TO NBC Nightly News
DATE 30 January 1994, 1:30 a.m.
RE Drug-related violence and psychoactive management(*1)
Your 5-part series on violence this week was thought provoking, and I appreciate having a chance to respond quickly, by fax. I want to add some remarks to my fax transmission of 24 January 1994, which I sent the same evening as the segment on drug legalization. Attached is a slightly revised version of that memo.
I would formulate the question of legalization and violence in this way, both for individuals and for society: "Which causes more harm (violence): Drugs, or the laws against the drugs?" My answer is, the laws cause more harm, than the drugs would, if tamed. For individuals, it seems to me that the people incarcerated for personal use, are being brutalized, and their families inconvenienced, more by their jail experience than would occur were they using their chemical responsibly, and the legal constraints make responsible use impossible (more on this later). For society, there would be greater longevity, in terms of people-years, and a greater GNP, even with their chemical use, were they not incarcerated. Horror-story anecdotes notwithstanding, the realities of casual contraband use are less negative than the public believes. Some would argue (I hear this on talk shows) that dying early from psychoactive abuse saves everyone trouble from that person not being a burden at an older age. In fact, a great many people die protracted and expensive deaths, at an old age, as a result of their lifelong psychoactive habits or dependencies. Relatively few die abruptly at a younger age.
In between the close up, personal perspective and the socioeconomic perspective, there is the perspective of people interacting one on one, en masse, spreading values by self-behavior modeling (as opposed to pointing to others' behavior) and imitating role models. This is the perspective in the context of which we find politicians saying "the message would be", as in, "if we legalized drugs, the message would be, use drugs" (which, by the way, 1) is misleading, and 2) I would prefer to replace with, "If we role-modeled our own responsible psychoactive use, others would imitate it.")
We should be taming psychoactive drugs, rather than stigmatizing them, spreading myths about them, and incarcerating their consumers. In fact, for the vast majority of psychoactive drug consumption, which is legal, our approach is to tame them-- or think we do, anyway. My idea is to refine this approach, make it consistent, use it across the board for all psychoactive chemicals, and let free market dynamics (for educational packages, NOT for chemicals) reduce the problems. For example, I heard that a Federal Drug Czar recommended State execution by hanging, of drug dealers. Applying the idea of psychoactive consistency, one does not have to be a Secretary of Education to logically conclude that he believed alcohol and tobacco are not drugs; surely he did not intend to execute bartenders and tobacco farmers. What would have been a better "message", to my mind, would have been for that person, who I understood was at that time stopping the practice of voluntary smoke inhalation, to say, "It is hard to do this, because along with the smoke is nicotine vapor, on which my body is psychoactively dependent." To my knowledge, he did not proclaim that. I believe that sort of self-behavior modeling would have gone a long way in bringing people together in a common framework of self-understanding.
Without valid concepts, one cannot think. Without common concepts, there can be no communication. Without communication, there's no chance for problem solving. It follows that problem solving in the area of psychoactive management won't happen until people have common concepts and can communicate with them. Is "drug" a common concept? No, because this means "unmanageable, illegal substance." So cigarettes and coffee and beer aren't drugs. Is "paraphernalia"? No, because coffee cups and sugar bowls and candy wrappers and tobacco pipes and ashtrays aren't illegal. Is "drug tolerance" something that happens to wine drinkers and cigar smokers? No, because these things aren't drugs. Can tobacco, alcohol, and caffeine consumers learn anything about managing psychoactive chemicals responsibly from cocaine, marijuana, or heroin users? No, because their chemicals are/are not drugs. "Drug" is a ruined word.
I maintain that this discrepancy is part of a massive, institutionalized denial system, albeit not a conspiracy, maintained for large-scale economic reasons and reasons having to do with the desperation of addicted consumers to maintain the status quo and keep their own needs obscured, that models and perpetuates denial of the drug-aspect of personal licit psychoactive use. Further, that this discrepancy, which seems to be part of the system of prohibition and enforcement, is a major cause of recreational chemical addiction, rebound phenomena, and violence. Whether "drugs" should be legalized or not, is a pseudo-issue. Actually, the substances that are true paradigms of dependent and automatic use, are already legal; the illegal ones are scapegoated second-runs.
Drugs and violence, to most people, means three things: 1) Drug use causes violent behavior by releasing inhibitions, 2) economic incentives in the illicit drug market cause violent competition for market turf, and 3) the urge to continue a drug habit leads to desperately violent behavior.
Debates about legalization frequently focus on 1), without adequate attention to 2) and 3). In fact, were 2) and 3) to be weighed against 1), it would probably be apparent that the increase in number of consumers of a given psychoactive, with a corresponding increase in violence, would be outweighed by a decrease in market incentives, leading to less violent competition over turf, as the price went down, and a decrease in desperate behavior, as the psychoactive substance became more accessible. Personally, I believe this. The experience of America with Prohibition against alcohol, showed this to be the case, with regard to 2). And, where 3) was not much of a factor in Prohibition, because alcohol was rather more easy to acquire than today's illicit substances, my understanding of the connection between criminality and violent, drug using behavior is that drug use does not cause an otherwise law abiding, peace loving person to become a violent criminal, but instead that those who provide merchandise for "midnight auto parts" and who steal stereos from homes to support their habits, were already engaging in criminal behavior, before acquiring the habit. In fact, only a small portion of people who use illicit drugs are "hooked" to the degree that they engage in desperate, violent solutions. So this, 3), is but a small factor. Granting all that, I do believe that 3) would shrink as a factor, were currently contraband psychoactives to be made legal.
Furthermore, I doubt whether an increase in number of consumers would necessarily show a parallel increase in violence. Those who are not currently consuming contraband, because of legal restraints, are relatively responsible (relative to the risk-takers who are consuming illegally) and might be expected to "hold their psychoactive substance", as one holds their liquor, in a responsible manner. So, to my mind, 1) is of doubtful significance, in considering legalization. On the other hand, there would still be violence resulting from psychoactive effects more subtle, yet more serious, than direct impairment. This has to do with so-called "side effects", rebound phenomena, and psychological effects resulting from the physiological action of the chemicals.
The popular view of psychoactives as directly causing an effect, such as greater alertness from uppers and reduced tension from downers(*2) overlooks the corresponding direct side effects and rebound effects. It also overlooks a psychological factor called extinction-induced aggression. These indirect effects involve a struggle of the body to get used to the presence of the psychoactive chemical. The success of that struggle results, paradoxically, in an appetite for the chemicals, to keep the psychoactive balance, because the counter-effort lasts long beyond the disappearance of the chemical from the body.
This "struggle" is involuntary and outside of conscious awareness (how many of us are, after all, constantly aware of how aware we are, as such?)(*3) There is a time lag, in the psychoactive rebound, and a peaking out. The peak, for alcohol, is typically less than a week. With tobacco, typically a few hours, for the pharmacological effects, and weeks, for their complications. With Valium, a week or more. With heroin, about a day. These peak-times vary widely, but one can say roughly that, the longer the action of the psychoactive, the longer the peak. This makes psychoactive management complicated because, once the psychoactive has left the system, the consumer believes (if they bother to think about it at all) that its effects are gone. Quite the contrary. The side effects, which simply means "not sought effects", are just starting. I like to say that it isn't drinking that causes problems with alcohol, it is dranking. In other words, it isn't the alcohol in your system, it's the state of the brain afterwards.
Most obnoxious alcoholic behavior is not drinking behavior, it is dranking behavior. Alcoholics don't have a drinking problem, by and large, they have a dranking problem. Alcoholics can drink more successfully than non-alcoholics; they have a skill of handling larger (ever larger) amounts of alcohol. But their dranking drags them down. Eventually the psychomotor agitation overcomes the downer effects of the normal dose, and more is required to produce the downer effect. This increase in drinking becomes (with the passage of time) an increase in dranking, more agitation, more drinking, etc. Tolerance rises just like in a heroin addict, and eventually the medical effects overcome everything, tolerance plummets, and the person caves in.
This psychoactive rebound effect, which is the core dynamic of most addictive consumption, is not taught as such in school, except in little pieces in different contexts, in different chapters of the school texts. I have examined dozens of texts for school classrooms and libraries, and never seen one page with side-by-side pictures of a row of needles with increasing amounts of heroin in them, and a row of glasses with increasing amounts of whiskey, or a row of ashtrays with an increasing number of cigarette butts, of shorter and shorter size. How instructive that would be; on the other hand, how demeaning it would be to Mom or Dad when the child came home from school and started noticing what was in their ashtrays, or asked questions about whether Dad was using more beer nowadays and enjoying it less(*4).
When psychoactive dosing is frequent or easy, as is the case with cigarettes, another factor may be involved in violence: Extinction-induced aggression. This is an automatic disappointment effect, such as is familiar when one drops a coin into a pay phone and it jams, or when one throws a wad of paper at the wastebasket and misses. Psychoactively, when one expects relief of withdrawal from, say, a puff on a cigarette, and notices they are missing, one gets momentarily angry. When one's psychoactive consumption is identified with relief of anxiety, this can build, sometimes within seconds, to a rage, through a feedback mechanism similar to acoustic feedback. Unspoken-- "I need a puff-- Where are the cigarettes, damn-- I NEED A PUFF-- ETC." The "extinction" is the idea that one does not follow a stimulus (the need for a puff) with a response. This phenomenon was described by Dr. Jerome Jaffee during a national conference on drug abuse, in New York City, in 1976. Dr. Jaffee hosted the only meeting, out of over a hundred programs that week, that had to do with tobacco, and predicted, accurately, that the public would be slow to accept tobacco as a drug of abuse.
These rebound and psychological effects, as motivators, can be observed in the laboratory. (Enclosed-- Diagram of an experiment demonstrating automatic dosing with nicotine, and described in detail in LICIT AND ILLICIT DRUGS, by Edward M. Brecher and the Editors of Consumer Reports.) But being aware of what happens in the home when Mom and Dad are smoking and drinking, is much more complicated. This at least can be said: There is practically no public awareness, of the fact that more misbehavior is caused by people not consuming psychoactively at their body's expected level, than during normal (expected) consumption. How difficult it is, therefore, for people to understand that a great deal of violence in the home is caused by people in withdrawal. Typical: "He doesn't have a drinking problem; he's so mellow when he drinks," or "He can really handle his liquor". The question is, what happens when one is not drinking at one's customary level? Drinking problems are far less common than dranking problems.
I was at a public hearing in the Elk County Court House in Ridgway, Pa., about 20 years ago, concerning a State Trooper who shot and killed a man who had been roaming around his neighborhood, shooting a gun randomly. A friend of the deceased testified regarding whether the man had been intoxicated or not. The friend said "He had a drinking problem, but had not been drinking for several days, and he even had been smoking a lot, but had not been smoking for several days." This, the court concluded, showed the man was not "under the influence". What it showed me was exactly the opposite; he was likely having a dual rebound reaction.
Rule #4 of the "Five Rules of Psychoactive Management" (see 24 January 1994 statement to NBC Television News) is relevant here. Side effects that go along with upper and downer use parallel these two mentioned direct effects: Going along with the increased alertness of uppers is an increase in tension; going along with a decrease in tension of downers is a decrease of alertness. And there are rebound effects, whose time lag makes them hard to observe: With uppers, the aftermath, as the body's reaction in fighting the direct effects continues, includes a decrease in alertness and tension; with downers, the hard-to-observe aftermath includes an increase in tension and alertness.(*6)
It has to be understood, in discussing this topic, that the vast majority of drug use is already legal, "drug use" meaning what it normally does, the consumption of a mind-altering chemical at one's own initiative, recreationally or compulsively, with the risks of addiction and/or otherwise degradation of lifestyle. The reasons people consume alcohol, tobacco, caffeine, and mood-altering prescription-type medication (a large percentage of which use is not prescribed) are the same as those motivating consumers of illicit substances, although this is sometimes denied by educators, and is not acknowledged in school textbooks. It is frustrating to talk to an auditorium full of students about the similarities among alcohol, marijuana, tobacco, cocaine, and heroin, and knowing they have been educated to be confused, because their textbooks have separate chapters on tobacco, illegal drugs, alcohol, and so on. Students are exhorted to "just say no" to drugs, an effort popular long before Mrs. Reagan spread that phrase. What they are not educated to do, is to manage their inevitable chemical consumption in a responsible manner. Regarding 1), whether drug use causes violence and whether the law can prevent this by restricting access, students do not get a clear view of this reality, and they will not, so long as the law restricts access to this fact by fostering the impression that illegal chemicals are different in their drug nature from legal ones-- The fact that the rebound from direct psychoactive action is a greater factor than the direct effects.
As to whether it is realistic to consider legalizing drugs, I think not. It is just about as likely that contraband material will be put under legal controls, as is the case with tobacco and alcohol, as that tobacco and alcohol will be made illegal. There are great economic forces against both alternatives. The prospect of exposing the details of those forces, both legal and illegal, is unpleasant. Does this mean I am pessimistic about my general thesis, that the discrepancy between attitudes about licit and illicit drugs is driving a massive engine of denial, that makes all self-initiated psychoactive use dangerously sloppy, wasteful and destructive? No, because I believe the market forces, and investment by social institutions such as enforcement and education, in perpetuating the myths and mistakes of psychoactive mismanagement, can be overcome by self-behavior modeling and the spread of concepts of psychoactive management.
A good example of this was Bryant Gumbel's interview this week with Pete Hamill, about Mr. Hamill's problems with alcohol. He was interviewed again, a few days later, by Dick Cavett. Mr. Hamill's candor was refreshing, and he was not bent on reforming the world. Another example was Katherine Couric casually and spontaneously mentioning her use of tobacco, during her school years, and her negative attitudes toward it, and recommending to the audience that they not indulge. These things may seem to have little to do with alleviating violence, but the point is, this sort of candid self-disclosure is refreshing, and exemplary, and something I can mimic, with good results, and have a better edge on potentially problematic chemical use. I'll bet more than a few viewers took a hard look at their tobacco use, not because Ms. Couric told them to, but because she showed them how.
One suggestion for an exercise in mass self awareness would be National Psychoactive Abstinence Week-- Everyone in the country would give up all their self-initiated psychoactive consumption (that which is not under prescription) for a week, and share their experiences. This is not aimed toward eliminating consumption; the users would resume using, at the week's end. This resumption of use is necessary in order to see how much tolerance had built up.(*6) Those unwilling to try this experiment would be seen as being at greater risk for dependency. One client I asked to stop for a month, to see what happened, called me saying "It's been 24 days, isn't that enough? And I'm going to a wedding, and not drinking will seem unsociable." I reflected with a comment like, "What are you telling me? That you have better reasons for drinking than for finding out if you are addicted, and you want my permission to change your values?"
Another suggestion for massive, public self-awareness, would be a White House operated psychoactive self-disclosure computer bulletin board, where computer users, probably chiefly under the influence of caffeine, would anonymously compare notes about their experiences with psychoactives. The Drug Czar could tap this BBS as a resource in forming policies about drug control. What does this have to do with violence? Increased public awareness of psychoactive realities, as such, can only promote better self-understanding and more responsible psychoactive management.
Here's something else I think would work, at the governmental agency level:(*8)
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