Rises in heroin and prescription painkiller abuse have languished lawmakers in Ohio and across the country in the past year, with some calling it an epidemic and others blaming it for an increase in crimes and deaths.
The issue has taken particular root in Ohio, where lawmakers have joined a chorus of advocates to prevent more drug abuse. On Thursday, Gov. John Kasich announced an initiative that encourages parents and schools to talk with their children about the dangers of drug abuse. In the Ohio legislature, lawmakers are hashing out harsher penalties and regulations in an attempt to prevent prescription painkiller and heroin abuse.
But many of these ideas, while genuine in their effort to address the problem, fall under the same framework of the war on drugs, a policy that has largely failed in reducing the demand or supply of illicit drugs over the past few decades.
Isaac Campos, a drug history professor at the University of Cincinnati and author of Home Grown: Marijuana and the Origins of Mexico’s War on Drugs, is highly critical of the war on drugs. He talked to CityBeat over the phone Friday. The interview, below, is edited for length and clarity.
CityBeat: What do you make of the ongoing discussion about an opiate epidemic?
Isaac Campos: From what I’ve read, there’s been a big increase in overdoses throughout the Midwest. The most interesting and plausible thing is that the Mexican distributors started distributing much higher-potency heroin as the crackdowns of cocaine and other things have had some effect. They moved into the heroin business and started distributing higher potency of heroin, which allows the people along the supply chain to make higher profits by cutting the heroin so they can get a lot more bang for their buck, basically. It also means users can get heroin for much cheaper than OxyContin or whatever they normally use. That’s No. 1.
No. 2 is they can not only get it cheaper, but it tends to be much higher potency than what they got before and maybe what they’re used to. That’s the No. 1 cause of heroin doses: the lack of knowledge about the potency of the particular drug that somebody’s taking. So if the potencies are substantially higher, you’re very likely to get tons of overdoses.
CB: The governor unveiled an initiative essentially asking parents and schools to more openly discuss drug use with students. And then the state legislature is considering strengthening rules on prescription painkillers. Based on what you know, do these kind of solutions work?
IC: The thing about it is clearly the problem is a mini-balloon effect that always happens. In this case, you put pressure on prescription opiates, and that has led to being harder to get them. They’ve also changed the formula to make OxyContin less pleasurable for users. And so they made it less desirable to take the stuff that people were taking before, so what people have done is started taking something else.
They’ve also made it more difficult for the drug distributors to make a profit with what they were distributing before, so they’ve changed to something else.
I think the idea that students don’t know that heroin is dangerous is utterly preposterous. … I suppose it’s a good thing to tell students — if they are actually going to tell them the truth — that these potencies are unpredictable and could kill them. But I imagine they might not tell them that; they might just tell them, “Heroin is dangerous for you.” You’d have to be living under a rock to not know that.
CB: As you alluded to, one study found cracking down on prescription painkillers might push people to use heroin. We’ve talked about the hydra effect before, in which one drug or dealer inevitably replaces a suppressed drug or dealer. Do you think this situation shows the same cause-and-effect?
IC: Absolutely. The hydra effect is usually used in respect to dealers, but we’ve seen this before back in the 1930s. A lot of people were smoking opium. It was the fashionable thing to do — and smoking opium really isn’t that bad for you — but there was a crackdown on that.
Also, when the Italian mafia took over the business, they decided to make it more profitable and squeeze out the smoking opium.
So all these smoking opium users switched to morphine or heroin, which are more dangerous and harder to predict. So you end up getting more deaths because the really dangerous thing about heroin is you just don’t know what the dosage is.
CB: Based on your research, what kind of solutions do you think would work? I know before we talked about Switzerland and the success they’ve had there with a maintenance-dose program.
IC: I always thought the much smarter course of action is to allow opiate addicts to have safe doses of opiates while trying to get them help to stop using opiates if that’s what they want to do. Most of these addicts I’m sure would love to stop using at one point, but maybe they’re not ready yet. But they would be much better off knowing what they’re taking while they’re not ready yet than overdosing on the street and buying from black-market dealers.
CB: Another aspect is how rarely officials go after the root of drug habits. It’s mostly more penalties, criminalization, imprisonment and attempts to cut supply. But there are huge socioeconomic problems surrounding drug use. What do you think they could be doing better in this regard?
IC: One of the big problems is people don’t realize drug problems are complex, so addiction is not simply a biological issue. The disease model does not explain what addiction really is. Addiction is a social, cultural and psychological problem; it’s not simply a disease of the brain.
I think that’s a big problem because that suggests the root of the problem is these drugs that hijack your brain, as some like to say, when really the problem is a much broader one that involves what’s going on in your life when you become a drug addict.
Of course, that’s way too complicated for politicians to utter. …
But addiction problems are real problems. People really do become addicted to drugs and it ends up being bad for their lives. But most of the bad things that happen to them are because the drugs are illegal. …
We can’t really expect the government to figure out all these issues. But we could hope that the government would have a more rational policy, like, for example, what’s going on in Colorado and Washington, where they’re dealing with marijuana in a more rational way.
CB: Switching subjects a bit, in the past year, Cincinnati saw a rise in local homicides and gun violence. Police say gang-related activity and drug trafficking is to blame. We’ve talked about this before, but do you think decriminalization or legalization could help put an end to this kind of violence?
IC: Oh, yeah. I don’t know what percent of shootings and that sort of thing in Cincinnati are related to drugs, but they’re related to illicit drugs, not people taking drugs.
Changing policy would have a big impact. You wouldn’t have these people fighting out this black-market turf over these drugs that are incredibly profitable because they’re illegal.
It would also have a huge effect in not sending so many people to prison, which are essentially schools of crime that totally screw people up psychologically and are places where you’re breeding more violence.
CB: Do you think that creates a vicious cycle in which people are moving in and out of prisons?
IC: Absolutely. And not only the people who are actually going in and out of prison, but all the kids of the parents who are in prison who are growing out without their parents. I think it has a massive effect. There’s so many pernicious effects to this policy. It’s incredible.
CB: Last time you and I talked about this, I mentioned that some war on drug supporters say gangs would just resort to selling other contraband if drugs were legalized. But you said, “How much easier is it to move two kilos of cocaine, which are worth $50,000 or so, across the U.S. border than it is to move $50,000 worth of assault rifles?” That stuck with me. Could you elaborate on that?
IC: There’s no doubt that even if we legalized all drugs tomorrow, you’d still have these big criminal organizations that have been making a lot of money off them. But over the long-term — or medium- or short-term, even — they’d start feeling a really strong pinch from losing all this drug revenue. They’ll still try to make money, but they’re not going to sustain their operations without the incredible revenue stream that they’re getting from drugs. Ultimately, all those organization will be weakened.
I mean, they’re so strong today because they can afford to arm themselves like an army and they can afford the kind of technology to thwart the high technology being directed at them. …
Right now, they’re legitimate security threats to states. But they would never be that on just arms running, prostitution or that sort of thing.
