University Times

Alcohol is far more dangerous — in terms of physical addictiveness, emotional dependency, organ damage and the build-up of toxins and tolerance in the body (among other risks) — than the outlawed hallucinogen peyote, according to a rating system first outlined in a standard pharmacology textbook of the late 1950s.

By the same measures, tobacco blows away cannabis as a public health menace. And barbiturates, available by prescription, are more harmful than heroin or cocaine — the merchants of which fill America’s prisons to bursting.

“This disconnect between pharmacology and policy has prompted endless charges of hypocrisy and irrationality,” said historian David T. Courtwright, who cited the drug-damage comparisons in a Sept. 25 lecture here, “Forces of Habit: Why We Make War On Some Drugs But Not On Others.”

“I’m not here to give a speech or sermon deploring this,” said Courtwright, whose four books on the history and politics of drugs have been published by the Harvard and University of Tennessee presses.

Nor did Courtwright, a history professor at the University of North Florida, recommend that bridal parties replace champagne toasts with 10-hour peyote trips.

Instead, Courtwright’s Scaife Hall talk — the annual C.F. Reynolds Medical History Society lecture — focused on how and why some psychoactive drugs came to be demonized, while others thrive legally.

For one thing, size matters in drug policy. “The most obvious reason for alcohol’s privileged status is that it’s simply such a large industry,” Courtwright noted.

Viticulture, brewing and distilling have flourished throughout the non-Islamic world for centuries, supporting families and filling government coffers with tax revenue. At the turn of the 20th century, Courtwright pointed out, the incomes of 13 percent of France’s labor force were tied to the production of alcoholic beverages.

Similarly, tobacco has been a highly profitable crop ever since Sir Walter Raleigh brought the plant back to England with him from Virginia, although the massive-scale manufacture, marketing and smoking of cigarettes didn’t take off until shortly after World War I, decades before scientists would link tobacco and cancer, Courtwright said.

“If, after the 1964 surgeon general’s report, the government of the United States had tried to prohibit tobacco, that would have affected 70 million smokers in this country. Do you think that was going to happen? No.”

Moreover, tobacco production currently supports an estimated 100 million families worldwide, he said.

In contrast, production of narcotics generally has been concentrated in poor and/or colonized areas of the world. For example, coca was cultivated almost exclusively in Peru and Java at the beginning of the 20th century and only a handful of industrialized nations were producing cocaine from it, said Courtwright — the most important such nation being Germany.

Pre-World War I Germany “was to drugs what Saudi Arabia is for oil today,” he said. “Germany could effectively wreck any international drug control agreement because the German manufacturing capacity was so great. Initially, Germany resisted efforts to control the international trade in drugs like morphine and cocaine.”

But then Germany lost the war, and the victorious allies insisted that Germany and its opium-growing ally, Turkey, ratify a Hague convention ceding control of narcotics exports to the League of Nations.

Hitler would pull Germany out of the League. “But, interestingly, the Nazis were absolutely scrupulous in honoring their agreements with respect to international narcotics control,” Courtwright said.

Despite their own abuse of controlled substances (and distribution of Benzedrine to German pilots and tank crews), Nazi leaders just said “nein” to drugs for the German volk.

According to Courtwright, one reason that the British Empire shed its role as the world’s leading proponent (and beneficiary) of the opium trade was that Westminster began earning less and less money from it.

“Why? Because more and more of the opium was being grown in China itself and not being shipped from [British] India,” he noted. “I’m not saying that that was the only reason that the British eventually turned against the opium traffic, but it was a major factor.”

How did Britain, Germany and other Western powers get mixed up with dope in the first place?

And why did some recreational drugs, but not others, catch on as global products?

First, it should be noted that all recreational drugs began as medicines, Courtwright said. “Even tobacco, the recreational drug par excellence, was introduced to Europe as an exotic medicine from the New World,” he said.
It’s only when drugs begin to be used for non-medical purposes that they become controversial, Courtwright declared. “I would say that all large-scale societies differentiate between the medical and the non-medical use of drugs, and that distinction is the moral and legal foundation of the whole international control system,” he said.

Courtwright also pointed out: “Drugs, without exception, started off as regional products for regional consumption.”

For example, coffee (caffeine being a psychoactive drug, albeit a mild one) originated in Ethiopia and spread first to Arabia and then to the rest of the Islamic world. Crusaders returning from the Holy Land brought coffee back with them to Europe. Retreating Ottoman Turk invaders left behind bags of coffee beans in their abandoned encampment outside the gates of Vienna. Europeans subsequently began cultivating coffee in the Americas — where, by the end of the 19th century, 70 percent of the world’s coffee beans were being grown.

Meanwhile, other regionally popular psychoactive drugs — kava, khat, betal, peyote — either had limited shelf lives, needed very specific growing conditions, or clashed with European life styles. (Peyote would have been sadly out of place at a court ball or on a foxhunt.)

European preference was crucial because, from the 16th to the 18th centuries, only Europeans had the ships, merchants, terrariums, etc. to spread drugs around the world, Courtwright said.

Europeans traded alcohol for slaves, furs and other commodities, and induced inebriated indigenous peoples to sign away their lands. British colonial administrators and their native merchant collaborators peddled so much monopoly-priced opium to Chinese laborers that, by the 19th century, the opium business was siphoning off between half and two-thirds of those workers’ wages, according to Courtwright.

One of the beauties of psychoactive drugs, profit-wise, is that they are the opposite of durable goods: “You smoke a cigarette and it’s gone,” Courtwright said. “And if you are dependent, you want to replace that drug quickly and smoothly.” In addition, as users’ physical tolerance for a drug grows, they buy more of it.

Even after getting out of the opium business, the British government by the 1880s was deriving half of its revenue from taxes on three psychoactive substances: alcohol, tobacco and tea, said Courtwright. During the same period, taxes on vodka were financing 70 percent of Russia’s military budget, he added.

“This was the era before income taxes,” Courtwright pointed out. “States had to get revenue from somewhere, and they were getting it from drugs.”

So why did those governments strangle the geese (certain geese, anyway) that were laying golden eggs?

Or, as Courtwright asked: “If the swells who run the show are profiting like crazy from drug commerce, why in the last 100 years or so has there been a global movement toward restriction and prohibition of drugs?”

Courtwright’s one-word answer: industrialization.

The Industrial Revolution vastly increased the volume of psychoactive substances available, drove down their prices, introduced modern advertising and spawned new inventions (hypodermic syringes, high-speed cigarette machines, etc.) that made it possible to ingest drugs in highly purified forms.

By 1900, a lowly chair-bearer in Singapore could buy an injection of morphine for the equivalent of 4 cents, Courtwright said.

Industrialization also made factory owners, as well as union leaders and workers themselves, much more concerned about on-the-job sobriety. One slip or stumble in a steel mill could be fatal.

“Also, as more work moved indoors, smoking became more problematic because the risk of fire in a factory is much greater,” said Courtwright.

Concurrently, socialistic health insurance systems with third-party payers, such as Wilhelmite Germany’s, introduced the idea that society as a whole foots the bill when hospital resources are squandered on treating preventable illnesses and injuries resulting from alcoholism and other addictions.

Also, improved documentation by epidemiologists, social workers and other statisticians raised public awareness of problems associated with psychoactive drugs. Armed with such data, Chinese nationalists began working with Western missionaries to end the opium trade with India, Courtwright noted.

In determining whether to ban or merely restrict individual psychoactive drugs, the following factors come into play, according to Courtwright:

• Harm to self and others. Even in individualistic nations such as the United States, where poisoning one’s body is widely seen as a God-given right, it’s a compelling anti-drug argument to note that “innocent others” are being harmed. For centuries, non-smokers complained that tobacco use was smelly and filthy. Since at least 1964, U.S. scientists and lawmakers have known that cigarettes can kill people who smoke them. But the mass movement to ban smoking from public places came only after evidence emerged that second-hand smoke endangered non-smokers, Courtwright said.

A related factor is the alleged link between violence and certain recreational drugs, he added. “Precisely how drug use causes violence and to what extent drugs are actually responsible for violence are enormously complex questions and they’ve been compounded, unfortunately, by prejudice and propaganda,” said Courtwright. “But let me just make this point: Even the perception that non-medical drug use is tied into violent crime has important political consequences that can lead to prohibition.”

Social costs. Obvious examples include worker absenteeism, lost
productivity and tax revenues, and higher costs for health insurance and public safety.

Courtwright told the audience, “Pittsburgh is a great place to make this argument: Abusive drinking is everyone’s business in a society where a liver transplant costs around $250,000. It’s not very persuasive to say, ‘It’s my liver’ in a world of third-party payers with high insurance premiums and high taxes.”

Although, Courtwright added, evaluating social costs gets tricky when you consider that moderate drinking may benefit the heart, and people who kill themselves with tobacco may indeed run up big hospital bills — but they also tend to die before collecting Medicare and company pensions.

• Religious disapproval. While hallucinogens figure into many tribal religious ceremonies, the world’s major faiths hold psychoactive drugs in suspicion when not condemning them outright.

“That’s not because major religions have anything against transforming consciousness,” said Courtwright. Quite the contrary. But major religions see drugs as lazy, chemical shortcuts to altered states that should properly be reached through prayer, fasting and meditation, he said.

• Deviant associations. American prohibitionists have linked opium with Chinese workers, alcohol with Catholic immigrants, heroin with urban delinquents in the early 20th century, and cocaine with young African-American men in more recent years.

“In every instance,” Courtwright said, “prohibitive legislation followed. Notice, please, that prejudice alone did not cause the legislation. That’s too simple. But it does make it easier to enact and maintain such legislation.
“Generally speaking, the smaller the target population [linked with a drug] is, and the lower its status, the easier it is to enact such restrictions and prohibitions.”

Quoting another writer, Courtwright suggested that if Viagra had originated in a clandestine, inner-city drug lab and had been nicknamed “Party Boy,” its possession and use might well be illegal.

• Group survival. Courtwright noted that Native American leaders opposed trafficking in liquor because it threatened their peoples’ very survival.

Similarly, 19th century Japanese aristocrats damned tobacco as the “poverty plant,” fearing that its cultivation in Japan would crowd out grain production and impoverish the people.

Group survival arguments are especially potent when intertwined with concerns about the ruination of young lives, he added.

When societies and governments condemn a psychoactive drug for all five of the above reasons — as gin was denounced in 18th century England, and crack cocaine in 20th century America — it’s guaranteed that governments will legislate against those drugs, said Courtwright.

Throughout the 20th century, alcohol and tobacco use were glamorized by Hollywood stars (“By 1930, four-fifths of all American films depicted at least some drinking,” Courtwright said) and reinforced by government leaders, who historically have set the tone for non-medicinal drug use.

Peter the Great, for example, took up smoking in the West, came home to Russia and rescinded his country’s ban on tobacco. Another tobacco fancier, Pope Benedict XIII, ended the Roman Catholic Church’s prohibition against smoking.

Using the Scaife lecture room’s slide projector, Courtwright screened a photograph of World War II’s Big Three allied leaders conferring at Yalta in 1945. FDR, looking pitifully frail and soon to die of a cerebral hemorrhage, nonetheless holds a cigarette, as does Stalin, a chain-smoker and heavy drinker. Churchill, who purposely cultivated an (exaggerated) image as a macho boozer, puffs on his chief public prop, an oversized cigar of the type that today bears his surname.

“Is this the crew,” Courtwright quipped, “that is going to have a ‘go’ at alcohol prohibition or tobacco restriction?”

(Incidentally, he pointed out, the United States has never truly outlawed alcoholic beverages. “Alcohol was never, never the equivalent of a Schedule 1 controlled substance in this country,” said Courtwright. Throughout the so-called Prohibition years, he noted, the law permitted limited home brewing, sacramental use of alcohol and the medicinal prescription of spirits.)

Courtwright predicted that alcohol “is going to weather the storm” of increasingly restrictive legislation and taxation better than cigarettes in the United States.

“One of the reasons that tobacco is increasingly vulnerable, quite apart from the mass of persuasive medical and epidemiological evidence, is that the composition of the tobacco-using population is changing,” he said. “Tobacco is becoming a loser’s drug.”

Courtwright said one of the more fascinating documents he’s come across in his research was a survey prepared by Harvard University for Class of 1970 alumni attending their 25th reunion.

“I don’t mean to be critical,” Courtwright commented wryly, “but this group was, shall we say, not known for pulmonary abstemiousness in its college days.”

Responding to the survey’s questionnaire, 38 percent of the alumni said they had smoked regularly in college. “But 25 years later, only 6 percent smoked at all, and of that, only 2 percent smoked more than 20 cigarettes a day,” Courtwright said.

History shows that when a country’s elite drop a psychoactive drug, its days as an affordable, freely available substance are numbered, he said.

Courtwright forecast a world-wide “convergence” of drug policies over the next 25 years as policy-makers gradually concur that current sanctions against some illicit drugs (notably, cannabis) are too heavy-handed, while public health considerations justify greater restrictions on alcohol and tobacco use.
After his lecture, Courtwright was asked to comment on the Bush administration’s stance that illicit use of opiates and cocaine is, in effect, bankrolling terrorism.

Courtwright replied: “Any person familiar with drug history will tell you that one of the reasons it’s so hard to prohibit international drug trafficking is that any time a region experiences a civil war, drug production and trafficking flourish because the contending guerilla armies use drug profits to buy weapons and pay their armies.

“In that sense,” Courtwright said, “it is literally true that when a person purchases illicit drugs, some of that money is going to…well, if not to terrorists, then to guerilla armies of some description. On the other hand, that cuts both ways” — in that the Bush administration seems to be turning a blind eye to opium dealing by Afghan war lords whose “semi-loyalty” America needs in propping up the new, pro-Western government in Kabul.

“That kind of hypocrisy is, in fact, an old story with deep roots in the Cold War,” Courtwright observed.

– Bruce Steele