WHY DO WE MAKE MAJOR PROBLEMS OUT OF MINOR DRUGS OF ABUSE?

Frederick H. Meyers, M.D.

Professor of Pharmacology

School of Medicine University of California, San Francisco, CA 94143

Presented at the 7th International Conference on

MAKING CITIES LIVABLE

Carmel, CA March 1, 1990

Note from Cliff Schaffer:

Dr. Meyers was the head of the Research Advisory Panel for the state of California. In essence, he was the man picked by the state of California to head up their long-term evaluation of the drug problem. As such, he probably knows as much about the subject as anyone on earth. I always find his comments interesting and enlightening.

What is your reaction to my appearance today? Possibly you are thinking, "Oh my God, here is another drug expert who has imposed on his long association and, friendship with the Lennards to get on the program at this prestigious meeting to intrude on our interests. He is going to tell us how terrible the drug problem is, how it is the factor making all neighborhoods unlivable and how impossible it will be for us to improve the livability of our cities until we eliminate drug use. The steps to be taken will involve inflating his personal status and providing more money for damaging treatment, irrelevant research, dehumanizing enforcement or wherever else his entrenched interest lies. And he will get everything wrong including failing to recognize that the factors that depreciate the livability of our cities also cause drug abuse and not the other way around.

Now actually that is what I think that your reaction should be. If you agree, I might be well advised to simply stop.

However, you should, I believe, hear me further to protect your plans for change. An hysterical, ineffectual "War on Drugs", which is what we are currently experiencing, will absorb funds and energy, provide excuses for inaction and deviousness and criminalize large groups within our society. Our present ineffective course will not change until:

I ) The public is taught the difference between drug effects and societal reaction to the presence of those drugs; the difference between drug effects and the associated criminal activity of the marketplace for an expensive, illegal commodity.

2) We consider that the unlivability of some of our neighborhoods and the factors that have led to that unlivability may be causes of drug abuse. The use of a given drug by a specific route of administration (e.g., smoking crack) is not uniformly distributed throughout our cities.

We do not have a drug problem. Different agents are used and by different routes of administration. Different drugs have differing inherent dangers and elicit different emotional reactions from the citizenry.

Let's contrast two specific drugs, alcohol and heroin.

Alcohol, like all sedatives, gives a pharmacologic reward. It relieves anxiety but also impairs judgment and psychomotor performance and causes excitement. Alcohol as a direct drug effect, that is because it is a disinhibitory agent, leads directly to crime and antisocial behavior. Quantitatively, it is by far the most important drug of abuse, being involved in half of the homicides, half of the fatal auto accidents, etc.

Heroin, in contrast, is inherently not very dangerous. The direct effect is to quiet the individual. Henry and I have long enjoyed Baldwin's statement that for many years what kept the peace in Harlem was Jesus and junk. You as citizens agree that narcotics are not very dangerous by providing people with a daily huge dose of methadone, a potent narcotic, as treatment for their use of a potent narcotic, heroin.

However, the societal reaction to the two drugs is not consistent with their danger. No one is ever more than a few steps from a drink or a bottle, The U.S. briefly tried the "noble experiment" of prohibition but abandoned it because the criminal activity associated with illegal booze was judged to be intolerable.

Yet our reaction to heroin use is to assign heavy penalties for its mere possession and to harass and isolate the user. I understand punishing an overt criminal act but do not understand the moralizing that underlies the terribly vindictive attitude toward heroin. Injecting heroin is fairly described as chemical masturbation, not inherently a heinous act however distasteful. I think that the citizenry is deliberately misinformed by people with an interest in maintaining the size of the drug problem and the current hysterical reaction.

Prohibition does not work; nothing we have done in the past 40 years has worked. It is time for the political and intellectual leaders of this country to openly criticize our present efforts, resist the current panic reaction by citizens and elected officials and help us redirect our efforts toward our youth, our economy and our cities.

There are some individuals and groups who plan to suggest legislation to decriminalize (not legalize) some areas of drug use. When you hear of the proposed legislation, I hope that you listen to argument pro as well as con.

If we can cease destroying each other over quantitatively unimportant drugs, we can close some prisons and get on with the primary problems -- humanizing the urban environment and working on the important public health problems presented by alcohol, poverty and mental illness.