Another Tiny Glimpse into Our Crazy War on Drugs

800px-Cocaine_structure

Representative Trey Radel (R-FL) pleaded guilty this morning to cocaine possession. As Radel recently voted to drug test all food stamp recipients, the temptation is strong simply to smile and declare that it couldn’t have happened to a nicer guy.

That would be wrong, not only because tu quoque is wrong, but because two wrongs don’t make a right.

I’ve said it before, and I will say it again: One of the most accurate class status markers in America is whether or not a superior can demand that you pee in a cup. Drug tests are for little people. So are strip searches. So are involuntary colonoscopies, if and when it comes to that.

These measures are not, of course, for members of the House of Representatives, who are busted in the nicest possible way, in unnamed but probably quite posh restaurants in Dupont Circle. There are certainly quite a few.

Radel was sentenced to one year of probation for possession of 3.5 grams of cocaine. This places him on the low end of the sentencing guidelines, which suggest that a crime of approximately this magnitude should receive “zero to twenty years.”

Ponder that for a moment. Our law contemplates, and would not frown upon, someone quite like the Honorable Mr. Radel receiving twenty years behind bars. Yes, there should be some room for discretion in any sentencing regime. But this much? And deployed just so? One is tempted to suggest that the crafters of the laws be held to higher standards, and at any rate certainly not to lower. But again with the two wrongs not making a right.

If you want my opinion – and you probably don’t – no one should go to prison for cocaine. There are a variety of ways that we could achieve this; the most plausible may be the prescription model. Don’t laugh. We’ve already done it with amphetamines, which are marketed to the respectable classes legally, by way of their entirely compliant doctors, under the name Adderall (Motto: It’s. Just. Speed.). Calling it “Adderall” removes the stigma, I suppose, and it keeps ignorant parents from worrying about their suspiciously functional progeny.

Now. We can talk about whether doctors should be so compliant, and we can talk about the problems of abuse once the prescription is written. And we should definitely have those conversations. But the fact remains that for good old-fashioned speed, there just isn’t much of a crime syndicate involved in pushing the stuff. Contrast this with the methylated stuff, and you begin to get an idea of how civilizing the whole process can be. Civilization, I suggest, is the largest part of the difference.

Prescriptionizing cocaine might be a harder sell, but then again, maybe not. Cocaine is a Schedule II drug, just like amphetamine (Motto: It’s. Just. Adderall.) – so the legality, if not the optics, should work out okay. Raw coca is grocery-store legal in many parts of South America. Coming up with a plausible therapeutic use might be a wee bit harder, but then again, isn’t harm reduction itself a good enough goal?

The longer one looks at it, the more it appears that drugs aren’t something that one does; drugs are a thing we do to each other – a regime of discipline that we inflict, or not, not based on harm, or on prudence, or on costs and benefits. But based, for all I can tell, on who holds the power. Things ought not to be this way, and they don’t have to be this way, but they are.

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46 thoughts on “Another Tiny Glimpse into Our Crazy War on Drugs

  1. That would be wrong, not only because tu quoque is wrong, but because two wrongs don’t make a right.

    Two wrongs don’t make a right, but a stupid policy whose pain is not felt by policy makers is a stupid policy that’s here to stay. A supid policy that inflicts its pain on everybody is a problem that might just solve itself. I remember one anti drug war poster noting that while asset seizure laws are crazy and evil, they do give the police an incentive to set their sights on a class of people who have money and political sway. Arrest a few senators’ kids and seize their BMWs and the craziness of the policy might start to dawn on them.

    Then again, maybe I’m not cynical enough. When management reshuffled our IT and put all of our critical servers in another state with a crappy uplink to save money, the engineering team took a productivity hit. I talked to the head of IT and said, “Well, at least the slowdown affects email too. Once starts to notice that, the problem will probably be fixed.” He replied, “You haven’t been doing this long enough. They’ll probably just have me change the QoS settings so his email gets priority over the engineering data.”

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    • Here is an issue and I don’t know what the answer is. My experience with crim law does not extend past crim pro and crim law in law school.

      Suppose he was sentenced to 5 years for his crime. What are the chances of it being thrown out on appeal? I think high but the appeals court would need to find a really interesting way to do it because it is a perfectly legal sentence. I’m not even sure how they would do it but it would happen.

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  2. Think Progress did note that the Congressman did support ending mandatory minimums for drug possession and made hints that he considers the drug war a waste of time and money.

    On the other hand, he also said he did not think marijuana should be decriminalized or legalized and this just reveals liberal biases of what we think the Tea Party stands for.

    Mainly he is being mocked for being a self-described “hip-hop conservative.”

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    • How does one square the circle and simultaneously hold that the drug war is a waste of time and money but at the same time insist that marijuana should be dricriminalized or legalized?

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      • I don’t think this one is too hard or necessarily wrong. You can think that sending drug addicts to jail is an inhumane policy but still think narcotics do a lot of harm and should not be legal. You can favor treatment instead of punishment, etc.

        I don’t think heroin should be legal but I don’t want to send heroin addicts to jail. I’m iffy on whether cocaine should be legal or not.

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      • A lot of people convicted of DWI are sentenced to treatment and community service rather than jail time in New York. Getting convicted DWI offenders to go through treatment is not easy. Many of them attempt to avoid their proscribed treatment. I imagine that proscribing treatment for drug convictions rather than jail time will have similar problems. Treatment programs for addictions work best when they are voluntary choices.

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    • Heroin was developed and marketed by Bayer as a non-addictive alternative to Morphine because early 20th century housewives had a bit of a problem with the drug.*

      So not everything works out as intended.

      *See Long Day’s Journey Into Night by Eugene O’Neill for a literary example.

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      • Eh, it wasn’t wishful thinking, it was ignorance. They were trying to produce codeine from morphine because codeine is less addictive. Instead, they got heroin, which they recognized as significantly more potent than straight morphine, but they didn’t understand that when it metabolizes, it becomes morphine, and because of the way it acts it actually gets morphine into your system faster than just morphine alone, which makes it even more addictive (speed of action is more important than potency for addiction). So thinking they had not necessarily codeine, but something different from morphine, they basically just assumed it would act like codeine and be less addictive. They just didn’t know better. It only took them like 15 years to figure this out (with more than a decade of people taking heroin for a cough!).

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      • – I reject your historically- and biochemically-accurate account of heroin’s genesis and fall from grace, because it does not comport with my view of Big Pharma as evil pill-pushing money-grubbers, rather than people who sometimes make harmful errors whilst attempting to help. ;-)

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      • It wouldn’t have been heroin, she was a bit too early for that. Heroin wasn’t in commercial production until the early 20th century.

        Wikipedia says it was a “sleeping draught” and the hyperlink goes to choral hydrate.

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  3. Zero to twenty years imprisonment is pretty substantial discretion on the part of the trial judge, IMO. Of course, there are other factors that go in to the sentencing guidelines so the ultimate discretion will be narrowed. But Congressman Radel, being, (to put a fine point on it) white and of at least middle-class economic means, will wind up getting a minimal sentence.

    Hell, he might even get re-elected, particularly given that this publicity comes at almost exactly the midpoint of the election cycle, when voters are paying the least amount of the already minimal attention they pay to electing representatives to our lower house.

    As to the rest of your point, I’m part of the choir you’re preaching to about moving towards decriminalization. The war on (some) drugs (used by some people) has so much to criticize and so little to recommend it from a public policy perspective that I’ve got to imagine the only thing keeping it going is massive political inertia.

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    • At this point the anti-drug movement is like the Dry movement during late Prohibition. They are so inherently welded to their idea that they are absolutely blind to all the problems and hypocricies surrounding the implementation and they refuse to bend.

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  4. Yeah I’m with everyone else. Honestly is there even a constituency at the League or in the commentariate that supports the war on drugs or even is largely sympathetic to it?

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  5. I agree with the main thrust of your argument, so perhaps it would be best to just pipe down. But there are some things you say that niggle a bit.

    1) One of the most accurate class status markers in America is whether or not a superior can demand that you pee in a cup.

    This is not entirely true. When I joined the medical staff of one of the finest medical centers in New York City, I was made to pee in a cup as a necessary step in the employment process. I had already completed three years on the medical staff of another of New York City’s finest medical centers (which didn’t make me pee in a cup, but wouldn’t have been unusual if it had).

    Now I don’t know if they make, say, the incoming head of surgical oncology pee into a cup. Probably not, would be my guess. But, even though I was a mere fellow in adolescent medicine, I don’t know that being made to pee in a cup accurately marked my class.

    2) We’ve already done it with amphetamines, which are marketed to the respectable classes legally, by way of their entirely compliant doctors, under the name Adderall (Motto: It’s. Just. Speed.).

    That’s just silly, Jason. We prescribe Adderall (more often than I think is warranted, I’ll admit) because it has verifiable medical benefits in the treatment was a well-defined condition. We don’t prescribe it because it gets kids high. We prescribe it because it can demonstrably improve the ability of certain children to concentrate in class.

    Cocaine is actually prescribed in very, very limited clinical situations. (We had a talk not so long ago by a lovely ENT provider from one of our affiliated hospitals, and he went into amusing detail about the various steps necessary to extract it from the vault where it’s kept.) If there were broader clinical applications, perhaps it would be prescribed more despite its incredibly potent addiction potential. Lord knows we dole out enough opiates in my profession (a post about which I still have languishing somewhere in drafts).

    But equating Adderall and cocaine is specious. One treats a common mental health problem and the other does not. Describing our prescription of the former as a kind of “compliance” is, if not entirely inaccurate in all cases, a gross overstatement.

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    • I’m aware that cocaine isn’t handed out nearly as freely as Adderall. It’s used as a topical anesthetic, yes? And certainly not for mood disorders: That’s one of the reasons why it’ll be much more difficult to move to a prescription model for cocaine.

      But I will definitely push back on Adderall being used for a well-defined condition. My understanding is that just about everyone knows how to present to their doctor the symptoms of this well-defined condition. That is, if they want to get some Adderall. And if your current doctor won’t do it, ask some of your especially thin, focused, and peppy-seeming friends. They will be happy to recommend.

      All of this is dishonest and rather noxious to me. But it is nothing if not civilized, when compared to the atrocities of the crystal meth market. So much the better, I say: Better pervasive lying than pervasive theft and murder.

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      • Look, man, if this is my cue to go to bat for prescription-happy doctors who are all too ready to scribble out a slip for Concerta, forget it. I will readily concede that ADHD medications are over-prescribed and the condition over-diagnosed.

        That does not change the fact that it is a condition, for which stimulant medication is the treatment of choice. We don’t prescribe Adderall or its ilk for the purposes of giving kids their jollies (and, for the record, the provider in our office who manages most of our patients with ADHD is notably loath to dispense controlled substances under the circumstances you limn in your comment). There really are kids with ADHD (a great many of them far too young to dissemble for the sake of secondary gain) and medications are prescribed to treat it.

        “I want to get high” may be more honest than some of the drug-seeking histories I’ve been presented with, it’s true. But since “not high” is not a recognized medical problem, conflating a prescription for Ritalin with one for an eight-ball is not sound.

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      • And what I’m saying is that there are two sides to this coin.

        What looks like — and actually is — a problem for your profession turns out to be a relative blessing for law enforcement, for users of amphetamines, and for innocent bystanders.

        None of that is to deny that it’s a problem in your profession.

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      • Am I OK with the notion of some kind of para-professional medical provider doling out prescriptions for people who are frankly seeking a high? Well, considering methadone clinics and the problem of over-prescription already discussed above, that prospect doesn’t really trouble my sleep much. (I’ll leave it to you and Hanley to hash out whether they would need to be licensed.)

        I am merely stipulating that treatment for a diagnosed medical condition, no matter how thin you may find the tissue of lies wrapped around it, is not the same thing as giving people a fix outright. I am very tetchy about the former, and I imagine I would be far from alone (though doubtless not utterly so) in starkly disavowing the latter, even supposing legal sanction.

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    • I don’t know if they make, say, the incoming head of surgical oncology pee into a cup. Probably not, would be my guess.

      I would guess the opposite. I’m about as anti-drug-war as they come, though I am willing to compromise to keep some of the harder drugs illegal, both as a matter of personal uncertainty (I don’t believe too many people would be so idiotic as to run out and pick up heroin addictions if heroin were legal…but I could be wrong) and as a matter of political pragmatism (many people who might bend on legalizing soft drugs won’t ever do so on hard ones, so it behooves me to settle for a compromise on the part we can all mostly agree on).

      That said, any profession which literally holds the lives of others in their hands may justifiably be held to a higher standard, not just morally, but as a simple matter of legal liability. If I were the hospital, and a patient dies and it later comes out the attending physician had a long-standing addiction that may have impaired his judgement or dexterity, that opens me up to a massive lawsuit.

      So what I am saying is, yeah, I would think they would make the guy pee in a cup. As a potential patient I HOPE they do, anyway.

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      • It occurs to me I may be misunderstanding this. Does the head of surgical oncology actually see patients or make care decisions? Or is he more of a manager of the doctors under him?

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      • Presumably the head of surgical oncology would be treating patients, yes.

        I picked that position as a random example of a high-ranking physician who may, theoretically, have some of the more tedious or invasive aspects of joining the hospital staff waived. I really don’t know if he/she would have to jump through the same hoops as I did as a new member of the house staff. It wouldn’t surprise me if some of that stuff went by the wayside as you moved up the administrative chain of command.

        But then, maybe not. And for the reasons you state, it wouldn’t really ruffle my feathers if not.

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      • Thanks. The distinction I was trying to make was that as you move up the chain of command, some stuff may go by the wayside not so much because of “class/hierarchy” per se, but more due to “distance from the scalpel”.

        I definitely care if my cab driver’s drunk. The taxi dispatcher, not so much.

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      • It isn’t that I think people will rush out to do heroin or meth or coke* but we know that harder drugs have serious damaging effects that are not present in marijuana.

        *Though we could be wrong. I am reading the Goldfinch by Donna Tartt and enjoying it very much. There was a section where the young protagonist and his friend spend most of 14-15 doing a lot of drinking and drugs. I expressed credulity at the amount and my girlfriend told me I was being a naive. She also tells me about people in college who were doing lots of coke and heroin. I didn’t know these people very well but there was one dorm at my college that had a section known as “coke alley” since the 1970s.

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      • When I had to take a urine test at Global Conglomerate, I was told that it was because there are government contracts out there that mandate “drug-free workforce”… and that applies to subs. And sub-subs. And sub-sub-subs.

        Apparently, there are contacts out there that you are not eligible for if you do not make your janitors pee in a cup.

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      • – we probably don’t need to go around this mulberry bush too much, but for even most of the harder drugs like coke and heroin, it’s my understanding that the ill physical effects are primarily a result of drug impurities and varying/unknown dose potency, both results of the black market.

        If even heroin and coke are pure, and taken in regular/known doses (even repeatedly over time), they are reasonably safe (with the caveats that one can certainly become addicted to them, which is unpleasant, and someone predisposed to heart trouble shouldn’t be taking stims etc.; and as always, labeling or dosage mistakes can happen, or people can be stupid)

        I have been assured repeatedly that more concentrated forms of hard drugs (say, meth from speed; crack from coke; etc.) are qualitatively different, and definitely inherently, definitionally physically harmful (I think there’s no question that they are more addictive).

        I am somewhat skeptical – every new-ish drug gets its own moral panic – but am willing to concede that others might be right and I might be wrong (and certainly have no intention of personally verifying).

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      • I agree with Glyph on the value of hiring those that are not actively using drugs. As an employer, I would require it as a term of initial employment.

        I will even go one step further. I would rather give my relief aid to those not using drugs as well. Not that I would build it into a government program, but I believe an aid agency which could prove non drug use would get more of my money than one which could not. One which could get those with drug habits and successfully work with them to be drug free might even get more of my money.

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      • I agree with Glyph on the value of hiring those that are not actively using drugs.

        Er, that’s not EXACTLY what I said (also, “actively using” is an ambiguous term. Is a weekend stoner an “active user”when Monday rolls around? After all, THC sticks around for 30 days).

        I simply said that in some jobs it makes sense to me for employers to vet for intoxicants. Doctors, pilots, bus drivers, that sort of thing.

        Kwik-E-Mart clerks, maybe not.

        Congresspersons, an open question.

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      • I’ve never had to pee in a cup, and I’d refuse to take a job where that was required.

        I’ve had two jobs that required a drug test. And it was humiliating because, well, there’s a part of my anatomy that gets bashful when it comes to performing on demand. The first job, it must’ve taken hours of sitting in the office, occasionally going in, with the person assigned to stand outside knocking after about 5 minutes to see if I was okay. The second job, I was able to do it more quickly and painlessly.

        I guess my point is, you might never take such a job, but some people who really need the work might do it because they don’t have a lot of other choices. Not that I necessarily lacked choices, but I really needed the jobs and those were the ones immediately on offer.

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  6. Though both reason and Balko (and others) have long documented the ‘war on doctors’ for being, in the State’s opinion, too loose with the prescription pad.

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