
Annoncering
Annoncering
Annoncering

Mark Kleiman: Drug use tends to follow epidemic cycles. When a drug appears, or reappears, it tends to do so at the top of the social spectrum – it’s associated with glamour. People are using it for the first time, and they’re having a good time. Very few people are in trouble with it because use is relatively new and it has terrific word of mouth. People say, “Oh my God, this is wonderful, you have to try this!” So you literally get an exponential growth in use. Every new user is a potential source of additional new users. You get a very rapid rise in the number of users.
Annoncering
In the case of cocaine, there was a rapid price decrease as drug dealers crowded into the market to take advantage of the bonanza. The price of cocaine dropped by 80 percent, which brought a new user group into the population. The development of the crack market made crack available to anyone with $5 for a rock; in the powder cocaine market, the price of admission was $100 for a gram. So, the social status of the drug fell along with the user group. Now, using cocaine puts you in a class not with hedge-fund managers, but with $5 crack whores. Surprisingly, people prefer to be in the “hedge-fund-manager” category, which doesn’t necessarily reflect sound moral judgment but is a social fact.All of those things created a peak in use. The number of people starting cocaine use peaked in about 1985, which was before the Len Bias affair. Then we got a set of panic-driven policies aimed at suppressing the crack epidemic. We got mandatory sentencing, aggressive law enforcement and a ramping-up of the War on Drugs.
Annoncering
The enforcement effort completely failed to reverse the decrease in price. Or reduce availability. The cocaine problem kept charging along. But if you didn’t have a lot of new users, and people who’d been using eventually run out of energy and quit or die, then eventually the pool of users starts to shrink. And you see that happen by the mid-90s. The level of cocaine consumption has been falling since. It’s now down to about half the mid-, late-80s level. It went from about 300 metric tons a year to 150 metric tons a year. This was entirely predictable as to its form. If you asked me in 1985 how long it would take, I wouldn’t have guessed the epidemic would last so long; stimulant waves tend to be short because stimulant-use careers tend to be short: stimulants wear you out.So it was actually surprising how long this lasted, but that it was going to come to an end was quite predictable. I think cocaine now has a bad reputation that will last a generation. It will be another 30 or 50 years before we have a problem again.So the decrease isn't tied to efforts by the government?
It’s possible that treatment efforts encouraged some people to quit sooner than they otherwise would have; that prevention efforts helped dry up the pool of new users; that enforcement efforts prevented a further decline of price. I’m not going to dismiss any of that. If we had done nothing, the crest might have come later and at a higher level. But I think the shape is pretty well fixed, by the nature of any drug epidemic.
Annoncering
Yes, the question is when a drug moves from being purely epidemic to being endemic. And that’s happened with cocaine. Remember, the first cocaine epidemic – the long slow one that starts with Sigmund Freud. That one played itself out by the late 1920s. After that, cocaine use went close to zero. That didn’t happen this time – there is still cocaine initiation going on. I do not see any time soon when cocaine is not part of the American scene. It looks to me as if cocaine, the opiates and cannabis, like alcohol, now have a steady user base – not just an occasional flare up. But a drug that’s as destructive as cocaine is when heavily used – especially as crack – isn’t going to become endemic at a high level. The drug we have that’s endemic at a high level is alcohol, and unfortunately that’s not going away. And it looks to me like cannabis is going to join alcohol.What about with methamphetamines and heroin?
Meth is even nastier than crack, so it tends to have a quicker up and down. The reason I was so surprised at how long crack lasted was that the immediately previous stimulant waves we’d seen were meth waves and those tended to be fairly short and fairly localized. That stuff doesn’t have to be around for very long for people to decide that it’s a bad idea..Heroin went through the cycle in the 60s and we’re still dealing with the remnants of that 60s heroin generation. What’s happened with opiates is the rise of the prescription versions, which started in the early 90s and really soared. You have almost as many new non-medical users of prescription drugs every year as you have new cannabis users. And that may be a permanent change. Oxycodone and hydrocodone are substitutes for heroin, but they’re more expensive. So you can get a secondary heroin wave as Oxycontin and Vicodin users get strung out and can’t afford the prescription versions, or want to switch to injection (which is more efficient) and switch to heroin. Or they switch when the supply of diverted pharmaceuticals dries up, for example when the authorities shut down a prescription mill.But faced with relatively cheap prices now, you’d think cocaine would still be massively popular.
The big price decrease was in the late 70s, early 80s. That was what produced the crack epidemic. The crack technology had already been invented – that wasn’t new. What was new was the price. But even at a low price, if people don’t want something, they’re not going to buy it. And people now know that crack is a really nasty drug. Though I’m told that powder cocaine is making something of a comeback.Reports indicate that there’s a rise in popularity of cocaine in Europe.
Europe is a decade or two behind us. I remember when we had the crack problem and Europeans were laughing at the stupid Americans because no European would be dumb enough to use crack. That was back when cocaine was still expensive in Europe. After all, they’re farther from the source. For a while there was an arbitrage trade of people moving heroin, which is cheap in Europe, to the US and bringing back cocaine, which was cheap in the US. But once those prices more or less equalised, Europe had a crack problem. Surprise, surprise! I doubt they’ll ever use as much as we were using because word has spread.You said it might be 30 to 50 years until another cocaine epidemic hits the US. Considering that the last one hit in the mid-80s, are we due for another one just about now?
No, it seems to me that everybody who’s around now has in their head that crack is a really bad thing, and associate that to some extent with cocaine. I don’t think even children of the Millennials will have forgotten that cocaine’s dangerous. I’m not predicting that we won’t have another cocaine wave in the future. But we’re probably immune as a society to cocaine becoming a fashionable drug for some decades into the future. There’s a grim saying among emergency room residents: all bleeding stops eventually.Are you saying cocaine’s bled itself dry?
I think so. ‘Til next time. The country forgot the first cocaine epidemic about 50 years after it ended; the same could happen again, but not in this half-century.@mvzelenks