Legalize cocaine? -- A prescription for disaster! Crack Madness: From the left and the right, the movement to decriminalize narcotics is dead wrong.

The Argument

March 03, 1996|By PAUL R. McHUGH | PAUL R. McHUGH,SPECIAL TO THE SUN

An epidemic -- addiction to "crack" cocaine -- is sweeping our city. Baltimore has close to 50,000 cocaine addicts. At Johns Hopkins Hospital we are treating hundreds this very day. My colleagues and I know cocaine addiction as a plague, shattering lives and provoking deadly violence.

And yet theorists from the left and right of the political spectrum argue that the "war on drugs" is a mistake. These traditional adversaries get to identical opinions by twisting observations to fit a social theory and block the evolution of a coherent, systematic public policy. Examples of this pernicious capacity of theory are, from the left, this book titled "Violence" by James Gilligan, M.D. (G.P. Putnam's Sons. 304 pages. $27.50) and, from the right, the Feb. 12 edition of National Review with articles by such writers as William F. Buckley and Thomas Szasz, M.D.

Most doctors facing an emergency avoid putting theory before facts. Consider three facts and how these authors deal with them.

Fact One: Drugs differ - much as microbes differ. Corollary: We should manage drugs according to the dangers tied to their differences, just as we quarantine diphtheria but not flu viruses.

Those who despair of the war on drugs point to the failure of Prohibition. Yet cocaine is unlike alcohol. Within most populations, 15 to 20 people consume alcohol for every person addicted to it. For every three or four people trying "crack" cocaine, one is addicted. This is a big difference. It prompts doctors to say "never try cocaine." Its addiction liability is too high.

Other stark differences distinguish cocaine from alcohol. Repeated doses of cocaine do not slow consumption. One dose immediately encourages another until either the supply of cocaine is exhausted or the addict is broke. All his energies can be drawn into seeking the drug, and he will do most anything for it. If you loved chattel slavery, you'll adore cocaine.

Cocaine speeds rather than slows the mind. It provokes energy and boldness to steal for more. As cocaine accumulates, paranoid delusions emerge, provoking addicts to assault others who, they imagine, are threatening them. Great energy with a paranoid flavor is a recipe for disaster.

Finally, cocaine is inexpensive. Remember, the stuff grows on trees. To undercut the illegal suppliers and their lawless markets, "crack" would have to sell at 75 cents per pellet. Do we really want a highly addictive substance, provocative of paranoia, to be as cheap as lunch money for 12-year-olds? Not me.

As for our authors, Dr. Gilligan knows addictive drugs differ but sees only bad faith and hypocrisy in legal distinctions regulating them. The National Review authors make no attempt to differentiate addictions. For all one can tell, they might be writing about chocoholics.

Fact Two: Violent acts emerge within a context of provocations - some accessible such as drug intoxication and firearms, some more intractable such as poverty. Corollary: Work on the accessible provocations promptly and on the more intractable factors steadily.

Flexing upward

Violence - especially homicides of young men between the ages of 17 and 34 - escalated after 1985. By 1993, homicides for males aged 15-19 had increased 154% (from 13 per 100,000 to 33 per 100,000 overall and to 250 per 100,000 for African-American males).

What happened in 1985? The Center for Communicable diseases' (CDC) report published October 14, 1994, simply rounded up the usual suspects - guns in the market place, poverty, inadequate education, family instability. No mention that crack" - "free base" cocaine - first appeared in 1985 to intensify cocaine's potency through smoking.

If such an increase in deaths occurred with fever, rather than violence, the CDC would have investigators crawling all over town. Long before five years had passed, it would report: "A group of our people, weakened by poverty, joblessness, and abandonment have been attacked by a new and vicious agent to which these conditions render them vulnerable. This agent, potentially lethal to anyone contacting it, must be routed out, its victims treated, its transmission stopped, and its vectors

eliminated."

But not this time. The CDC failed to notice the new agent but inveighed against "poverty, unemployment, undereducation and social acceptance of violence" - problems with us since Adam left Eden; none new in 1985.

Dr. Gilligan is not helpful. He holds the class war responsible for violence. The upper class, he thinks, tries to "distract attention from [this war] by ... such policies as criminalizing drugs that have no demonstrable direct [pharmacological] effect on violent behavior [such as cocaine] thus providing an enormous ... subsidy [to] organized crime groups ... [since] the smaller the supply, the higher the price."

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