On April 3 1924, a group of American congressmen held an official hearing to consider the future of heroin. They took sworn evidence from experts, including the US surgeon general, Rupert Blue, who appeared in person to tell their committee that heroin was poisonous and caused insanity and that it was particularly likely to kill since its toxic dose was only slightly greater than its therapeutic dose.
They heard, too, from specialist doctors, such as Alexander Lambert of New York's Bellevue hospital, who explained that "the herd instinct is obliterated by heroin, and the herd instincts are the ones which control the moral sense ... Heroin makes much quicker the muscular reaction and therefore is used by criminals to inflate them, because they are not only more daring, but their muscular reflexes are quicker." Senior police, a prison governor and health officials all added their voices. Dr S Dana Hubbard, of the New York City health department, captured the heart of the evidence: "Heroin addicts spring from sin and crime ... Society in general must protect itself from the influence of evil, and there is no greater peril than heroin."
The congressmen had heard much of this before and now they acted decisively. They resolved to stop the manufacture and use of heroin for any purpose in the United States and to launch a worldwide campaign of prohibition to try to prevent its manufacture or use anywhere in the world. Within two months, their proposal had been passed into law with the unanimous backing of both houses of the US Congress. The war against drugs was born.
To understand this war and to understand the problems of heroin in particular, you need to grasp one core fact. In the words of Professor Arnold Trebach, the veteran specialist in the study of illicit drugs: "Virtually every 'fact' testified to under oath by the medical and criminological experts in 1924 ... was unsupported by any sound evidence." Indeed, nearly all of it is now directly and entirely contradicted by plentiful research from all over the world. The first casualty of this war was truth and yet, 77 years later, the war continues, more vigorous than ever, arguably the longest-running conflict on earth.
Take heroin as a single example. And it's a tough example. In medical terms, it is simply an opiate, technically known as diamorphine, which metabolises into morphine once it enters its user's body. But, in terms of the war against drugs, it is the most frightening of all enemies. Remember all that those congressmen were told about "the great peril". Remember the Thatcher government's multimillion pound campaign under the slogan "Heroin screws you up". Think of Tony Blair at the 1999 Labour party conference fulminating about the "drug menace" or of William Hague last year calling for "a stronger, firmer, harder attack on drugs than we have ever seen before". And now look at the evidence.
Start with the allegation that heroin damages the minds and bodies of those who use it, and consider the biggest study of opiate use ever conducted, on 861 patients at Philadelphia General hospital in the 20s. It concluded that they suffered no physical harm of any kind. Their weight, skin condition and dental health were all unaffected. "There is no evidence of change in the circulatory, hepatic, renal or endocrine functions. When it is considered that some of these subjects had been addicted for at least five years, some of them for as long as 20 years, these negative observations are highly significant."
Check with Martindale, the standard medical reference book, which records that heroin is used for the control of severe pain in children and adults, including the frail, the elderly and women in labour. It is even injected into premature babies who are recovering from operations. Martindale records no sign of these patients being damaged or morally degraded or becoming criminally deviant or simply insane. It records instead that, so far as harm is concerned, there can be problems with nausea and constipation.
Or go back to the history of "therapeutic addicts" who became addicted to morphine after operations and who were given a clean supply for as long as their addiction lasted. Enid Bagnold, for example, who wrote the delightful children's novel, National Velvet, was what our politicians now would call "a junkie", who was prescribed morphine after a hip operation and then spent 12 years injecting up to 350mg a day. Enid never - as far as history records - mugged a single person or lost her "herd instinct", but died quietly in bed at the age of 91. Opiate addiction was once so common among soldiers in Europe and the United States who had undergone battlefield surgery that it was known as "the soldiers' disease". They spent years on a legal supply of the drug - and it did them no damage.
We cannot find any medical research from any source which will support the international governmental contention that heroin harms the body or mind of its users. Nor can we find any trace of our government or the American government or any other ever presenting or referring to any credible version of any such research. On the contrary, all of the available research agrees that, so far as harm is concerned, heroin is likely to cause some nausea and possibly severe constipation and that is all. In the words of a 1965 New York study by Dr Richard Brotman: "Medical knowledge has long since laid to rest the myth that opiates observably harm the body." Peanut butter, cream and sugar, for example, are all far more likely to damage the health of their users.
Now, move on to the allegation that heroin kills its users. The evidence is clear: you can fatally overdose on heroin. But the evidence is equally clear, that - contrary to the claims of politicians - it is not particularly easy to do so. Opiates tend to suppress breathing, and doctors who prescribe them for pain relief take advantage of this to help patients with lung problems. But the surprising truth is that, in order to use opiates to suppress breathing to the point of death, you have to exceed the normal dose to an extreme degree. Heroin is unusually safe, because - contrary to what those US congressmen were told in 1924 - the gap between a therapeutic dose and a fatal dose is unusually wide.
Listen, for example, to Dr Teresa Tate, who has prescribed heroin and morphine for 25 years, first as a cancer doctor and now as medical adviser to Marie Curie Cancer Care. We asked her to compare heroin with paracetamol, legally available without prescription. She told us: "I think that most doctors would tell you that paracetamol is actually quite a dangerous drug when used in overdose; it has a fixed upper limit for its total dose in 24 hours and if you exceed that, perhaps doubling it, you can certainly put yourself at great risk of liver failure and of death, whereas with diamorphine, should you double the dose that you normally were taking, I think the consequence would be to be sleepy for a while and quite possibly not much more than that and certainly no permanent damage as a result." Contrary to the loudly expressed view of so many politicians, this specialist of 25 years' experience told us that when heroin is properly used by doctors, it is "a very safe drug".
Heroin can be highly addictive - which is a very good reason not to start taking it. In extreme doses, it can kill. But the truth which has been trampled under the cavalry of the drug warriors is that, properly prescribed, pure heroin is a benign drug. The late Professor Norman Zinberg, who for years led the study of drug addiction at Harvard Medical School, saw the lies beneath the rhetoric: "To buttress our current programme, official agencies, led originally by the old Federal Bureau of Narcotics, have constructed myth after myth. When pushers in schoolyards, 'drug progression', drugs turning brains to jelly, and other tales of horror are not supported by facts, they postulate and publicise others: 'drugs affect chromosomes'; 'drugs are a contagious disease'. Officials go on manufacturing myths such as the chromosome scare long after they are disproved on the self-righteous assumption that if they have scared one kid off using drugs, it was worth the lie."
Take away the lies and the real danger becomes clear - not the drugs, but the black market which has been created directly by the policy of prohibition. If ever there is a war crimes trial to punish the generals who have gloried in this slaughter of the innocent, the culprits should be made to carve out in stone: "There is no drug known to man which becomes safer when its production and distribution are handed over to criminals."
Heroin, so benign in the hands of doctors, becomes highly dangerous when it is cut by black-market dealers - with paracetamol, drain cleaner, sand, sugar, starch, powdered milk, talcum powder, coffee, brick dust, cement dust, gravy powder, face powder or curry powder. None of these adulterants was ever intended to be injected into human veins. Some of them, such as drain cleaner, are simply toxic and poison their users. Others - sand or brick dust - are carried into tiny capillaries and digital blood vessels where they form clots, cutting off the supply of blood to fingers or toes. Very rapidly, venous gangrene sets in, the tissue starts to die, the fingers or toes go black and then have only one destiny: amputation. Needless suffering - inflicted not by heroin, but by its black-market adulterants.
http://www.guardian.co.uk/comment/story/0,3604,506507,00.html
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Don't worry, B. Caapi
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