Drug Policy – Part 2

The Gateway Effect

Now, if one skims through the Wikipedia page on the Gateway Drug Theory you’ll note that there seems to be more evidence against the theory. Now, that somewhat is and isn’t correct. The strong version of the Gateway Drug Theory is that substance abuse is like a trail of candies, with the closest one next in the chain allures you into trying the next. That theory does seem to have been disproved. The weak version, however, would be like if you were to remove all spicy dishes on the planet except those that were equivalent to a 5-star rating at the spiciest restaurant in the world. In that case, there would probably be very few people who ate spicy food because there is no first step to take that isn’t 100%. That is to say, a gateway drug doesn’t draw you in, rather it lets you take baby steps instead of having to jump past your comfort level all at once. Rather, the pressure to advance up the ladder comes from bravado, peer pressure, or whatever else, but the existence of intermediate challenge levels makes you more likely to find something you are willing to try. Even with the complete array of steps that one can take in terms of spiciness in modern day, you’ll note that most people still peek at say 30-50%.

Using the weak version of the theory, the RAND “Mathematical Model” would be moved to be in favor of the theory, neither of the rat studies are applicable, and the “Study of American Adolescents” doesn’t appear to be testing anything beyond that if you find cases where people didn’t do as the theory states, then the theory is wrong — which I can only say seems to be about as intellectually dishonest a test as one could fashion.

Given that we have seen that when the social stigma of prostitution is removed, the demand for prostitution rises, I think we can add that in as another item of evidence in favor of the weak theory.

Market Factors

But then there is the Amsterdam example from the gateway drug theory tests. While it seems likely that a stepping-stone effect does exist, it doesn’t necessarily mean that legalizing a lower drug, like marijuana, will lead to greater use of heavier greater drugs. If all drugs were legal, then it might; but they aren’t.

A factor to what you do is how much money is in your wallet. Another factor is the sort of effect that you are trying to achieve.

Say that there are 10 flavors of ice cream. I arrange those in order from least tasty (#1) to most tasty (#10) and add 10¢ to the price for each level higher in the chain of taste. A person will test the cheapest and decide whether to continue on or if he’s satisfied with that taste at that price. If he continues on, he tries the next most delicious and the next most delicious.

If, on the other hand, I price the least delicious ice cream at 10¢ and then price the others starting at $5, increasing at 10¢ after that point, it’s possible that after trying #1, that next ice cream that they try is any one of the remaining 9 types. Once you’re resigned to the $5 hit, the difference in price between everything that remains isn’t all that large a factor.

But then say that I take the first 3 types, sell them each at 10¢, and the rest starting at $5. While I’ll still see people trying the more expensive ice creams in a random fashion, it’s quite possible that only very few people will try any of those. With the selection of the three ice creams, the variety on offer is wide enough to satisfy almost everyone’s tastes, and the leap from there to the next level (pricewise) isn’t seen as being worthwhile.

Presuming this model to work in the real world, it has two implications. Firstly, is that if you are overly prohibitive, it may backfire and cause greater use of harder drugs. Secondly, is that you can control which drugs are used more often by adjusting the relative costs. That is to say, you can decide where the $5 hit (illegalization) comes, and the relative price (taxes, prison sentences, and fines) of the individual items.

Another form of displacement is that a person’s budget is limited. If he has $5 in his wallet and a 6 pack of beer costs $5 and a pack of marijuana cigarettes costs $5, he has to choose between them. When marijuana is legalized, for example, it’s quite possible that the number of people who get drunk and go out and crash their car into a pedestrian will shrink as the number of marijuana smokers increases. On the other hand, the number of cases of cancer will increase, which cost will fall on the taxpayer. Though it’s to be admitted that it doesn’t appear that usage of marijuana changes (and subsequently, the usage of alcohol or tobacco) with legalization/decriminalization because most people are ignoring the criminal penalties for possession already and hence it doesn’t factor into cost.

The Teen, College Student, and Party Goer

It may seem odd that the criminalization of marijuana doesn’t appear to inhibit usage, but the thing to notice is that outside of those living in poverty, the mass users of drugs are students between perhaps ages 14 and 22 (i.e. high school and college). And more importantly is to note that for all of those under the age of 21, purchasing alcohol is a crime, and all those under the age of 18, purchasing cigarettes is a crime. For the grand majority of the group who we are interested in, the principal price barrier — legality — is already rendered moot; once you have already started on that path, continuing on it seems a non-issue even when cigarettes and alcohol become legal for you. The only remaining price difference is the question of perceived danger and the amount of pressure that others place on you to try something. Very few kids are going to try heroin because, simply, it’s viewed as too dangerous and the purpose of the drugs are to be social and/or to diminish inhibitions, not so much to get high. Getting high on heroin makes you largely useless so far as socializing goes.

Smoking is a good drug for socializing because it gives you something to do with your motor controls section of your brain while you stand around talking. Drinking is a better one because it accomplishes that same purpose while also diminishing your inhibitions and hence making you feel more free to dance, make jokes, and break the ice.

The addictive qualities of alcohol and cigarettes don’t make kids drink alcohol and smoke, rather they keep the kid from being able to drop the habit when he becomes an adult or when he starts to realize the dangers.

The major dangers for a partier, is that he will OD, that he will be taken advantage of, that he will do something stupid like driving while intoxicated, or that he will become addicted — which is really a crap shoot, dependent on the addictive properties of the drug. There’s no knowing beforehand whether you will or won’t be the type to become addicted.

But whereas most drug usage is for partying purposes, and this is where the greatest impetus to push through the barrier of illegality comes from, there is also the small groups where two or three people might get together to be mellow and high. They smoke marijuana, or perhaps try some other form of opiate (like heroin). Generally, this is going to be a fringe group as sitting around staring at the roof isn’t something that appeals to most, whereas dancing and socializing does. And generally, they probably won’t try harder drugs because while they don’t want to party, they do still want to socialize at least a bit. And as middle-classed kids, they have a future to look forward to and don’t want to risk it by trying something dangerous.

The Poor

On the other hand, when it comes to the poor, the goal is more to relieve stress, zone out, or otherwise to self-medicate. The danger here isn’t so much drunk driving, but rather domestic violence, heightened probability of committing a violent crime, and the willingness to go for the harder drugs. Overwhelmingly, though, alcohol is still the winner. It is cheap, legal, and gives enough of a buzz and a dulled mind to satisfactorily accomplish the desired ends. But it is at the same time a drug that, unlike marijuana, makes one more likely to act stupidly due to heightened emotions and lowered rationality — rather than to mellow out and be at peace with the universe.

Heroin, while in the same class of drugs as marijuana (opiates), is however of sufficient addictiveness that when the person isn’t placid and at ease, they’re liable to commit a crime to finance their urge.

The Poor – Needle Park

For those addicted to heavier drugs, the idea was introduced to create a region for legalized drug trafficking and use. The theory was that prices would lower, meaning that there was less need to rob convenience stores and so on, gang confrontations would happen separate from where law-abiding citizens lived, and charity and medical organizations would be able to hand out fresh needles and other supplies to help prevent the transmission of HIV and other illnesses.

The problems with this model is that, 1) it draws drug addicts from surrounding regions. In Europe, that might be from countries which still had drug prohibitions, whereas in the US it would probably be from states which maintained restrictions. 2) NIMBYism seems to get the parks shut down. Everyone around the bad region is affected by those going in-and-out, especially when confrontations spill over. A zone of legalized anarchy is, for obvious reasons, liable to impact its surroundings. And overall the cynicism of “let them go and kill themselves over there” is too great for most to accept.

Personally, I’m fine with cynicism, but if such locations are consistently shut down or are perceived as a failure by most of the population, then the point is moot.

The Poor – Heroin Centers

The original idea of heroin prescription was that you are treating an addict with a particular regimen that is controlled, and hence can be gradually diminished so that the person is free of the addiction. I don’t believe that this has met with a particularly large amount of success. The sort of person who is on heroin is on it because he feels his life sucks. He’s happiest on the drug, and that’s a heck of an impetus even without the addictive qualities of the drug itself.

The idea that followed this, then, is simply to let them have it. There is no prescription, you simply register into a program and show up once a day. If the government sells heroin, it can underbid an illegal seller — with the lowered price equating to less crime. There is no needle sharing, there are no gang confrontations, and the quality of the drug is purer and less harmful. Daily contact with a trained medic increases overall health and happiness of those who enroll in the program. Overall, this doesn’t seem to decrease heroin use nor lessen the number of people who start the habit, but it does lessen the secondary impacts on society. Overall, it does seem to be a successful system:

http://nceph.anu.edu.au/Publications/Opioids/work14a.pdf
http://www.sptimes.com/News/073101/Worldandnation/Heroin_for_addicts_wo.shtml

Potentially, similar systems could be set up for other drugs — though due to the nature of how a drug works, it may be that a person can’t be stabilized on a particular dosage, that they wouldn’t want to stay at the facility while under the effects of the drug, or otherwise the system would be non-applicable. Certainly, it is worth testing. I don’t believe that one would need to worry about regular teens showing up at a medical clinic full of addicts to get high, nor anyone being naturally attracted to such a thing except for those who would have been willing to purchase those same drugs legally. I don’t see any reason to think that the existence of such clinics would increase demand as time went on.

Drugs are Drugs

Now, while a heroin clinic may decrease the downsides of heroin usage among the poor, we are still failing to impact the drug usage of teens, and the much larger issue of alcohol use among the poor.

The problem I see is that there is a disconnect for most people between caffeine, cigarettes, alcohol, and drugs. What if I was to tell you that a new drug called Woozle had the same qualities as alcohol but without dampening motor reflexes and with a lower level of addictiveness? What if I was to then tell you that Woozle has already existed for 20 years, is used by teens regularly at parties, and if you’re found using it you’ll be stuck in jail for 20 years?

Personally, I don’t know if Woozle exists, but I do know that with the way the US currently functions, if we found better alternatives to drugs like alcohol and tobacco, they would be prohibited and people would continue to use alcohol and tobacco and they would be ever-so-hesitantly scared of Woozle because they know it’s a “drug”. Yet, it would be perfectly easy if the true effects (positive and negative) of Woozle and other improved drugs were known to adjust the market place such that they became the drugs of choice. Teens may be idiots, overall, but they still understand that if they can get the same effect without as great a risk of a car accident, they’ll probably go for it. For all I know, if one could make a beverage out of Ecstasy, it would completely replace the market for alcohol among teens, and make the world a better and safer place:

http://en.wikipedia.org/wiki/File:Rational_scale_to_assess_the_harm_of_drugs_%28mean_physical_harm_and_mean_dependence%29.svg

While I do appreciate that self-medication with a narcotic is something to be frowned upon, at the same time it’s clear that it’s going to happen, be it with alcohol or Ecstasy. Ultimately, you would rather have people using the drugs with the fewest downsides for the rest society, if nothing else. A history of thousands of years of alcohol might give us an emotional bond to that particular drug, but frankly it’s possibly one of the worst drugs you could have be legal compared to equivalent alternatives due to its effects on driving and violent crime. Tobacco and marijuana are poor choices because even if you reduce second hand smoke they lead to an increase in cancer, and the bill for chemotherapy falls on the rest of us. A rational reappraisal of all known compounds that might be used for social or stress-relieving purposes and a marketing push to move people to those drugs and then prohibiting alcohol, cigarettes, and marijuana (or more likely price-adjusting them to be luxury items) could very well be the greatest thing that we could do to reduce addiction and crime.

There may well be place to out-and-out prohibit certain things, but that should be based on something greater than tradition.

General Remarks

Prohibiting alcohol and cigarettes to younger teens is ultimately futile due to the shared interaction with college students at clubs and parties. Raising the legal age to 24 may succeed in letting the price barrier start to kick in, particularly if the difficulty of counterfeiting drivers licenses was raised at the same time. But on the other hand, I don’t see young adults who want to party and who’ve had a history of alcohol and drug use within living memory deciding to go ahead with clean and wholesome partying. Those who were willing to buy illegally would buy for everyone and the illegal market would grow. The heightened down-cost might make such parties less common, but I don’t know that I’d want to trust that, and I’d certainly not like to give strength to organized crime.

If marijuana is legalized, actively pushing it as a preferable alternative to alcohol among the poor could very well result in lower crime rates. It seems like a drug that would fit their desires well enough and so a targeted push would likely be effective. With cost reductions in criminal proceedings (which can cost in the hundreds of thousands of dollars per case) due to lessened violent crime and removal of possession crimes from marijuana, the raised cost of treating cancer patients may well be equivalent or even net to a benefit.

With drugs like Rohypnol (the date rape drug), cyanide, or other drugs for malevolent purposes, maintain prohibition seems entirely reasonable.

With drugs like steroids, I believe that a sort of peer pressure is in action (the race to the bottom effect), that there aren’t better alternatives to be switched to, and that both the public and the competitors themselves would probably prefer that steroid use go away. In light of that, I don’t see any particular argument to legalize their use.

Conclusion

Overall, I would recommend prohibiting as many drugs as can be prohibited. But the prohibition of drugs should be based on the real world effects, not tradition. There should be enough legal narcotics to provide a well-rounded and generally safe menu, and the rest illegal or priced out of feasibility for most. Ultimately, that gives the police more time and money to dedicate to worrying about tracking down and destroying the stuff that matters.

There is the worry that people would be popping twenty types of pills at the same time, but that’s why I would further suggest that these drugs be included as part of drinks or food — something that takes time to partake, takes up physical space, and gives you something to do while you socialize. If that’s done and people were educated about the dangers of mixing pharmaceuticals (which I think they are), I don’t think you would see that much mixing.

Drug Policy – Part 1

In general, my position would be that while the government is far from perfection, even still if you see them doing something that you disapprove of, quite likely if you had the service of a team of researchers and experts you might well come close to the same answer as you see out in the world from day-to-day. When things go wrong, more likely it’s because even the experts got it wrong, not because the layman knew something that they didn’t.

A case where this might not be so true is when new discoveries are made in the world. If those discoveries are well-covered in the media and gain traction in the public consciousness, then politicians will move to analyze and act on the information — for example in the case of global warming where, essentially, the choice was to do little-to-nothing as one would expect (see the Climate Change series, particularly parts 3-4). But when those discoveries aren’t very well popularized, politicians as a class are generally non-fussed to investigate nor act on the information. As someone whose income depends on maintaining popularity, they have no incentive to rile the waters for the sake of something their electorate hasn’t ever heard of. You might blame politicians for that, or you might blame the mass media for failing to properly educate the populace, but ultimately newspapers educate the populace about the things that the populace wants to pay to read about. Your average person who buys newspapers or watches the news has children and they know that Drugs are Bad and that their children are susceptible to being lured in to drug abuse. They don’t want to read about anything but grunt force to combat drugs. There simply isn’t any profit to be made by telling them that they’re ignoring information.

What a Person Wishes to Do to Themselves is Their Own Business

In times past I’ve argued that a social security web is probably for the best, though in principal one could say that it’s everyone’s own right to screw themselves over by improper foreplanning, and I’ve argued that allowing people to sell their own bodies is probably bad, though theoretically it doesn’t involve anyone else. From that, you might think that I don’t subscribe to the idea that people have a natural right to mess themselves up as they see fit. In actuality, I’m quite happy to let people screw themselves up. You’ll remember that one of my arguments for social security is that the general public will always end up voting for it, so the point was moot.

But overall, I’d say that my position is far more nuanced than an absolutist, Libertarian ideology of personal sanctity. The two places where I agree to intercede into self-destructive behavior are:

1) It actually does end up costing or harming the rest of society, so it’s not just an issue for the individual.

2) Most cases are due to issues of human cognitive failings, rather than personal choice. For instance, if a person chooses to jump off a bridge because his life sucks, I respect his right to do that. However, if a version of the game of chicken developed where kids were daring each other to jump off a bridge first, then I’d view that as a situation where it is acceptable to step in and attempt to stop the practice because its not an issue of choice, it’s an issue of destructive herd mentality.

In essence, #2 is a branch of #1, highlighting a particular version of social harm that can easily be overlooked so that it doesn’t seem like it’s an issue that affects anyone else.

Now, in the case of drugs, there are two versions of potential social harm. Firstly is the issue of social pressure. Most people do not choose to take drugs, they start using them because taking drugs is what is done among their peer group. Secondly is that a drug user is liable to commit crimes either under the influence of the drug or, if heavily addicted, as a way to earn money to support their habit. If both of those issues could be solved, I couldn’t personally care in the slightest if a person was smoking crack in his basement or not. It doesn’t affect anyone but him and he is aware of the dangers.

The Danger of a Drug

While I don’t personally care about the harm that a drug can cause to the individual (so long as he took of his own will), it is still a consideration that most people put in when considering the relative dangers of allowing drugs to float freely in the marketplace. This danger can either be via the amount that the drug affects ones senses, and hence the chance that you will do something stupid, or the potential for the drug to act as a poison on the body (either all at once, or incrementally over time.)

People also generally care about the relative addictive qualities of a drug. It is considered a risk that someone will try something either due to medical needs or because of peer pressure (or out of general ignorance) and end up becoming hooked. The influence of the drug or the illegal nature of the drug might then lead to the person getting into trouble and screwing up their life, a fact which they are powerless to stop due to the addictive quality. Since the potential legalization of drugs is on the table during this discussion, we won’t consider the possible ill-effects that can come of buying and selling illegal narcotics, only the potential for the mind-altering properties to get the person into trouble.

Marijuana

Before embarking on a general discussion of drug policy, I would like to discuss marijuana.

In a rational world, one would be able to draw out a chart with three axises, one for addictiveness, one for the strength/duration of any mind-altering features there are of the drug, and a third for the physical/poisonous danger of the drug. One should be able to say that within a particular cuboid near (0, 0, 0), those chemicals are safe for public consumption and anything else is (for example), illegal. You would not need to individually create a new law per narcotic, only to ask the FDA to test the drug in a laboratory setting and set its position on each of the three axises. More importantly than that, anything other than this rational method of handling falls prey to judicial review. Like I pointed out in my discussion of judicial review, if you dislike the amount of sugar being consumed by the populace, arbitrarily choosing one or two high sugar items while leaving plenty of others to choose from is unacceptable as law.

Personally, I have never smoked, drank, nor done drugs. I think people who do are almost certainly morons who have fallen prey to the idiocies of the rest of society. Banning all drugs and summarily executing anyone caught with any would, so far as I’d be concerned, be a perfectly acceptable option to dealing with drugs if they are actually a danger to society. So it is very safe to say that I have no particular love of adding marijuana to the roster of legalized narcotics available in daily life. But by all rational consideration, if the world is happy enough to allow such drugs as alcohol and tobacco to be publicly and legally sold, one must allow the production and sale of marijuana. It is less addictive than both tobacco and alcohol, its dangers as a mind-altering substance is less than alcohol, and its toxicity is probably on-par with an unfiltered cigarette (which is legal). There is probably a decent bet that, if legalized, a filtration system to remove some percentage of the carcinogens from marijuana cigarette would be developed and implemented. And of course, it’s worth noting that the relative toxicity of a drug is probably not a matter we should concern ourselves with (beyond the issue of second hand smoke).

http://www.tcada.state.tx.us/research/slang/compare98.pdf
http://www.neurosoup.com/pdf/addictivepropertiesofdrugs.pdf
http://www.parl.gc.ca/37/1/parlbus/commbus/senate/com-e/ille-e/rep-e/summary-e.pdf

Because marijuana is not properly a “drug”, it doesn’t count so far as the rest of our discussion goes. The debate for or against it is solved by simple jurisprudence, without having to review any issues of drug policy at all. You may personally think that the world would be better off without another legal narcotic, but regardless of our desires we live in a land based on the rule of law, and the rules of law are that law not be capricious. If you don’t want marijuana in the public sphere, you have to be willing to give up alcohol and cigarettes.

You might argue that marijuana and alcohol combined in the body create an effect greater than the sum of its parts. Even if that is so, that would be cause for criminalizing the taking of both of these narcotics at the same time and/or fashioning much stricter consequences for driving under the influence of both. For example, there are various chemicals which you are free to buy and sell, but combining them into a bomb or poisonous gas is prohibited. And in a rational world, at least until such time as it was demonstrated that the effects of having both drugs legal was a serious worry to the general welfare of the nation, prohibition is presumptuous. The original logic that went into the banning of marijuana appears to have been that — at the time — Mexicans and blacks smoked marijuana, and Mexicans and blacks caused crime. Since we now know that marijuana mostly causes people to become placid, it’s unlikely that there was actually any particular causal link. Point in fact, if there is a correlation between marijuana and violent crime, it’s most likely a negative relationship, making it less likely that the person will commit a violent crime.

The Question of Addiction

Prohibition of drugs is generally considered to be towards the goal of preventing addiction. There is a theory, however, that there is a maximum addiction rate for drugs which actually prevents almost everyone from becoming addicted.

A simple example is that of alcohol, which is of medium to high addictiveness. When people go to college or university, there is often a strong drinking culture. For four years, a significant percentage of our population drinks excessively at least once a week. At the end of that time, however, nearly all of them stop without any particular hassle. Similarly, since the push to stop smoking has started in American society, the number of smokers (as a percentage of population) continued to fall from around 1965 to perhaps 1988, but since that point, the level has more or less stabilized at around 20%. Regions like California seem to have continued to decrease, but that’s possibly due to a fewer number of people starting the habit, while older smokers pass away.

With smoking being of high to very high level addictiveness, it seems to be that at least 50% of everyone can successfully stop, and of course another large percent never tries. The level of alcohol addiction is perhaps around 4% of the total population (of those of non-partying age), but with only about 60% of adults drinking alcohol at all, it seems to be that about 93% can successfully moderate their intake. Though I’ll admit that I don’t trust the accuracy of those numbers. Addicts can be high functioning and hence are unlikely to be listed among those who are dependent, and “adults” includes those in college. It might be safer to assume that the number of people who couldn’t quit drinking is around 25% percent (to make a wild guess), lining up with its halved level of addictiveness compared to tobacco. I would further speculate that the person who is most likely to have a hard time quitting one drug is the same person as will have a hard time quitting another, this study on the correlation of food addiction to drug addiction seems to support that.

The Drug Abuser

For the purposes of our discussion, I’d divide the classes of drug abuser into 5 groups:

1) The teen or young adult party goer.
2) The poor.
3) The poisoner, using drugs as weapons for purpose of prank, rape, or murder.
4) The hippie or libertarian.
5) The adult addict, previously of group 1 but whose addiction didn’t fade or who was prescribed a medication and became addicted.

Groups 4 and 5 are our low-impact groups. It’s unlikely that they will affect anyone else except perhaps a spouse or their near family. More importantly, the way to diminish group 5 is to diminish group 1. Doctors are aware of the risk of habit forming addictions and so we can presume that if one was prescribed that the doctor felt the risk was worth it. I don’t know that I would recommend naysaying that. For our purposes, we will ignore both of these classes. The other three, however, really must be discussed separately. The causes and potential solutions are going to be entirely unrelated.