Wednesday, February 3, 2021

Which way euphoria? (1983)

From the February 1983 issue of the Socialist Standard

Twenty years after it was first discerned as a threat to what are still known as civilised standards, the black image of drugs persists. There are still nightmares about heroin-crazed addicts terrorising the land in a frantic search for their next fix. Anxious parents watch their composed, ambitious children for the first signs of descent into the pit of addiction from which the only escape is premature death.

What substance is there to these fears? Some drug addicts do lead excessively unhappy and disordered lives, inflicting on themselves awful illnesses like hepatitis, septicaemia or gangrene and losing parts of their limbs. Very often they resort to crime to raise the money for their drugs and their very recklessness leads to a high death rate. Heroin addicts are 30 times more likely to die than anyone else in a comparable age group.

But it must also be said that too often the debate on the issue is heavily misinformed. For example there is the myth of the instant and progressive addiction, the dread process by which the first whiff of cannabis fumes leads inexorably to the syringe surging with heroin. It is truer to say that those who pass from soft drugs to hard do so because the soft ones are unable to answer their demands. In fact, for most people the first experience of a drug like heroin is very unpleasant, like being sick after the first few cigarettes. Immediate addiction happens very rarely, if at all; as one addict put it, “You have to work at it".

Of course the addicts’ self-image is anything but black; to them drugs offer an ecstatic release. One describes using heroin as like “golden fire running through your veins”, another exults "This is what men go to prison for and it’s worth it”. The opiates, especially heroin, act on the central nervous system to blot out stress and anxiety and replace it with euphoria. A doctor’s description is: "The addict feels he has eaten to his heart’s content, experienced full sexual satisfaction and eliminated all anxieties . . " It is reasonable to ask why relief and pleasure should be regarded as a threat to society and be subject to heavy legal penalties.

The answer of the everyday, law-abiding, hard-working traveller on the Clapham omnibus is, of course, that drug addiction is unhealthy and there is plenty of evidence which apparently supports that opinion. But it is arguable that the more degraded aspects of the addict's life are caused by the social reaction against drugs rather than by the substances themselves. Up to a point heroin in itself need do little organic harm to the body; much of the damage commonly associated with it is due to the context in which it is used — the dirty, sometimes communally used needles, the dilution with water from the bowls of public lavatories, the adulteration which illicit supplies are vulnerable to, the malnutrition caused by the high prices for drugs on the streets. None of these factors would operate, were the drug not legally controlled and restricted. Not all heroin users descend into filthy, shambling addicts; in the House of Lords on 13 December 1955 Lord Amulree confessed: “I like my little drop of heroin: it works very well for me. I have taken it for 25 or 30 years but have not yet become an addict".

Addictive drugs have existed for a very long time but it is only comparatively recently that they have been defined as the cause of social problems. Morphine was first isolated from opium in 1804 and was widely used as a painkiller and in patent medicines. Heroin, a derivative of morphine, was discovered in 1874, when it was hailed as a new wonder medicine, non-habit forming and free of morphine’s undesirable side-effects. Amphetamine was first produced at the end of the 19th century. During the war the stimulant benzedrine was supplied to both German and British troops; 72 million tablets of it were issued to the British forces to be taken, according to the official instructions, when the men were “. . . markedly fatigued physically or mentally, in circumstances calling for a special effort”. In Japan the widespread use of stimulants during the war led to a serious post-war problem of dependence. Cannabis — not addictive and a very different substance to the opiates and amphetamines — has been known medicinally for thousands of years although its uses were not opened to the western world until 1839. It was a popular medicine for the wounded during the Crimean War. In 1933 the effects of marijuana on American troops in the Panama Canal Zone were assessed, with the official conclusion that “. . . no recommendations to prevent the sale or use of marijuana are deemed advisable”.

The Pharmacy Act of 1868 laid it down that opium and its derivatives, on which Victorian medicine heavily depended, were poisons and must be controlled. The Dangerous Drugs Act of 1920 took this a step further, defining heroin as illegal unless prescribed by a qualified doctor. In 1925 the Geneva Convention internationally outlawed the non-medical use of cannabis, morphine, heroin and cocaine. Heroin came under further threat in 1955, when Health Minister Ian Macleod announced his intention of prohibiting its manufacture. This provoked stormy opposition from the doctors, who were commonly prescribing the drug to case the discomfort of terminally ill people. The government backed down, as governments usually do when they are in conflict with the medical profession, and there the matter rested for a while. There were then few known addicts — about 300 or 400 — and most of them were either elderly people who had formed the habit through medical treatment or nurses and doctors whose addiction originated in their working association with drugs. The situation was controlled with regular prescriptions; the Brain Committee on Drug Addiction produced in 1961 a reassuring report.

It soon became clear, however, that the Brain Committee had misread the situation. At the very time they were sitting an unprecedented boom in drugs was in existence. Its origins are obscure; one investigator traced it to a burglary of opiates from a pharmacy in 1951, others thought the immigration of the 1950s brought a lot of regular users into the country, or that the stringent anti-drug laws introduced by the Canadian government in 1958 caused a flight of addicts to England's easier legal climate. Whatever the truth, it was clear that a new element had come on the scene — the non-medical use of drugs, by young people, for pleasure. Officially the demand for drugs was still catered for through GPs but such was the demand that a black market flourished as addicts discovered that prescriptions were more readily obtainable from a few pliant doctors who were prepared to sell them to their clamouring patients. These doctors became publicised as the heartless, avaricious villains of the drugs boom; some of them flavoured the media hacks' outpourings of righteous indignation by having foreign-sounding names like Petro and Frankau. They were hounded, prosecuted. struck off, imprisoned. One of them is now in Broadmoor.

The Brain Committee, having got its breath back, reported again in 1965, by which time the number of known opiate addicts had risen to 927. A new Dangerous Drugs Act came into operation in 1968 which drastically changed the scene. Drugs such as heroin could now no longer be prescribed by GPs but only by specially licensed doctors mainly operating in drugs clinics attached to hospitals. These doctors were often qualified psychiatrists, which implied a secondary function that they would treat the addict out of dependence. In most cases the clinics attempted to supplant heroin with methadone, a synthetic opiate which has an active span of 24-36 hours (in contrast to heroin’s 8 hours) which in theory allows the user to function in a more stable way — in other words go to work, pay the bills and so on. Some doctors became very enthusiastic about methadone and there was a boom in it during the 70s. as the patients wheedled for an over-prescription which they could sell so that they could buy illegal heroin.

Another requirement of the 1968 Act was that doctors had to notify the Home Office of all addicts of drugs like cocaine and heroin who came to their notice — an enforced breach of medical confidentiality which had hitherto been applied only in the case of contagious diseases. For the first five years of the Act’s operation the numbers of known addicts hovered around 3000. From 1973 it began to climb steadily until 1978, when it really took off:
1973 1974 1975 1970 1977 1978 1979 1980 1981
3023 3252 3425 3474 3605 4116 4787 5107 6157
For a number of reasons, these figures do not give a true picture. Many addicts are not known as such to their GP and they avoid contact with the clinics, preferring to hustle for illegal supplies or to wheedle prescriptions for drugs like diconal from doctors who are prepared to “treat" them as private patients in need of a sedative. The physical consequences of injecting diconal can be horrible — limbs swollen like purple balloons, massive fiery ulcers and sometimes death. This is the reality behind such estimates as that of the Institute for the Study of Drug Dependence, that the official figure of known addicts in 1981 of 6157 masks a true figure of about 30,000.

In such ways are the pronounced intentions of Acts of Parliament frustrated. Such laws are formed on the assumption that a problem can be easily defined by legal draftsmen and a gaggle of MPs in a debate. It can then be controlled, equally simply, by prescribing punishments for anyone who steps outside the law. But the definitions, the prescriptions — and the problem which starts it all — are not immutable. Fashions in drug abuse change in response to influences like availability. The end of Prohibition in America led to the outlawing of the social use of marijuana, as the liquor interests feared the effects of the drug on what they hoped would be a post-Prohibition boom in sales of drink. The people who were prosecuted in the famous Operation Julie had been occupied in making a lot of very pure LSD. The Customs and Excise recently said (Guardian, 6 January 1983) that a lot of high grade heroin is now on sale in this country, which cuts down the risk of illness and death because it is pure enough to be sniffed or smoked rather than injected.

Cohorts of psychiatrists and social workers probe and worry about the cause of drug addiction. Most of them agree that the addict has a personality inadequate to cope with everyday crises. As the first experiments happen typically in adolescence, the observers are able comfortably to ascribe it all to the rebelliousness of puberty, to an immature desire to shock parents, teachers, bosses. Well, the function of psychiatry and social work is to patch up casualties, not to prevent war; they leave untouched the vital questions of why personalities are deemed inadequate and why the adequate (which of course includes the psychiatrists and social workers) are expected to cope. Commando-like, with persistent crises. They pay no heed to the structure and the role of the family, school and the employing class.

A more useful approach recognises that the casualties in the drugs world come from the casualty class in society. The recent Pullitzer divorce case in America showed that the other class can easily support a drugs habit without spiralling into ragged destitution. The same applies to this country. Standing outside a picturesque village in Southern England, in acres of lush meadows and barbered gardens, is a large medieval manor house where anyone who can afford the mountainous fees can take their addiction to be expensively hidden, soothed and nursed. Any worker who is mistakenly accepted there is rapidly diagnosed as untreatably psychopathic and discharged to the nearest NIIS hospital.

What hope is there, in this sorry situation, from the addicts? Some of them pretend to some insight into their difficulties, offering “social pressures" or some other easily available cliche. But what is this “insight" worth? The great amphetamine boom of the 60s and 70s was a pathetic attempt by youngsters who hated their job or were bored at school to prolong their leisure time by staying awake — which obscured the fact that the real, accessible problem was in the fact that they needed to be employed and to be trained for employment. The disarray of capitalism is not to be seduced into order through any pill or syringe. Capitalism devotes an enormously disproportionate effort to stamp out the illicit, uncontrolled use of drugs and it does so because it is determined that workers shall experience euphoria only on capitalism’s terms, as the reward for constructing a secure job, a modest mortgaged home, a regulated, aseptic nuclear family.

As a social system it rests on a leucotomiscd acceptance of the disciplines of wage-slavery. It can be ended, and social euphoria achieved, only as the work of brains which are free of any kind of junk.
Ivan

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