Chasing the Scream: The First and Last Days of the War on Drugs

Hari dedicates much of this chapter to the story of Bud Osborn, a Vancouver man who led the “first mass rebellion by drug addicts against the system built by Harry Anslinger” (188). Osborn had a traumatic childhood, which included several suicide attempts. As an adult, he became an addict, but in the 1990s, he became an activist and community organizer because so many of his friends were dying of overdoses in the Downtown Eastside area of Vancouver. Osborn knew that heroin overdoses occur for two primary reasons under the system of prohibition: First, a user has no way to know the purity of the heroin they buy on the street; and second, users must administer the drug secretly to prevent arrest, so no one is there when an overdose occurs. With fellow addicts, Osborn formed the Vancouver Area Network of Drug Users (VANDU), and they began taking actions that immediately saved lives. In one VANDU protest, the group placed thousands of wooden crosses in a park to represent all the overdose deaths there over four years. Hari explains that “these activists believed that if people knew—if they could see the addicts as human—they would care” (198).

Hari argues that these addicts could not have taken such a stance anywhere else because they might have lost their jobs and possibly their housing, but the Portland Hotel Society—created to house addicts—gave them “safe ground on which to stand” (198). VANDU was successful in many ways. Unfortunately, Vancouver’s mayor was a fiscal conservative who continued to reject all measures to help save addicts’ lives. However, after meeting with VANDU members and hearing the facts, the mayor’s opinions changed, and he came to view the drug war as “the ultimate big government program—a criminal waste of money” (202). He even became a proponent of legalizing marijuana. In 2003, Vancouver became the first city in North America to feature a legal supervised injection site, named InSite. Because of VANDU’s work and the opening of InSite, the city’s medical health officials announced in 2012 that the average life expectancy in the Downtown Eastside area had risen by 10 years. Hari argues that “to find a rise in life expectancy this drastic, you’d have to look to the end of wars—which is what this is” (203). 

In this chapter, Hari travels to both countries in which he is a citizen, Britain and Switzerland, to examine two examples of alternatives to the drug war. First, he covers the story of John Marks, a psychologist in the North of England who operated a legal heroin clinic in the 1980s—until the country’s policy changed under pressure from the American government in the early 1990s. Although the US banned doctors from prescribing heroin in 1930s, Britain continued to allow doctors to prescribe it. Hari points out that because of this policy, the number of addicts in Britain did not swell, as it had in the US; crime dropped; and the negative health effects of street heroin began to disappear. Marks realized that that his clinic was “working wonders by bypassing criminality and providing safer forms of the drug” (210). In addition, Marks saw that heroin usage in his region fell. One doctor attributed this to addicts no longer having to raise money for their fix of street heroin and, in turn, no longer selling a portion of that street heroin to other users. Hari posits that under prohibition, heroin “becomes, in effect, a pyramid selling scheme” (213).

Next, Hari covers Switzerland’s reforms to drug prohibition. He describes Switzerland in the 1980s and 1990s as a nation with a severe heroin and HIV epidemic. In 1999, Ruth Dreifuss became the first Jewish and first female president of Switzerland and immediately found a loophole in Swiss law that allowed heroin to be dispensed to citizens as part of an experiment. Her large experiment let addicts who needed more than methadone receive heroin if they met three conditions: They were of legal age, they had attempted at least two other treatment programs, and they forfeited their driver’s license. Hari explains that Dreifuss’ program was “built around helping the patients to slowly rebuild, to get therapy, to get a home, and to get a job” (220). One of the primary arguments against the program was that addicts will always accelerate their consumption if a drug is made available. The Swiss found that this was true for a brief time. However, most addicts stabilized their dose and slowly reduced their use over time.

Although the numbers of HIV infections and addicts had dropped drastically, the Swiss also came under pressure from the US to abandon the program—but even conservative Swiss voters decided to continue it. Hari notes the seeming contradiction to the Swiss model in the US and the “iron law of prohibition.” Experts agree that the prescription drug crisis in the US resulted from something close to what the Swiss had done with heroin—doctors prescribing high-powered opiates to patients too freely. Many problems involving crime and overdose deaths in the American opiate crisis occur because the drugs are eventually cut off after a patient becomes addicted, not because they were prescribed. Hari also explains that the reason so many Americans who begin with prescribed opiates end up moving to heroin is the iron law of prohibition. This law states that prohibited substances increase in potency as they become less available. Hari points to what occurred during alcohol prohibition, when Americans switched from preferring beer to hard liquor, as an example: “[P]eople responded to a change in the law by shifting from a milder drink to a stronger drink” (230). 

Hari visits the world’s first country to decriminalize all drug usage in this chapter, and he interviews the man responsible for the country’s revolutionary drug law reform. The country was Portugal, which in 2001 made it legal to possess as much as a 10-day supply of any drug, and the man responsible was João Goulão, a doctor who headed the 1999 commission to tackle the country’s drug problem. Hari explains that “Portugal had, by the 1980s, one of the worst heroin addiction problems in the world” (236). According to Goulão, “heroin use started among marginalized people but then it came to middle classes and even high classes” (237). Goulão knew that only a small percentage of users were addicts, but even that number was so large that nearly everyone knew an addict. The committee’s decision was based on the belief that addicts should be treated as “full members of society” (238-239) and that the state’s only interest should be to encourage addicts to seek treatment.

The heart of this reform was not only to stop treating addicts as criminals and getting treatment for those who were willing, but also to offer them a better life. To help addicts find decent jobs, anyone who hired a recovering addict received tax breaks and incentives. Hari argues that “prohibition is based on externally preventing people from using drugs through fear and force; the Portuguese alternative is based on the belief that drugs aren’t going away, so you need instead to give people the internal tools—the confidence, the knowledge, the support—to make the right decisions for themselves” (248). The negative results of decriminalization that many feared before the policy took effect did not materialize in Portugal. A respected study showed a very slight increase in overall drug use, but the country still had lower average drug use than most European countries. Most importantly, however, “the number of problematic drug users had literally been halved, from a hundred thousand to fifty thousand” (249). 

In this chapter, Hari visits yet another country that took a bold step to reform drug laws. In 2012, Uruguay became the first nation to fully legalize a drug: marijuana. Hari begins with a biographical snapshot of the man behind this bold step: José Mujica, who was elected as president in 2009. Mujica was a guerrilla fighter with the left-wing opposition to the military dictatorship that ruled the nation in the 1970s. He was a prisoner for 12 years—and was held in solitude at the bottom of a well for two of those years. Because Uruguay is a transit route for smuggling cocaine and marijuana to Europe, Mujica feared that cartels would take over his country like they had in Mexico. He knew that “when you legalize drugs, you bankrupt most of the cartels” (259), so he decided to go further in rejecting the drug war than anyone ever had. Mujica fully legalized marijuana, assuming that other drugs would follow. The only question, as Hari points out, was how legalization would operate.

Advising Mujica on this question were two British policy wonks who founded the Transform Drugs Policy Institute. Their advice was to follow the model that already existed for “the two deadliest drugs on earth—alcohol and tobacco” (262). They argued that marijuana use should be subject to regulations like those for alcohol and tobacco: no advertising, severe punishment for users who drive, health warnings, strict age restrictions, and sales only through licensed vendors who run great risk. Use of harder drugs, like heroin, on the other hand, should be—like amphetamines and opiates—available only with a doctor’s prescription. The advancement from decriminalization to legalization is a big step but is crucial to ending the war on drugs. As Hari explains it, decriminalization ends the punishment of users but not supply by criminals, whereas legalization would “set up a network of stores or pharmacies or prescription where users and addicts can buy their drugs” (264).

Hari points out that opponents of legalization rightfully still have concerns because common sense says that usage would rise—and that addiction and overdose deaths might rise too. However, the results from Portugal showed that while usage did slightly rise, “addiction fell substantially” (268). Similarly, the results from both Vancouver and Switzerland showed that overdoses dropped significantly because of the iron law of prohibition. Mujica followed the blueprint that the Transform Drugs Policy Institute offered, and by 2014, pharmacies in Uruguay could sell marijuana to anyone over 21, citizens could legally grow a limited number of plants for their own use, and the crop could be grown legally and taxed throughout the country. 

In the final chapter, Hari discusses the American drug law reform campaigns that took place in the states of Colorado and Washington in 2006. Hari argues that in looking at these two different campaigns, he “found two different routes out of the drug war” (275). The campaign in Colorado, led by activist Mason Tvert, attempted to convince voters that marijuana was safer than alcohol. Tvert held that if voters believed marijuana was more dangerous than alcohol, they’d support keeping it banned, but if they believed it was safer than alcohol, they’d support its legalization. The campaign in Washington, led by attorney and former prosecutor Tonia Winchester, argued that the drug’s prohibition has caused more harm to society than the drug itself. Winchester’s approach resembled reform campaigns in other countries in that her message was conservative. Hari explains that “the Washington campaign argued that drugs should be legalized not because they are safe, but because they are dangerous. It’s precisely because they are risky that we need to take them back from the gangsters and cartels, and hand them to regulated stores” (282).

Because the philosophies behind these two reform campaigns were so different, their models of how legalization would work differed too: The tax revenue from legalizing marijuana in Washington would go to treatment for addicts and prevention programs in schools, while the revenue in Colorado would go to building schools. Colorado allowed citizens to grow marijuana in their homes, but Washington resisted this idea. In wondering why public opinion has changed so radically about marijuana since the 1930s, Hari argues that people “haven’t just changed their minds about prohibition—they have changed their minds about the drug. If you read out Harry Anslinger’s warnings today that marijuana routinely turns people into slavering murderers, even conservative audiences laugh out loud” (284). Despite the differing arguments about legalization in the Colorado and Washington campaigns, and despite resounding doubts about either reform passing, both campaigns won by comfortable 10% margins. 

In the conclusion of Chasing the Scream, Hari once again alludes to the personal conflict he feels between being a prohibitionist and being a legalizer. This feeling stems from his experiences with addiction in people close to him. He has learned that the sort of shaming that comes from prohibition only makes their conditions worse. In writing about the possibility of the drug war finally ending and all the steps across the world to get there, Hari makes an analogy between this fight and that of the gay activists who fought back against police at the Stonewall Inn in 1969: “[W]hen we talk about ending the drug war, we are a little like the gay activists of 1969—the final end to the war is so distant we can’t see it yet, but we can see the first steps on the road, and they are real, and they can be reached” (269).

Hari closes his book with an anecdote about the man who was its central figure and the lone architect of the international war on drugs, Harry Anslinger. According to Hari, in the 1950s, Anslinger received information that a very senior and important member of Congress was a heroin addict. This member of Congress was such an important figure that “his decisions and statements helped to shape and direct the destiny of the United States and the free world” (297). Anslinger confronted the man but was threatened and backed down, allowing the man, whom he greatly admired, to continue using heroin without facing the law. This member of Congress was Senator Joseph McCarthy, the staunch conservative who became famous as America’s most renowned anti-communist. Hari argues that “all over America, Anslinger had cut off legal avenues to drugs and forced addicts to go to gangsters for a filthy supply. But he had always pictured it being done to the ‘unstable, emotional, hysterical, degenerate, mentally deficient and vicious classes’” (297).