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are in Research Legalisation:
The First Hundred Years
What happened when drugs were legal and why they were prohibitedMike
Jay Lecture
presented at a conference in London, July 17th 2002, organized by the Institute
for Public Policy Research (IPPR) about 'Legalization' in their conference series
on drug policy.
Today, as the notion of legalising drugs is making its way into the mainstream
political agenda for the first time in living memory, one of the most common objections
to it is that it represents a high-risk experiment whose outcome cannot be accurately
modelled or predicted. Yet within the context of history, the opposite is true:
it is the prohibition of drugs which is the bold experiment without precedent.
A hundred years ago, any of us could have walked into our high street chemist
and bought cannabis or cocaine, morphine or heroin over the counter. At this point,
mind-altering drugs had been freely available throughout history and across almost
every culture, and their prohibition, pressed forward largely by the goal of eliminating
alcohol from modern societies, was a radical break with the traditional wisdom
of public policy.
Nor
was it the case that the prohibition of drugs was a response to their sudden emergence
in Western societies. In 1800, virtually the only drugs familiar to the West were
alcohol and opium; but by 1900, the constellation of substances which form the
modern category of illicit drugs - opiates, cannabis, cocaine, stimulants and
psychedelics - had all found their niches within a consumer culture driven by
scientific discovery and the expansion of global trade. The nineteenth century,
typically regarded as an era of repression, moral probity and social control,
could also be billed as 'Drug Legalisation - The First Hundred Years' (Jay 2000). There
is much which today's policy makers can learn from this era. Not only were most
of the policies now being debated - statutory control and regulation, medical
supervision and legal exclusion - all pioneered with varying degrees of success,
but the legal availability of drugs offers a glimpse of how the general public
originally negotiated their benefits and dangers, and how the various substances
found their own levels within the society at large. History, of course, has its
limits: it cannot tell us everything, and cannot be expected to repeat itself
exactly. Cannabis, for example, was legal throughout the nineteenth century, and
its levels of use remained for various reasons quite low: if it were legalised
tomorrow, we would hardly expect its prevalence to fall to nineteenth-century
levels. But history nevertheless illuminates many of the underlying dynamics in
the modern drug debate, not least by offering the possibility of distinguishing
between the consequences of drugs themselves and those which only followed once
their use had been prohibited. Perhaps
the most significant difference was that today's prime distinction between 'medicinal'
and 'recreational' drugs was, in a society without illicit drugs, at best embryonic.
Opiate and cocaine preparations, like alcohol and tobacco, were both intoxicant
and medicine, and the distinction between 'use' and 'abuse', 'feeling good' and
'feeling better' was vague and subject to medical and social fashion (Berridge
& Edwards 1987). Today's Class A substances were not typically understood
as drugs of 'abuse' but as tonics, pick-me-ups or mild sedatives, medicines 'for
the nerves' inhabiting a middle ground perhaps similar to that occupied today
by health supplements, over-the-counter stimulants or energy drinks. This was
not because they were only available in mild preparations like opium tinctures
and coca teas: even in the late nineteenth century, when pure cocaine and injectable
morphine were readily available, the great majority of the public chose to continue
consuming these drugs in dilute and manageable preparations. Even
in this era of mild plant and patent preparations, though, there was a clear need
for some types of statutory drug controls. Until the 1860s, the market was unregulated:
anyone could sell any substance to anyone, and make whatever claims they wished
for it. Although most doctors were not overly preoccupied with the dangers of
opiate addiction - which was typically seen as a marginal side-effect of the most
effective medicine in their pharmacopeia - accidental poisonings and overdoses
were a risk which was clearly exacerbated by preparations which labelled their
contents inaccurately or not at all. The emergent pharmacy profession began to
lobby for control of the sale of such substances, and in 1868 the Poisons and
Pharmacy Act was passed. This limited the sale of arsenic, cyanide and opium,
previously sold everywhere from grocers' to pubs, to registered pharmacists; the
pharmacists, in turn, were obliged to record details of their sales (date, quantity
and purchaser). In
retrospect, this initial level of statutory regulation was perhaps the most effective
public policy initiative of the era. Public confidence in the drug business rose,
and misuse fell. Deaths by accidental overdose, suicide or poisoning remained
steady from the 1870s to the 1900s at less than 200 a year in Britain - a figure
which today's doctors would gladly trade for the thousands associated with modern
prescription drugs (Parssinen 1983). The combination of reliable health information
and traceable sales provoked a modest public reaction against opiate drugs, the
first indication that a population presented with a credible assessment of the
dangers of drug use will to some extent regulate their use on their own initiative
(Musto 1973). But
there were two initially unrelated dynamics in nineteenth-century culture which
would, by the end of the century, have dovetailed to put the outright prohibition
of drugs on the political agenda. The first was a growing set of racial anxieties
at the prospect of a multicultural society; the second was the extension of medical
science into the notion that drug addiction, and by extension all drug use, was
a disease which needed to be addressed under medical supervision. It
was the racial anxieties which bit first. In 1874, the Opium Exclusion Act passed
in San Francisco became the first drug prohibition in the modern West: but this
was a prohibition to the Chinese population only. It was represented as being
for the immigrants' own good as well as for the protection of the whites who might
be contaminated by the foreign habit, but the most obvious driving force was the
fear of miscegenation between Chinese and whites in the informal and disinhibited
surroundings of Chinatown opium dens (Kohn 1987). Around the same time, the political
mood in Britain was turning against the imperial adventures of the Opium Wars,
and images of a China 'enslaved' by addiction to British opium became prevalent
through the reports of missionaries and campaigning journalists. Although these
images have subsequently been shown to have been greatly exaggerated (Newman 1995),
they transformed the perception of opium from indigenous medicine to foreign poison,
and anti-opium groups (including Quakers and Temperance activists) promulgated
the fear that the growing Chinatowns in Britain might become breeding-grounds
for the new 'plague' (Harding 1988). Metaphors
of 'plague' and 'contagion' were, simultaneously, being given new and literal
force by a medical profession for whom the addictive qualities of opium, morphine
and cocaine were becoming more significant. The development in the 1870s of the
hypodermic syringe, and consequent wider use of potent alkaloidal extracts like
morphine, fuelled medical concerns about unprecedentedly powerful and dangerous
drugs being available to the general public. Opium users like Thomas de Quincey
had long since pointed out that constant use of the drug led to serious physical
cravings, tolerance of high doses and withdrawal symptoms (in opposition to much
of the medical opinion of the 1820s, which saw these effects simply as over-indulgence
or vice). But from the 1870s onwards the modern notion of addiction came to take
shape, along with the still-familiar claim that this was a 'disease' which required
specialist treatment by professionals (Harding 1988). This, particularly in the
context of the contemporary 'degeneration theory' which proposed that indulgence
in drugs could pass on hereditary disorders to the users' offspring (Pick 1989),
gradually led to some doctors calling for all opiates to be prohibited to the
general public without medical supervision. There
was an element of professional self-interest in all this: opium was the most common
and effective remedy of its time, and the majority of the population understandably
preferred self-medication with cheap patent pills and tinctures to paying doctors'
fees. But there was also, in the new world of cocaine, morphine and needles, a
pressing need for new medical advice and statutory controls: manufacturers' guarantees
of strength and purity, professional guidance around the potentially hazardous
issues of injection and dosage, and public information about the risks of addiction.
Yet many medical voices went further, arguing for an outright ban with an urgency
perhaps attributable to the fact that the largest group in the emerging addict
population were medical professionals: from the 1870s to the 1920s, the profession's
own surveys repeatedly suggested that around half of all addicts were doctors
and their wives (Jay 2000). As the medical profession grew in expertise and stature,
their calls for legal controls on opiates and cocaine became more authoritative.
For the medical profession was not only becoming better organised to extend its
remit into new arenas of public health - it was developing its new views against
the background of a popular and influential Temperance movement. Temperance
had a diverse set of lobbying groups behind it - the church, the Women's Movement
and, particularly in America, the moral high ground of politics - but at its core
was an aspirational middle-class crusade to convert the alcohol-fuelled culture
of the working classes to civic responsibilities, Christian virtues and 'moral
hygiene' (Behr 1997). Most campaigners, doctors and churchmen alike, were united
in their belief that alcohol was by far the most significant root of social evil,
and the dangers of drugs like opium and cocaine were only stressed in the particular
contexts where ethnic minorities lived cheek-by-jowl with the white working classes
(Musto 1973). Nevertheless, the Temperance movement had the side-effect of carrying
the drug debate in its wake. Medical diagnoses like 'opium inebrity' were coined,
and the urge to indulge in any form of intoxication was classified as 'moral insanity',
a condition whose ultimate recourse was confinement in an asylum (Harding 1988).
The public voices prepared to defend the traditional use of drugs were few, and
the new medical taxonomy of drug use as a disease, and by extension a contagious
'plague', dovetailed with broader fears about miscegenation and racial contamination
to produce a climate where, led by the United States, the League of Nations began
around 1900 to agree on international measures to prohibit the non-medical use
of opiates and cocaine. The
basic template for today's drug laws was hammered out at summits like the Hague
Conference of 1911, and mostly passed into national law in the form of emergency
wartime legislation like Britain's 1915 Defence of the Realm Act, later codified
in the Dangerous Drugs Act of 1921 (Kohn 1987). The initial effect most noticeable
to the general public was that the range of preparations available over the chemist's
counter - long-time staples like cannabis, opium or coca tinctures, as well as
recently-developed brand medicines like Bayer Pharmaceuticals' new cough treatment,
'Heroin' - were replaced with synthetic alternatives like codeine or ephedrine,
alongside useful new palliatives like aspirin. Despite their universal availability,
the problematic use of the newly illicit drugs was little higher at this point
than it had been a generation before (Parssinen 1983), and the prohibition initially
led only to a limited and regional illegal traffic in pure and concentrated substances
like morphine, cocaine and heroin (Musto 1973). The pressing drug issue of the
day was the campaign for alcohol prohibition in America, which built up an irresistable
head of steam until the 18th Amendment brought it into law, via the Volstead Act,
in 1920. Historically,
there are clear examples of prohibitions which have worked. We only have to look
around the world today to see that drugs which are prevalent in some countries
have been prevented from gaining a foothold in other similar ones by legal exclusion.
But the common denominator of successful prohibitions is that they have nipped
a drug habit in the bud, interdicting supply before demand has been established
(Courtwright 2001). Once demand is present, the financial arbitrage presented
to suppliers will always be a more powerful driver than government tools for interdiction
and enforcement. Counter-examples are rare - the Japanese success in curtailing
amphetamine use in the 1950s is perhaps the best - and American prohibition was
not among them. Alcohol use was too widely established across the social spectrum
to halt an illicit traffic which began on the day the law was passed and which
proceeded, through financial muscle and the corruption of public officials, to
develop a vast shadow economy which in its centres like Chicago came virtually
to amount to an alternative government. The
collapse of the American experiment with prohibition in 1932 left America both
internally ravaged by organised crime and corruption and externally isolated from
the rest of the world which had balked at following its lead, and it was in this
climate that much of today's drug legislation was assembled, driven through League
of Nations Conferences and Geneva Conventions mostly by American initiatives (Davenport-Hines
2001). There were many interest groups in America who had much to gain by switching
the focus from alcohol to drugs, and from rebranding traditional medicines as
'new menaces'. The US Narcotics Bureau needed to shake off the stigma which attached
to the Alcohol Bureau by showing that their new quarry was a genuine enemy, far
more dangerous than alcohol, and that this time their goal was one which every
citizen should support and respect. Medical opinion, too, was keen to backtrack
from the less-than-credible excesses of their anti-alcohol warnings and to reverse
the nineteenth-century consensus by insisting that substances such as cannabis
were, in fact, more dangerous than alcohol. The press and other media, too, found
their readers and listeners eager to believe that drugs might be the slippery
slope to hell which had been claimed of alcohol a generation before. Drugs were
still prominently linked with ethnic minorities, and new anxieties led to the
'anti-narcotic' laws being extended to control the sale of new substances such
as cannabis, associated with the Mexican immigrant population, which had previously
been assessed (by a British Royal Commission among others) as a minor public health
issue. The
new legislation left a picture almost unrecognisable from the one which had existed
before prohibition. The thrust of the original drug prohibitions - to protect
the majority white population from the habits of ethnic minorities - failed to
stem demand as drugs flowed through the emerging multicultural societies in much
the same way as other culturally specific tropes like fashion, music or food (Shapiro
1999). Medically, new and serious problems emerged. The mild patent preparations,
which had proved the most popular forms of the now-illicit drugs, had vanished:
now opiates and cocaine were provided by illicit traffickers only in their most
concentrated, lucrative and dangerous forms. The health costs of drugs increased
in other ways, as risky procedures like injection moved away from the ambit of
doctors and chemists and into more dangerous and unhygenic areas situated specifically
beyond the reach of the law. Criminal organisations, many with their origins in
alcohol prohibition, filled the vacuum left by patent and pharmaceutical companies,
enforcing their illicit trade with violence. Drugs were not without their problems
before prohibition, but the majority of the problems associated with them today
only emerged fully under the legislation of the twentieth century. These
problems may have been produced by prohibition but, although many of them would
not survive long without it, they cannot all be expected to vanish overnight with
its repeal. The last century of public policy has transformed our traditional
relationship with drugs into something new and uniquely problematic, for which
history offers no tailor-made solution. It does, however, offer a reminder that
the drug which presents the most obvious public health problems is alcohol, and
that although alcohol policy remains highly problematic it has broadly proved
to be best tackled not with prohibition but with socialisation under an umbrella
of statutory regulation and education. History offers, too, an illustration of
how a society legally permeated by today's illicit drugs used to function, and
shows that high levels of overall drug prevalence can coexist with low levels
of problematic use. Finally, if offers a chance to evaluate the tools of control
and regulation which might form an alternative to our present policy and which,
once an outright ban has failed to prevent availability of any drug, have historically
proved the most effective response. Mike
Jay is a journalist and author of several books, among which Emperors of Dreams:
Drugs in the Nineteenth Century (Deadalus 2001). References Behr,
Edward (1997), Prohibition. Penguin. Berridge,
Virginia and Edwards, Griffith (1987), Opium and the People: Opium Use in Nineteenth
Century England. Yale University Press. Courtwright,
David T (2001), Forces of Habit: Drugs and the Making of the Modern World. Harvard
University Press. Davenport-Hines,
Richard (2001), The Pursuit of Oblivion: A Global History of Narcotics. Weiderfeld
& Nicholdon. Harding,
Geoffrey (1998), Opiate Addiction, Morality and Medicine. Macmillan Press. Jay,
Mike (2000), Emperors of Dreams: Drugs in the Nineteenth Century. Deadalus Press. Kohn,
Marek (1987), Narcomania: On Heroin. Faber & Faber. Musto,
David F. (1999), The American Disease: Origins of Narcotic Control. Oxford University
Press. Newman,
Richard (1995), Opium Smoking in Late Imperial China: A Reconsideration. Modern
Asian Studies 29:4, Cambridge University Press. Parssinen,
Terry (1983), Secret Passions, Secret Remedies: Narcotic Drugs in British Society
1820-1930. Manchester University Press. Pick,
Daniel (1989), Faces of Degeneration: A European Disorder c.1848 - c.1914. Cambridge
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Harry (1999), Waiting for the Man: The Story of Drugs and Popular Music. Helter
Skelter Publishing. |