Drugs and the Law
Erich Goode, Professor of Sociology at SUNY Stony Brook
From: Drugs in American Society, First Edition, Chapter 7
©1972 Alfred A. Knopf, Inc. ISBN 0-394-31323-2
In this and the next chapter I shall argue that: (1) Drug laws
are passed and enforced independently of their stated goals of
deterrence, rehabilitation, and public safety. I submit that instead
they are passed and enforced for ideological and moral reasons,
not "rational" ones. (2) The drug laws are ineffective.
The deterrent effect, which was at best only partial in the past,
is swiftly breaking down and will probably prove even less effective
in the future. Rehabilitation has always been a complete failurethe
prison system has served to perpetuate drug use, not to cure the
users. Public safety has actually suffered because of the
drug laws. (3) The drug laws probably do more total damage to
societyin terms of agreed-upon criteria of harmthan they
prevent. Ironically and tragically, it is the law and its enforcement
that is principally responsible for the size of the addict population,
for the recent increase in addiction, and for a majority of the
most harmful features of drug use and the drug scene. Finally,
I submit that to the extent that a shift is coming about in law
enforcement vis-à-vis drugs, this represents an ideological
shift far more than a realization that the drug laws have not
If a large cross section of the public were asked to give the
reasons underlying the existence and enforcement of the drug laws,
by far the most common response would be that the populace must
be protected from the harm that drugs do to individual users,
as well as to society in general. A deterrence-and-containment
policy is seen as motivating the legal mechanism. Even the well-informed
layman and the expert hold to this view:
Most laws are instituted to protect society, or to protect the
individual. Laws concerning drugs fit into this legal framework.
For example, narcotics are outlawed because their continued use
can cause physical and mental debilitation of the individual and
lead to crime against society. Obviously, society must have laws
governing the distribution and use of dangerous drugs... (Uhr
and Uhr 1970, p. 112).
However, the closer we examine the laws, and drug use, the less
tenable this position becomes. Presumably, the more dangerous
a drug is (or potentially dangerous, if significant numbers of
individuals were to use it), the more vigorous will be the legal
attempts mobilized to prevent its use; a drug whose potential
for damage is low would presumably be far less likely to fall
within the orbit of criminal law. In actual fact, there is almost
no relationship whatsoever between harm, potential or actual,
and the existence of drug laws and efforts at law enforcement.
There are, of course, many different ways of measuring the "damage"
that a drug does or might do. Joel Fort has elaborated a scheme
of dimensions of "hardness," which takes into account
mainly brain and organic damage, insanity, addiction, violence,
accidentsparticularly vehicularand obviously death (Fort
1968; Fort 1969, pp.98-99). These are "nonpolitical"
dimensions, since nearly everyone would agree that they do constitute
damage or harm; on this point at least there should be no controversy.
In terms of Fort's scheme, the first category of hardness would
include the most "dangerous" drugs currently in use:
alcohol, barbiturates, amphetamines, nicotine (in cigarettes),
and probably cocaine. Any individual who is a heavy, chronic,
long-term user of any one of these drugs stands an extremely high
chance of damaging his body and mind. In addition, all the drugs
in the group except for cocaine are very commonly used; thus the
actual rates of damage are high. The second category of
hardness would include drugs whose damage potential is moderate,
relative to the first five agents, given frequent, long-term use:-
all the narcotics (because of the possibility of overdosing and
the very real specter of addiction, as well as the pangs of withdrawal)
and the hallucinogens (because of the possibility, however small,
of temporary psychosis). The third category would include drugs
that, given current medical and pharmacological knowledge, appear
to cause fairly infrequent and relatively superficial damage:
caffeine, aspirin, and marijuana.
This is not to say that these
drugs are completely "safe"no drug, no chemical agent
of any kind, is completely safe, and that includes water. There
are as many as a thousand aspirin poisonings each year, mainly
of young children who swallow massive doses, as well as some resulting
from suicide attempts. About 0.2 percent of the population develops
idiosyncratic pathological responses to aspirin, such as skin
rashes. (A physician told me of a patient whose skin fell off
in sheets after ingesting aspirin.) And the knowledge of how aspirin
works pharmacologically is, as with marijuana, more or less lacking
(Fort 1969, pp.25, 41, 141). However, aspirin is typically used
with no damage whatsoever to the user.
Yet of the five extremely damaging drugs, alcohol and cigarettes
are readily available to anyone above a certain agein any
quantity, without restraint; amphetamines and barbiturates are
available by prescription (and are very commonly and heavily used
by prescription for largely nonmedical or pseudomedical reasons);
and cocaine is completely criminalized. Of the moderately dangerous
drugs, the narcotics and the hallucinogens, possession of both
is a crime, although illegalization efforts are more heavily concentrated
on the former than on the latter. Of the relatively harmless drugs,
caffeine and aspirin are readily available, and marijuana is completely
criminalized. Possession of even a small quantity of marijuana
(a quarter of an ounce in some jurisdictions), as well as any
sale or transferincluding handing someone a joint that is being
passed around a circle of friendsconstitutes a felony, punishable
by a prison sentence ranging up to life imprisonment. In at least
one stateRhode Islandthe minimum penalty for the sale of
marijuana to a minor is thirty years' imprisonment; the maximum
is life. The severity of this penalty is surpassed only by that
for first-degree murder and treason; it is a harsher penalty than
that for rape, second-degree murder, arson, and armed robbery.
(A separate but related question is whether or not these penalties
are carried out. But the symbolic and attempted deterrent functions
of the severity of the law cannot be ignored.) The Rhode Island
penalties are not leftovers from an earlier, less enlightened
age; rather they are the product of a revision in the penal codes
instituted in 1962. Now, if we wish to claim that selling a twenty-year-old
college student a couple of joints of marijuana is more damaging
to him that murdering him without intent, we may safely argue
that the penalties are consistent with damage. But such a contention
is ludicrous, and the position is completely untenable.
Thus instead of an intimate and causal connection between damage
and the law, what actually exists is an extremely loose, almost
nonexistent relationship. Society does not construct laws to protect
itself or the user from the damage that a drug will, or could,
inflict. Yet most people think that that is why the laws
against drug use exist and are enforced. And legislators and law
enforcement officers no doubt believe that they create and uphold
drug laws because drug use is "dangerous." The
"empirical" argument about damage is superimposed on
an essentially moral and ideological beliefthe assumption that
use of certain drugs is wrong, evil, and undesirable, and should
be outlawed. But in reality this is a rationalization, a shaky
scaffoldingand it has little or nothing to do with the existence
of the laws or their enforcement.
The whole relationship between the harmfulness of drugs and drug
laws is but one example of the ambiguity of law in general. Some
forms of crime outlawed by society and routinely enforced obviously
do harm some members of society, along some agreed-upon definition
of harm. Murder is one such example. But many forms of criminal
behaviorperhaps most forms of criminal behaviorharm no one,
not even the perpetrator of the crime. (Unless performing the
act itself is declared to be harmful. Homosexuality is one example
of a "victimless" crime; but some will claim that homosexuality
is itself harmful, and given this premise there is no possibility
of arguing with the charge.) Moreover, many forms of behavior
that are extremely destructive to society and to many of its individual
members are quite legal. The record of damage due to alcohol consumption
is probably without equal in the history of drug use, but the
restrictions placed on the drinker are fairly liberalhe may
destroy himself in private but not in public. Warfare, to choose
a nondrug example, is always catastrophic, but most politicians
make no attempt to render it illegalinstead they have always
made the refusal to destroy human life in combat a criminal
act, under the claim that such killing is for the good of everyone
involved. Faulty design and manufacture of products certainly
cause thousands more deaths each year than, say, sex crimes, yet
politicians and the public become incensed over the latter and
are comparatively indifferent about the former. Even the toothless
consumer protection laws now in effect were enacted only as a
result of the efforts of a few vigorous crusaders, and not by
any means as a result of public or official acknowledgment of
the potential and actual harm presented by dangerous products.
In sum, the view that laws are passed and enforced as a result
of the "objective" danger presented to society by the
prohibited behavior is not only extremely naive but fallacious.
Behind the passage of every drug law in existence is a well-organized
and effective lobby that has convinced lawmaking bodies and agents
of social control that drug use is in fact a menace to public
safety and health. In no instance have medical, pharmacological,
psychological, or sociological researchers been asked to prepare
a thorough evaluation of the potential or actual dangers of the
various drugs so swiftly criminalized. Often, as in the case of
the Federal Marihuana Tax Act, the only "evidence" to
justify the passage of drug laws has been presented by those who
undertook to get the laws enacted in the first place. Howard S.
Becker has coined the term "moral entrepreneurs" to
describe those highly committed individuals who take it upon themselves
to disseminate their views to the public and to make sure that
their own version of right and wrong becomes law for all (Becker
1963, pp. 147-163). The moral entrepreneur is an ideological imperialistit
is his position that what he believes must also be right for everyone
and that anyone doing what he disapproves of must be punished
by the might of the law, by the state, by society as a whole.
The existing rules do not satisfy him (or hersome of the most
influential moral entrepreneurs in history have been women, such
as Carrie Nation, the alcohol prohibitionist)
... because there is some evil which profoundly disturbs him.
He feels that nothing can be right in the world until rules are
made to correct it. He operates with an absolute ethic; what he
sees is truly and totally evil with no qualification. Any means
is justified to do away with it. The crusader is fervent and righteous,
often self-righteous (Becker 1963, pp. 147-148).
Naturally, all moral entrepreneurs believe that what they want
to see passed into law is good for others and not merely
a crystallization of their own personal views and prejudices.
Thus anti-marijuana crusaders do not see themselves as imposing
their ideology and morality on the public. Rather they see themselves
as doing good, as helping others, as lifting up the drug
user to see the error of his ways, as protecting society from
the damage that drug use can do to humanity. (But then, as Camus
said, the welfare of humanity is always the alibi of tyrants.)
In short, the passage of laws is basically a nonrational process
that represents an ideological, moral, and political victory of
some segments of society over others. Laws are sometimes, even
often, a reflection of majority sentiment, but this is not a necessary
condition for their passage. Public sentiment and outrage is a
useful resource for the moral entrepreneur in his battles.
(Most of the state laws criminalizing marijuana possession were
pushed through without any fanfare whatsoever.) Likewise, expert
documentation and testimony may be useful in the battle to get
laws passed, but they too are not essential. As noted earlier,
a majority of experts doing research on marijuana use favor the
decriminalization of the drug (Clark and Funkhouser 1970), and
more and more researchers are turning to this view. Of course,
it is always possible to hand-pick "experts" in drug
research to present views that are already favorable to official
opinion. Even when a full range of views from the scientific community
is elicited on a given issue, ignoring the views of the majority
is a simple matter. The Nixon administration dismissed The
Report of the Commission on Obscenity and Pornographythe
most thorough and well-documented study ever conducted on the
subjectin just such a manner. Likewise, President Nixon stated
publicly that whatever the findings and recommendations of the
National Commission on Marihuana and Drug Abuse, he would never
legalize marijuana. Such commissions are used primarily as rhetorical
devicesthey are useful insofar as they can shore up some official
view; if they cannot serve such purposes, they are buried.
Thus it is utterly nonsensical to claim that because a
nation has passed or enforces a certain law outlawing some behavior,
the behavior in question must be harmful to the populace.
Yet many observers have made just this assertion. Edward Bloomquist,
for instance, claims that the Nigerian government's enactment
of harsh legislation against cannabis possession demonstrates
the drug's harmful effects on the vigor of a developing nation
(Bloomquist 1971, pp. 23-24). (The penalties in another developing
nation, Iran, are particularly harsh for drug sellers. Dealers
are shot on public television, and TV sets are placed in village
squares so that everyone can see these important events. But just
what this demonstrates with regard to the effects of the drugs
in question is not clear.) The classic statement exemplifying
this fallacy was written by a South American physician, Pablo
Oswaldo Wolff, who observed that, in regard to cannabis: "All
civilized countries have included in their protective legislation
a prohibition of the use of Cannabis for enjoyment purposes, because
the social and criminal danger to which it can give rise at
any time is of immense gravity" [my emphasis] (Wolff 1949,
p. 49). A more contemporary observer, Director of the Essex, New
Jersey, County Youth and Economic Rehabilitation Commission, echoes
Wolff's sentiment: "Why is it that marijuana is the only
drug that is outlawed in every civilized country of the world?"
(Lordi 1968, p. 163). Three "health" experts make the
same observation with regard to drugs in general. The drug laws,
... have been enacted to protect society. Legal controls such
as quarantines, isolation, and penalties have always been necessary
to stop the spread of various diseases and illnesses. Since the
best evidence supports the view that compulsive drug abuse is
an indication of an emotional illness in an individual, society
is justified in insisting on some type of regulation on the manufacture,
distribution, and use of drugs. Such regulation can be viewed
as a part of preventative medicine (Jones, Shainberg, and Byer
1969, pp. 69-70).
The bizarre Alice-in-Wonderland quality of this statement becomes
pointedly clear when we realize that (1) most users of illegal
drugs are not, and never become, "compulsive" drug users,
yet they are just as liable to arrest as those who are; (2) the
conclusion that because (some) drug users are emotionally sick
they should be punished and incarcerated is not only illogical
but cruel and treacherous; (3) drug users are subject to penalties
regardless of whether they do, will, or can "spread"
their drug habits to othersthe isolated drug user is still
breaking the law; (4) drug laws and law enforcement may not even
be effective in dealing with the problems they are designed to
solve. The above quotes illustrate that medical analogies are
sometimes employed to shore up the edifice of criminal law. And
it is on such nonsense that entire legal edifices are often built.
A historical view of social and legal attitudes toward drug addiction
can give some perspective on the effectiveness of the drug laws.
The social image of the drug addict has turned almost full circle
since the second half of the nineteenth century. Addiction to
morphine as a result of administration during surgery was common
during and after the Civil War, and addiction came to be known
as the "soldier's disease," or the "Army disease."
Late in the nineteenth century and early in the twentieth many
preparations containing addicting substances were available over
the counter. Opium and morphine were contained in preparations
for headaches, toothaches, menstrual pains, insomnia, nervousness,
depression, and just about everything else; they were seen as
a kind of panacea for a wide range of ills. Naturally, thousands
of people, including many respectable middle class housewives,
became addicted as a result. Because of the connection between
medical therapy and addiction, the drug addict was viewed as a
helpless victim, an unfortunate sick person in need of medical
attention (see, for example, Terry and Pellens 1928; Lindesmith
1965, 1968; Duster 1970; Smith 1966). But by the 1920s the public
image of the addict had become that of a criminal, a willful degenerate,
a hedonistic thrill-seeker in need of imprisonment and stiff punishment.
Curiously enough, at the same time the public view of many medical
afflictions, such as leprosy, epilepsy, and insanity, moved in
the opposite direction; these conditions came to be regarded as
strictly medical problems rather than as signs of immorality and
depravity (Duster 1970, p. 10). Today this trend has begun to
reverse itself; among many physicians as well as some segments
of the public, addiction is coming to be viewed as largely a medical
It is, of course, almost completely impossible to estimate with
any degree of precision just how many addicts the freely available
over-the-counter narcotic preparations called into being. Figures
kept at the time are notoriously unreliable, and estimates range
from a low of 100,000 to a high of several million. In 1919 the
Treasury Department issued a report claiming that there were approximately
a million people addicted to narcotics at the turn of the century.
Other estimates, based on extrapolations from a number of local
surveys, range from slightly less than a quarter of a million
(Terry and Pellens 1928) to just under half a million (Kolb and
DuMez 1924). Since it is virtually impossible to check the reliability
of these estimates, let us accept the in-between figure, half
a million, as roughly accurate. In the early 1900s, as opposed
to the 1970s, it is clear that (1) addiction was largely a consequence
of medical problems, rather than related to a search for euphoria
and peer-generated excitement; (2) the middle-aged, rather than
the young, were addicts; (3) women, rather than men, were more
likely to be addicts; (4) whites were more likely to become addicted
than blacks; (5) addicts were drawn from the entire social class
spectrum, and probably somewhat more from the middle class, rather
than primarily from the bottom of the class structure (this tendency
is breaking down today, however); (6) addicts came from the entire
rural-urban continuum, rather than predominately from very large
cities and their suburbs.
One drug text presents a two-page graph (supplied by the Bureau
of Narcotics) showing the number of addicts in the United States
from 1900 to the 1960s (Jones, Shainberg, and Byer 1969, pp. 68-69).
The peak is reached early in the twentieth century, just before
federal legislation was passed, at about 200,000a not unreasonable
figure; this is followed by a sharp drop a few years later, to
a low in 1945 of under 20,000 addicts; then a small but significant
rise to 1960 is recorded, to approximately 50,000 addicts. Downswings
in the chart early in the century follow the enactment of new
laws. Really effective reductions, however, did not occur "until
the Bureau of Narcotics was established in 1930 to enforce..
. laws and apprehend violators" (Jones, Shainberg, and Byer
1969, p. 67). Many defenders of the existing legal structure viewed
the "reduction" in the number of addicts between the
inception of the narcotic laws and the end of World War II as
evidence that punitive policies were actually an effective deterrent
against addiction. In 1948 several physicians employed by the
government wrote: "This reduction has been largely due to
vigorous enforcement of the Harrison Act and the Federal facilities
for the treatment of addicts" (Vogel, Isbell, and Chapman
The view that laws and their enforcement are effective
against drug use and addiction is widespread. What, however, are
the facts? A close look at the facts actually demonstrates the
opposite point of viewthat existing and ongoing drug policies
have, from their beginnings to the present, been a contributing
factor in worsening the drug problem, that punitive policies and
approaches have been an almost unrelieved failure.
In December 1914 Congress passed the Harrison Act, which outlawed
the sale of over-the-counter narcotic preparations and placed
the addict in the hands of the physician. Whatever the intent
of the law, it is clear that most addicts simply continued to
receive drugs from their physician, on prescription, instead of
directly from their local pharmacist. If a physician construed
the administration of morphine to a patient to be within the scope
of legitimate medical practice, he had the right, within the law,
to maintain that addict on morphine. On the face of it, then,
the law did not change anything. It was the Supreme Court that
drew a restrictive interpretation of the Harrison Act and that
decided what was to constitute "legitimate" medical
practice; in a series of decisions from 1919 to 1922 the court
declared maintenance of an addict to be outside the scope of medical
practice and therefore illegal. However, in 1925, in the famous
Linder case, the Supreme Court overturned its earlier decisions,
declaring addiction per se not to be a crime and paving the way
for the legality of maintenance. The court affirmed the decision
in 1962, in Robinson v. California. Thus the present punitive
policies are a consequence of decisions made by the Supreme Court
between 1919 and 1922, decisions that were superseded and reversed
by later rulings A good case could therefore be made for the unconstitutionality
of present legal policies.
Because of police harassment of physicians following the passage
of the Harrison Act and the wave of arrests of doctors following
the Supreme Court's decisions, most physicians became unwilling
to shoulder the legal risks attendant upon treating the addict
and eventually discontinued administering narcotic drugs. One
study estimated that in the two dozen years after the Harrison
Actand primarily after 191925,000 physicians were arraigned
on narcotics-selling charges, and 3,000 actually served prison
sentences (New York Academy of Medicine 1963). Thousands more
had their licenses revoked. The authorities could not have encouraged
the emergence of an underworld traffic in narcotic drugs better
even by design. The arrest of physicians during this period took
the following form selling drugs was declared illegal, thus driving
most physicians out of the practice of treating addicts; the few
who continued to do so, whether for idealistic or mercenary reasons,
naturally attracted a sizable clienteleand just as naturally
were charged with "trafficking" in narcotics.
Apparently, the dilemma was at least dimly perceived by some officials,
since in 1919 and 1920 forty-four ambulatory clinics were opened
with a view toward the rehabilitation and eventual cure of addicts.
The programs were highly variable in method and effectiveness.
In the New York clinic, which received the most attention and
publicity, drugs were handed out more or less indiscriminately
to anyone who claimed to need drugs; moreover, through various
tricks many addicts were able to obtain much more than their share
and to sell what they did not use to other addicts. The New York
clinic was investigated by the Bureau of Internal Revenue, and
a highly critical report was written of its operations. Muckraking
journalists attacked the program; several reporters posed as addicts
and discovered that they could receive addicting drugs almost
upon demand. A public outcry was voiced; campaigns were launched
to close the clinics. All but one of the forty-four clinics had
been shut down by 1921, and the project was entirely abandoned
by 1923. The program was branded a disastrous failure. Actually,
the New York clinic, the object of the most vigorous criticism,
was the least well run and most clearly unsuccessful. The clinics
in New Orleans and Shreveport, Louisiana, appeared to have been
successful in their stated goals: (1) relieving the addict's suffering-
(2) offsetting the illegal drug trade; (3) curtailing the spread
of addiction and (4) reducing the criminal activity of addicts.
These efforts, however, received little public attention.
The demise of the public clinics, engineered by prohibitionist
officials, was then used by them to galvanize popular sentiment
against the strictly medical approach to addiction. The public
came to support the view that the addict had to be dealt with
punitively, that addiction was a matter for the police and not
the physician. Actually, the medical approach was not tried in
most clinics; rather simple maintenance, or handing out drugs
without any medical treatment whatsoever, was the rule. The more
carefully run, medically oriented programs did not convince those
in power that a true medical approach could in fact work. Addiction
came to be seen as inherently untreatableand inherently criminal.
A shift in enforcement came about at almost the same time as the
demise of the public clinics. In 1919, the first year of their
operation, there were only 1,000 federal arrests on narcotic charges.
In 1921, when all but one of the public clinics had closed, there
were 4,000 federal arrests. And by 1925 there were over 10,000
arrests (Lindesmith 1965, p. 143).
Clearly, then, what happened as a result of the Harrison Act was
not a diminution of a once large addict population but the appearance
of a totally different population altogether. Far from reducing
a problem, legislation and enforcement practices on drugs appear
to have created a problem out of whole cloth. The federal
laws outlawing the sale of narcotics seem to have created three
distinct groups from the existing addict population. The first
of these groups represents the majority of the middle class addicts,
mostly women; when the supply of opium and morphine was discontinued
for the nervous, distressed housewife, she eventually turned to
the use of barbiturates, under the care of her physician. What
the law did for this segment of the population of addicts was
to take the over-the-counter narcotics away and replace them with
sedatives, by prescription. Exactly the same types of people
who used narcotics in 1900 are now using barbituratesmiddle-aged,
middle-class, white women with various quasi-medical, largely
emotional problems that (they feel) can be solved by taking a
drug. The laws did absolutely nothing to terminate this class
of addicts, who certainly were in the majority in 1900they
simply changed the drug to which people were addicted.
The second group created by the narcotic laws consists of those
addicts who discontinued use altogether. But it is likely that
this segment comprised the least addicted of the turn-of-the-century
addict population. Thus the legislation probably "helped"
only those who were most capable of being helped, and who constituted
the least troublesome problem anyway. The third segment of the
addict population constitutes the present group of "street"
addicts. A certain proportion of the earlier addicts refused to
discontinue the use of narcotics, and since they did not, or could
not, obtain legally available drugs, they became dependent on
an illegal supply and thus automatically joined the ranks of the
It is obvious then, that the first half of the 1920s witnessed
the dramatic emergence of a criminal class of addictsa criminal
class that had not existed previously. The link between addiction
and crimethe view that the addict was by definition a criminalwas
forged. The law itself created a new class of criminals.
Our confidence in this view is strengthened when we examine the
role of the sedatives today. It is interesting that the barbiturates
began to be used on a more or less widespread basis about the
same time that the narcotic over-the-counter drugs became criminalized.
Barbital (whose trade name is Veronal) was discovered in 1903,
and phenobarbital (or Luminal) in 1912. The current use of the
sedatives, including the barbiturates and the "minor"
tranquilizers, certainly outstrips the use of over-the-counter
narcotic preparations at the turn of the century. Continued administration
of doses that are somewhat larger than the moderate doses commonly
prescribed will produce addiction, an actual physical dependence
in the user, and that daily use of approximately a gram or two
will produce a severe dependence, then there may well be a million
sedative addicts in the United States todayusers who would
actually suffer severe withdrawal symptoms if their supply of
drugs were discontinuedand the large majority of these addicts
are taking their drugs legally, under medical supervision. In
short, the sedatives of today have become the functional equivalent
of the freely available narcotic drugs of the turn of the
What are some consequences of the punitive approach to addiction?
It cannot be doubted that the criminalization of narcotics had
the immediate short-run impact of reducing the number of addicts
in the population. But what about the long-range effects? To justify
their policies, and their right to eminent domain in the drug
field, the police wish to convince the public that the post-1914
enforcement practices have brought gains to American society.
But like many such propagandistic claims, the argument falls apart
on careful scrutiny. A wide range of unanticipated and undesired
consequences of the police approach to drugs makes us suspect
that had more intelligent policies been pursued, many of the most
noxious features of addiction would not exist today.
Probably the most important contribution that law enforcement
has made to the problem of addiction is the creation of an
addict subculture. It is important to emphasize that prior
to 1914 no addict subculture of any significance existed in the
United States, and there was no inevitable link between narcotic
use and crime. There was a small population of opium smokers,
consisting primarily of Chinese immigrants and of bohemian, literary,
underworld, and demimonde figures who learned the habit from the
Chinese. Addicts did not display any special cohesion or loyalty
as a group; they possessed no lore concerned with the acquisition
and administration of drugs, no ideology elaborating the qualities
of various drug highs, no justification for using drugs, no status
ranking unique to the world of addiction, no rejection of the
nonaddict world. During the formative 1920s these elements of
an addict subculture began to emerge. Alfred Lindesmith has said
that by 1935, when he was studying addicts in Chicago, "there
already was a subculture without doubt" (Alfred Lindesmith,
1971: personal communication). It was the criminalization of
addiction that created addicts as a special and distinctive group,
and it is the subcultural aspect of addicts that gives them their
recruiting power. Up until the past few years external factors
have played a more important role in curtailing the spread of
addiction than anything the police have done. Alcohol prohibition
(1920-1933) focused the activities of organized crime on the distribution
of liquor rather than narcoticsin fact, got organized crime
started on a big-business scale. The depression of the 1930s also
had a delaying effect on the growth of the addict subculture.
And the disruption of drug supply lines during World War II slowed
down to a considerable degree the recruitment of new addicts.
By the end of the war some experts thought that addiction to narcotics
had ceased to be a problem of any magnitude; at that time there
were only 20,000 known narcotic addicts in the United States.
But starting in 1945, and especially in the late 1960s, addiction
began to rise dramatically. It is entirely reasonable to view
this rise as largely due to the recruitment powers of a gradually
developing subculture of intensely committed addicts. And it was
through the efforts of the police and the courts that this subculture
came into being in the first place.
A second major consequence of the punitive police approach to
drugs was the rise in the criminal activity of addicts. The
view that addicts are "inherently" criminal is totally
without foundation. However, it is clear that addiction and crime
are closely related. Almost every addict, aside from the wealthy
and those in the medical profession, is also a criminal, engaged
in some illegal moneymaking venture. A "slave" (or a
legitimate conventional job) does not pay enough to support a
heroin habit, but many "hustles" do. "Boosting"
(stealing from a store) and burglary are probably the most common
forms of theft for addicts, although armed robbery, "snatch
and grab" street tactics, and automobile thefts are also
common. Most junkies have sold heroin, but they generally do so
only on a small scale, since dealing in large quantities requires
a greater cash outlay than addicts can scrape together at one
time. A number of other hustles, such as pimping and confidence
games, are not uncommon, but they require more skill and ingenuity
than most people, whether addicts or not, possess. In addition,
many successful criminal ventures involving large sums of money
require precision and reliability, traits that are alien to the
addict because of his overwhelming commitment to his habit. So
notoriously unreliable are addicts that most criminal gangs will
disassociate themselves from a member of their ranks who is discovered
to be an addict. Most female addicts prostitute themselves, although
they will also "boost."
There is no question, then, that there is an intimate relationship
between addiction and crime in the United States. (This is not
true in most other nations, and it was not true in this country
before 1914.) But it is also important to ask the reasons for
the addict's criminal pattern of life. The police, in an effort
to justify the existing punitive approach to drug prevention,
claim that the typical addict's criminal career began before his
involvement with heroin. A former director of the Bureau of Narcotics
and Dangerous Drugs has written: "It is generally the criminal
who turns to addiction rather than the addict who turns to crime"
(Giordano 1966). Supposedly the conclusion to be drawn from this
fact is that addiction is a criminal matter, a problem
for the police to handle, and not a medical matter at all: "Any
intelligent layman who becomes convinced of this fact... will
see no solution to a crime problem by providing free drugs
to criminal drug addicts. How can they be expected to live useful,
productive lives on narcotics when their lives were enmeshed in
crime before they became addicted?" (Giordano 1966). The
problem with this position is that it is true but irrelevant,
a non sequitur. It is well known that most addicts are engaged
in criminal activities prior to addiction and typically have a
prior arrest record as well (O'Donnell 1965). This is, however,
a fairly recent development. Most of the addicts of a generation
ago were addicted before they engaged in criminal activities on
a routine basis (Abrams et al. 1968, p. 2147); the transition
can be traced to the abortive efforts of law enforcement policies
and practices. Moreover, addiction clearly increases the frequency,
the rate, and the seriousness of the crimes
committed, as well as the likelihood of arrest. It is highly questionable
whether any addict would persist in stealing hundreds of dollars
of merchandise a day if he did not need to "support"
a costly habit. It would be foolish to argue that the urban crime
rate would not drop sharply with the institution of some kind
of clinic maintenance program. Although the rate of crime for
clinic addicts would probably be higher than that of the population
at large, it would be far lower than the current rate of addict
crime under the police-controlled system.
Perhaps the most foolish and erroneous view currently in vogue
on the drug question is that embodying the "chemicalistic
fallacy"the view that addicts engage in crime because
of the biochemical effects of heroin itself. It is seriously entertained
in some quarters that as a direct action of illegal drugs the
user's "character" is destroyed, he becomes a degenerate,
his "morality" declines, and he inevitably turns to
crime. It has been well over thirty years since Alfred Lindesmith
launched an assault against this "dope fiend mythology,"
but the myth persists, trailing the wreckage of human life behind
it. There is nothing inherent in the molecules of heroin that,
when united with the cells of the body, compels the user to go
out and commit crimes. The addict does not simply commit crimeshe
commits moneymaking crimes. As arrest data show unambiguously,
the addict is far less likely to commit crimes of violence, such
as assault and rape, and far more likely to commit crimes that
lead directly to quick cash. The view that addicts simply commit
crimes of all kinds because of the direct action of drugs themselves
is a grotesque and archaic point of view and is refuted at once
by a look at the facts.
If the rehabilitative rationale that is used to justify the drug
laws were actually functional, someone who is arrested and punished
for a narcotic violation would be unlikely to continue using drugs
after his punitive experience. In fact, the opposite is true.
In one study of 9,000 addicts in Chicago it was found that 86
percent had been previously arrested on narcotic charges. The
authors of the study conclude that there is a "treadmill
of addiction," with the same addicts being continually arrested
and re-arrested, and with new addicts replenishing the supply
from time to time (Abrams et al. 1968, p. 2142). Various studies
of recidivism among addicts who have served prison sentencesor
who have been detained in government-supported "hospitals"indicate
a relapse rate of between 50 and 97 percent (Hunt and Odoroff
1962; Duvall, Locke, and Brill 1963; O'Donnell 1964, 1965; Lindesmith
1968). Most studies show a recidivism rate closer to 90 percent;
the rate of relapse for addiction is probably higher than that
for any type of crimewith the exception of committing homosexual
acts. In many ways prisons serve to intensify the addict's involvement
with narcotics, since the majority associate only with other addicts
in prison and their major topic of conversation revolves around
drugs. The marginally committed narcotics user will find himself
associating with, and gradually acquiring the attitudes and values
of, the addict subculture in prison. The lesson to be drawn from
follow-up studies of addicts released from prisons and federal
hospitals is that relapse is overwhelmingly the rule and not the
exception. Punishment appears to have virtually no effect on deterring
the addict from using drugs after his release. Prison is clearly
not the answer.
It is obvious that efforts at criminalizing addiction have failed.
Any agency other than law enforcement with such a high rate
of failure would be forced to reevaluate its methods of dealing
with the problem. Over half a century of failure is a long
and dismal record indeed. Since the police are to some degree
insulated from criticism, they may safely ignore a factual assault
on their methods and may remain unwilling to admit their failure
to deal with the problem. An answer to why this society continues
to pursue the same unworkable and disastrous policies toward drug
addiction would require a volume-length discussion. However, a
number of suggestions in this direction can be made. When a form
of behavior directed toward a stated purpose fails to achieve
its goal, the sensible observer begins to look for unanticipated
goals or consequences, for latent rewards or blind spots. I am
often asked by my students in criminology, deviance, and delinquency
classes if the reason for the inability of society to rid itself
of the drug problem is that the police receive large payoffs from
organized crime. My feeling is that this explanation is far too
facile. It is true that more than a few narcotic squads are involved
in drug peddling and receive money directly from the criminal
underworld. (During the summer of 1969 fifty out of the 300 agents
in the Federal Bureau of Narcotics' New York office were forced
to resign in the wake of a scandal exposing widespread drug peddling
among law enforcement agents. It is exceptional for such behavior
to reach public view but common for it to occur.) In itself, however,
this does not account for the continuation of the obviously unsuccessful
drug programs in force today, though it might explain why one
or another drug peddler is not arrested.
I believe that the following factors play a role in insuring that
the agents of social control, as well as a majority of the public,
will continue to view their efforts as reasonable and efficacious,
and to regard any reform of the system as an erosion of justice.
(1) The symbolic functions implied by severe penalties
play an important role in their continuation, whether or not the
penalties are effective. A policy is not only a practical attempt
to achieve clearly demonstrable goals; it is also a statement
of one's own ideological stance. In the case of drug laws, punishing
the wrongdoer affirms one's undaunted opposition to drug use.
To take a less severe stance would somehow imply that one approves
of taking drugs, that at the very least one tolerates drug use.
Savage penalties signify one's desire to do something about the
problem, even if the penalties actually achieve the reverse. The
polarization of sides on all significant issues produces the need
for displaying statements of one's ideology. When the issue of
"law and order" becomes crucial, support for the police
in all their efforts becomes a watchword for a specific political
stand. The outcome of the police efforts is basically irrelevantwhat
counts is which side one is on.
(2) Ideological considerations limit objective evaluations
so powerfully that one is unable to see the destructive effects
of one's own actions, or the actions of parties that one supports.
The fact that many efforts to stamp out crime actually strengthen
it will not be recognized by those who initiate such actions.
Policemen will reject the contention that the death penalty does
not deter homicideeven though data supporting this assertion
are a matter of public recordbecause such a view does not square
with their ideology. Moreover, the claim that one has actually
contributed to something that society views as repugnant is an
extremely uncomfortable thought and will not be readily believed.
Thus it is extremely unlikely that anyone involved in pursuing
or supporting existing drug policies will actually understand
or perceive his impact on the drug problem. It is easier to rationalize
and justify one's efforts than it is to attempt to make them really
(3) Vengeance is a powerful motive in the desire to punish
the deviant and the criminal. Any strict observer of the law and
existing morality will perceive an imbalance in the moral economy;
the conformist will feel a sense of "distributive injustice"
if the transgressor is not punished, and when he is the conformist
has cause for satisfaction. A person who observes the law will
feel that he has "paid" much more and has received much
less in return than the deviant and the criminal who have managed
to beat the system. The desire on the part of the law-abiding
citizen to punish the transgressor need not bear any relationship
to criteria of "effectiveness," because his punishment
becomes seen as an end in itself.
(4) Deviance and crime, and deviants and criminals, present a
vast resource for social control agencies. It has been
noted repeatedly that the agencies whose supposed goal is to stamp
out antisocial behavior and to "correct" individuals
committing it often do their best to insure that these individuals
actually continue that behavior. In prisons, mental asylums, courts,
welfare agencies, reformatories, or any one of a dozen correctional
institutions, there appears to be almost a self-perpetuating
quality to the efforts of social control. But this is not
as strange or contradictory as it seems at first blush. Social
control agencies derive support from deviance; the deviant is
defined as the special area of competence of the agency, which
receives public funds for its supposed special competence. Deviance
is a domain, a sphere of interest, a "turf," an area
of control, power, resources, expertise, and concern; it is a
kind of happy hunting ground. Without this domain, the functions
of the agencies dealing with it would be dubious. A correctional
agency cannot be too successful, for that would eliminate its
very reason for being and would involve a scramble to discover
another problem area. Dealing with an ongoing problem for decades
also gives an agency "seniority" in that areaeminent
domain, in the case of the police. The police, then, draw ideological
and material sustenance from drugs and drug users. It is not a
domain that the police are going to give up easily or willingly.
It has profited them too handsomely.
The colossal failure of drug policies can in part be attributed
to the confusion between intention and effectiveness. Most drug
policies are, and continue to be, based on ignorance. Lawmakers
do not pay attention to the latest research being done in a given
area. The "experts" selected to justify law enforcement
policiesselected for ideological and not scientific reasonstypically
know little more than the lawmakers themselves. Creators and enforcers
of the law are, unfortunately, victims of their own propaganda.
They have no idea of what the impact of their efforts will be,
largely because they have an erroneous and simple-minded view
of the social and psychological realities of the drug scene. Often
this ignorance causes more damage than the absence of any policy
"The law is an ass," said Mr. Bumble in Dickens' Oliver
Twist. In the area of drug use, this appears to be irrefutably
the case. Drug laws have not worked. The illegal use of drugs
is growing apace. Each new, stiffer law is announced as a more
effective instrument in the fight against drug abuse. And each
year the number of illegal drug users increases. Yet law enforcement
officers will continue to apply the same witless and self-defeating
policies, to enforce the same stillborn laws. And the lawmakers
will comply by cranking them outwithout any effort to review
the principles on which they rest. Evidence demonstrating the
failure of police efforts will be ignored, discounted, and even
suppressed. A roster of pseudo-experts will be encouraged and
financed by agencies of social control to provide "proof"
making present policies appear expedient and reasonable. Efforts
to significantly reform the law will be resisted, and more stringent
penalties, as well as more police power, will be called for. Nonpunitive
methods will be discredited. And because ongoing policies are
based on errors of fact and logic and a distorted conception of
drugs and drug users, the existing problems will continue to grow
and the policies will almost inevitably be abortive.
The legal situation in relation to marijuana represents a qualitatively
different problem from that of narcotic addiction. While many
(although certainly not all) heroin addicts wish to discontinue
the use of heroin, very few marijuana users wish to stop smoking
cannabis. The laws criminalizing marijuanadirected, paradoxically,
principally and most stringently against sale and possession,
and almost not at all against use itselfrepresent what Jerome
Skolnick calls "coercion to virtue" (Skolnick 1968).
Marijuana use is a classic case of the "crime without a victim";
the user harms no one except himself, and many observers question
whether even the user is harmed by the use of marijuana. (Other
observers argue that the fact that marijuana use is spread among
friendsmuch like a communicable diseaserefutes the claim
of a victimless crime. However, the solitary user is just as liable
to arrest as is the gregarious, sociable user who "turns
on" friends. No one who wields this argument suggests that
solitary users should be exempt from the marijuana laws.) Since
there is no victim, there is no complainant, no one to report
marijuana crimes taking place. While the ratio of detected to
undetected murders approximates one to zero, detected to undetected
auto thefts one to zero, and detected to undetected rapes approximately
one to four, there is something like one detected to several hundred
thousand undetected acts of marijuana use, one detected to several
thousand undetected acts of marijuana sale, and one detected to
at least tens of thousands of undetected instances of marijuana
possession. The marijuana user who is arrested is in the tiny
minority, whereas the overwhelming majority of street narcotic
addicts eventually become arrested during their addiction "careers."
There are prison cells to hold only several hundred thousand criminals
in the United States, and something like 20 million Americans
have tried marijuana, half of them using the drug on a more or
less regular basis. Regardless of the wisdom or justice of the
laws, of their effectiveness as deterrent devices, or of the
relative harm or harmlessness of the drug itself, it must
be realized that anyone seriously enforcing the marijuana laws
faces enormous strategic and logistical problems. In fact, any
reasonable observer would have to say that enforcement of the
laws is a complete impossibility.
The federal marijuana lawthe Marijuana Tax Actwas passed
by Congress and signed into law by President Franklin Roosevelt
in 1937. It was ruled largely unconstitutional in 1969 in Leary
v. United States because of its double-jeopardy feature in
relation to the fifty state laws outlawing the sale and possession
(and in some jurisdictions the use) of marijuana. (The federal
law did not literally penalize the possession of marijuana; rather
it penalized the failure to pay the excise tax of $100 per ounce
on the transfer of marijuana. But if one were willing to pay the
federal tax and were to fill out the necessary forms, one would
have automatically incriminated oneself under the state laws.)
The act was replaced on the federal level by the Comprehensive
Drug Abuse Prevention and Control Act of 1970. The federal law
is, however, far less crucial than the fifty state laws criminalizing
marijuana. First of all, the number of arrests on the state level
is much greater than the number of federal marijuana arrests.
Since 1968 in California alone about 50,000 marijuana arrests
have taken place each year, and the total arrests in all the other
states is at least triple this figure. The number of arrests at
the federal level is minuscule in comparison. Second, arrests
at the state level involve primarily users and petty sellers,
whereas at the federal level most of those arrested are marijuana
sellers, usually of large quantities and often at the importation
link of the distribution chain. As recent research has indicated,
most state-level marijuana arrests take place as a result of accident
a patrolman stumbling upon marijuana in someone's possessionand
not of planning. One study reported that the overwhelming bulk
of state-level marijuana arrests took place without the work of
an undercover agent, without the aid of an informant, and without
the use of a search warrant or an arrest warrant (Morton et al.
1968). Over a third of the arrests (45 percent for adults, 36
percent for juveniles) took place in an automobile, and another
quarter or so (21 percent of the adults, 35 percent of the juveniles)
took place in a public place. These facts indicate the dominant
role of "patrol enforcement" and the almost complete
absence of a systematic enforcement strategy in marijuana arrests
at the state level. In the study just cited, undercover agents
supplied only 3 percent of the adult marijuana arrestees and 7
percent of the juvenile arrestees. The accidental nature of state-level
marijuana arrests is clearly a source for the feelings of distributive
injustice among those arrested.
Another feature of the state marijuana laws (also likely to produce
resentment) is their enormous variability. Nebraska has the most
lenient state law. For possession of a pound or less of marijuana
the Nebraska law calls for a penalty ranging from a nominal fine
of $ I to seven days' confinement in a county jail and/or a fine
up to $500, plus compulsory attendance in a "drug education"
course. For possession of more than a pound, the law calls for
confinement of from six months to a year and/or a $500 fine. Of
all the states, Texas has the most severe penalties; its law calls
for imprisonment of from two years to life for the possession
of marijuana! It might be reasoned that such a barbaric penalty
could never be imposed today; unfortunately for some, sentences
of thirty to fifty years were actually handed down in the state
of Texas in the late 1960s and early 1970s.
By what set of criteria should the effectiveness of the marijuana
laws be judged? There are at least five basic functions supposedly
served by the marijuana laws and their enforcement: (1) deterrence,
(2) rehabilitation, (3) public safety, (4) vengeance, and (5)
symbolic representation. The first three of these are instrumental
goalsmeasures can be set up to determine whether or not they
have in fact been achieved. The last two are symbolic or ideologicaland
beyond the reach of empirical tests. The deterrence function can
perhaps be measured by comparing the current popularity of marijuana
with that of alcohol. The fact that there are "only"
20 million or so marijuana users in comparison with 80 to 100
million drinkers of alcohol (these are overlapping groups, of
course) suggests that some degree of deterrence has in fact taken
place. But, this trend is swiftly breaking down. Various studies
indicate that the rate of increase in the number of college students
who have tried marijuana is approximately 1 percent every one
or two months. If the present pattern continues, it is highly
likely that by the 1980s marijuana will be the drug of choice
among the under-thirty segment of the American population. (Alcohol
is still the most popular drug among the young.) In this sense,
the deterrence aspect of the marijuana laws has been, and will
increasingly be, a failure.
No follow-up studies have been done of the impact of law enforcement
on arrested marijuana users. However, it is known that the number
arrested is a minuscule percentage of the total population of
users, and that users who are sent to jail are a small proportion
of all arrested users. Most marijuana arrest cases are either
dismissed, granted parole without a jail or prison sentence, released,
or acquitted. If law enforcement were pursued vigorously, and
if jail sentences were the norm, the deterrence and the rehabilitation
functions of the law could be tested properly, but the marijuana
laws have become similar to others that are fitfully, unequally,
and irrationally applied and enforced. Thus, given the relatively
small number of marijuana users who ever serve a sentence, the
rehabilitation function can be said to be almost completely null
The public safety issue is clearly contingent on deterrence. The
reasoning is that since the laws prevent millions of citizens
from using marijuana less damage is done to the body social, because
less of the drug is consumed and fewer people are being harmed.
The issue is also contingent on three other factors: (I) whether
marijuana is in fact dangerous and damaging; (2) the lack of substitution
of marijuana for other drugs, such as alcohol; and (3) the lack
of damage to society obtaining under the present situation. The
majority of the studies summarized in Chapters 2 and 3 suggest
that on the issue of the harmfulness of the drugsocial, psychiatric,
and medicalmarijuana appears at present to be no more damaging
than commonly accepted household substances. Moreover, nearly
all the studies claiming damage to moderate or heavy users have
not produced convincing evidence (see, for example, Kolansky and
Moore 1971; Campbell et al. 1971; Kew, Bersohn, and Siew 1969;
Talbott and Teague 1969; Isbell and Jasinski 1969). If such evidence
is to be found, the future awaits it; it has not been turned up
at this writing.
The question of marijuana substitution is also not easily resolved.
The anti-marijuana forces have argued that the fact that many
marijuana users also drink demonstrates that substitution does
not occurand that instead of only one problem we will have
two if the marijuana laws are relaxed. The pro-cannabis forces
argue that if marijuana were decriminalized, less alcohol and
more marijuana would be consumed, and since the medical damages
of alcohol considerably outweigh those of marijuana, less total
damage would occur to users and to society. The "anti"
argument is couched in the form of X plus Y (damage as a consequence
of alcohol use plus damage as a consequence of marijuana use);
X plus Y is clearly greater than X alone. The "pro"
side holds that what really occurs is X plus Y minus Z (the
damage prevented as a consequence of converts from alcohol
to marijuana). Actually, the fact that marijuana users also drink
alcohol does not invalidate the substitution thesis, since there
is no way of knowing how much they decrease their intake of alcohol
after smoking marijuana. It is possibleeven likelythat the
level of alcohol use among marijuana smokers is higher than that
of the general population and that users reduce their alcohol
consumption after smoking marijuana. The substitution thesis is
being tested by a number of physicians who are suggesting and
implementing marijuana use in their therapy as a cure for alcoholism
(see, for example, Mikuriya 1970, 1971). Dr. Jordan Scher suggests
that a large-scale study should be made on the feasibility of
a substitution program. Marijuana, Scher writes, "is not
very noxious physically," whereas alcohol, especially among
alcoholics, is associated with "frequently psychopathic and
violent, combative, and destructive features," is "responsible
for 50 percent of automobile and plane accidents, killing 50,000
and maiming and injuring about five times this many annually,
and for 50 percent of all arrests for whatever reason." Dr.
Scher writes that in regard to legalization, "I am not really
sure I am in favor of this idea," but "it may come about
in the not too distant future" (Scher 1971, p. 972).
In spite of all the arguments for and against the decriminalization
of marijuana, the fact remains that these "logical"
issues are probably of little consequence in the debate. Marijuana
is illegal because most of the public, as well as those in power,
are ideologically opposed to its use, because it is a symbol for
many other activities and beliefs that are also condemned, and
because there is a connection in the minds of many people between
marijuana use and belief in a politically and morally unconventional
ideology. The medical argument is added to the moral and
ideological sentiments to make the anti-marijuana stance appear
to be reasonable and rational. The eventual acceptance and decriminalization
of cannabis will come about as a consequence of the following
factors: (1) the rhetorical and forensic skills of the pro-marijuana
lobby in outpropagandizing their opponents; (2) their tactical,
organizational, and strategic abilities; (3) the conversion of
millions more Americans as a consequence of having tried the marijuana
experience; and (4) the gradual dying off of a generation with
a restrictive world view and the coming into power of a generation
that finds the marijuana experience ideologically acceptable.
Marijuana's "objective" properties will play a very
minor role in this process.
1. Documentation of this assertion would require
a book-length presentation. The scheme, however, agrees with Fort's.
There is at least one methodological difficulty, and that is how
much of the drug constitutes "heavy" use and over how
long a period of time. A "heavy" tobacco smoker might
consume forty or fifty cigarettes a day, whereas a heavy smoker
of marijuana might consume one or two joints a day and a heavy
user of LSD might trip twice a week or so at the most. Thus if
we were to accept as one possible definition of "heavy"
use that quantity consumed by the one in ten heaviest users, we
would be considering vastly different quantities of different
drugs consumed, and the patterns of use of each drug would influence
our findings. "Heavy" use of alcohol would be the quantity
drunk by the 10 percent most frequent drinkers of everyone who
has used alcohol in the past six monthsa definition that would
be approximately identical to all alcoholics. But obviously, this
would vary from nation to nation. Another definition might be
the quantity that is necessary for the user to be under the influence
of the drug all his waking hours, regardless of actual patterns
of use. There are serious problems with this definition too, such
as the fact that it would be difficult, if not impossible, for
users of some drugs to be high all the time, given the development
of tolerance No definition of "heavy" use covering all
drugs is completely satisfactory, and such a comparison is partly
a methodological problem.(back)
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