It is an old belief among conspiracy theorists that the push to make marijuana illegal was a tactical move by Dow Chemical to take hemp off the market allowing them to sell more nylon and other synthetic fibers. Of course this is absurd. There was public worry about marijuana long before nylon was synthesized, as well as some local legislation against marijuana and opiates, not to mention alcohol prohibition. The drug war being simply a variation on the temperance movement, we do not need a conspiracy to explain it.

However, that does not mean that companies will not take advantage of the law when it works to their benefit.

One recent example is the legislation against flavored cigarettes, excluding menthol. The argument, of course, is that it is for the children, but that is the explanation for almost everything in recent times. But it is likely true. Most of the supporters are probably legislators who really believe that mint or citrus flavored tobacco will make children smoke. So, why exclude menthol? Well, because one of the few supporters from the tobacco industry is Phillip Morris, who sell no flavored tobacco products, but make a lot of money from menthol cigarettes. Of course, their competition is doing well selling currently legal flavored tobaccos. Which may explain why they are welcoming more regulation of their industry.

Another area where existing industries benefit from regulation is the pharmaceutical industry. I have mentioned this before in passing, but there are many examples. For instance, under a free market if a doctor prescribed a medicine by name, you could choose to take a generic or not. However, under our extremely regulated market, a doctor can force you to buy only the brand name, which is beneficial to the company owning that name. Likewise, the regulation serves to insulate these companies from competitors, as even the generic market is handled by only a handful of labs. The incredible amount of regulation simply makes the barriers to entry excessively high. Even with the elevated profits from effective cartelization, the entry barriers keep the cartel closed.

And that is the truth of regulation. While many libertarians will tell you industry suffers from regulation, that is not entirely true. Many businesses suffer from regulation, but not all. Existing companies can often benefit from regulation, either by giving them an advantage over competitors or by keeping out competitors entirely. So, while the economy as a whole is harmed by regulation, it does not always harm individual companies.

So, how does this relate to my topic? Why isn't this over on Random Notes with the rest of the general economic and political essays?

Well, because I think that ending  pharmaceutical regulation is just as important as decriminalizing illicit drugs. While most "dug legalization sites" focus purely on allowing people to use marijuana and cocaine, I think that those freedoms are meaningless if we keep the current prescription laws. What sense does it make to allow citizens to buy cocaine if they need a doctor's approval to get antibiotics? Not only does it make no sense to have heroin sold on the street while morphine sulfate is kept under lock and key, but it also sets up a precedent which has the potential to restore drug prohibition.

Let us imagine that all of the prohibitions on marijuana, cocaine, amphetamines, heroin, and so on have been removed, yet we still have our prescription laws in place. Is it not likely that someone, seeing all the ahrm done by drugs, will propose that perhaps we should make recreational drugs prescription? There is even an already existing argument. Birth control pills are by prescription because, among other reasons, it is a way to get women to see their gynecologist. And while I think this is more of a make work than public health measure, obviously others do not. So with that nominally benevolent example, is it not a good idea to have drug users see their doctor every so often? After all they have lots of health problems, so what is the argument against making drugs prescription?

And so, once again, drugs are under lock and key once more. Admittedly, the control is handed to doctors rather than judges, but that fits with our modern health-oriented nanny state. And who really cares? If my tyrant is a doctor or a politician, it matters little to me. What does matter is that someone else has legal control over something that should be my decision alone.

So, if there is to be decriminalization, I would argue that the prescription system is clearly part of the system that needs to be eliminated. Without that reform, any other changes will be simply meaningless.

As the subject of mental illness has come up several times in recent essays, I think it is time for me to clarify my position. I have several times made mention of the fact that I have some problems with current views and so I feel I should probably explain why. It also will make much easier when I finally write on my thoughts about the problem of involuntary commitment and other mental health issues.

My first problem is that there are no real objective diagnostic criteria. While some postulate a physical or genetic cause, the fact remains that, outside of a few dementias, we have found physical markers for none of our mental illnesses. Which means that diagnosis is based on arbitrary criteria. And more than that. Arbitrary criteria which cannot even be quantified.

And that is the real difference. You see, I am sure when I mentioned arbitrary criteria, some clever person would mention that a blood sugar of , say 60, is arbitrarily set as the cutoff for a "low" value. And it is true that what is the borderline for high and low is something of an arbitrary choice. But he difference is that there is still a blood sugar to measure, and numbers can be compared, values can be measured and so on. We can describe physical conditions at various numeric values.

Can we do that with sadness? What value of sadness is too sad? When does depression become an illness?

But it is not just the lack of quantification, it is also the fact that these supposed illnesses are just exaggerations of normal behavior, or even behaviors which could be normal in other contexts. If I am sad the day after my wife dies, most agree it is normal. If I am just as sad a week later, it is ok for most. A month, maybe. A year, and many think I have a problem.

And therein lies the problem. Some would and some wouldn't. Whether I am just sad or clinically depressed in the end comes down to judgment call on the part of the therapist, and is based more on what the cultural norms say about depression than any real diagnostic criteria. But, in my mind at least, cultural norms do not an illness create. Which means mental illness is more in the nature of behavior than an illness. When we say someone is mentally ill, more often than not we simply mean he has transgressed too far against our cultural norms.

And that isn't an illness. And it certainly doesn't sound like something biological in origin.

Now, usually by the time I reach this point, someone who has a friend or family member with a problem becomes offended and says "If you knew someone with [whatever] you wouldn't doubt it was a real disease!" Or maybe "it was biological!" But the truth is I have known many people with mental disorders, yet that does not change the facts. Mental illnesses are basically either an inability to meet certain social norms or the exaggeration of a specific trait or behavior. Why must that be a disease and not just a sign of normal human variability? We accept that there are virtuosos who excel in positive directions without calling it a disease. So if there are piano prodigies, why not fear prodigies, which we call paranoia? Why must the bad extreme of behavior be a disease while the good extreme is a virtue?

It seems to me that what we call mental illness is much more likely simply a problem of behavior or acculturation, sometimes simply an extreme of  temperament, and in some case, simple play acting by someone whose situation is improved by being thought "crazy".

Now, to blame much of it on aculturation and behavior is not to lay the blame on parents, as was common in the past. Likely some percentage of personality is innate, established form birth. And given that, an individual's reaction to stimulus can be rather unpredictable, even at a very early age. It also explains how two children from the same environment can grow into quite different adults. Parents play some role, but so does everything that goes into the environment surrounding a child. Which means that the behavioral and cognitive problems which we label mental illness could come from any number of sources, or even from the interaction of several.

Now having said that, I am sure some will come back with some very extreme example and argue that it "just couldn't be" due to behavioral or acculturation issues. But that ignores how little change it takes to result in completely bizarre behavior. For example, try this tomorrow. Whenever anyone uses a word beginning with the letter S take great offense. It is but one small change, a simple matter of a strange connotation no one expects or shares with you, but see how bizarre your behavior becomes. If that one small change can make you seem completely erratic, then imagine someone with a library of literally hundreds of idiosyncratic connotations, who has their own personal set of meanings attached to actions or words.

Now, I am not arguing here for a return to General Semantics, arguing that all of mental illness is a linguistic phenomenon. But I do think that added or missing connotations for words can explain much of the strange verbal and emotional behavior exhibited by some. Of course, that is not the only cause. A failure to understand rules of reasoning and association can be another. Psychiatrists even seem to recognize this, pointing out the superficial way schizophrenics associate ideas, yet they do not make the logical conclusion that schizophrenics simply don't know how to properly link ideas, and instead see it as a symptom. On top of this we can add extremes of personality, including an excess or lack of affect, as well as poor control of impulses, and maybe poor understanding of behavioral norms, and we can find an explanation for nearly everything that we are told is the result of  "mental illness".

It is less comforting to think that the crazy person is that way simply because he never learned what he needed to behave better. It makes us feel better to think he is sick. But just because something is comforting does not make it true.

POSTSCRIPT

Many will argue that I can't be right because psychological drugs "work".

I would argue that many work only in a very vague sense. For example potent sedatives do make some pliable and docile, but that does not mean they are cured, just drugged.

Others work, but not for the reason supposed. For example, many supposed anti-depressants (eg Paxil) are also sometimes abused for their euphoric effect. Is it any wonder that a euphoria producing drug will make people less depressed? That shows nothing about serotonin or dopamine. It just proves getting high makes people feel better for a time.Likewise, drugs which have a stimulant effect tend to be prescribed to those with lethargy, and not surprisingly have some beneficial effect. In the long run, a lot of psych drugs differ from self-medication with illegal drugs only in the view of the law.

But even those cases where a drug does not produce euphoric or stimulant effects and yet serves to elevate mood, that does nothing to prove problems are an "illness". The fact that inducing chemical change in the mind can effect mood proves nothing it all, except that mood, like all thought, is an electrochemical process. We know that. But it says nothing about the origin of depressions, autism, or any other disorder.

NOTE: As this is relevant for both of my blogs, it has been simultaneously posted on Random Notes and Examining the War on Drugs.

ADDENDUM

In some ways my thoughts mirror those of Thomas Szasz and Peter Breggin. I know that both are not held in high esteem by many in the medical community, but that does not mean they are wrong. While working in social services I had interaction with many supposedly suffering from mental illness and saw the supposedly minimal side effects of psychiatric medications. I also saw real organic brain damage while working with the retarded, so I have seen the difference between a real physical problem and the array of misbehavior and confusion we call mental illness.

Having said all that, I am open to the possibility that I am wrong, either in specific cases, or in general. Perhaps some mental illnesses do have an as yet unknown physical cause, but, as I said, excluding dementia of various types, I have not seen any persuasive evidence. And the ever changing genetic markers for schizophrenia have convinced me that media reports on the topic tend to insufficiently research before announcing breakthroughs.

Often a proponent for removing criminal penalties for drug use will propose that drug use should be treated "as a public health issue". This position seems to be more common among the left wing proponents of decriminalization than among the libertarian/conservative proponents, but from time to time I have heard it from representatives of almost every political position. To many it must sound the same as outright decriminalization. However, I will argue that not only is it not the same as simple decriminalization, but it represents an approach potentially as harmful as the one we have today.

The first problem is that the statement itself is not clear, and admits to at least two different readings. As the listener can choose the more or less extreme meaning, it allows the speaker to propose something more extreme than the listeners hear without doing so obviously. However, while I believe most of those proposing it are suggesting the more invasive meaning, I will examine both possible understandings.

The far less intrusive meaning is that we should decriminalize drugs and leave it to the state to deal with the related health problems. While I personally have a problem with a state funded health care system, I doubt it will vanish with drug decriminalization, so this seems a strange thing to propose. It would be like proposing "after decriminalization the sun will still rise in the east". However, doubtless this is how many hear the proposal, and so many support this "medical model" who would not agree with the more intrusive meaning.

The more intrusive, and far more likely, meaning is that we would remove criminal penalties, but would treat drug addiction as a disease we need to combat. Which sounds fine, until you ask about the specifics, and how it would really differ from our present system.

Now, let us look at the first problem, the assumption that every drug user is an addict suffering from a disease. Now, I have written elsewhere, and will doubtless write again, about my problem with seeing human behavior as a disease, but for purposes of this argument let us assume that drug addiction is a disease, and can be treated. Even so, these proposals seem to assume that most or all of drug users are addicts. Now, I now that some argue that anyone who has even tried a drug is on the path to addiction, but I don't think that is anywhere close to the truth. Any number of polls show that a huge percentage of the population has tried one drug or another, yet a very small percentage are addicted.

I suppose the proponents would say that they do not feel that every drug user is an addict, they would simply taker steps to prevent casual users from becoming addicts. However, as that involves treating all users as teetering on the verge of addiction, the difference seems insignificant to me. Whether we treat all users as addicts or teat them as addicts and likely addicts is not that important, it means that every drug user will be of interest to those trying to treat drug addiction.

And why does this matter? Because the proponents never quite make it clear how they plan on handling the "public health question" of drug addiction.

The problem is that there are many ways that a public health issue can be handled. When most people hear the phrase "treating it as a public health measure" they imagine public awareness advertising, clinics, treatment centers and so on. And that may even be the way some mean it. Were this wjhat was meant, it would not be much different from decriminalization. True it would involve added money spent on all there "programs", and it would still allow drug users accused of crimes to claim sort sort of "disease" in an attempt to eschew personal responsibility, but other than that it differs little from decriminalization.

But there is the other side of public health, the sort characterized by the involuntary commitment of those who are a threat to themselves or others. And that too is a public health response. That is the possibility that troubles me, the public health approach which attempts to coercively treat.

Now, it is possible that those promoting a medical approach do not intend to use coercive means, they intend to simply use "education" and provide "treatment", but in the end I do not doubt that they will end up using coercion. At first it will probably be applied in limited areas, likely those convicted of other crimes who are also addicts will be forced into treatment. Maybe those who have interactions with family services. Or traffic offenses. But, once we have admitted that those who have legal problems can be forced into treatment, what is the argument against forcing addicts who have not run afoul of the law? Which leads us, in the end, to the same situation we have today, the only difference being that we use coercive treatment rather than jails. But ask any Soviet dissident who was found "schizophrenic" how much difference there is between hospitals and jails.

The problem with the medical approach is very simple. So long as we believe that drug use is a problem, and one with which the state must deal, we will end up adopting coercive approaches. Whether we jail or force them into treatment, as long as we think the state has an interest in the drug use of citizens we will end up with citizens being treated coercively. It is an inevitable outcome of the way we view our state. As long as the state has the right to protect people form themselves, can force them to avoid things it considers harmful, then it matters little whether we do so on moral or legal or medical grounds.

In other words, there really is no difference between our current penal system and the "medical" model in the long run. And so there is no reason to switch from one to the other. The only solution which produces substantially different results is for the state to declare that it does not care what substances its citizens ingest, for good or ill.

Any other solution is just dressing up the current solution in different terminology. Does it really matter if you are jailed, or hospitalized, if you are held against your will the name doesn't matter.

Though it seems to have passed into common usage, I have to say that the term "legalization" to mean the removal of criminal penalties for drug sale, use and possession is a particularly bad choice. 

The problem with legalization as the term for removing criminal penalties is that it implies there was something inherently criminal in the first place, or that drug crimes are rightly criminal but we have chosen not to prosecute. We never talk of legalizing property ownership, or working, or marriage. Things which are not proper concerns of the criminal justice system are not "legalized". Even things which were wrongly made illegal at one time (eg. miscegenation, alcohol) are not "legalized" but "decriminalized".

I know it is a petty concern in the scheme of things, and I would not reject a solution over terminology, but it just struck me that the term was a particularly bad choice, and I had to mention it. As it has become the most common term, I will continue to use it (or the better "decriminalization") and won't complain again, just wanted to point this out.

Sorry for the silence on this blog, but it appears that I lack the truly manic energy needd to regularly post four or five articles a day on two different blogs. Thanks to work on my other blog, and a rather busy week at my real job, this one has suffered a bit.

But don't despair! I have two new topic I plan to write next week. Admittedly, these two are all I have in mind for the immediate future, but at least something is coming.

The first is a bit of a cheat, as I plan to take the best from the old posts on my other blog and write a kind of "round up" of my best work. But the second is much better, a look at the difference between legalization and the often mentioned "medical model" of drug regulation. I may also write a cross-posted article, posted simultaneously on both blogs, looking at views of addiction, insanity, legal competence, and the question of involuntary commitment. As it relates to both the drug war and many other political questions it is a good choice for a simultaneous post. However, as it is a rather heavy piece, it may take  awhile to finish it.

After that we will have to wait and see.

Whenever I mention legalization, someone will inevitably reply "I don't have a problem as long as I don't have to pay for their choices". And that is a legitimate concern. My argument for legalization often follows a similar argument I make for open immigration, starting with the caveat "if we can first eliminate the welfare state". And just as open immigration would be a disaster with our current welfare state in place¹ , legalization will be more costly if enacted with our current laws in effect. However, unlike open immigration, I do not think the costs of legalization would be prohibitive.

Still, as I want to be fair, let us look at the most likely costs, and see what we can discover.

The most obvious cost would clearly be health care, as drug users are prone to health complaints. And, if we assume that legalization would increase the number of those using drugs, then we would need to take that into account. However, I think there are a few factors which argue against a greatly increased cost, as well as an analogous situation which supports some of those arguments.

First, as I argued before, I think most addicts not likely to be deterred from drug use by laws, which means legalizing drugs would create mostly casual users. As casual use of non-intravenous drugs produce relatively few health problems, and as casual users are unlikely to use intravenous drugs, this means the health problems resulting from drug use would likely be very similar to what we see now. There may be a slight increase, but I doubt it will even be noticeable.

However, let us assume that there were a huge increase in drug related illness, what would be the cost? Drug abusers are not likely to wait until late in life to begin, so most will exhibit the effects of long term use early in middle age. As the most common illnesses resulting from drug abuse, AIDS and hepatitis, are often fatal, it is likely that these drug users will die at a relatively early age. As some studies with smokers suggest, even if the disease itself is medically costly, by dying at an early age these people will still result in a net savings to the health care system². It is not absolutely certain, as I am unsure how the costs of AIDS or hepatitis compare to emphysema and lung cancer, but it is quite possible that an increase in drug use could actually save the system money³.

Finally, I would argue that we cannot base public policy entirely on banning acts which cost the system money. Were we to consistently do so, we would certainly have to ban alcohol, as the consequences of long term alcoholism are just as damaging, if not more so, than long term drug abuse. And, as they are not usually fatal, but are debilitating, those costs last much longer than the comparable costs from an intravenous drug user⁴. Nor is that enough. If we base policy on the "social cost", then we must go beyond even the most silly CSPI request, and place legal limits upon food intake based on weight, as obesity clearly kills many more than drugs ever will.

I could go on, but you can see my point. There may be increased medical costs, there may not, but that cannot be the sole basis for our decision. If we worry that legalization will cause skyrocketing medical costs, then the answer is not to keep a ban on drugs, but to reform how we handle medical costs. Why keep a bad law to balance out another bad law? We should fix the original problem.

Moving on from medical costs, the next problem area is public welfare.

As a former social services employee, I can state that some fears are based on a mistaken belief, though one with a grain of truth behind it. The mistaken belief is that drug addiction is a disability, and entitles addicts to welfare money or medical assistance, that is not true⁵. Drug addiction alone does not qualify anyone as disabled. However, drug addiction does often make it easier to convince a mental health professional that one has other underlying mental illnesses, which may serve to make one disabled, and thus qualified for monetary or medical benefits. Still, strictly speaking, drug addiction alone does not qualify anyone as disabled.

be among casual users, who are hardly the group which will be applying for welfare. Of course, there are any number of well meaning psychiatrists, psychologists, social workers and others out there who would be happy to declare a drug addict "bipolar" or a "borderline personality" in order to help them get medical benefits, so this may be something of a moot point. On the other hand, I would argue that it really doesn't matter. As I have argued before, the only rel increase in drug use would likely. The hard core addicts are already with us, and those who would seek a place on the welfare roles are already doing so. Legalization will probably change very little in terms of the number of addicts applying for or receiving welfare.

The only other significant area of cost will be in law enforcement, and here it is arguably a savings rather than a loss.

Many have proposed that legalization will add to the number of crimes as the number of addicts swells. I just cannot imagine this would be true. First, as I continue to argue, I think the number of addicts will not increase. But even if we imagine that it will, does anyone think drugs will be more expensive when legal? Thanks to markup and risk premiums, as well as the relatively closed market, drug prices are absurdly high now, legalization, as with alcohol in the 1930's, will cause a massive price drop. With drugs much cheaper, addicts will have less reason to rob, not more. Even if their numbers swell, the amount of crime per addict should drop more than enough to offset the increased numbers.

However, for the sake of argument, let us agree that the number of addicts will grow, and that they will commit more crimes, I still say the net cost of law enforcement will drop. How so? Because while addicts may be committing more petty crimes, the former drug dealers themselves, no longer fighting over turf, will have much less cause to murder one another, reducing the number of very costly homicide investigations and prosecutions. In addition, all of the money spent on drug enforcement, interdiction, surveillance, and all the rest, will be free for other uses. Considering the net savings in those two areas, I just cannot see petty crime rising enough to outweigh the savings.

Of course, it is possible some of my predictions are wrong, and there is some cost I have missed. Or perhaps I have been overly optimistic in my estimates. Both are always possible. But, as it see it now, legalization will, on the whole, result in a net savings rather than loss, at least in financial terms. Of course, it will be an uneven savings. In some areas we may even spend a bit more, while others will see a tremendous savings, but, on the whole, I think we will find that the final balance will show that we will come out ahead.

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1. Costs of welfare for new immigrants is not the only argument against open immigration in today's world. Obviously security concerns would need to be considered. Even when I claim to support "open" immigration, I do not propose a suicidal allowance of every immigrant. My proposal for open immigration, provided welfare as we know it no longer exists, would still allow the state to bar known criminals, citizens of declared  hostile nations, known terrorists, and those with infectious diseases. I do believe that free mobility of labor is beneficial to all concerned, but I also am realistic enough to recognize that there are concerns other than purely economic. However, this is a topic for my other blog, so I will stop this footnote now.

2. Not so sound mercenary, but as many drug abusers manage to get themselves declared mentally ill as well to collect SSI from social security, an early death also results in a net savings for social security, making the state's savings from an early death even greater.

3. To be fair there may be some additional costs from unforeseen events among casual users such as strokes from excessive cocaine use, and overdoses from inexperienced casual users of heroin, but as these are most likely to prove fatal to casual users, their net effect will likely be to reduce, rather than increase health care costs. There may be the rare case where a casual user has a mishap which increases his overall health costs while not shortening his life (eg. a cocaine induced stroke causes nonlethal brain damage), but such things are not likely to be that much more frequent with legalization than they are now. As they will be rare events, by definition they will have only a minimal impact on overall costs.

4. My wife is a nurse, as I have mentioned before, and her descriptions of the dementia suffered by chronic alcoholics has convinced me that alcoholism and the subsequent long term care, is clearly much more expensive than any IV drug user could ever be. Not to mention that her, admittedly subjective, perception is that alcoholics simply have more problems than even the worst drug abusers. (And she previously worked at a Baltimore hospital filled with addicts, some of whom went so far as putting toilet water on wounds to cause an infection so they could get drugs.)

5.  My first hand knowledge ended in 1996 when I left social services. However, when I thought my condition was growing worse, I checked out my employer's long term disability policy, and saw that they used the social security criteria (for the most part). Looking at SSA's rules, it appears they are much the same as I remember. Drug addiction and alcoholism do not, in themselves, qualify one as disabled, and may even serve to undermine some claims. So, it appears that my impression, though a bit out of date, is correct.

This is not directly related to my topic, but I will tie it in eventually, so please bear with me.

Earlier I described some of my difficulties with finding pain medication, and the lack of results I had from non-opiate pain relievers. I often thought that the horrible side effects and lack of benefits were a quirk of my physiology, but I have recently had another thought. What it everyone, or almost everyone receives little benefit and suffers horrible side effects, but fears to tell their doctor because they worry about having their truly effective opiates cut off? After all, the only reason I stopped taking them was that I had been cut off from the opiates I needed at the same time the side effects became so severe I was becoming suicidal.¹ Now I know it is possible that my side effects are unique, or maybe I suffer them with greater intensity than others, but it is also possible that fear over being cut off from opiates may skew clinical trials and subsequent reports of effectiveness.

Now, I know clinical trials are double blind studies, but if a medication has any obvious side effects, it is not that hard to tell if you have a placebo or a real medication. Not everyone may notice them, but in general it is impossible to have a truly double blind study if there are any identifiable side effects tot he medication. So, knowing that their medicine depends on pleasing the doctor, and knowing the doctor hopes for favorable results, is it not possible that patients in the study might misreport the pain relieving benefits of the drugs?

And one the drugs are in general use, I can personally attest to the pressures doctors apply. I was given several drugs which did absolutely nothing. However, my condition was variable enough that I could always report some variation in the pain. A doctor would often latch on to this and force even more ineffective medicine on me. Combined with the doctor's obvious reluctance to prescribe any opiates, the message was clear, I was expected to say the medication worked. And I did so, if only to ensure the trickle of truly effective opiates. Only once I realized how many absolutely horrible side effects some of these medicines had did I find the nerve to reject any more.²

So, why is this on my blog? Why mention my speculations about patients misreporting drug benefits?

Because it is caused by precisely the sort of laws I am discussing. Were medications freely available without prescriptions,  none of us would have to worry that a doctor would refuse to provide them, and we would not find ourselves in the position of having to lie to a doctor to prevent him from cutting off necessary pain relief.  Barring that, if the government did not treat pain doctors as if they were drug dealers, those doctors may be a little less reluctant to provide opiates which have proven effective³, and they may be a little less eager to prescribe something else simply because it is not monitored by the DEA.

Of course, perhaps I am wrong, and doctors would fear opiates just as much even without drug laws. Or maybe the fondness for psychiatric medications would cause them to push them even without the threat of the DEA, but somehow I doubt it.

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1. This is not an exaggeration. I had trouble digesting food, awaking every night choking and then vomiting up undigested food. I was so confused that requests such as "what do you want for lunch?" could reduce me to tears. And my photosensitivity meant that I could not leave the house. Thanks to the side effects of the medications they had prescribed, the neurologists were worried that I was suffering from ALS (among other possibilities), yet no one could find any clear cut diagnostic signs. At that point, fearing that my symptoms would only get worse, I finally asked why the signs of my supposed ALS started when I started taking these medications. As an earlier medicine had caused deafness that "it wasn't supposed to", I figured that other medications may have unlisted side effects and so I stopped taking them.

2. My present pain doctor is truly a wonder, as he has been open to my statements that I suffer terrible side effects and no benefits from a number of medicines. I did allow him to try two other medications, as well as a lidocaine infusion, and a lot of injections in my neck and spine, but he has been very willing to accept my honest statements regarding their effectiveness. Unfortunately, that is a rarity. Even the supposed expert diagnosticians at Johns Hopkins to whom he once referred me were more like my earlier judgmental doctor who assumed a report of ill effects indicated drug seeking.  A doctor who believes his patients is almost unknown in the field of pain management.

3. It is amusing to read medical sources on neuropathies and other nerve pains. They constantly insist that these conditions never respond to opiates and to claim that opiates are completely inappropriate, yet the treatments listed always include opiates. Either opiates work or they don't, yet the authors seem to want to have it both ways. My thought is that if opiates suppress all nerve signals, they surely should work on neuropathies as well as they work on any other condition, but lacking an MD perhaps I am unqualified. All I can say is that, though my condition is supposedly impossible to treat with opiates, opiates are the only treatment which allowed me to resume my job, raise my son and have something approaching a normal life. Then again, as this anti-opiate stance appears to be of recent provenance, at least when I consult older versions of the Merck manual it appears to indicate so,  it may be more politically driven than medical. And before any doctor says that politics would never enter into medicine, explain the removal of homosexuality form the DSM IV, or the sudden disappearance of "paraphilic rapism", not to mention all the dramatic changes in what is and is not appropriate pain management, or the battle of "complementary medicine", where the effectiveness of qi gong and acupuncture varies with congressional funding. Politics exists in medicine as much as it does in any field. (By the way, as a person who suffers from crippling pain whenever he suffers an injury, I find it horrifying that the JHU experts actually suggested acupuncture. As I lost use of both arms for almost a day after having blood drawn, does acupuncture make ANY sense?)

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POSTSCRIPT

As I have gone on a bit about my medical condition, I suppose I should come clean about the details before anyone asks.

Officially it is designated "Complex Migratory Pain Syndrome", but I have a feeling that was sort of made up by the diagnostician I saw to have something to put in the blank. It is supposedly a cousin of better known Reflex Sympathetic Dystrophy, except my condition has spread from only my legs, to my torso, arms and even face. Pain tends to originate in one limb and spread following certain rules, moving generally from left to right, and from legs to arms, so stubbing my toe can end up with piercing pains in both of my arms, or muscles spasms in my hands so severe I can't write.

Then again, a number of my symptoms don't fit at all. I suffer tremors and muscle weakness that are not symptoms. I do not seem to have the surface pain most people report, but have a lot more deep tissue pain. I have hair loss, mottling and swelling in my feet and shins, and some in my hands, but nothing like the horrible disfiguring swelling I have seen in journals. And I have a lot of sensory distortions that just don't fit. My hands and feet constantly feel as if they are covered in fine grit, and I often feel as if cold water is dripping along my arms or legs. I also get pinpoint pains, kind of like cigarette burns, that I have never heard described, and I suffer from numb patches I have never heard mentioned as part of RSD. I have difficulty regulating my body temperature, either sweating uncontrollably for prolonged periods or else failing to sweat even when my body temperature rises, neither of which I have heard as a sign of RSD.  Finally, my facial pain, which feels like a bad toothache that jumps from place to place and side to side, is something I have never heard described anywhere.

On the other hand, I do fit a lot of symptoms as well. I do have skin changes and hair loss. When they injected anesthetics into the ganglia at the base of my spine, and in my neck, my extremities did see a temperature decrease. Those are supposed to be good indicators. So I suppose it is possible I have the condition, but have a very unusual form.

Anyway, to wrap this up, for those unfamiliar with the condition, it is basically a short circuit of the sympathetic and parasympathetic nervous system in which the body begins to read nerve signals which are supposed to regulate things like the lymphatic system as pain signals (or perhaps as sensory signals, as I suffer sensory distortions other than pain). It seems to be aggravated by injury or cold, and it seems to follow certain patterns As I mentioned before, mine tends to move left to right and bottom to top. For instance, I had blood drawn from my left arm. About fifteen minutes later, it turned bright red, swelled, and felt like it had been flayed. Ten minutes later, an identical reaction began in my right arm.  Sometimes it appears strain can cause the same results, as there are days where typing triggers spams in my hand, or walking triggers them in my feet or shins. Spasms are usually followed by color changes, heating, and various sorts of pain. Sometimes burning, sometimes itching, sometimes piercing, or others. It is hard to catalog all the different kinds of sensations.

And that is a brief summary of what is wrong with me. I was having treatment for spinal stenosis in my lumbar spine in later 2005 when this started. After a third course of steroid injections into my spine had cleared up my back problems, I started to notice numbness in my feet and shins. A little later, I began to feel as if my feet were always dirty, and at night they would suddenly feel cold, followed by burning pain and muscle cramps. I thought it was related to my back, and saw another orthopedist, but then in June 2006, I suffered a major episode, losing use of my legs, control of my bladder, and generally scaring myself horribly. (That episode still hasn't been explained. None of that relates to RSD, but as it hasn't happened again, I suppose I can live without a diagnosis.)

After that the pain just got worse and worse, spreading to my arms before the end of 2006. I spent the year of 2006, and part of 2007 looking for a diagnosis. After MRIs of every bit of my body, muscle and nerve conduction tests, five spinal taps, blood tests, three neurologists, two orthopedists and a vascular specialist, I was still without a diagnosis. At various times I had feared I was going to die of ALS or MS, or worried that I had a variety of peculiar cancers, autoimmune diseases or porphyria. But each was dismissed in turn, leaving me even more worried as we had no idea what was wrong.

My pain management was a bit of a mess as well. I had voluntarily gone through withdrawal once already, when my back got better, preferring to get it finished rather than letting my doctor wean me off. But when my pain returned, I was back on oxycodone,  whose shortcoming I mentioned before. And as a result of my incredible pain, I was constantly exceeding the prescribed dose. Which led to two involuntary withdrawals as doctors cut me off. I was careful to never finish my medication early, but apparently taking the maximum prescribed dose is enough to upset a neurologist.

But I finally did receive a diagnosis, and found a competent pain doctor. But my misadventures left me with a changed perspective on the war on drugs. I had always been a proponent of legalization, but, to be honest, I always thought it was a lost cause. I thought, and still do, that it was a mistake for the libertarians to emphasize it so strongly in their platform. But, still, having seen firsthand how badly the war on drugs can harm an innocent whose only crime is a defective nervous system, I have come to think that I need to take a bit more involved stand on the issue, and put a bit more effort into seeing that the issue gets the attention it receives.

But I seem to have turned a short postscript into a second article, so I will cut myself off now. I have mroe than described what is wrong, and that was all I intended to do. But when you are as long winded as I am, even a brief note seems to grow into several pages of text.

Whenever I mention my belief in drug legalization, one of the many questions raised is why I care. Many people seem to think that anyone pushing for drug legalization must be a secret stoner. And, to be fair, many drug legalization groups do give that impression. NORML, for example, outside of a few doctrinaire libertarians, often gives the impression, rightly or wrongly, of being made up of people with lifetime subscriptions to High Times magazine.

And that is  major hurdle in even interesting people in the question of drug legalization. Many seem to think that the only people drug laws even touch are drug users and the dealers who supply them. However, the truth is far different. In a previous essay I explained how banning certain drugs has led to problems in many foreign nations and along our borders.

But perhaps that is a bit too abstract. So, I will mention just a few ways that ordinary citizens are harmed by our drug laws.

The first is of personal relevance, as it has led to many difficulties for me. That is the way that drug laws have kept doctors from properly managing pain. As the federal government has begun to meddle more directly in doctors' choices about pain management, the medical community has become more reluctant to manage pain. I wrote about this at some length in my other blog, but let me just say that, in the past two years, I have been cut off from pain medication and been forced to undergo opiate withdrawal twice, have been left in excruciating pain without any medication for over a month total, and been called a drug addict and liar to my face by one doctor. Unfortunately I did not have a diagnosis at the time, so I was at the mercy of doctors. I do now have an official diagnosis (which took over a year of tests to establish), so I can receive some pain medication, but I still cannot honestly describe my pain to doctors for fear of being thought a drug seeker and being cut off once more. All because we fear that someone may wrongly gain access to opiates.

And patients like me are not the only ones to suffer from this. Doctors suffer just as much from our war on drugs. Rather than managing pain as dictated by their medical opinion, they have to temper that medical opinion with considerations of what DEA agents may think. And do not think this is an exaggeration, doctors are being sentenced to jail on the basis that a DEA agent believes they are over prescribing. Unfortunately, the DEA has never defined what constitutes over prescription, leaving doctors subject to lengthy jail sentences¹ based on vague or nonexistent rules. Is it any wonder that doctors are reluctant to prescribe enough medication to keep me, and those like me, from suffering? No matter how much they might want to eliminate pain, they have to consider that doing so could land them in jail.

If we don't limit ourselves to those who are directly touched by drug restrictions, the list of those harmed gets much longer. For instance, there are those who live in the inner city, who see their neighborhoods turned into open air drug markets, those killed by stray bullets during turf wars and those whose children are recruited into working as lookouts and mules by drug dealers. Now, admittedly, inner city crime is hardly caused entirely by the drug laws, a large part of the blame must be placed elsewhere. But the drug laws do make criminality much more profitable than it would be otherwise, and make a life of crime much more attractive. If all they had to offer was stealing cars and burglary, it is unlikely criminals could recruit as easily as they do today. So, while legalizing drugs will hardly eliminate crime, it clearly will make crime a lot less attractive, and will probably slow the collapse of our inner cities.

Nor are city dwellers the only ones made less safe by our drug laws. By filling our prisons with drug users and dealers, we add to already over crowded prisons. In the worst case, this leads to prisoners being released early due to overcrowding. But we do not need early release for overcrowding to be dangerous. Overcrowded prisons also lead to an environment where judges prefer shorter sentences to avoid the necessity of such early releases. And from experience it is evident that shorter prison sentences almost always lead to increases in crime. Even if we discount the problem of early release, prison overcrowding is still a risk, as crowded prisons are both more prone to escapes and are much more dangerous for those who have to guard  those prisoners. So, even ignoring early release, prison guards are placed at greater risk by the crowding the drug laws cause in prisons and jails².

There are other ways in which drug laws harm all of us, mainly in the surrender of our rights and in the growth of intrusive government, but as I plan to deal with those topics separately, I will leave them alone for now.

Even ignoring that topic, I think I have made my point. Drug legalization is not a topic which benefits just s few stoners who want a legal buzz. From patients to doctors to city dwellers to prison guards to the entire populace of the US, there are many, many people who are touched by the drug laws. Despite popular impressions, the laws harm more than just drug users and dealers. We may disagree over whether the benefits outweigh the harm, but let us at least recognize that these laws have a far wider reach than most people recognize.

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1. I shall deal with some details of this case later. The description in the article paints a slightly different picture than other reports. However, for the moment let me say that, one thing the press and many doctors fail to realize is that oxycodone, while "active" for 6-8 hours, really only provides pain relief for about 1-2 hours. It is one reason many legitimate patients end up using "huge" quantities of the drug. Having found a doctor inclined to prescribe longer-acting pain medications, I no longer take the "excessive" amount of medication I once did, but at one time I had a doctor cut off my medication as I was taking "excessive amounts". And trust me, I was not doing so to get "high", I did so simply to allow me to get up off the sofa and move around the room. (Sadly, while pain relief lasts only 1-2 hours, CNS depression lasts the full 8 hours, so the struggle was often between finding adequate relief and avoiding a lethal dose.)

2. Obviously there are logical limits to this argument. We could easily cause our prisons to be less crowded still by releasing everyone not guilty of murder, for example. But that is obviously absurd. My argument is simple. Those who commit violent crimes clearly deserve to be in prison, as do those who steal from others. Drug dealers who fall in either category should be in jail or prison as well. On the other hand, I do not think society is at risk if we do not incarcerate drug mules (who often receive absurdly stringent sentences, sometimes averaging longer than those committing homicide receive in the same jurisdiction), users, or users who turn "dealer" to support their habit.  Releasing those who were jailed solely due to violation of drug laws does not seem to increase the danger to the public in the way releasing violent criminals or even thieves would.

Having written about unintended consequences in a very general way, I now do want to look at some specific unintended consequences of the war on drugs. Again, in my mind these seem to be sufficiently harmful that they argue for ending the war on drugs, but I know many will disagree. So, I am presenting them simply to make clear exactly what the costs of the war on drugs are. It is quite possible that many will  argue  that, even with these consequences, the war on drugs is worthwhile, and I can understand how some could come tot hat conclusion, but I think we are all better served if we agree in advance what the real costs are.

When people mention the foreign policy costs of the war on drugs, most think of the often heard argument that the war on drugs finances hostile foreign powers. And this is a valid concern. Drug profits do support insurgencies throughout South America, as well as warlords in Afghanistan and Thailand. Beyond that many terrorist and criminal groups, such as the KLA, are involved in some segments of the drug trade as well. Admittedly, many are funded more by European drug smuggling than US,  but the US prohibition on drugs play a part as well.

However, that is only half the story. The funds that drug growing, growing and smuggling pours into these groups is harmful, but the subsequent consequences are worse. Let us look at just one example, Columbia.

Columbia has been plagued for a long time with numerous insurgent groups. At one time these groups were funded by the USSR through their intermediary Cuba. However, with the fall of the USSR, Cuba no longer has the money to maintain a world wide network of insurgent groups, and Columbian insurgents were forced to turn to drugs and kidnapping for revenues¹. And, while kidnapping may be profitable, if we are honest, the drug revenues were the primary source of support for these groups. Whether they participated directly in the drug trade or hired themselves out as muscle for drug cartels, it was the cocaine trade which kept the insurgency alive. Without the drug trade, these rebels would not have vanished, but their ability to cause large scale harm would have been seriously diminished.

But it is not enough to say that our drug laws kept the insurgency alive. What we need to see if how that insurgency hurt US interests. In the nation of Columbia we have a relatively large military presence. Not just to help the nation keep the insurgency in check, but also to participate in drug interdiction and eradication. During peace time this may be of little concern, but now that we are involved in an increasing number of conflicts, we find ourselves with troops tied up in various parts of the world, pursuing drug interdiction and fighting insurgents funded by drug revenues. All of which are direct outcomes of the war on drugs.

Nor is it only in drug producing nations we find our military tied up in drug related functions. The Coast Guard expends quite a bit of effort in attempting to prevent drugs form entering the nation, as does the Navy from time to time. Again, resources that could be otherwise employed are being tied down in pursuing drug smugglers.

And the military resources are not the only cost. On our southern border, faced with an overwhelming wave of illegal immigrants, our border patrol has to expend efforts on preventing drug smuggling at the same time they try to stem the tide of immigration. Admittedly, thanks to the fact that human smugglers and drug smugglers are often the same people, or at least use the same routes, this is not as serious a problem as the military we tie down in Columbia.

However, that overlap does point out one other consequence to the war on drugs that is often overlooked. By making illegal border crossings so profitable, the drug trade across the Mexican border has inspired an ongoing search for newer and safer routes into the US. With millions of dollars of profit available for successful smugglers, a lot of effort is expended on finding ways into the country. The problem is, once those routes are established, not only are they used for drugs, but for large scale human smuggling as well.

Now, this is not to say that there would be no human smuggling were it not for the war on drugs, but human smuggling is simply not profitable enough to inspire the sort of ingenuity the war on drugs has. In some senses drug smuggling has served to subsidize human smuggling. By making the discovery of routes exceptionally profitable, it has opened up new paths which the human smuggler can then exploit at little cost².

Of course, as I said, many may argue that these costs are justified, that the need to keep people from harming themselves with drugs is sufficiently important to tie up troops in foreign lands, to tolerate increased funding of warlords, and to help subsidize the penetration of our southern border. That is a possible position, and I am sure some will make that argument.  All I ask is that, when we debate thew war on drugs, that we are honest about the costs. Often we hear that the only people who are harmed by the war on drugs are a few drug users. But, if we are to be honest, we have to admit that the effects of making drugs illegal reaches far beyond those who use, or even sell, drugs, and touches the entire world.

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1. Now that Chavez has oil revenues with which to fund rebel groups, Columbia insurgents may be able to survive a loss of drug revenues. Unfortunately the time to legalize drugs and starve them into submission may have passed. But perhaps Chavez will not ahve the longevity of the Castro regime, and we will again have a chance to do so.

2. People will argue that there is no cost in establishing a smuggling route, but they are mistaken. Admittedly, it is not a traditional monetary cost, but to establish a new smuggling route it must be explored, tried out, and run several times to see if the users will be caught. The lower profit human smuggling enterprises do not support as much willingness to be caught as the high profit drug routes do. In that way, the drug profits serve as a subsidy for the human smugglers.

I think one thing which plagues the war on drugs, perhaps more than most other areas of public policy, is the tendency for simple, well meaning policies to produce unintended consequences. Of course this is a problem for every area of public policy, from the way that welfare helped create unemployment and single parent families to the host of unintended beneficiaries receiving farm subsidies, every policy is subject to unintended consequences. However the war on drugs seems to have more than its fair share.

Perhaps it is because policy tends to be more driven by emotion than in other areas. People do tend to get more worked up about drug dealers than farm policy. Or maybe it is because there are few whose livelihood depend on drug policy,  so less independent analysis is done of drug laws than business regulations. Whatever the reason, drug regulations tend to produce more side effects than other areas of the law.

Perhaps an example will help. It isn't exactly a drug law example, but from the related area of regulation of alcohol.

Recently I was discussing the laws in the United States restricting access to alcohol by those under 21¹. This was around the same time I was writing on the same topic in this blog. My conversation followed the normal pattern for such discussions. As there were no teeangers present, no one mentioned that they could join the military but not buy a beer, but the other tired old topic did arise. That being Europe's general lack of age based drinking restrictions.

However, I will not be mentioning that particular topic. First, because it has been discussed ad nauseam. Second, and more importantly, because it is one of those topics which "everyone knows", yet about which almost nothing concrete can be established. Yes, Europe lacks laws concerning drinking by those under 21, but what effect does that have? Many people have provided anecdotal evidence of teens being "more responsible" about alcohol, but is it true? Europe not only has no laws about drinking under age, but it also differs in a number of other respects. For example many nations have very harsh laws concerning drinking and driving, so it is quite possible teens do not drink and drive more because of those laws than because of the liberal drinking restrictions. The point being that it is very hard to control for other differences, making it a very poor example.

That being the case, I am going to avoid the argument that by prohibiting teen drinking we create a more irresponsible attitude toward drinking among teens. It is possible that is the case, it is possible that the opposite is true. Since I can't make a strong case either way, I will focus on what I can prove, that our age based restrictions tend to promote excessive binge drinking.

Now, let me start by saying that the purpose of these restrictions is quite simple. The laws exist to keep teenagers from drinking and to prevent adults from selling or giving alcohol to teens. And by and large the laws do achieve that end. Not completely, as the amount of teenage drinking proves, but they definitely make it more difficult for teens to drink, and much more difficult for them to obtain alcohol². So, in this regard they are successful.

What I am going to add, however, is that precisely because they succeed there, they lead to more dangerous behavior among those teens who do drink. Not only that, but that such an outcome is a logically necessary outcome of the law.

Think about the situation of the teen who wants to drink. Provided he does not ahve a willing older sibling or friend, he is unlikely to have regular access to alcohol, which means that when he does have access, he is going to purchase as much alcohol as his limited means allow. As he will be unable to go back for more should he run out, it only makes sense o adopt an attitude that too much is better than not enough.

However, having obtained the alcohol he is confronted with a new problem, leftovers. As he is a teenager he is not supposed to be in possession of alcohol. He can hardly bring it home and store it for later. He doesn't want to keep it in his car or home, as it is illegal for him to possess it. So, as a result, he will make sure he consumes every bit of alcohol in his possession. Leftovers will simply be wasted, as they cannot be kept for later.

Now I am not about to commit the mistake so many do after raising such issues, and follow up an unintended consequence with the argument "thus we should eliminate the drinking age". The simple fact that a law has unintended consequences does not logically mean that the law should be repealed. What it does mean is that we should examine the law again, and see if we still believe it is important enough to maintain despite the additional costs³. In some cases that may mean that a law should be repealed, but in many others, most likely we will decide that the law is still worth the added costs.

However, even that was not my main point. I do not want to argue the merits of enforcing a minimum age for drinking. All I wanted to point out was that laws, even seemingly simple laws such as those concerning drinking ages, often have unintended consequences. And not just unintended consequences, but consequences which are contrary to the goals of the law itself. Doubtless those who wrote laws about drinking ages were equally opposed to teenage binge drinking, yet inadvertently that is precisely what they encouraged.

And that is my point. When we look at drug laws, either in hindsight or when proposing new laws, we need to look not just at the explicit goals and the obvious effects, we need to delve a bit deeper and try to see if there are any other effects, any unintended consequences, and ask ourselves if the law is still worth enforcing given all we know about the costs.
 
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1. This is a good analogy to the federal take over of drug laws I mentioned in my last post. Drinking age used to be purely the concern of the states, but the federal government, using highway funds to blackmail states, forced the states to follow federal policy. This is a topic I may deal with at greater length in my main blog, as federalism is a major topic there, but for the moment I would point out that, even where the federal government has no explicit enforcement policy, the control of purse strings gives the federal government effective control. Thus even matters which are nominally controlled by the states are often really controlled by the central government.

2. I cannot speak for the present day, but during my own teen years we often commented on the fact that it was easier to find drugs than alcohol. Perhaps I should mention that as another unintended consequence, the relative difficulty of finding alcohol versus drugs leading those seeking an altered state to drugs rather than alcohol. But then again, it is hard to say whether using drugs or drinking alcohol is a worse choice, especially given the results of long term alcohol abuse. So I think I will leave that topic alone for the moment.

3. In the case of drinking ages, I think most will consider them worth maintaining even with the added incentive to excessive drinking by teens. And, I must admit, I can understand the logic. The teens who are driven to binge drinking are those teens who would be drinking whether or not the laws were in effect. However, were the laws repealed, there are doubtless other teens who would drink who currently do not. So, by keeping the law you simply increase the amount consumed by a set number of teens. If you repeal the laws, those specific teens will still drink, just not quite so much, but another set of teens will also begin drinking. So the laws limit the number of individuals who drink, even if it does increase slightly the amount drunk per person.

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POSTSCRIPT

Please do not think that I am being one sided because of the example I provided, I want to look for unintended consequences of legalization as well as criminalization. I even want to look for the unintended results of allowing greater variability between the states. (For example, to find fault with my favorite cause, federalism, there is a great likelihood of cross border smuggling should a state enact sweeping legalization without their neighbors doing the same. This would doubtless create a very profitable criminal traffic into neighboring state, offsetting much of the decline in crime legalization would bring by creating a matching, or even greater, increase in crime in nearby states.)

I only chose a law relating to criminalization because such laws are all we currently have. At present legalization is a dead issue, the federal government having refused to allow a handful of states to enact even  limited medical marijuana laws. As I have to work with what I have available, I am forced to draw examples from the laws making drugs illegal. Were there legalization measures available to criticize, I would take those on as well. Unfortunately that is not an option at the moment.
 

I just noticed that this blog was featured on the opinion page, so I wanted to say thanks to the Townhall editorial staff for giving this blog a little attention.

It is still in its infancy, not quite as well developed as my other blog. For instance, I am sure readers will notice that I have tendency to fluctuate between an impartial review of the war on drugs and a desire to present arguments for my own position. But I am slowly working out all the kinks, forcing myself to tone down my own opinion, and even rethinking which topics I want to cover, as I noticed even my selection of topics was a bit biased. Hopefully I am getting closer to what I want, a fair evaluation of the measures proposed and taken in the war on drugs. Not completely free of my own bias, but not dominated by it either. It is a tough line to walk, but I think I am making some progress.

Well, let me know what you think. Anyone who drops by, either from the Townhall featured blog link, or from the links on my main blog, add a comment to tell me your opinion. Make a few allowances for being relatively new, but don't hold back too much. A compulsive writer like me, I can take criticism, I know I have had enough on my other blog.

This is a bit off topic, but as it relates to addiction, I suppose it falls within the scope of this site.

Whenever discussing mental illness, including addiction, with those who favor a biological explanation, it is almost inevtiable that someone will bring up the fact that this or that mental illness causes chemical, or electro-chemical, changes in the brain, and then use this to argue that only chemical intervention can cure the disorder.

I just don't see how that follows.

First of all, thought itself is nothing but an electrochemical process in the brain. Thoughts cause electrochemical changes. So why could not those electrochemical changes counteract the changes caused by a mental disorder?

But even if we assume that the electrochemical changes caused by thought for some reason could not correct the changes caused by illness, then why could thought not overcome the impulses caused by those problems. For example, if I touch an open flame, a strong biochemical signal tells me to withdraw my hand, yet I can force myself to keep my hand there. So there is nothing absolute about a biological urge. We can still overcome it.

This is not to say chemicals can be of no help. Obviously a healthy dose of morphine would make it easier to ignore the impulse telling me to take my hand out of the flame. And perhaps various psychiatric medications can be of help. I just don't see how anyone can argue that they are the sole possible cure.

But, as I said,  this is a bit off topic. I only mention it as people sometimes argue that addiction is also uncontrollable, and for the reasons mentioned above, I cannot agree with that position either. However, we are drifting a bit far afield form my declared topic, so I will cut things short.

As a final thought I will simply offer this, that were addiction utterly incurable without pharmaceutical assistance, how did we ever have any former addicts before pharmaceuticals were developed?

POSTSCRIPT

Note that my final sentence also applies to those on the other end of the spectrum who are extreme proponents of 12 step programs. Most are quite modest in their claims, but I have met a few who claim there is no recovery without a 12 step program. To which, again, I must reply, then how did we ever have former addicts before the 12 step program was developed?

My complaint with the American media is not so much that they are biased, as that they are biased yet pretend to be neutral. It is why I go so much easier on the openly opinionated press of other nations. While British newspapers, for example, may be even more biased that the bulk of American media, most of them are openly so, which makes it easier for their readers to evaluate their content. If you know that a source is biased, you can mentally adjust for that bias, and reach something approaching the truth. For example, if you know you are reading a liberal source, when they blame every misfortune on the president, you know to take it with a grain of salt. However, when you read that the president is to blame in an ostensibly neutral source, you take a very different meaning from it.

So, as I respect those who openly proclaim their bias, I am going to explain my position on drug legalization up front. Now, I hope this will be, in some ways, unnecessary, as I will try to present my analysis of drug laws in as unbiased a manner as possible. But as it is possible, maybe even likely, that my own beliefs will color my analysis, despite my efforts to remain unbiased, I feel I should tell everyone from the start what I believe and why. Armed with that information, should my writing prove more biased than I think, readers will be able to assess what is unbiased evaluation of drug laws and what is just my opinion.

From the few essays here and those in my other blog, it is clear that I believe in drug legalization. And by legalization, I mean not just allowing people to use currently illicit recreational drugs, I mean total legalization, the creation of a free market in both recreational and prescription drugs, as well as tobacco and alcohol¹. Obviously states will still have the power to decide what laws will be applied with regard to minors², for the simple reason that minors lack full legal rights³ of adulthood, but other than that I would prefer to see no restrictions.

My belief in legalization rests on a number of foundations. The original reason, and still one of the primary reasons, is what some would call a theoretical basis, though I think it is remarkably practical. It is summarized best by the quote I posted yesterday from von Mises, arguing that if the state can control what is good for one's body, then there is no reason to keep the state from regulating what is good for one's mind. On, to put it more plainly, once you allow the state to tell people what is good for them in one area, there is nothing to stop it from telling them what is good for them in all areas.

For those who doubt that drug laws can lead to a loss of rights, I would ask that they look at drug forfeiture laws⁴. Traditionally, US law has not deprived criminals of their property. Yes, stolen goods were usually restored to their owners, ill-gotten gains could not be used to post bail, and, more recently, some laws existed to keep criminals from profiting from their illegal acts, but that was it. Excluding the taking of items to be used as evidence, the law did not concern itself with goods which were not actually stolen or contraband. Drug laws have changed that. Having managed to demonize drug dealers sufficiently that citizens no longer worry about an abrogation of their rights, laws now allow for the confiscation of goods involved in only the most tangential way. And before people think I am crying about the yachts of drug kingpins, I would point out that the cars of drug users are often seized as well, along with possessions of people uninvolved in drug deals in any way. For example, a private charter plane, where a passenger is later found to be smuggling drugs, can be seized, even though the owner was completely unaware of the smuggling. Of course he can apply to get back the plane, but again, our fear of drugs has warped the law enough that he has to prove his innocence to have his property returned. All of which is quite contrary to our legal traditions. But by introducing the assumption that citizens must be protected form themselves, we have opened the door to all sorts of abrogations of individual rights. That the state has been rather modest in its aims so far is no guarantee it will always be so.

However, my argument does not rest solely on this one argument. I also have several pragmatic supporting arguments. From the way Prohibition created a permanent, deeply embedded criminal class, it seems evident that the war on drugs could easily create a similar new criminal class, which might even survive drug legalization. Even if that does not come to pass, it is evident that much of our criminal violence has a basis in drug laws. I am not foolish enough to argue that legalization will end all of that violence, or even end all of that crime, but it will certainly reduce the motivation behind much of that violence, leading to some reduction.

Nor is that all. From funding communist rebels in Columbia to filling jails resulting in the release of other violent criminals, the drug laws have had several negative side effects, unforeseen at the time the laws were passed. In an essay of this sort, I hardly have the time to go into every possible effect, but perhaps a few in the realm of foreign affairs will help. Our drug laws raise the price of heroin drastically  providing funding for warlords in Afghanistan and Thailand, while cocaine funds revolutionaries throughout South America. Our drug eradication programs have tied up both money and military resources in a number of nations when we need them elsewhere. And traffic in marijuana, cocaine and heroin has established many routes across our southern border which are used not only to smuggle drugs, but immigrants as well. Without the drug trade having blazed the trail, it seems unlikely that so many routes would have been found for human smugglers to exploit⁵. Doubtless human smuggling would exist even were there never any drug smugglers, but the fact that drug smugglers have established routes across the border has certainly made the business of human smuggling much easier and more profitable.

Having explained what harm I think drugs laws do⁶, I suppose I should spend a moment explaining my understanding of the possible harm done by legalization.

The most common argument against legalization is that removing existing laws will result in an increase in drug use, most often argued as an increase in youthful drug use. However, as I have explained elsewhere, I don't think this is as much of an issue as some would believe.  I believe that those who would become addicts seem unlikely to be deterred by laws against drug use. As they are willing to suffer withdrawal and all the other health problems associated with addiction, as well as the social stigma, just to use drugs, they are very unlikely to give up drug use just because of the threat of being arrested. So, that means that the only people who are likely to be deterred from drug use by laws are the casual drug users, or those who use "soft"⁷ drugs. However, I would argue that even now there is little deterring casual drug users. As I wrote elsewhere, thanks to our "two tiered" enforcement system, the middle and upper class drug users have little to fear from drug laws. If caught, they can enter treatment and almost always avoid any kind of jail sentence, even for repeated offenses. Given this, there is no real fear of punishment keeping most casual users from using drugs, so, were the laws removed it would not make the climate much more attractive for casual use than it is now.

There are other argument, that crime would rise, that other societal breakdown would occur, and so on. As I can't address every concern here, let me promise that I will speak to each individual claim in the future. What I will say here is that I am aware that legalization may not be completely pain free. Very little in life is absolutely good without any ill effects, and why should this be any different. What I do think is that the painful effects will be less severe than critics think. There will surely be some problems, but I just think the benefits far outweigh the likely harm, and, in the long run, most of the ill effects will be better handled with approaches less intrusive than the war on drugs. But, as I said, I will have to make those arguments later, as answerring every possible problem would make this already long essay far too long.

Having explained my reasoning, let me add one final item. While I think the nation as a whole would benefit from drug legalization, I think there is an even better solution. Were the federal government to eliminate its drug policy, and allow each state to chart its own course, we would probably be in a better position to argue these points. As the attempts by several state to legalize medical marijuana show, there would definitely be some diversity in drug laws but for federal interference. With differing state laws we could actually see what problems and benefits come with differing laws. In addition, states could more closely tailor their laws to the beliefs of the residents.Not just that, but each state could look at the results of other states' experiments and adopt those policies that seemed most beneficial.

From our point of view, probably the greatest benefit of independent state policies would be that, instead of arguing purely theoretical positions, or relying on historical analogies, we could look at the results in states of varying policies and use those examples to explain what the costs and benefits of policies are. In other words, eliminating our uniform federal policy would allow us to have some degree of local experimentation, and take this debate out of the theoretical realm. Perhaps such experiments would prove my beliefs wrong,a nd show that drug legalization was a bad idea all along, but at least I would know it with some degree of certainty. At the moment, our imposed federal policy prevents the states from deviating at all from the single allowable set of drug laws⁸.

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1. I find it odd that there are some who argue for drug legalization, yet support the nanny state restrictions on tobacco. It seems a completely untenable position, as the same arguments for "protecting" adults from tobacco apply to "protecting" them from drugs. If we allow one form of paternalism, there is no rational argument against the other.

2. Whether restricting access by law works or not is a question open to debate. In an ideal world, I would want parents to perform this function rather than the state, but fighting for drug legalization is enough of an uphill battle without adding the argument about giving children access to alcohol as well. So this topic can be left for another day.

3. Exactly how the rights of minors differ from those of adults is arguable. Obviously they enjoy all the legal protections of life, liberty and property that an adult does. Historically, they have been assumed incompetent to enter into certain obligations, but not all. This seems reasonable, but where we draw the line is open to debate. However, as children do lack some ability to contract, this opens the door to legally restricting their rights to purchase specific goods, to operate cars, and so on. As I have not spent much thought on this question since turning 21, the last time I cared very deeply about the topic, I will have to postpone any discussion until I can give it more thought.

4. As I plan to write a more detailed article on the way our view of rights, the role of police, and the way the government treats citizens has been changed by the war on drugs, I am providing only a short example. The essay should be written this weekend, so this single example won't have to stand alone for long.

5. It is arguable whether coyotes would have created these smuggling routes exclusively for human trafficking had the routes not already existed for smuggling drugs. On a dollar per pound basis, even marijuana is far more profitable than humans, and due to the need for oxygen and minimal food and water, as well as a need to keep temperature from rising too high, drugs are far easier to move. Given that, it seems most likely the human traffic is simply piggybacking on known drug routes and would be greatly reduced were there not drug routes already established. But that is a sufficiently intricate topic that I will put it off until I can deal with it on its own.

6. Obviously, this is not an exhaustive list. I have not even touched on a topic personally important to me, the way drug laws have harmed the practice of pain management. But I do not want this article to run on too long. So I will be dealing with many other topics in individual essays later. If I failed to mention something, please feel free to post a comment. While I may already be aware of it, and simply omitted it for reasons of space, it is quite possible you have thought of something I missed, so I am very happy to hear from readers about things I might have missed.

7. The distinctions seem a bit arbitrary. Heroin is really the only drug with an easily acquired physical dependency. Alcohol dependency requires quite a while to develop, and claims of physical dependency for other drugs seem to be arguable. However, as people seem to insist on dividing drugs into "hard" and "soft", I suppose we can call heroin, cocaine and amphetamines hard drugs. However, even this is a bit arguable, as people differ on whether MDMA ("ecstasy") is  hard or soft. As it is a variant on amphetamine, I would suppose it is "hard", but due to quirks in the way the body handles the drug, it is not open to the same regular abuse as amphetamines. As I said, the distinction is a bit arbitrary and not one I endorse.

8. On paper the states have control over drug laws, but that is a fiction. As the federal opposition to state medical marijuana laws has shown, the federal government is willing and able to strike down any state laws which deviate from federal drug policy. While the laws are nominally under state control, in practice we have a single drug policy set at the federal level.