Alcohol and Other Drugs
Amphetamines, Cocaine (crack cocaine) and Heroin
The information in this section is not intended to minimize the obvious risks of these drugs, but it is vital to have a sense of perspective and to point out the gross exaggerations about many illegal drugs in the minds of the public.
It is particularly important to have a sense of the dangers relative to alcohol, a better known drug that is always available to would be drug users.
Regardless of the drug involved, there are basic principles that apply to all.
* It's not the drug, it's the user. There are thousands of drugs, legal and illegal, for a user to choose from. The outcome will primarily be determined by the caution of the user.
* Dosage is a very critical factor. At standard doses, no common drug poses a significant threat to most users. As dosage escalates, risks often increase radically.
* Prohibition will always make use of that drug more dangerous, partly by depriving most users of accurate ways to control dosage and purity.
* Millions of doses of each of these drugs are taken every day with no significant ill effects. All of them have been abused by a small percentage of users providing numerous true and frightening but atypical anecdotes.
* Alcohol is, dose for dose, quite arguably the most dangerous drug.
- Most likely to cause death (except tobacco)
- Most dangerous to the fetus, including "crack", which is NOT known to cause fetal damage.
- Most closely linked to anti-social behavior such as crime and violence including rape and family abuse.
- Most closely linked to brain and organ damage
- Most likely to deprive the user of judgement and motor coordination.
See: Science notes 2
- About as addictive as any other drug (except tobacco)
See: Science notes 2
* Marijuana is much less dangerous than the other drugs covered in this section.
Used legally for decades. Problems arose but were far smaller than today.
Used by our pilots in Iraq and elsewhwere for many decades. Issued to pilots by the U.S. government to increase performance and safety.
It is difficult to estimate how many traffic deaths have been caused by fatigue that might have been averted if such use was legal, but we do know that fatigue is one of the major causes of traffic fatalities.
Millions of those least responsive to caution and the laws are using more dangerous illegal versions currently.
There is no evidence that cocaine (or crack) is more addictive than alcohol. This point was made in the White House sponsored report by IOM in 1999 and typifies the gap between scientific reality and public perceptions.
" In 1994, after two years of research in 19 countries, a group of well-respected investigators concluded that coca leaf chewing is not addictive. They also found that most cocaine users consume very little of the drug and experience few serious problems."
- "A Duty to Censor," REASON magazine, August/September 1998
The item above suggests that one approach to now illegal drugs is to legalize them in their least addictive forms, in the case of cocaine, cocaine leaves or coca tea brewed from those leaves. One of the inherent dangers of prohibition is that it produces drugs in their most concentrated forms.
Even in its current form, cocaine users behave much as alcohol users do.
Published in International Journal of Drug Policy, 10 (1999), 223-234.
by Peter Cohen, PhD, et al
Cohen's data was collected in extensive interviews with drug users in Amsterdam, from 1987 to 1997. Cohen has also studied cocaine users in Frankfort, Germany and San Francisco.
" ... most drug users apply all sorts of self imposed controls. These controls are very similar for all drugs one studies. They are learned within life styles and environments in which the prohibition of drugs - and the legal constraints that come with it - has become utterly irrelevant. "
" ... life time experience with cocaine in reality is no more than floating and experimental contact for most. Or, in the words of the Toronto based Erickson et al. (1994), 'Most use is infrequent and self-limiting.'"
"Frequent current use of cocaine - more than 20 times per month - among cannabis users in Amsterdam occurs with one per [thousand] (2 respondents out of 2,368). Heroin experience is almost non existent among life time cannabis users ... "
" ... it is also apparent, that after the average 5 year career of cocaine use, 89% of the sample is either abstinent or using at low levels (of less than 0.5 grams of cocaine per week). "
" This does not contradict the fact that excess and frequent cannabis or cocaine use does occur for extended periods ... But such users are not the norm."
" As is true of another potentially high risk drug, alcohol, the large majority of users of cocaine or cannabis succeed in structuring the use of these drugs within their complicated and busy lives."
"These findings suggest that it would be better to legally regulate drug consumption and enable drug users to control their own drug use, than to try to prevent drug use by its prohibition.
Paper presented at the Euro-Ibero-American Seminar, 8-9 October 1998, Palácia da Bolsa, Porto, Portugal, promoted by the President of Portugal.
Heroin is a slightly more potent derivative of morphine. It was developed as a cough suppressant by the Bayer company at about the same time that Bayer announced aspirin. The body converts heroin back into morphine almost instantly. It is frequently used medically to treat severe pain outside the U.S.
The only common long term health problem due to repeated heroin use is extreme constipation. The need of an addict to take the drug three or four time a day is a major personal burden but need not be a major problem for society. The many problems today are largely side effects of prohibition.
It is interesting to note that during the decades when opiates (opium, morphine and heroin) were legal, many doctors encouraged "hopeless" alcoholics to switch to opiates in order to avoid the abusive anti-social reactions provoked by alcohol abuse. (The treatment profession today would reject any such suggestion, but the history helps to illuminate today's double standard.)
"I would urge the substitution of morphine instead of alcohol ... In this way I have been able to bring peacefulness and quiet to many disturbed and distracted homes. ... The mayors and police courts would almost languish for lack of business; the criminal dockets ... would have much less to do than they now have. "
- Dr. J. Black in a Cincinnati medical journal, 1889. Cited by E. Brecher in Licit and Illicit Drugs.
"More than any other unstable group, drunkards are likely to be benefited in their social relations by becoming addicts. When they give up alcohol and start using opium, they [stop] becoming drunk or violent."
"... a common experience of every physician who has studied the subject ... [is that leading citizens] as are cited above, and they are not uncommon, have taken as much as 15 grains [some 10 times the normal dose today] of morphine daily for years without losing one day's work because of the morphine."
- Dr. L. Kolb, Assistant Surgeon General, specialist on addiction, 1928. Cited by E. Brecher in Licit and Illicit Drugs.
For more on the ability of heroin addicts to control use, to function normally and to avoid health problems, see Heroin.