Chasing the Scream

Chasing the Scream

by

Johann Hari

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Chasing the Scream: Chapter 17 Summary & Analysis

Summary
Analysis
When Hari starts his research, Portugal has the world’s most progressive drug laws. But then, the tiny country of Uruguay and two U.S. states fully legalize cannabis for the first time. Hari visits Uruguay and interviews its eccentric president, José Mujica, to understand the effects of legalization. During Uruguay’s dictatorship, Mujica spent more than two years imprisoned at the bottom of a well. He coped by talking to himself and befriending frogs and insects.
Hari returns to the Americas to look at how a select few governments have gone even further than Portugal, by legalizing marijuana and creating regulated markets for its sale. While none of these governments have established public health programs as comprehensive or successful as Portugal’s, they do show how better drug policy can address the supply side of the equation as well as the demand side.
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After his father’s death, Mujica spent his childhood selling flowers in Uruguay’s capital, Montevideo. When he was in university, the country fell into a deep crisis, and the army started planning to overthrow the government. Mujica and his wife joined a guerilla group that gave food and weapons to the poor. The police shot him, then imprisoned and tortured him and his wife until the dictatorship fell 13 years later.
Mujica’s remarkable backstory shows that, like all the other drug reformers Hari has profiled so far, he was a dreamer and an underdog before he rose to power and changed the future of drug policy forever.
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In 2009, Mujica was elected president. But instead of embracing the presidential lifestyle, he continued living on his farm, donated most of his salary to the poor, and took the bus to work. He legalized abortion, same-sex marriage, and marijuana. Drug cartels were eyeing Uruguay as part of a potential trafficking route to Europe. Mujica’s team studied the evidence and realized that the best way to stop the cartels would be to legalize drugs. But he had to overcome the two factors that had always made legalization impossible: U.S. influence and popular opposition. Fortunately, U.S. states were already legalizing marijuana, and Mujica quickly convinced the Uruguayan public to back legalization, too.
Mujica is about as far as a politician can get from Harry Anslinger or Joe Arpaio. His eccentric lifestyle choices demonstrate that, unlike the vast majority of politicians, he cares far more about sticking to his moral values than gaining and wielding power. And like Ruth Dreifuss, his primary focus when governing was to reduce violence and suffering in general, not just help the people he thought most deserved it. Thus, rather than choosing the most politically convenient explanation for drug violence and immediately translating it into policy, he approached the issue with enough humility to actually seek out and follow the scientific evidence.
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The most famous drug legalization activist in history was Timothy Leary, the militant Harvard professor who famously promoted using drugs like LSD and defying social norms during the 1960s counterculture movement. But Mujica consulted with the English scientists Danny Kushlick and Steve Rolles, who wanted to legalize drugs for the opposite reasons as Leary: to prevent young people from using them and maintain political stability. During his reporting career, Hari befriended them.
Hari mentions Timothy Leary because he’s likely to be the kind of person (or the specific person) whom most people imagine when they think of legalization: an unstable drug user who wants to destroy the foundations of civilized society. But in reality, the arguments for legalization are really no different from the ones for decriminalization.
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Kushlick and Rolles believe that modern societies already have the framework they need to legalize drugs. They point out that tobacco and alcohol were once prohibited around the world, until governments realized that legalization is safer. Today, tobacco is legal, but modern societies still view smoking as harmful and unpleasant. This social pressure has greatly reduced tobacco use in the last half-century. Kushlick and Rolles suggest treating less harmful drugs, like marijuana, the same way as alcohol and tobacco. Meanwhile, they suggest integrating more harmful drugs, like heroin, into the existing medical prescription system.
The drug war has taught most people to unthinkingly accept the “drugs-hijack-brains” theory and associate drugs with madness, violence, and crime. As a result, it’s tempting to imagine drug legalization as a radical, scary departure from the existing system. But Kushlick and Rolles suggest that in reality, it wouldn’t be. Legalization would simply mean fewer street dealers and more stores and prescriptions. The public wouldn’t be forced to take drugs or even accept them in most places.
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Under legalization, Kushlick and Rolles suggest, users would get pure drugs from doctors, pharmacists, and regulated stores—rather than adulterated drugs from dangerous criminal gangs. Just like the end of Prohibition in the 1930s U.S., drug legalization would dramatically reduce crime and violence. Kushlick calls legalization “a drama reduction program” because the drug trade would become, above all, boring and tedious. The difference between decriminalization and true legalization is whether the government regulates the supply of drugs.
Elsewhere in the book, Hari has suggested that it would be better for drug users to get pure, medical-grade drugs for several reasons. Most importantly, the dangerous adulterants in drugs wouldn’t affect their health, and they would be able to choose the precise dose they want to use, rather than gambling with drugs of unknown strength. Medical-grade drugs would be cheaper and more reliably available, which would save drug users time and money. Similarly, drug users wouldn’t have to risk dealing with violence in order to get them. But perhaps most importantly, a legalized drug market would shut down the organized drug crime that has plagued places like Ciudad Juárez and hollowed out institutions like the Mexican justice system.
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Understandably, many people fear that legalization will increase drug use—which could increase addiction, overdoses, and young people’s risk of using drugs. Hari discovers that the scientific evidence on this question is mixed. For instance, when the Netherlands decriminalized marijuana, drug-use rates didn’t increase. But when it allowed cafés to sell marijuana, use did significantly increase, including among young people. However, marijuana use is still less common in the Netherlands than in the U.S. or in the EU as a whole. Moreover, many people switched from alcohol to marijuana, so when alcohol use is included, legalization actually reduced overall drug use in the Netherlands.
Hari again emphasizes that he’s no pro-drug fanatic—instead, he’s seriously concerned about the possible dangers of drug legalization, which is why he analyzes them in full. While he admits that the data still isn’t conclusive, he will soon go into detail about the harms that increased drug use may cause. Notably, since mere decriminalization doesn’t appear to cause the same increase in usage as legalization, some readers might conclude that it is a better option.
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On the other hand, the available evidence strongly suggests that in the U.S., Prohibition decreased both casual drinking and serious alcoholism by 10 to 20 percent. Put simply, many people prefer not to break the law, and Prohibition made it much harder to find alcohol. Hari argues that drug reformers must admit that legalization will probably cause “a modest but real increase in [drug] use.”
Even though the data is still inconclusive, Hari thinks that the drug warriors are right to fear drug use increasing under legalization. His readers will have to decide for themselves whether they agree, and whether the numerous benefits of drug legalization are worth the drawbacks of “a modest but real increase in [drug] use.” Hopefully, in time, evidence from places like Uruguay will provide a clearer picture of legalization’s true effect on drug consumption.
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While legalization may increase drug use in general, it will dramatically reduce the harm associated with drug use—which is more important. First, legalization will help teenagers. Years ago, when a 12-year-old asked him for help buying liquor, the undercover cop Fred Martens realized that it’s much easier for American kids to get marijuana, pills, and heroin than liquor because the U.S. strictly regulates alcohol vendors. Legalization will put the same requirements on other drugs, and therefore dissuade underage people from using them.
It’s misleading to simply focus on the number of people who use drugs because, as Hari has repeatedly argued, the majority of drug use isn’t actually harmful (and much of it is beneficial). Still, youth drug use is generally harmful in and of itself, because young people’s brains are still vulnerable and developing. And Fred Martens’s anecdote suggests that drug prohibition actually drives young people toward using more harmful, less regulated substances. Still, scientific studies would clarify this potential risk of legalization.
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Next, the evidence is less conclusive about whether legalization will reduce drug addiction. Alcohol Prohibition in the U.S. suggests that it won’t, while Portugal’s experience suggests that it will. In particular, Portugal shows that investing in effective treatment programs is the key to reducing long-term addiction.
Again, scientists need to collect better evidence before they can definitively say whether legalization affects addiction. Of course, the only way for them to collect this evidence is by analyzing societies that actually do legalize drugs. Hari also points out that legalization itself probably won’t be the key factor that affects addiction rates. Instead, those rates will depend on the quality of the  treatment options available for addicts. Of course, it’s still possible to create better treatment programs if drugs remain criminalized, or if they are decriminalized but not fully legalized.
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Finally, the evidence from Vancouver and Geneva suggests that legalization will also dramatically reduce overdoses, for two reasons. First, it will give users access to unadulterated drugs, so they actually know what dose they are taking. Second, the iron law of prohibition suggests that lower-dose drugs will be more available and more popular after legalization.
The evidence about drug legalization’s effect on overdose deaths is far clearer and stronger than the evidence about its effect on children’s drug use or overall addiction rates. As dying of an overdose is the worst-case scenario for a drug addict, this evidence supports the hypothesis that legalization will make drug use far safer for addicts overall.
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Yet Hari still struggles to convince himself that all drugs should be fully legalized. What about powerful drugs like meth and crack? Should they be openly available, and would doctors ever prescribe them? While these substances only represent five percent of the overall illegal drug market, they’re still controversial. Some drug reformers think they should remain banned, while others believe that people should have the right to take any drug they want, even if it harms them. And others propose that these drugs should only be available in regulated clinics, like the safe injection sites in Vancouver and Switzerland.
Next, Hari emphasizes that legalizing all drugs does not mean treating them all in exactly the same way. Policymakers and the public will have to debate what exact policy structure to use, and they can choose the specific solution that minimizes the harm of each specific drug. Of course, Hari’s overarching point is simply that legalization gives the government control over the drug market—and any democratic solution to regulating drugs is inevitably preferable to leaving them completely uncontrolled in the black market.
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But Hari still worries about crack and meth. As a child, he learned that crack and meth are so powerful that nearly everyone who uses them becomes an addict. However, the pioneering drug researcher Dr. Carl Hart has found that only a minority of crack and meth users—about 20 percent—ever become addicted. Hari scarcely believes this when Hart first tells him. But later, he remembers that trauma and isolation are much more responsible for addiction than the chemical hook in drugs. Whereas the drug war spreads trauma and isolation in order to fight the chemical hook, legalization exposes a few more people to the chemical hook in order to reduce trauma and isolation.
Like much of the research that Hari has cited throughout his book, Dr. Hart’s work on crack and meth totally contradicts the common wisdom about drugs. But this doesn’t mean that Hart’s research is unreliable—instead, it shows that the common wisdom is disconnected from the reality of drug use and addiction. For Hari, a slight increase in crack and meth addiction is a small price to pay in exchange for better treatment options, like those that Portugal has adopted. Of course, it’s also highly likely that the people who are willing to try drugs just because they’re legal don’t belong to the traumatized, isolated minority who end up addicted. Still, some readers might still prefer policy options that provide better treatment without making drugs like crack and meth widely available. 
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Hari concludes that readers should assess their values and “draw up a balance sheet” to decide whether to support legalization. After three years of research, he has one very good evidence-based argument against legalization: it will modestly increase drug use. Meanwhile, there are several good evidence-based arguments for legalization. It will crush drug gangs around the world, which will significantly reduce violence. It will make it harder for teenagers to access drugs, it will reduce overdoses, and it will free up resources for addiction treatment programs. Perhaps most importantly, it will turn addicts and prisoners into productive members of society. Of course, the pros and cons might vary for different drugs.
Hari offers his own personal conclusions about drug legalization, but ultimately, he encourages his readers to come to their own conclusions. This is particularly important because, as he has shown throughout the book, popular debates about the drug war are usually dominated by politically motivated stories with little grounding in science. Fighting this tendency requires starting with the evidence, not with a preformed conclusion. Thus, while Hari strongly believes that legalization will bring all the benefits that the drug war has long promised, his goal is to start productive conversations about drug reform, not necessarily to convince readers of his own opinions.
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Following Kushlick and Rolles’s recommendations, Mujica’s government made it legal for Uruguayans over 21 to buy marijuana in pharmacies and grow it in their homes. This policy isn’t a radical historical anomaly—rather, drug prohibition is the anomaly. In the future, Hari hopes, people will learn to view prohibition as a century-long failed experiment. Hari recalls his visit to President Mujica’s shack on the outskirts of Montevideo. Mujica and his wife both tell Hari that by owning fewer material things, people can learn to focus on what really matters: winning freedom for themselves and others.
After giving a complex theoretical explanation of how legalization would work and what it would do, Hari describes Uruguay’s system—which is likely to seem remarkably tame to his readers. Certainly, it’s far tamer than the drug war. Indeed, it’s scarcely different from the system for buying legal alcohol and tobacco in most modern democracies. And Hari’s readers are likely to find it even less unusual today, when legal marijuana is common throughout the Americas and Europe, than they would have when he first published this book.
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