Heroin maintenance programs have been used in some European countries (notably, Switzerland and Great Britain) with relative success for many years. The gist of these programs is providing an addict with a dose of pure heroin and a supervised setting in which to inject it. But this post is not about the relative merits or drawbacks of heroin maintenance, but rather about an ethical concern regarding heroin maintenance best expressed by Robert J. MacCoun and Peter Reuter in their wonderful RAND study, Drug War Heresies. I will quote the passage in full:

Feasibility [of heroin maintenance programs] is not desirability. Heroin maintenance has a contradiction at its heart. Having chosen to prohibit the drug, society then makes an exception for those who cause sufficient damage, to themselves and to society, as a consequence of their violation of the prohibition. Society’s decision is setting the damage level that entitles a user to access. It can require that an addict cause a lot of damage to gain access, which is expensive (in terms of crime and health risks) and inhumane. However, if it sets the barrier low, then access to heroin becomes too easy, and the basic prohibition is substantially weakened. That contradiction alone does not make maintenance bad public policy, but it does raise a fundamental ethical concern.

Obviously, this is not the only precedent when our society ultimately rewards an individual for a persistent violation of its laws. Take illegal immigration: migrants who are enterprising enough to overcome the obstacles (physical and otherwise) that the United States erects around its borders are often able to naturalize. Illegal immigration is a perfect example of an extra-legal status-quo: illegal aliens are tolerated because the U.S. is addicted to cheap labor.

Similarly, heroin maintenance programs involve a trade-off: despite general prohibition, some addicts who are “persistent in their addiction” are allowed access to heroin. In return, the society receives the aggregate benefits of lower health costs (no more diluted black-market heroin, no needle-sharing, not as much overdosing), lower crime-fighting costs (addict doesn’t have to resort to crime to finance his habit at black market prices) and a possibility of social re-integration of an addict back into the community.

But wait! Despite the benefits of the program, the ethical dilemma is still there! But only until one realizes that an exception to the rule does not always involve a compromise with ethics. This particular case involves a prohibition regime that is largely detrimental both to addicts and to the society at large. Any hole punched in this regime that moves it towards harm reduction and more sensible drug policy can be considered ethically suspect only on a purely logically-abstract level, insofar as it represents a contradiction with the existing policies.

Another, fairly straightforward way of removing the contradiction would be either shutting down heroin maintenance programs (not a correct choice, in my humble opinion) or legalizing heroin. Of course, the problem with that solution (in addition to the obvious political ones) is that nobody is really sure what’s going to happen: some say that if we legalize, we just might end up with a much greater number of addicts. It is a valid argument – there is no firm basis on which one could confidently argue that a spike in addiction won’t happen. On a theoretical level, one trick to avoiding mass heroin addiction in a legalization regime is a fine line between making access to heroin hard enough so that only the determined seekers of the drug would bother, but not making it so hard that it is easier or cheaper to obtain it in the black market. Drawing that fine line would not be easy; however, we did it with illegal immigration: the amalgam of border patrols, fences, regulations and penalties makes sure that we are not flooded with migrants; however the restrictions are not draconian enough to prevent our economy from getting its regular injection of cheap workforce.

An article in USA Today called “A better way to deal with Afghanistan’s poppy crop (As heroin trade grows, a Nixon-era plan in Turkey provides a model)” talks about different ways of dealing with Afghanistan’s poppy crop, which is estimated to be the source of 90% of the world’s heroin supply. The article sensibly disfavors spraying the crops with herbicide, welcoming

“…pilot projects under which the morphine factories would be set up in Afghan villages and monitored by village elders and outside groups. The factories could provide employment and income for the villages – and plow some profits into alternative industries.”

(Like I wrote in one of the previous posts, unless you are willing to legalize the stuff, buy it from farmers at black market prices. Of course, it is a temporary solution, since farmers will be induced to grow more of the stuff since it is so lucrative and there is a ready buyer. But – I digress.)

The article generally gets the situation right; however, what really caught my attention was the comparison of the current initiatives to Nixon-era crusade against the Turkey opium. The article writes about

“…a program that largely eliminated heroin production in Turkey in the 1970s with the support of President Nixon and Congress.

Like the Bush administration in Afghanistan, Nixon at first insisted on spraying the poppy fields. But Turkish leaders refused because of a revolt from their farmers. The compromise included guaranteed markets for the morphine. Within a few years, Turkey was no longer the premier source for heroin.

Boy, they really got this one wrong. First of all, according to the CIA estimates, even before the Nixon campaign, Turkey produced only from 3 to 8 percent of the world’s illicit opium and nobody was sure what percentage of that, if any, reached the United States (most was destined for European markets). Secondly, the Nixon crusade against Turkish poppy was reflective of the “administration’s determination to achieve quickly some dramatic breakthrough on the opium front.” So, the Nixon quest was largely politically, not pragmatically motivated – Turkey was chosen because as a NATO member it was more susceptible to U.S. pressure, unlike, for example, India, Laos or Burma, all of which produced substantially more poppy than Turkey.

So, to summarize – the USA Today article correctly treats some of the issues behind Afghani poppy cultivation, but gets the history totally wrong by comparing current programs to Nixon’s misguided attempt to rack up election points. For a brief, but nevertheless informative and fascinating story about Nixon’s fight against Turkish poppy, see:

Agency of Fear: The War of the Poppies

– a short chapter in Edward Jay Epstein’s Agency of Fear: Opiates and Political Power in America.

Originally written on May 21, 2007

I got reminded of this ubiquitous mantra that was all over TV a few years ago when I read the following:

“Profits from Afghanistan’s thriving poppy fields are increasingly flowing to Taliban fighters, leading U.S. and NATO officials to conclude that the counterinsurgency mission must now include stepped-up anti-drug efforts.”

Source: CNN: Poppy profits fuel Taliban

“The traffic in drugs finances the works of terror,” said George W. And – he is right. Trading in illicit drugs is a lucrative business, and, considering that drugs are a black market commodity, a logical choice for those who want to stay under the radar. The thing is, trading in any black market commodity is acceptable as a clandestine financing scheme.

It’s funny how the leading U.S. and NATO officials still readily conclude that stepping up anti-drug efforts will help combat drug profits. Do they really think that it will work this time? I actually know a way that will pull the financial rug out from under the Taliban: buy all of the Afghani poppy supply at current black market prices (I am pretty sure it’s gonna come out cheaper than waging another unsuccessful anti-drug campaign) or, better yet – legalize poppy. Removing illicit drugs from the black market economy will immediately financially undermine most, if not all, of terrorist networks, organized crime entities and cartels.

Not like that’s gonna happen in the foreseeable future. For now, it seems like the way to combat illicit drugs and terror link is by throwing more money and resources at massive interdiction campaigns that are doomed to fail right from the start, or by engaging in this sort of rhetoric:

“‘DEA’s Target America is the first exhibit that makes the connection between illegal drug trafficking and terrorism, leaving no doubt that drug abuse can not be viewed as a victimless crime.’ …. said Administrator Hutchinson.”

Source: DEA: DEA AND GIULIANI OPEN NATIONAL MUSEUM EXHIBIT ON DRUGS AND TERRORISM

Right. Lets place the blame for terrorism squarely upon the shoulders of a drug user/abuser/consumer. After all, (s)he should have known where the money that pay for drugs might go to. According to Hutchinson, that makes a poor drug user culpable. According to my old Torts hornbook, there might be a small problem with proximate causation in that scenario. I’ll side with my hornbook on this one, because otherwise I could be blamed for slavery in Africa, just because I drink my cocoa in the morning.