Read Chasing the Scream: The First and Last Days of the War on Drugs Online
Authors: Johann Hari
The first people to notice an effect were the local police. Inspector Michael Lofts studied
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142 heroin and cocaine addicts in the area, and he found that in the eighteen months before getting a prescription from Dr. Marks, they received, on average, 6.88 criminal convictions, mostly for theft and robbery. In the eighteen months afterward, that figure fell to an average of 0.44 criminal convictions. In other words: there was a 93 percent drop
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in theft and burglary. “You could see them transform in front of your own eyes,” Lofts told a newspaper,
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amazed. “They came in in outrageous condition, stealing daily to pay for illegal drugs; and became, most of them, very amiable, reasonable law-abiding people.” It was just as Henry Smith Williams had said, all those years before.
One day, a young mother named Julia Scott came into his clinic and explained she had ended up working as a prostitute to support her habit. Confronted with patients like this, John told an interviewer, he was starting to feel “anger. It makes me furious that a group of young able people . . . should suffer from the same death rate as people with smallpox, between 10 and 20 percent. I’m not a bleeding heart, and I don’t think there’s anything glamorous about drugs; I try to make my clients realize that what they are doing is boring, boring, boring.”
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He wanted Julia to be bored, not terrified and in danger—so he wrote her a prescription. “I stopped straightaway,” she said later to Ed Brantley of CBS’s
60 Minutes
when they came to report on the Liverpool experiment. “I went back once
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just to see, and I was almost physically sick just to see these girls doing what I used to do.”
Now she was working as a waitress, and able to be a mother to her little girl. As Julia pushed her daughter on a swing, Bradley asked her: “Without that prescription, where do you think you’d be today?”
“I’d probably be dead by now,” she said. “I need heroin
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to live.”
The changes taking place as John Marks expanded his prescription program weren’t limited to his patients. On the streets of the neighborhood, the drug gangs started to recede. John overstated it
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at the time when he said drug dealing had been totally wiped out—the writer Will Self, reporting on the ground, asked around and learned there were still dealers to be found. But the police said there were far fewer than before—Inspector Lofts explained at the time: “Since the clinics opened,
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the street heroin dealer has slowly but surely abandoned the streets of Warrington and Widnes.” It was as if time was running backward—to the era before the drug war. In a small brick building by the River Mersey, a California dream was being reborn.
But John Marks differed from Henry Smith Williams in one important way. Henry thought that drug addicts would need to be given their prescription for the rest of their lives. That was the part of his story that most disconcerted me. It seemed that the only alternative to the drug war forever was being prescribed a drug forever.
But since then, a discovery had been made about addiction—one that Henry Smith Williams couldn’t have foreseen. It was first spotted by a psychologist named Charles Winick, who set up a free clinic for addicted musicians in New York in the 1950s. Winick, like everyone else, used to believe that once you were a heroin addict, you were a heroin addict until you died, but what he found was something very different. “Heroin use was concentrated
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in the 25 to 39 group, after which it tapered to very little,” he wrote. Most addicts simply stopped of their own accord. They “mature out of addiction . . . possibly because the stresses and strains of life are becoming stabilized for them and because the major challenges of adulthood have passed.”
This process—the fancy names for it are “maturing out” or “natural recovery”—is
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not the exception: it’s what happens to almost all of the addicts around you. This finding is so striking I had to read about it in slews of studies before I really took it on board: Most addicts will simply stop,
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whether they are given treatment or not, provided prohibition doesn’t kill them first. They usually do so after around ten years of use.
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So once John Marks knew this, he came to believe his job was a matter of keeping them alive long enough to recover naturally. That’s why every week, the addicts of Widnes turned up at John’s office for a meeting, and left with a prescription for smokable heroin or—in a small number of cases, as we will see shortly—cocaine. John explained to the public: “If they’re drug takers determined
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to continue their drug use . . . the choice that I’m being offered, and society is being offered, is drugs from the clinic or drugs from the Mafia.”
There was one obvious reason why people were worried by John’s experiment. If there is no punishment—if you give people drugs for free—surely they will use them more? This was one of Harry Anslinger’s most reasonable objections. If you reintroduce prescription, he warned, “drug addicts would multiply
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unrestrained.”
It seems like common sense. But John, by contrast, thought the rate of use would hold steady:
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If being ostracized by your family, riven with disease, and plunged into poverty didn’t affect your decision to use, how would a few free heroin reefers make a difference?
It turns out both sides were wrong. Drug use didn’t rise, and it didn’t hold steady. It actually fell—including among the people who
weren’t
being given a prescription. Research published in the
Proceedings of the Royal College of Physicians of Edinburgh
compared Widnes, which had a heroin clinic, to the very similar Liverpool borough of Bootle, which didn’t. In Bootle, there were 207.54 drug users per hundred thousand people; in Widnes it was just 15.83—a twelvefold decrease.
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But why? Why would prescribing heroin to addicts mean that fewer people became addicts? Dr. Russell Newcombe, working out of John Marks’s clinic, discovered what he believes is the explanation.
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Imagine you are a street heroin addict. You have to raise a large sum of money every day for your habit: £100 a day
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for heroin at that time in the Wirral. How are you going to get it? You can rob. You can prostitute. But there is another way, and it’s a lot less unpleasant than either of them. You can buy your drugs, take what you need, and then cut the rest with talcum powder and sell it to other people. But to do that, you need to persuade somebody else to take the drugs too. You need to become a salesman, promoting the experience.
So heroin under prohibition becomes, in effect, a pyramid selling scheme.
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“Insurance companies would love to have salesmen like drug addicts,” with that level of motivation, John remarked.
Here’s why drug use went into reverse in John Marks’s clinic. Prescription, it turns out, kills the pyramid selling scheme, by stripping out the profit motive. You don’t have to sell smack to get smack. This explains why when you prescribe heroin, fewer people are recruited to use heroin, and why when you prescribe cocaine, fewer people are recruited to use cocaine.
As Russell Newcombe tells me this, I can’t help but think of a weird little twist of history. Harry Anslinger always said drug addiction was infectious. It isn’t, in normal circumstances—but the system of prohibition he built makes it so after all.
John Marks was being shouted at. The public meeting was getting nasty, and he was being abused. But it wasn’t a right-winger or conservative yelling at him. At this time, Liverpool was run by a Communist group called Militant Tendency, who believed in establishing an immediate socialist revolution in Britain.
John Marks, they declared, was preventing that revolution by tranquilizing the working classes with heroin. The opiate of the masses turned out to be . . . opiates, literally. Marks was blocking Marx.
The father of one of John’s patients stood up, and addressed the crowd. “I was a bit puzzled by John giving Jimmy heroin to start with,” he said, “because I thought the job was to get him off. But you know what—since he started with this Dr. Marks, we now see him at mealtimes, he sits with us and talks with us, he’s even back with his girlfriend, and you know what, lads? He’s got an offer of a job next week.”
John Marks expected that the news of these results would spur people across the country, and across the world, to do the same. Who would turn down a policy that saves the lives of drug users
and
leads to less drug use
and
causes dealers to gradually disperse?
At last, this ripple effect seemed to have begun. He was asked to set up a bigger version of the Widnes clinic at the Metropolitan Centre in Liverpool, and then it was decided that every health district in the region from Southport in the north to Macclesfield in the east would have a prescribing clinic of its own.