I’m delighted that the New York Times finally has a columnist wiling to point out the idiocies of the drug war. Too bad he’s such a sucker for the idiocies of the extreme libertarian fringe of the anti-prohibition movement.
One of the great drug-war follies is to pretend that drugs such as cannabis and MDMA are as dangerous as heroin (or its close substitute, pure oxycodone), smokable cocaine (including crack), and methamphetamine. It would be useful if John Tierney used his platform on the op-ed page of the New York Times to make that point, and the related point that alcohol is, at a pharmacological level, much more dangerous than many currently illicit drugs.
Instead, Tierney seems to be intent on pretending that some of the really dangerous drugs are in fact no big deal. Last time, Tierney massaged a bunch of statistics he clearly didn’t understand to “prove” that Oxycontin abuse is not really a significant problem. Today it’s methamphetamine’s turn to get a coat of the Tierney whitewash.
Tierney cites the low ratio of meth addicts to lifetime meth users in the National Survey on Drug Use and Health as evidence that meth isn’t very addictive. But everyone in the field knows that the aptly named NS-DUH misses the majority of problem drug users.
For example: In 1989,the NS-DUH — then called the NHSDA — estimated that there were 500,000 people in the United States who used cocaine or crack weekly or more. But the arrestee drug testing data showed that three to four times that number of heavy cocaine users were arrested that year. A projection of the NHSDA frequency estimates suggested that total cocaine consumption in the US was about 30 metric tons a year, though it wasn’t hard to see from the level of activity in the market that the real number had to be about 10 times that large.
When you reflect that heavy illicit drug users make up about 2% of the adult population, while the nonresponse rate in the household drug surveys runs about 20%, it’s easy to see how a big chunk of the drug users might be in the group that couldn’t be found or decided not to tell the nice man from the government’s contractor about their illegal activity. (For a devastating critique of the national drug data collection effort, see this National Academy panel report.) NS-DUH is useful for some purposes, but measuring chronic serious drug abuse, as opposed to drug use, isn’t one of them.
Moreover, lots of students take amphetamine or methamphetamine occasionally to study for exams or write papers, and most of them don’t enjoy it much. That bulks up the denominator of the addict-to-total-user ratio with people who never use the amphetamines recreationally.
Contrary to Tierney’s assertion, the demon-drug status of meth isn’t new. Back in the late 1970s, in the argument about how risky cocaine was, the hawks used to argue that cocaine might possibly be nearly as dangerous as meth
(As it turned out, the hawks were mostly wrong about snorting cocaine powder, but turned out to be right about smoking crack or freebase.) That meth and heroin were more or less the gold standards for drug dangerousness wan’t even controversial: everyone knew meth as the drug that spoiled the “Summer of Love.” (It wasn’t the drug warriors who put up those “Speed Kills” posters; it was the hippie Deadhead docs at the Haight-Ashbury Free Clinics.) Meth was known to be much more toxic than heroin (all this was more or less pre-AIDS), but heroin generated a much more persistent addiction, partly because it wasn’t nearly as rough on the body.
I have never heard anyone who knows anything about drug abuse assert that methamphetamine — snorted, smoked, or injected not under medical supervision — is anything but an insanely vicious drug of abuse.
As a snorted/smoked/injected drug, meth is highly addictive (which means a conversion rate of somewhere between a fifth and a third of those who try it more than casually) and highly toxic to lots of organs, including the brain. A couple of years’ steady use of meth leaves marked and lasting cognitive deficits, which is not true for any other recreational drug, including even alcohol.
That’s entirely consistent with the fact that oral methamphetamine, used under medical supervision, is a reasonably safe and highly useful drug for nacolepsy, ADHD, and increased alertness for people who absolutely must stay alert for long hours, such as combat pilots. (Tierney quotes Jacob Sullum to the effect that he’d rather be on the road with a truck driver using meth than with one who is tired. That omits the possibility that the driver on meth is also tired, having used it precisely to cut down on his sleep time. Tired and edgy is a bad combination. And even that leaves out of account what happens to a truck driver who uses meth steadily for months or years.)
Yet Tierney reaches deep into his top hat and pulls out the proposition that methamphetamine is less dangerous than alcohol. Of course, meth does less total damage, because alcohol is so widely used. But if Tierney means what he seems to mean — that starting the recreational use of methamphetamine is less risky than starting to drink — he is simply wrong, and I challenge him to find a single competent phamacologist (a class to which, despite his manifold virtues, Jacob Sullum does not belong) who agrees with him.
Just as someone needs to tell the drug warriors that not all illicit drugs are equally dangerous, someone needs to tell the extreme libertarians that not all illicit drugs are equally safe. Some illegal drugs are actually quite nasty. And anything that makes it harder for policy-makers and drug users to accurately distinguish degrees of risk makes the drug abuse problem worse.
The true-believing drug warriors such as Bill Bennett love opponents like Tierney. By making dumb mistakes and utterly far-fetched arguments, he discredits not only himself but those of us who know more than he does, hold less extreme views, and would like to see some progress toward sanity on drug abuse control before we’re all too old to care.