Microkhan by Brendan I. Koerner

The Marching Powder

November 4th, 2009 · 12 Comments

CocaineWhen Latin percussion god Tito Puente died some years back, The New York Post speculated that a 40-year cocaine addiction had finally caught up with the man. This piece of gossip turned out to be of (to say the least) dubious veracity, but it stuck with us nonetheless. That’s because it got us thinking about whether or not cocaine use inevitably leads to addiction, one of the central tenets of the “Just Say No” campaign that was inescapable during our Reagan Era youth.

The issue is more salient than ever, now that skepticism about the War on Drugs appears to be reaching critical mass. With marijuana seemingly headed for decriminalized status in at least a handful of states, will there eventually be an organized movement calling for a similar rethink on cocaine?

We’re not yet convinced that the emergence of a National Organization for the Reform of Cocaine Laws (NORCL) would be a good thing, but we are curious about the evidence attesting to the true nature of coke’s addictive powers. The typical Drug Warrior stat is that three-quarters of those who try the drug will become addicts. But as with so many figures spouted by those with a vested interest in maintaining blanket prohibition, this number is never accompanied by credible sourcing. Much more believable, then, is the state cited in this New York Times piece:

According to the Institute of Medicine of the National Academy of Science, 32 percent of people who try tobacco become dependent, as do 23 percent of those who try heroin, 17 percent who try cocaine, 15 percent who try alcohol and 9 percent who try marijuana.

Those stats alone aren’t enough to sway us into the NORCL camp. But another data point worth considering are the conclusions found in the World Health Organization’s 1995 report on cocaine use (PDF). The report, allegedly suppressed by the U.S., clearly doesn’t regard occasional cocaine use as any more deleterious to personal and public health than good ol’ drinking:

In all participating countries, health problems from the use of legal substances, particularly alcohol and tobacco, are greater than health problems from cocaine use. Also, in many countries, chronic problems related to poverty, hunger, infectious diseases, war and social disorder overshadow any health problems related to cocaine use. Most participating countries agree that occasional or experimental cocaine use does not typically lead to severe or even minor physical or social problems.

Yes, we’re well-aware of the downside of what the WHO describes as “intensive use”—in fact, we lost a cherished family member to the habit. But we’ll confess to having an Economist-style libertarian streak, as well as a love for scientific reason. If cocaine is, indeed, far less addictive than commonly advertised, shouldn’t we at least start having the conversation as to how it might be effectively brought aboveboard and regulated?

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12 Comments so far ↓

  • Jordan

    By the same token, it’s kind of a head-trip to read some of the mainstream media’s reports about cocaine before 1980, such as the infamous Newsweek article in 1971 entitled “It’s the Real Thing”. There just wasn’t a strong perception at that point that cocaine was a dangerous substance. Though it may be safe to say that this perception only lasted as long as cocaine was seen as the province of rich, white people.

    One of the reasons that the decriminalization or legalization of cocaine makes me twitchy is that we would essentially be signing off on the idea of freebase and crack cocaine being alright as well. A ready and legal supply would make it that much easier to produce free base derivatives and I feel much more trepidation about their legalization. While the addictive potential of crack is overhyped (no drug will make you addicted after one hit), inhalation of free base cocaine does raise blood concentrations much higher than compared to insufflation. That raises the addictive potential of inhaled cocaine far above that of cocaine•HCl.

    While I think that eventually all or almost all drugs will be legal for private consumption, I think we’re going to have to proceed with enormous caution. The level of misinformation spread by the government has desensitized much of the population to the very real dangers posed by some drugs and it’s going to take a lot of work to put them in a position where they can make a more informed decision about whether or not to use a given substance.

    On a slight tangent, while I was trying to learn about nootropics (you should totally do a post on the subject), I found out that amineptine, a dopamine reuptake inhibitor, used to be available over the internet because it was unscheduled in the United States. While it does have a lower abuse potential than cocaine, it works through essentially the same mechanism.

  • Captured Shadow

    I’ve never tried recreational cocaine because I have a feeling I would really, really like it.

  • Brendan I. Koerner

    @Captured Shadow: I admire your self-control kung fu.

    @Jordan: Thanks for the fantastic comment. I think your third graf nails it–there’s so much passion around this topic, it’s tough to separate the facts from the myths. Even worse, there simply aren’t enough facts in circulation, because non-biased research has been in short supply.

    I’m not sure I agree that widespread drug legalization is inevitable. But if it did come to pass, could it survive the inevitable upsurge in deaths that would immediately follow? I’ve always thought that cocaine decriminalization would cause a huge spike in overdose deaths for at least a couple of years, as lots of people gave it a try (and not always in the most responsible manner). If the decriminalization experiment were allowed to continue, those deaths would eventually decline. But I’m not sure voters would have the intellectual fortitude to wait out the trend.

    Haven’t read much about nootropics in ages. Though I am always intrigued by the potential for access to such drugs to result in a new sort of class stratification. Like, you can’t be a member of the elite unless you have a steady, illicit supply of Provigil.

  • Jordan

    It’s almost surprising that there hasn’t been more research into cocaine as it’s a class II drug, which should make it a whole lot easier to get access to than class I drugs. The sheer amount of paperwork to get a license for that research is mind-boggling.

    I tend to think that drugs will become legal over time, but it will be a rather slow process. Marijuana is likely to become legal within a decade. Two on the outside. Once we open that door, a lot will have to change. If nothing else, we will be forced to modify or withdraw from the international treaties governing the production, transport and sale of illegal drugs. Given the difficulties of rewriting international treaties, Congress may take the easy way out and complete pull out from those treaties. Once that happens, it seems much more likely that other countries will also withdraw and begin to change their own laws. Once there’s one example of change, maintaining the system will become that much more difficult. And without the pressure and money that the US has brought to bear on the international drug trade, a lot of governments will probably relax their own laws. In the US I think any legalization or decriminalization beyond marijuana will take much longer, but if there are other countries that can establish successful alternatives to outright prohibition, the pressure for change within our own country will significantly grow. With that said, I can also imagine that a less homogenous set of laws between countries will allow for differentiation in priorities. Some countries will be more strict, others less. The people who really care about such things will move around. Hopefully in the end it will be better for everyone.

  • Brian Moore

    ” I’ve always thought that cocaine decriminalization would cause a huge spike in overdose deaths for at least a couple of years, as lots of people gave it a try (and not always in the most responsible manner).”

    I think certainly some people would, but remember that it would also work on the other side. Now legal, those who did use it could seek medical attention immediately, without fear of prosecution.

    Also, we really do have cocaine decriminalization data (albeit for Portugal):

    http://www.scientificamerican.com/article.cfm?id=portugal-drug-decriminalization

    “Five years later, the number of deaths from street drug overdoses dropped from around 400 to 290 annually, and the number of new HIV cases caused by using dirty needles to inject heroin, cocaine and other illegal substances plummeted from nearly 1,400 in 2000 to about 400 in 2006, according to a report released recently by the Cato Institute, a Washington, D.C, libertarian think tank.”

    This is Glenn Greenwald’s research, I heartily endorse just about anything he prints on the drug war.

  • Brendan I. Koerner

    Yeah, I’m intrigued by the results of the Portuguese experiment. The Economist did a big piece on it recently, and I admit that I was surprised by how well it’s worked out.

    To expand on my comment above, though, I wanted to stress that the media (of which I reckon I’m a part) will always make drug-policy revision really difficult. Let’s face it, if coke enforcement is ratcheted down, the press will jump all over every OD death of an affluent (and white) prom-queen type as proof that the policy has failed—even if the broader picture totally contradicts the tragedy of that individual case.

    C’mon, can’t you just see the NY Post front page now? (Photo of a smiling teenager, headline of “SNOWED OUT.”) Those kinds of inevitable stories will make it very hard for more level-headed discussion to win out in the end. The forest for the trees problem, I guess.

  • Brian Moore

    No, you’re 100% right. Every single death from drugs after that point will be laid at the doorstep of the people who tried to change the policy.

    “My opponent voted to loosen up on drug enforcement, and so little Sally Jenkins tried coke and died! Vote for me/”

    It’s just crazy that we all know that tactic would work really well, too. But no matter how many times police kick down people’s doors late and night and shoot them (or get shot ) or their dogs, somehow that isn’t the responsibility of the pro-drug war people.

  • Brian Moore

    And I think it’s this “huh, if I support this, my opponents will claim that I am responsible for these horrible effects” is probably the largest factor in delaying a large number of policies that really need to implemented, like toning down the drug war, prosecutors, our imprisonment rates, anti-terrorism policies, or half a dozen other things. Same with any entitlement or subsidy — for better or worse, any mention of reducing them is met with worst case scenarios.

    If there’s a potential bloody shirt (even if it’s less bloody than the status quo) to wave, there’s no point (for a politician) to support the policy change.

  • nomore

    I went through a brief, but not brief enough, period when I REALLY liked cocaine. I was on the verge of liking it way too much, and it was costing me way too much. I stopped. Just like that. This was after several months of using too much too often.

    Makes me question the whole “It’s so addictive so fast” argument. Oh, and I haven’t used it in about 10 – 12 years.

  • Brendan I. Koerner

    @nomore: Thanks a mil for the spot-on comment.

    I think what you describe is the predominant usage patterns for most folks–the fat part of the cocaine Bell Curve, if you will. You experiment, you have a brief period of fun, you become aware of the obvious downsides, you stop, and then you never really think about it again.

    But the conventional wisdom is that you try it once and you become a zombie. And the prevalence of that stereotype nips any rational debate in the bud.

    As we noted in the post, we’re well-aware of the addictive nature of cocaine–we recently lost an extremely close family member to the stuff. But despite that tragedy, we realize that long-term good will come from seeing the forest in lieu of the trees.

    More on the NORCL concept to come, for sure. Stay tuned…

  • Brian Moore

    “Makes me question the whole “It’s so addictive so fast” argument. Oh, and I haven’t used it in about 10 – 12 years.”

    I’m definitely in the “legalize” camp, but people’s reactions to almost all psychoactive drugs are widely different. Some people simply will not become addictive. Some people will. Others can become addicted, but it takes awhile. Some people’s systems literally can’t process the drug and they just get sick from using it.

    You see this with cocaine, alcohol, nicotine, psychiatric drugs, and everything in between. The extent to which we can predict a drug’s effect on the brain is still in its infancy — standard operating procedure in psychiatry is to simply keep prescribing drugs until one works. This isn’t because they’re hacks, but because that’s simply how things work now: the effects of these drugs are so different for each person that until we have some magical gene and chemical analyzer that can say “this is what will happen when you take this,” we can’t say for certain.

    In some cases, we have identified certain genes (and/or chemical setups) that cause people to be highly affected by certain drugs. Since alcohol is legal, we can easily research it. And we’ve identified a certain group of people who simply respond much faster to alcohol than others, because they aren’t able to break it down as quickly. So they get drunk from 1-3 drinks. I don’t think they necessarily are more able to be addicted to it, but they feel the effects faster.

    This is part of the problem: back when were originally regulating all these drugs, everyone assumed that everyone responded the same way as the standard study patient. (who tended to be a white male: so this led to a huge lag in identifying things that are different for non-white, non-males — like female heart attack symptoms) And why it’s definitely not the same mechanism, it’s easy to see in say, peanut allergies. What is tasty for one is deadly for another. It would be weird to say that no one could eat peanuts because some reacted so poorly to it. It’s always a gradient — even more so with drugs that affect your brain.

  • Brian Moore

    “But the conventional wisdom is that you try it once and you become a zombie. And the prevalence of that stereotype nips any rational debate in the bud.”

    Definitely. But I suppose there’s hope — pot managed to go from “reefer madness” to the brink of legalization in only a few decades. While I’ll admit that cocaine probably has a steeper slope to go, perhaps a few years of old voting people dying will one day change the consensus.

    And one more thing about the variability of reactions: I think this makes the case for legalization stronger. If there are people who won’t react poorly to certain drugs, but some people who do, then we do not want the latter camp to be experimenting in a dark alley. We want them to be with friends who can call the paramedics if something goes wrong. Similar to the same argument in alcohol regulation: underage drinkers are less likely to see medical attention for someone who needs it because they don’t want to get in trouble.

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