Extreme Measures

There has been no comprehensive plan when looking at the drug epidemic hitting the United States. The typical response has been to crack down harder, to give harsher, more punitive measures to the users as well as the dealers involved. One seem things to be forgotten in all the back and forth with policy and mandatory minimum sentences, the people the politicians insist should be locked away forever, they are people. People have families, young people make mistakes, and when these mistakes define the rest of their lives there really is only one path. With recidivism standing around 50% there is clearly something that isn't working. Despite the fact that politicians like Bill Clinton and his colleagues now understand that signing mandatory minimums into law for minor drug offenses was a mistake, the situation has sat as is while the prison population rises. [1]

Number of Incarcerated Americans from 1920-2006 Courtesy of Vice News

When looking internationally at countries like the Netherlands and Portugal with the most lenient drug laws in the world something interesting has happened with decriminilazation of marijuana and other hard drugs. While other nations like the United States and Britain have approached drug enforcement with harsh punitive measures for low level offenders, Portugal was the first to decriminalize all drugs in 2001. With 15 years having passed since Portugal's decriminalization something astounding has happened, hard drug use and the use of marijuana has dropped. Despite the expectation from critics of the act that Portugal would become the center for drug tourism. The use of marijuana for those over the age of 15 fell to 10% as opposed to the typical 40% average amongst the same demographic in the U.S. As far as hard drug use Portugal's rate of HIV and AIDS dropped 17% after legalization as well as the number of drug induced deaths. [2]

Statistic Courtesy of TRANSFORM

Though the solution to the problem seems extreme in response to the problem, in 2001 it was estimated that 1% of Portugal's population was using heroin. The response if a Portuguese citizen is caught with more than a 7 day supply of any controlled substance now involves drug treatment specialists, counselors, and a judge. What has been proven over the 15 years that Portugal has legalized drugs is that those using hard drugs are more likely to seek treatment because users don't face criminal charges. Vans patrol cities offering alternatives to hard drugs and those wishing to be rehabilitated can be directed to state services to help those suffering from addiction. [3] The United States has taken a more progressive look at addiction in recent years in the wake of the heroin addiction that has taken hold. In Massachusetts the police in the Boston area have worked with treatment centers to open supervised injection sites with medical personnel standing by to avoid overdoses. What has been found with programs like these is that addicts are more likely to seek treatment when state services are made available when there is the promise of no charges being brought against users. [4]

Though Portugal in many ways is a success thus far it is hard to tell whether the United States would ever be able to follow suit due to the controversial nature of drug legalization as well as the differences in the legal system. So far there have been no recorded cases with the amount of success that Portugal has had. Heroin and addiction aren't a new issue, but in recent years has grown into an epidemic internationally. Decriminalization might be a solution, but continuing harsh punitive measures has been proven to only worsen the situation.   

[1] Anderson, Brian. "So You Want to Abolish Mandatory Minimums for Small-Time Drug Dealers."Motherboard. Accessed July 1, 2016.

[2] O'Neal, Tony. "Ten Years Ago Portugal Legalized All Drugs -- What Happened Next?" Alternet. July 14, 2011. Accessed July 12, 2016.

[3]Aleem, Zeeshan. "14 Years After Decriminalizing All Drugs, Here's What Portugal Looks Like." Mic. 2015. Accessed July 13, 2016.

[4] Murkin, George. "The Success of Portugal's Decriminalisation Policy – in Seven Charts." Transform: Getting Drugs Under Control. July 14, 2014. Accessed June 22, 2016. 

Where Do We Go From Here?

Vice News founder Shane Smith Sitting down with
 President Obama discussing non violent drug offenders

When addressing the use of narcotics and the trade, the measures that have been taken in trying to deal with drug epidemics whether it be heroin, crack, or methamphetamine the response has always been the same, punitive. The punitive response to addicts purchasing drugs doesn't help the addicts or improve their lives, putting addicts through 12 step programs work to some extent, but the nature of the conversation over narcotics hasn't changed, but it needs to. When looking outward at countries who have all but eliminated the epidemics that different nations have suffered one thing is clear, the punitive response doesn't seem to work anywhere. Jailing those who are addicts and those involved in the drug trade has only served to place 1% of the population of the United States in detention facilities. In the home of the free and the brave there are more people in prison than in any other country in the world. One thing that must be clear is that not every solution internationally can be applied to every country, there are extreme measures though that the United States wouldn't be able to adopt. Malaysia and a host of other countries are famous for executing drug traffickers, despite the extreme measures, drug trafficking there is down, but not significantly so. Before offering a solution it might be more beneficial to hear from those suffering from addiction and from law enforcement on what should be done.

The following are stories from addicts as well as law enforcement on their thoughts on the drug war, drugs, and addiction. The content due to its nature may be disturbing or graphic in its content, but is essential to understanding the reality of the situation and addressing possible solutions. The first look at those involved in the drug trade would have to start with those farmers in Mexico, Mexican production of heroin has jumped in order to meet demand. A poppy fame in a Vice special says this when asked about the effect of their work on people. "This plant is all people here have to support themselves with. We're aware that by planting this, we hurt many people. There are many who throw away their lives just to get high." [1] When looking at the situation in Mexico there really isn't any solution or alternative offered to those who produce poppy flowers and process them into heroin, the situation also is very similar in Columbia and Peru, the worlds largest cocaine producers. Government efforts have been made to combat the production of poppy in Mexico, but the alternatives and incentives for producing anything else isn't viable for these farmers to be able to live.

Mexican soldier raiding a poppy farmers crop

When looking at the stories of addicts and where the drugs have gone the urban age of drug use is over and the center of overdoses is in Huntington West Virginia, right in the middle of Appalachia. Huntington is a small community with just near 50,000 people this small city just averages about 3 overdoses a day, a seemingly small number per day that adds up to 1095 overdoses a year. The response has been a money ball kind of response with police intelligence trying to fight the epidemic with statistics and patterns. When looking at the root of the problem in Huntington several things are pointed out by Vice as factors. One of the biggest factors in the recent epidemic is the pharmacuetical industry's skewing of statistics of dependency of the synthetic painkillers like oxycontin. Dr. Andrew Kolodny is a physician who works with Physicians for Responsible Opiod Prescribing and has this to say about the epidemic. "The way you get a blockbuster drug is by getting doctors to prescribe it for things like low back pain, and if its a drug thats very hard to stop taking then you've got the magic formula." The statistic that was used was that less than 1% of these patients were getting addicted to these opiods, but what was cited hundreds of times by experts and doctors was in fact a paragraph from a letter to the editor of the medical journal reviewing the drug. [1]

Mickey sits down with Vice journalist Thomas Morton and talks about his addiction.

Micky, a heroin addict who overdosed in Huntington sat down and talked with Vice reporters and had a lot to say about being an addict. "I lived on the streets, riverbanks, tents, spent winters out there. You would think that would be enough to have a person wanna stop and change, but fuck it didn't stop me. Most people come in here to get to a life they had prior to this, I never had one, it's like learning to walk again." [2] When asked how many times Mickey had overdoes he replied "i've overdosed about 7 times, probably more thats the amount of times i've been to the hospital." The ugly reality is that heroin addiction has touched every person today and if it hasn't it is more than likely to at some point in their lifetime. I myself have a few friends who's siblings have become addicted to heroin, luckily for my friends their siblings have undergone treatment and one of them has become functional and rehabilitated, both have relapsed several times and their journey to heroin began with prescription opioids. Both were young men in their early 20's, white, and stole and sold family members belongings in order to feed their addiction. This is the primary demographic of the addict,  

What can we do to fix this system? There isn't one solution as the problem is complex and included a variety of transnational issues that would have to be addressed. The reality is for many addicts that their doctors prescribed them these pain killers and trusted them when told they were safe. In response to having that supply of pills cut off most people turn to heroin to maintain that standard of pain management instead of suffering from a withdrawal from those pills. What awaits those who are caught buying or selling are mandatory minimum sentencing for drug offenders. These minimum sentences are meant to target the upper level people involved in drug trafficking organizations. What began the mandatory minimums was October 1986 in the middle of the crack epidemic. The statutes put put in place were not put in place to reduce crime, but had very much to do with politics and fighting "the war on drugs." This has led to a situation where non violent drug offenders are incarcerated for very long periods of time for crimes and when released have little opportunity and are at higher risk for recidivism. What is interesting is the rate of violent crime nationally has gone down, but the and number of those who have become incarcerated is staggering. [3]

[1] Ackerman, McCarton. "VICE Premieres 'Heroin Crisis' Documentary | The Fix." The Fix. June 3, 2016. Accessed June 20, 2016.

[2] Stuck, Taylor. "Huntington Featured on 'Vice' Heroin Segment." The Herald-Dispatch. June 6, 2016. Accessed July 12, 2016.

[3] "US: Repeal Mandatory Federal Drug Sentences." Human Rights Watch. 2016. Accessed July 2, 2016.

  

     

The Heroin Epidemic Now

Heroin use in the last decade has exploded exponentially, with the DEA citing that the number of heroin overdoses in 2010 jumped from 3036 to 10,574 in 2014. Unlike the previous heroin epidemic of the 1970's, the number of U.S. military personnel that have served in the recent wars in Iraq and Afghanistan aren't known to have experimented with heroin and opiates while deployed in active combat zones. What makes the current heroin epidemic unique is that it has been created essentially internally, with the over prescription of pain killers by doctors in recent years. Some of the drugs of choice have been opioids such as hydrocodone, fentanyl, oxycontin, and demerol have been prescribed by doctors to patients for a myriad of reasons. [1]      

Unlike the previous heroin epidemic in the 1970's the center of addiction isn't limited to a large urban center, but has touched every city and small town throughout the United States. A prime example of the breadth of heroin's reach is its huge prevalence in Huntington West Virginia, the new capital of heroin overdoses. Huntington is unique in that it's rate of overdoses averages 3 or more a day and hasn't let up. [2] What is unique about heroin as a drug is that the increase in the number of overdoses leads to increases in sales of heroin. With increased overdoses often there is an increase in the purity in the heroin that is being used which boosts sales. If there is a death related to an overdose there is often a flood of sales that follows because less heroin is needed to maintain dependency. The center for disease control has studied heroin use from 2002-2013 in a study to determine the demographic and percentage increase in heroin use.

Center for Disease Control Statistic on Heroin use and Deaths

What was concluded was that the highest rates of use increased amongst those between the ages of 18 and 25 making below $20,000 a year. [4] According to Vice News and the Center for Disease control heroin use has increased 63% over the last decade. [3] In the years between 2010 and 2013 heroin use was reported to have almost tripled between these 3 years. [1] Despite the fact that there is an assumption that the epidemic will run its course there is little that seems to have been addressed when looking at the number of prescriptions of painkillers which are used at an increasing rate each year. Another thing that makes the increase in heroin use today different from the 1970's is the internet which besides use for legal purposes has changed the shape of how people interact and do business has changed the means of illegal exchange as well. Alongside the usual street level dealing which is universal in practice and sales new methods for drug marketing and sales have emerged in the last decade with websites like Silk Road making it as easy as shopping on Amazon for heroin, cocaine, guns, or even hit-men. 

  

   

[1] Owen, Tess. "Heroin Kills White People More Than Anyone Else - And Nobody Is Sure Why | VICE News." VICE News RSS. January 27, 2016. Accessed June 17, 2016.

[2] Ackerman, McCarton. "VICE Premieres 'Heroin Crisis' Documentary | The Fix." The Fix. June 3, 2016. Accessed June 20, 2016.

[3] Curry, Colleen. "Why America's Ongoing Heroin Epidemic May Soon Run Its Course | VICE News." VICE News RSS. July 8, 2015. Accessed June 8, 2016.

[4] "Vital Signs: Demographic and Substance Use Trends Among Heroin Users — United States, 2002–2013." Centers for Disease Control and Prevention. 2015. Accessed July 1, 2016.

Heroin's Beginning in the United States

          The beginning of heroin use in the United States is almost as old as New York City itself. It was in 1914 that the Harrison Narcotics act was passed and heroin became a controlled substance which could only be prescribed by doctors, but in 1924 the importation of heroin was made illegal. Richard Nixon was the first in a long line of presidents to declare a war on drugs.[1] What is significant about the city of New York is that in the midst of what was called an epidemic, and to certain degrees was an epidemic. The National Institute on Drug Abuse estimated that from 1969-1974 the number of heroin addicts in the United states was estimated to be about 500,000, out of that figure 200,000 were estimated to live in New York City.[2] From 1968-1974 were the primal years of heroin, heroin's youth and strength in the United States and New York were at their height during these years.[3] The significance of New York in this era of use and abuse is that the city housed almost half of the user population. The culture of drugs and use during this time can be attributed to a few figures who have remained cultural icons even today. Frank Lucas is a cultural figure and was in large part responsible for the supply and distribution of heroin from the beginning of the late 1968 to the mid 1970's.[4] What is unique about the period in which Lucas operated is that during this era in drug use in New York had become the epicenter of heroin use.

          One of the things that characterized the heroin market in the late 60's and early 70's was interestingly enough brand recognition. This was something that was unique to New York in particular, in the 1970's "dope stamps" were created by distributors to distinguish their product from the competition.[1] Lucas's brand was "blue magic", the name and the level of purity were both things that distinguished his brand over other dealers and suppliers. This product was what U.S. military personnel had experimented with if they had used heroin in Thailand or Vietnam. In a study done on returning veterans from Vietnam, 54% of those who had used heroin in Vietnam became addicted to it and 73% of those who had used it at least 5 times had become addicted.[2] In the same study the interviewed 85% of veterans out of the 617 man sample claimed to have been offered heroin while they were serving in Vietnam, often quite soon after arrival. Of this sample 35% of the men claimed to have tried heroin and of that percentage 19% became addicted to heroin.[3] This is an astounding number considering that this is only from a small sample of troops. Considering the amount of troops returning to the United States having been exposed to or tried heroin, the market for heroin was at an all time high. 

Unknown U.S. Soldier Snorting Heroin 

          One of the things that only worsened the scenario was the failure in the ability to enforce and arrest those involved in the trade. In the wake of the Knapp Commission, the New York Police Department was in 1970 under the microscope and under more scrutiny than ever.[1] This investigation was prompted by a well to do "hippie cop" by the name of Frank Serpico. What Serpico had discovered when working for the Seventh Division in the Bronx was that officers in his unit didn't interfere with gambling, but had an active role in the collection of payoff's. Unit commanders received a larger portion of the money collected and it was evenly distributed amongst his entire unit. When Serpico attempted to report these activities to his higher ups, his concerns were reportedly dismissed despite the number of high level officers involved. Serpico reportedly took his concerns up to the mayor's aide, which were dismissed as well by the mayor's office. When there was a lack of action taken Serpico went to the New York Times with the story which produced public outcry.[2] The result of the story landed the former prosecutor Whitman Knapp as the head of the commission appointed by the mayor. 

Heroin Dealer displaying his product and tool of his trade

          The results of the commission lead to sweeping arrests of officers involved in extortion, narcotics, and protection schemes. What is significant about the aftermath of the commission is not just in the number of police officers involved, but the way the exposure changed the way narcotics enforcement was approached. To avoid the temptation of the vast profits earned in street level dealing, police were instructed to avoid contact with street drug dealing as it was a "corruption prone opportunity."[3] In accounts by users in the wake of the corruption scandal and the Knapp Commission began the largest open air bazaar for narcotics the world had ever seen. The only area that surpassed Harlem as a retail drug market was the Lower East Side of Manhattan, which had an area of approximately fifty square blocks that was branded by the police as "the retail drug capital of the world."[4] A regular heroin user recalls this phenomenon "on Eldridge Street, there used to be a store front in about 1972 and they had a pool table between you and the dealers and you would tell them what you wanted and they'd throw the amount of bags on the pool table and you'd put the amount of money and that was the typical place with the guy with the baseball bat keeping everyone in line and you would see them out front in the morning, lined up outside the place. The cops would pass by. It was just fucking incredible, fifty guys in the morning, and I mean like all walks of life, guys with suits and ties on, on their way to work, guys on their way to the methadone clinic."[5]

New York Gang members of "Savage Skulls" tussle it out with knives drawn

          The fact that there was an epidemic is more than clear, the role that the Vietnam war played on exposing heroin to troops is a clear factor in the return of heroin to popularity. The corruption it caused and the ways it physically shaped the city of New York have been highlighted. What has yet to be determined is where does the transition from heroin to cocaine occur? 1978 is the year that heroin's popularity began to wean. Though cocaine was present in New York during the 1970's the explosion of use begins in the late 1970's with the progressively falling rates of heroin use. The political response to the heroin epidemic can be seen as well intentioned, but in the matter of policing and dealing with the actual problem the response was underwhelming at best. Though in 1978 the issues of narcotics had become a national issue with President Carter attempting to implement programs to stem the flow of drugs the drug of choice had shifted from heroin to cocaine. Heroin purity in 1977 fell to its lowest at 4.9% which the previous year had been at 6.6%.[6] Heroin overdose deaths also fell the same year by 27% which had 1,000 fewer people dying in 1977 than 1976, though a seemingly small number this was significant.[7]

---

[1] Schneider, Eric C. Smack: Heroin and the American City. University of Pennsylvania Press, 2011. 

[2] Kerr, Peter. "GROWTH IN HEROIN USE ENDING AS CITY USERS TURN TO CRACK." The New York Times. 

[3] Blumstein, Alfred, and Joel Wallman. The Crime Drop in America. New York: Cambridge University Press, 2006. 

[4] Lucas, Frank, and Aliya S. King. Original Gangster: The Real Life Story of One of America's Most Notorious Drug Lords. New York: St. Martin's Press, 2010.

[5] Wendel, Travis, and Ric Curtis. "The Heraldry of Heroin: “Dope Stamps” and the Dynamics of Drug Markets in New York City." Journal of Drug Issues 30, no. 2 (2000): 225-59. ProQuest.

[6] Robins, Lee N., John E. Helzer, Michie Hesselbrock, and Eric Wish. 2010. "Vietnam Veterans Three Years after Vietnam: How Our Study Changed Our View of Heroin." American Journal On Addictions 19, no. 3: 203-211. Psychology and Behavioral Sciences Collection, EBSCOhost(accessed April 15, 2016).

[7] Robins, 2010

[8] Armstrong, Michael F. They Wished They Were Honest: The Knapp Commission and New York City Police Corruption. New York: Columbia University Press, 2012.

[9] Armstrong, 2012

[10] Wendel, 2000

[11] Schneider, 2011

[12] Wendel, 2000

[13] Musto, David F., and Pamela Korsmeyer. The Quest for Drug Control: Politics and Federal   Policy in a Period of Increasing Substance Abuse, 1963-1981. New Haven: Yale University Press, 2002.

[14] Musto, 2002