I’m a great believer in logic, data and fact and going where such things take you. Which is why this piece about a prescription heroin program in England run by a Doctor John Marks from the 80’s was such an eye opener to me:
He told them to stop using, and they argued back, telling him they needed it. ‘I found this a bit of a headache,’ he says, ‘and I had bigger fish to fry.’ He decided to shut the programme down.
But as he prepared to do this, there was a directive from Margaret Thatcher’s government. Every part of Britain had to show it had an anti-drugs strategy, it said, and conduct a cost-benefit analysis to show what worked. So Marks commissioned the academic Dr Russell Newcombe to look into it. He assumed Newcombe would come back and say these patients were like heroin addicts everywhere, at least in the cliché — unemployed and unemployable, criminal, with high levels of HIV and a high death rate.
Except the research found something very different. Newcombe found that none of the addicts had the HIV virus, even though Liverpool was a port city where you would expect it to be rife. Indeed, none of them had the usual problems found among addicts: overdoses, abscesses, disease. They mostly had regular jobs and led normal lives.
this seems completely counterintutive but Doctors were not surprised:
He discovered that all doctors agree that medically pure heroin, injected using clean needles, does not produce these problems. That’s why when people are routinely given heroin in hospitals — to treat the pain of a hip operation, for example — none of these problems occur. But under drug prohibition, the criminals who control our drug trade cut their drugs with whatever similar-looking powders they can find, so they can sell the heroin in more batches and make more cash.
That’s just capitalism 101, but here was the real surprise
And something nobody predicted took place. The number of heroin addicts in the area actually fell. Research published by Dr Marks in the Proceedings of the Royal College of Physicians of Edinburgh compared Widnes, which had a heroin clinic, to the very similar Liverpool borough of Bootle, which didn’t — and found Widnes had 12 times fewer addicts.
This is another batch of totally counteractive data, but again to why these results too place was again Capitalism 101.
But why would prescribing heroin to addicts mean that fewer people became addicts? Dr Russell Newcombe, working out of John Marks’s clinic, told me what he believes is the explanation. Imagine you are a street heroin addict. You have to raise a large sum of money every day for your habit: £100 a day for heroin at that time in the Wirral. How are you going to get it? You can rob. You can prostitute. But there is another way, and it’s a lot less unpleasant. You can buy your drugs, take what you need, and then cut the rest with talcum powder and sell it on to other people. But to do that, you need to persuade somebody else to take the drugs too. You need to become a salesman, promoting the experience.
So heroin under prohibition becomes, in effect, a pyramid-selling scheme. ‘Insurance companies would love to have salesmen like drug addicts’ — i.e. with that level of motivation — Dr Marks explains. Prescription kills the scheme. You don’t have to sell smack to get smack.
Eventually the program was discontinued and the people on it went to street drugs and an early death.
I’m going to want more data and frankly I don’t like the concept of ceding a portion of the population to an addiction which is plenty destructive to health in it own right, but given the situation in cities like Chicago and Baltimore which have become war zones over the drug trade a pilot program of this nature would seem worth a shot.
If I was Donald Trump as soon as I was re-elected I would bring Dr. Marks out of his exile in New Zealand and give him a free hand to try something like this in Chicago or Baltimore or even San Francisco. Given the state of these cities are in there would seem to be little to lose and a lot to gain, unless you are the drug cartels.