is how much of the drug constitutes "heavy" use and over how long a period of time. A "heavy" tobacco smoker might consume forty or fifty cigarettes a day, whereas a heavy smoker of marijuana might consume one or two joints a day and a heavy user of LSD might trip twice a week or so at the most. Thus if we were to accept as one possible definition of "heavy" use that quantity consumed by the one in ten heaviest users, we would be considering vastly different quantities of different drugs consumed, and the patterns of use of each drug would influence our findings. "Heavy" use of alcohol would be the quantity drunk by the 10 percent most frequent drinkers of everyone who has used alcohol in the past six monthsa definition that would be approximately identical to all alcoholics. But obviously, this would vary from nation to nation. Another definition might be the quantity that is necessary for the user to be under the influence of the drug all his waking hours, regardless of actual patterns of use. There are serious problems with this definition too, such as the fact that it would be difficult, if not impossible, for users of some drugs to be high all the time, given the development of tolerance No definition of "heavy" use covering all drugs is completely satisfactory, and such a comparison is partly a methodological problem.(back)

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