1 We are all addicts
2 Why prohibition fails
3 Toxic stress
4 Heroin, cocaine, cannabis and LSD
5 Legal drugs and their dangers
6 The drugs war
7 The only way ahead

1. We are all addicts

The problem in perspective. We are all addicts. Whenever a drug user is taken to court the chances are high that the people involved in the prosecution the judges and the police officers will be using and addicted to more dangerous substances than the defendant in the dock.

Have you ever drunk a cup of coffee to help yourself wake up in the morning? Have you ever made yourself a cup of tea when you have been feeling physically or mentally tired? Have you ever been so bored, lonely or fed up that you have eaten a bar of chocolate or a biscuit when you knew that you were not hungry? Have you ever taken a sleeping tablet to help you get a good night's rest? Have you ever taken a pill to help calm your nerves prior to an aeroplane flight, a trip to the dentist or an important social event? Have you ever smoked a cigarette or a cigar? Have you ever drunk a glass of sherry, champagne, beer or wine?

If you have answered 'yes' to any of those questions and of course you have! then you know what it is like to need to use a chemical to help you put up with or overcome your daily problems or to alter your mood. If you use any of the substances I have mentioned above on a regular basis, then you are probably an addict. Alcohol, tobacco and caffeine are much more addictive and hazardous to your health than some illegal substances. The surprising but inescapable truth is that most people are addicted to something.

Drug use is accepted as normal in modern society. Governments subsidize the production of tobacco and take a substantial profit on the sale of tobacco and alcohol. Many religious ceremonies involve the use of alcohol. Respectable housewives organize coffee mornings and share pots of tea together. It is, therefore, hardly surprising that drug abuse is not just commonplace but is the biggest epidemic of the twentieth century and by far the most important cause of illness and death in the western world.

Everyone does it: I doubt if there is a policeman, judge or politician anywhere in the world who has not used drugs at least once in his or her life. Most of those who oppose the use of drugs such as cocaine, heroin and cannabis are probably hooked on drugs which are far more dangerous than most illegal substances.

The fact that the use of some drugs is regarded as legal while the use of others is deemed illegal complicates the subject of drug abuse enormously. There is no logic in the laws which decide which substances are legal and which are illegal. Many of the world's most dangerous substances are perfectly legal while some relatively innocuous substances are illegal. Substances such as alcohol which are legal in one country will be illegal in another. Drugs are put into 'legal' or 'illegal' categories through an illogical, bizarre, irrational and entirely arbitrary selection system which depends more upon personal preferences, prejudices and commercial expediency than upon rational thought. The result is that in any court where an individual is being tried for possessing or using an illegal drug, the chances are high that the majority of those responsible for ensuring that the law is applied will be addicted to substances which are far more dangerous than the substance which has been used by the defendant.

Putting drugs into 'legal' and 'illegal' categories has not made much difference to the number of people prepared to try them. Laws which are patently abused or based on weak foundations get very little respect and the laws which are designed to limit drug use get about as much respect as the laws which govern the speed of motor cars on motorways. A recent survey in America showed that 59 per cent of American doctors have used illegal mood altering drugs while 77 per cent of medical students have used them. Around a third of medically qualified Americans use mood altering drugs regularly. Doctors are cutting down their consumption of tobacco which they recognize as being extremely dangerous but they are not cutting down their use of illegal drugs which they consider to be less harmful.

And other citizens seem to agree with them. Experts estimate that an astonishing twenty million Americans use marijuana regularly while seventeen million have experimented with cocaine and half a million regularly use heroin. A few years ago a survey by the Ladies' Home journal showed that a third of American women under the age of twenty five years old had taken cocaine. In 1962 American statistics showed that only four per cent of people between the ages of eighteen and twenty five had smoked marijuana. Twenty years later, after a programme of suppression that had cost billions of dollars, sixty four per cent of people in the same age group had tried it. Drug prices have consistently fallen, despite attempts to reduce the quantities available, and the purity of illegal drugs goes up as the price comes down.

In 1978 a White House presidential adviser on drugs reported that one in nine high school seniors were using so much marijuana every day that they were 'stoned' or under its influence from the time they got up in the morning until they went to bed at night. In the United Kingdom the figures are more vague. The official figures suggest that around 50,000 people are addicted to heroin and cocaine but officials suggest that the real figure is probably ten times as high. It is impossible to obtain accurate figures because people who use illegal drugs do not usually talk openly about their 'crimes'. That is another problem: drugs that are illegal cannot be regulated and the extent of their use cannot possibly be estimated accurately. All around the world illegally obtained drugs are being used by a constantly growing number of people most of whom would probably describe themselves as normal and law abiding.

Drug smuggling is now the biggest and most profitable industry in the world. According to The Economist cocaine is the most profitable article of trade in the world. In California the cash value of the cannabis crop is said to be greater than the value of the grape crop supposedly the state's leading agricultural product. The world's drug business is estimated (by a United States senate subcommittee) to be worth over $500 billion a year with $475 billion tax free profits. Just 'laundering' that amount of money is very big business and many of the world's most apparently respectable banks are involved. There are drug dealers whose annual earnings exceed those of many countries. When Johnny Carson told an Oscar presentation audience that 'The biggest moneymaker in Hollywood last year was Colombia. Not the studio the country', he probably was not far from the truth. Drugs are so light and so easily transportable that they are now preferred to diamonds as an international currency. In 1978 when thousands of Iranians fled their country during the Ayatollah Khomeini's revolution, many took their wealth with them as heroin because it was lighter than the equivalent in currency.

Millions of people are being turned into criminals by a series of inexplicable laws which are also threatening our civil liberties and encouraging violence on a hitherto unimagined scale. Despite strenuous and expensive efforts to uphold these laws the world's law enforcement agencies have failed, are failing and will clearly continue to fail. They are failing partly because the demand for drugs has always been there. Laws outlawing drug use are as doomed as laws outlawing prostitution. They are also failing partly because the laws which exist are widely disliked. (Laws which outlaw drug use are as unpopular and as widely disregarded as the laws which exist supposedly to control the speed of motor cars on the roads). And they are failing because they are overtly hypocritical and uniquely ill thought out. People know that tobacco is more dangerous than marijuana and so they have no respect at all for a law which flouts common-sense.

Laws which prohibit the purchase, possession or use of drugs do not, it seems, have very much influence on the use of those drugs but they do turn the people who use them into criminals, thereby creating a whole range of new problems. The credibility of the law is damaged and the number of people with no respect for the law is increased. Irrational laws which allow the free sale of some dangerous drugs and ban others (far less dangerous) drugs push millions of otherwise law abiding citizens into close contact with criminals, make them vulnerable to blackmail and expose them to other forms of crime. Thousands of serious crimes are committed by individuals who want (or need) the money to pay for extremely expensive illegal drugs. It is estimated that Britain's addicts steal at least £20 million worth of goods a day to pay for the drugs they buy. The vast untaxed profits made by those who produce, import and market illegal drugs have encouraged new levels of violence in the underworld and have helped create and sustain a remarkable series of super-rich criminal fraternities.

Do not assume by what you have read that I am in favour of drug use or in sympathy with drug abuse. I recognize that drug addiction is now a major world-wide problem. Several years ago in my book Addicts and Addictions I described drug addiction as 'the twentieth-century plague' and I think the description is still valid. There are addicts in every country in the world. For countless decades addictions have wrecked homes, destroyed careers and ruined lives in a hundred different ways. Back in 1970 more Americans were evacuated from Vietnam for drug-related reasons than for war injuries. In 1978 Lester Wolff, then chairman of the United States House of Representatives Select Narcotics Abuse and Control Committee, estimated that ten to twenty per cent of the two hundred thousand troops America had in Europe were taking 'hard' narcotics regularly. This was, he admitted. equivalent to having almost two divisions using drugs. By the mid 1980s a Department of Defense survey showed that 31.4 per cent of American servicemen in Europe were using drugs such as cannabis. cocaine and LSD and one in ten admitted to working under the influence of drugs. There have been many cases of drug abuse aboard nuclear submarines and at nuclear bases.

The cost of drug abuse is usually regarded as consisting of treating addicts and policing airports and coastal areas. But it is a much bigger problem than that. The total cost of drug use and abuse is almost impossible to quantify. During the 1980s Roger Smith, chairman of General Motors, reported that absenteeism, largely due to drug and alcohol abuse, cost his company one billion dollars a year. The American Department of Health and Human Services has estimated that drug use in factories and offices costs America at least twenty-five billion dollars a year.

Despite all the money and effort put into controlling drug abuse - most of it into more and more pieces of legislation and increasingly sophisticated police forces - the problem is getting worse.

According to Dr Williarn Pollin, Director of the National Institute on Drug Abuse in the United States, more than one quarter of all deaths in America are premature and caused by addiction. But it is legal drugs which cause the vast majority of the deaths. In Britain tobacco kills 100,000 people a year while there are 700.000 alcohol addicts and 700,000 families struggling to cope with the problems alcohol addiction produces. There must surely be something fundamentally wrong with our present system. In America approximately 100.000,000 people drink alcohol and about 60,000,000 smoke tobacco - both legal substances. The combined death rate for these two drugs is around 500,000 people a year. In the developed world the average adult spends around $325 a year on tobacco and $750 a year on alcohol; cigarette smokers kill thousands through their side stream smoke; drunken car drivers kill hundreds of thousands. And yet approximately 20,000,000 Americans use cannabis ~ which is illegal - but no one has yet died from it. In America around 500.000 people use heroin regularly and another 500. 000 use cocaine every day but the total number of deaths attributed to all illegal drugs is around 3,500 a year - and most of those deaths are a consequence of the fact that the drugs involved are provided illegally. are often contaminated and are of doubtful and variable purity. The startling truth is that the illegal drugs of addiction are not as dangerous as the legal drugs of addiction.

The cruellest irony of all is. perhaps, the fact that drug dependence and drug injury are now the commonest doctor induced diseases and both are among the commonest of all diseases. At any one time, six out of ten people will be taking a drug of some kind and half of those drugs will be have been prescribed by a doctor. If all those drugs were essential and safe the figures would not be so worrying. But four out of every ten people who take prescribed drugs suffer severe or noticeable side effects and many end up needing medical treatment for problems produced by the drugs they have been given. Every year in Britain 200,000 people are admitted to hospital because of a drugs overdose of some kind and 4,000 of them will die. In other words more people in Britain are killed by prescribed drugs than are killed by illegal drugs in America and Britain together. Amazingly, one in every six people in hospital are there because they have suffered side effects from treatment they have been given. It is, it seems, doctors as much as patients who are addicted to drugs (though it is, of course, patients who end up suffering the physical and mental agonies of that addiction).

In Britain, where doctors get most of their training and information about drugs from drug companies, eight out of ten consultations end with the doctor writing out a prescription. Doctors sometimes claim that this happens because patients expect a prescription (in much the same way that a child visiting Father Christmas in a store grotto expects to be given a present) but this simply is not true. Millions of the patients who are given a prescription did not want to be given drugs and as many as one in seven fail to have their prescriptions dispensed.

Of all the problems produced by the drugs that doctors prescribe, drug addiction is undoubtedly one of the most troublesome. And although doctors have been instrumental in building up the world's heroin and morphine addiction problems, it is with the so-called 'minor' tranquillizers and sedatives that doctors have done most damage. At the start of the twentieth century doctors regularly prescribed bromide for nervous or anxious patients. Thousands became addicted. During the middle part of the century bromide was replaced by the barbiturates which were regarded as much safer and less likely to produce dependence of any kind. Then, in the 1960s and 1970s when the dangers associated with the barbiturates had become widely known, a newly discovered group of drugs - the benzodiazepines - were introduced as safe, effective and non addictive alternatives for patients who needed help to relax or to get to sleep. Within a very short space of time thousands of doctors were prescribing vast quantities of the benzodiazepines for millions of patients and by the late 1980s virtually every developed country in the world had a major benzodiazepine addiction problem. For the third time in less than a century doctors and the drug industry had successfully created and promoted drug addiction.

With all addictions the size of the problem is increased dramatically by the fact that the majority of addicts cause enormous pain and heartache to those around them. Each individual case of addiction acts like a small explosion, involving and destroying wives, husbands, parents, children, brothers, sisters, friends, neighbours, employers and workmates. No one knows how many lives have been ruined by drug use, abuse or addiction but the total number of lives affected must be at least five times as big when those whose lives are indirectly affected are included. How many of us can say that our lives have never been touched by another's addiction? Addicts are squeezed between those selling drugs (aggressive and threatening when the drugs are illegal and subtle, manipulative and insidious when the drugs are legal); the punitive legal system and the harassed, unimaginative and over-pressured medical profession. Friends and relatives are frequently left to try to pick up the pieces of a shattered life themselves and, fired by a mixture of love, guilt, fear and compassion, are left to struggle to deal with social, mental, emotional, spiritual and physical demands for which they have no training and no preparation.

Although drug addiction is now recognized as a major international problem, many people still have a narrow view of what is a 'drug' and what makes an 'addict'. People who happily drink themselves silly every Saturday night or who smoke sixty cigarettes a day look down their noses at individuals who use cocaine or heroin and imagine that because one type of addiction is legal and another is illegal there must be some real difference between the severity of the two. The truth is, of course, that the only differences are social and legal. The alcohol addict is just as much a victim as the heroin addict and is, indeed, almost certainly more at risk of suffering long-term physiological damage. Social and environmental circumstances and many factors outside individual control (including luck or a lack of it) determine the nature of an individual's addiction.

Sadly and perversely, our attitudes and prejudices are determined by our circumstances, social position, personal experiences, family and, most of all, by our local laws and customs. In the Andes a hill worker will chew coca leaves; in Jamaica a labourer will depend upon cannabis; in New York, London and Sydney a labourer will rely on beer to get him through the day whereas an officer worker will ease away tensions with a glass or two of vodka or gin. The influence of our laws on our habits is immense and I have no doubt that by making drugs such as heroin, cocaine and marijuana illegal and allowing drugs such as tobacco and alcohol to remain legal the authorities in many countries have helped to contribute to the size of their drug addiction problems. Some folk fear cocaine and heroin because they (wrongly) assume that their very illegality proves that these drugs are dangerous. But they assume that drugs such as alcohol and tobacco which are legal cannot possibly be all that bad. The result is that our bizarre and irrational legislation is responsible for millions of premature deaths. Patterns of drug use - and abuse - are embedded deep in our culture and there is no readily accepted, legally approved drug available anywhere in the world that is not now, has not been in the past, or is not likely to be in the future, the subject of a vigorous campaign of suppression in another culture.

A number of useless and purely pedantic arguments have confused the picture even more and have contributed to the size of our current problem by encouraging a false sense of security among politicians, doctors and drug users. There have, for example, been attempts to divide drugs into 'hard' and 'soft' categories. Drugs such as heroin and cocaine are usually put into the first group whereas drugs such as the benzodiazepines inevitably find themselves in the second group. This sort of classification has no basis in science, for the benzodiazepine tranquillizers are much more dangerous and much more addictive than the so called 'hard' drugs.

There have also been numerous attempts made to differentiate between 'dependence', 'habituation' and 'addiction'. For many years, for example, the amphetamines were regarded as producing nothing more than a mild habituation. It was argued that they could not possibly be considered 'addictive' and the suggestion was that there was a major difference between habituation (a self-directed enthusiasm for a drug) and addiction or dependency (a physiologically based need to keep taking a drug). By the time doctors had realized that the amphetamines are, in fact, among the most addictive of all drugs it was too late: they had been widely over-prescribed and many hundreds of thousands of users had become dangerously and in some cases irreversibly addicted. Today, we know that it is in practical terms quite impossible to differentiate between psychological addiction and physical addiction; both are serious and potentially destructive.

Another major error made by many of those who have written about addiction has been to assume that it is possible to define a particular drug's addictive qualities in a very specific way. In practice this has added to the confusion because it is not solely the pharmacological properties of a drug that make it addictive; it is a combination of the drug's pharmacological qualities and the circumstances in which a person finds and uses the drug. You only have to look at the different effects that alcohol can have on different people to see the truth of this.

And finally the whole picture has been blurred even further by the fact that modern pharmacists have succeeded in producing an almost infinite variety of refinements on original products. Many of these refined products have completely different properties to the originals. Heroin is obtained from opium but is considerably more powerful. Cocaine is derived from the coca leaf but the two substances have very different qualities. By and large the more modern variations are far more powerful and potentially dangerous than the natural originals.

However far back in history you go, there is always evidence to show that whenever times were hard or difficult men and women tried to forget their personal agonies and overcame their fears and anxieties by using drugs. Drug use - and drug abuse - is not a new phenomenon. But it is becoming a bigger problem. And there are several reasons for this.

First, as I have already explained, modern pharmacological compounds are infinitely more complex and more dangerous than original, natural products. We have access to far more potentially addictive products than any other people in history. Today the individual under pressure can choose between heavily promoted and cleverly marketed legal drugs such as tobacco, alcohol, caffeine and tranquillizers and widely available, seemingly glamorous illegal products such as cocaine, heroin and cannabis. People have always used substances such as leaves, fermented grapes, plant juices and hallucinogenic fungi to enliven or calm their lives but never before have there been so many people refining, preparing, manufacturing, distributing and promoting products designed to help us escape from our own world.

Our ability to move around the world in hours instead of months has meant that we now have the opportunity to share habits and customs with different races. We frequently find ourselves in possession of drugs for which we have no historical cultural uses. Every country has its own accepted drugs of addiction (often used for stimulating thought or conversation or for helping people to work or to relax) but international travel has given us open access to a lending library of psychoactive substances which we don't understand or know how to use properly. For centuries the natives of Peru used coca leaves and learned how best to use them. Then scientists from the west took the leaves into their laboratories and produced cocaine. The Peruvians are now using cocaine. We in turn have introduced much of the world to the dangers of the cigarette (the most efficient way of using tobacco to cause cancer) and refined alcohol (the quickest way to rot your liver).

Second, attempts to control drug use by introducing a web of laws have backfired. Many of today's problems have been created by our attempts to outlaw drug use.

Third, we have changed our world enormously in the last century or so in a thousand different ways. Agriculture, industry, communications, transport and welfare - all have changed. In many countries the sanctity of the family has been abolished. Individual pressures in the 'developed' world are quite different today to the pressures which existed a generation ago. Most of us have fewer fundamental fears (What will we eat?', 'How will we keep warm?') than our ancestors had but we are exposed to far more frustrations and far more pressures which are totally outside our control. Most importantly, the changes have taken place at such a rapid rate that we simply have not been able to evolve fast enough. As a result we have acquired an infinitely varied number of physical and mental problems produced by our responses to the stresses created by these developments.

At the same time that international travel has made it easy for us to exchange drug use with other countries, the variations in local laws and customs have created great confusion and bitterness between many populations. We in the west complain angrily about farmers in South America or the Middle East growing opium poppies or coca bushes and we insist that they destroy their natural, long established crops to protect our citizens from the refined products which our scientists will make out of those simple, natural and relatively harmless substances. At the same time we use drugs such as alcohol which they abhor, condemn and fear. We are so arrogant that when we are told that we must not take our alcohol into their countries we regard them as interfering and we treat their laws with contempt, making no secret of the fact that we think them rather backward and exceptionally repressive.

As a community our attempts to deal with drug addiction have been unsympathetic, ineffective and largely counterproductive. Legislation has been introduced to outlaw those types of addiction which are not protected by powerful business interests, while those drugs which are protected by industry remain freely available and attempts to control their availability or promotion are regarded as unacceptably repressive in a free society. We describe those who use legal drugs as 'sick' and 'in need of help' but those individuals who are caught using illegal drugs get very little sympathy or help. The standard theory seems to be that if an addict is caught he or she must be punished and put in prison. We ignore the fact that this 'remedy' doesn't work because as soon as the addict is released from prison he goes straight back to his old surroundings. The forces and pressures which led him into drug addiction won't have changed (indeed, being in prison has probably made things worse) so his responses to the world won't have changed either. Nothing will have been done to change his self-image, motivation or lifestyle. He picks up his bad habits again not because he has a continuing and irresistible physical need but through social circumstances. Most heroin addicts are not hooked on heroin but they are irretrievably bound to the heroin lifestyle. Sending addicts to prison simply ensures that the problem will continue.

Ever since humans first discovered ways to 'escape' from their misery by the use of drugs, men and women have used artificial stimulants and psychoactive drugs to improve or hide the way they feel. Drug addiction is commoner today than it has ever been. We have spent a fortune trying to suppress drug use. But drug addiction is a plague which is growing faster than at any previous time. Those who sell drugs are richer than ever and drug law enforcement has failed miserably. Drug treatment programmes fail and seem doomed to continue to fail. What all the legislators and politicians and doctors seem to forget is that it is our nature to escape from unhappiness when we can. Attempts to prevent or penalize drug use are all doomed to failure.

When I first supported the idea of the decriminalization of drugs in 1986, numerous interviewers and reviewers seemed to have difficulty in realizing that I was being serious. Today, the idea has attracted a considerable amount of support. But many of those who opposed decriminalization still refuse even to talk about the idea. Many of those who oppose drug use seem to me to be able to combine hysteria and remarkable naivety with their demands for more legislation, not less. Writing in The Economist recently, a worried American citizen argued that 'The solution is a tough-minded policy that identifies and punishes drug use in five areas: at school, behind the wheels of vehicles, for parolees and probationers and for teenagers at home. Such a wide policy of zero tolerance can be enforced only by widespread use of urine testing. When this new technology is employed, the demand for drugs will wane, the gangsters will drop drug sales, and the epidemic will end.' Others worry that any move towards decriminalization will be seen as being 'soft' on crime. Politicians find such an approach difficult to accept, even though their much loved out-and-out war on drug use has clearly failed to have any effect at all.

When an advisory committee suggested in 1968 that Britain should consider changing the law on marijuana, the then Home Secretary James Callaghan said that 'to reduce the penalties for possession, sale or supply of cannabis would be bound to lead people to think that the government takes a less serious view of the effect of drug taking.' In 1972 Richard Nixon set up the National Commission on Marijuana and Drug Abuse in America. The commission recommended the decriminalization of marijuana but Nixon had apparently already rejected the recommendation before the commission had finished its deliberations. When in 1983 it got wind of suggestions that a more liberal attitude towards drug use might prove profitable the United Nations Narcotics Control Board stated that 'determination may sometimes be giving way to permissiveness. To adopt such an attitude would be retrogressive.'

Those who oppose a more liberal approach invariably seem to confuse decriminalization with legalization (the former suggests merely an absence of legal control whereas the latter suggests approval) and to assume that those who support a more liberal approach must be permissive. In fact, of course, decriminalization is usually offered simply as a logical and sane method of controlling and limiting drug abuse more efficiently and humanely. Sometimes those who oppose a more liberal approach do so because they seem genuinely frightened (frequently claiming that drug addicts are a major source of crime and infection in our society and seemingly convinced that anyone who takes one puff on a marijuana cigarette will inevitably end up turning into a super-sex-crazed-child-molesting-old-lady-mugging-bank-robbing-lunatic) while sometimes there is an undeniably racist element in scare propaganda.

When American reporter P. J. O'Rourke suggested legalizing drugs to a policeman, the law enforcement officer replied: 'We're talking scum here. Air should be illegal if they breathe it'. According to The Times in London, the Guardian Angels' method of dealing with drug offenders in America is 'to raid a house, beat up the addicts and destroy all drugs and equipment; then to empty their pockets and burn their money. It works and costs nothing'.

Even today many voices of the establishment find the mere thought of decriminalization too much to bear. just look at the attitudes expressed by four of Britain's leading national newspapers in 1989 after I produced a pamphlet entitled Drugs: The argument for decriminalization. The Observer described suggestions of legalizing drugs as 'nonsense of a pernicious kind'; The Times said that 'Drugs are an evil to be fought, not to be accommodated'; The Guardian predicted that 'legalizing the trade would only increase addiction', and The Daily Telegraph argued pompously that 'a government which gratuitously added one more health risk in order to ease its task would forfeit public respect'. Under continuing pressure from public opinion, politicians all over the western world continue to call for more funds and more resources to fight the drug 'war'.

Maybe our politicians would do better to look at the reasons why people take drugs rather than putting all their efforts into trying to deal with what is a consequence of society's problems rather than a primary problem in itself We live in a strange society. Our politicians and legislators attack drug use and then go home and drink themselves silly. They give out pompous and patronizing advice and ignore the real problems. In the summer of 1983 the British government issued a press release designed to discourage glue sniffing. The release said: 'Don't do it. It's just not worth it'. The politicians seem to have ignored the fact that when twelve-year-old children are so miserable and lonely and empty of hope and so full of despair that they spend their free hours huddled underneath canal bridges trying to blow their minds and escape the real world by sniffing glue out of old crisp bags, there is something drastically wrong - and an appeal to 'pull up your socks and be a sensible fellow' may not be the sort of help that is needed.

2 Why prohibition fails

History shows that drug use is an old-established method of dealing with unpleasant stresses and with anxieties of all kinds.

Men and women have always used drugs to enable them to escape from their day-to-day anxieties and worries, to enable them to find peace and temporary contentment, to excite and stimulate themselves when they feel bored, to give themselves energy when they feel tired and to allow themselves to experience and explore new worlds.

Primitive peoples chewed nuts and leaves and ate mushrooms to give themselves energy; the priests of ancient civilizations used herbs to enable them to influence the moods of their congregations and to enter mystical states in which they could talk to the Gods; opium was first used seven thousand years ago; alcohol was first brewed and sold five thousand years ago. The use of drugs to change perceptions is older than industry. older than the law, older than medicine and older than farming. In ancient caves archaeologists have discovered evidence to show that stone age people heated poppy heads so that they could inhale the fumes in order to forget the cold. their hunger and their fear of being eaten alive.

Every generation - even those from times which now seem to us austere and obsessed with strictly regimenting the behaviour of the masses - used drugs to escape from those things which they found distasteful, distressing or simply disappointing. No group of individuals were more correct than the British Victorians but it is clear that they were avid drug users. Alcohol was popular but the most widely abused drug of the age was laudanum - a tincture of opium - which was immensely popular with men and women of every social group. Everyone from the aristocracy and the intelligentsia down to the working classes consumed their laudanum in a seemingly endless variety of over-the-counter preparations such as Codfrey's Cordial and Dr J. Collis Browne's Chlorodyne. Addicts drank a pint or even more a day of their favourite, powerful concoction. Writers such as Edgar Allan Poe, Charles Dickens, Wilkie Collins, and Thomas de Quincey all wrote under the influence of opium while Robert Louis Stephenson wrote The Strange Case of Dr Jekyll and Mr Hyde under the influence of cocaine and Sir Arthur Conan Doyle used the same drug when working on his Sherlock Holmes stories. Not to be outdone, the Americans of this era took to drug use with great vigour and by the end of the nineteenth century could choose from over fifty thousand over-the-counter medicines which contained drugs such as heroin, morphine, cocaine and cannabis. It was even possible to buy products containing opium through the Sears Roebuck mail order catalogue.

Ever since the first bureaucrat discovered the pleasures of obfuscation, authorities of one sort or another have attempted to stop the use of drugs. In the Ottoman Empire Sultan Murad IV introduced the death penalty for smoking. In the seventeenth century tobacco was prohibited in several European countries and a Russian Tsar introduced a law ruling that anyone possessing tobacco should be tortured until he revealed the name of his dealer. In Germany the death penalty was introduced for tobacco users in 1691. But every available piece of evidence shows quite clearly that all attempts to stop the use of drugs have been unfailingly ineffective. If history shows anything at all, then it shows that it will never be possible to outlaw illegal drug use because no law can ever make the demand disappear; and so long as there is a demand for drugs there will be people willing to supply the required product or something similar to it. Laws which are designed to outlaw drug use are doomed even more certainly than the laws which are destined to outlaw prostitution. The prostitute's client is likely to be respectable and to fear exposure but the client of the illegal drug salesman will often live outside the system and may in any case be well aware that there is little social disapproval among his peers of drug use and abuse.

Indeed, if drug laws have any effect on drug users it is to excite them rather than to discourage them. Many of those who use drugs do so because their lives are dull; they are looking for stimulation. What those who call for more laws do not understand is that the risk of being caught frequently increases the pleasure of drug use and attracts and encourages the drug user, and that the demand for drugs which provide some relief from life's vicissitudes is deeply engrained. In a crisis people will use almost anything to help them escape from their world. In the mid-nineteenth century the distillation of illicit whisky in Ireland fell off partly because of the failure of the corn crop and partly because of the legendary activities of the temperance campaign led by Father Mathew - a miracle worker who is personally credited with having managed to persuade half a million Irishmen to take the pledge. But just because the Irish were not drinking alcohol, they did not stop drugging themselves. While the stills remained unused the Irish started using a replacement. The drug was readily available because it was at the time being (quite wrongly) used by doctors as a treatment for cholera and it was popular because it produced a form of intoxication which was similar to that associated with alcohol. Within a very small space of time 50,000 Ulstermen and women had consumed 17,000 gallons of ether as an 'alternative' social lubricant. The popularity of ether dropped suddenly when the following year's successful grain crop enabled the illegal still owners to get back to business and start making whiskey again. The pledges offered to Father Mathew were conveniently forgotten.

The American attempt to outlaw the sale and use of alcohol during the 1920s illustrates perfectly the uselessness of legislation as a weapon in the war to control drug abuse. Prohibition began in 1919 as a result of the Volstead Act which was passed as the eighteenth amendment to the United States constitution after pressure from organizations such as the Women's Christian Temperance Movement ~ but despite a veto from the American president. In an attempt to ensure that the new law was obeyed and that no one made, sold or drank any alcohol at all, over a thousand special agents were hired and equipped with special badges, pistols, machine guns and hand grenades. Despite the enthusiastic publicity films which showed special agents making holes in barrels of illicit whisky and gin and allowing the contents to spill down into the drains, the result of prohibition was a disaster of quite monumental proportions.

By making the manufacture and sale of alcohol illegal the government closed down respectable distilleries and bars and opened the way for crooks like AI Capone to take over and supply the continuing demand for alcohol. By the mid 1920s just half a dozen years after prohibition had been introduced there were 30,000 illegal clubs selling alcohol in New York alone, while AI Capone controlled over 10,000 bars in Chicago. The government had opened the way for the development of a massive, powerful, well structured and extraordinarily rich underworld. By 1933 when the government realized that prohibition was just not going to work, America had acquired an enormous underground network of well organized criminals.

When, after fourteen years of prohibition, the American government finally realized that the consumption of alcohol was almost certainly going up rather than coming down, they passed the twenty-first amendment to the constitution, repealed the prohibition laws and allowed the legal sale of alcohol once again. But prohibition had already done more harm than good. In the first two years of prohibition the number of hospital admissions from alcoholism decreased slightly but within three years the incidence of alcoholism had gone up to pre-prohibition levels. After prohibition ended the amount of alcohol being produced and consumed fell by an astonishing fifty per cent.

More important still, in order to maintain their lavish lifestyles and keep their armies occupied the crooks who had made their fortune out of alcohol had to look for something else to sell. No one should have been surprised when the mobsters started importing and selling drugs such as heroin and cocaine. The prohibition of alcohol was a major social disaster which encouraged thousands of people to take up drinking (its very illegality made it exciting and glamorous and the gangsters selling it were clever enough to make their clubs fashionable and attractive places) and also created the crime empire which now imports, distributes and markets narcotics. The international drugs 'industry' which currently inspires so much legislation around the world is largely a consequence of the legal attempt to end the consumption of alcohol.

Those politicians who want to see the prohibition of heroin and cocaine enforced by the law seem conveniently to have forgotten the lessons they should have learned from prohibition. They should listen to the wisdom of John D. Rockefeller Junior who was originally in favour of prohibition but who, having seen the eighteenth amendment working, admitted 'that a vast array of lawbreakers has been recruited and financed on a colossal scale; that many of our best citizens, piqued at what they regarded as an infringement of their private rights, have openly and unabashedly disregarded the eighteenth amendment; that, as an inevitable result, respect for all law has been greatly lessened; that crime has increased to an unprecedented degree - all this I have slowly and reluctantly come to believe'.

When prohibition ended, and alcohol was again legalized, a government that had one day opposed the drinking of alcohol with all its might immediately started taking a tax on sales of alcohol. This apparent oddity illustrates quite nicely the hypocrisy which is never far from the surface when drugs are concerned.

Consider. for example. what happened in China in the nineteenth century.

In the eighteenth century the Portuguese had started selling opium to the Chinese. When they realized the commercial potential the British started cultivating huge opium plantations in India where they could grow the opium they intended to sell to the Chinese. The sale of opium to China soon became a major source of income for Britain and for companies such as Jardine Matheson of Hong Kong and by the 1830s British companies were exporting half a million pounds of opium to China every year. When the Chinese emperor became worried about the effect all this opium was having on his people. he tried to stop the trade. but the British started a war to force the Chinese to allow them to continue selling the drug. The opium wars dominated much of the middle period of the nineteenth century simply because it was in Britain's commercial interest to maintain its drug sales. Many of Britain's largest international companies founded their fortunes on the sale of a drug which is now illegal.

How, I wonder, would Britain like it now if the Colombians began a war to protect their cocaine trade? Is it possible that the descendants and beneficiaries of the gangsters who currently sell cocaine and heroin will be running respectable and politically powerful international companies in the mid twenty-first century?

3 Toxic stress

Why the drug problem is getting worse. Why twentieth century life puts people under so much pressure that they need to use drugs to survive. And why those who endorse our drug control laws are hypocrites.

Despite all the efforts that have been made to combat drug use and to limit drug abuse, there is absolutely no doubt that drug use and drug abuse are both increasing rapidly.

In theory we should live relatively stress free lives. Few of us in the west have to worry about keeping warm, having enough food to keep us alive or finding somewhere warm and secure to sleep at night. We are better equipped with gadgets designed to make our lives easy than any of our ancestors ever were. We should be happy. We should not need to take drugs to find contentment or to help us escape from the world in which we live. We should not need to use drugs in order to make our lives more exciting.

But more and more people do take drugs. And millions of perfectly normal, apparently sensible, outwardly successful men and women are prepared to risk their freedom and their health for the relatively short moments of pleasure and contentment which they obtain from using drugs.

There are many reasons why.

Some people use drugs to help them cope with daily life; some want to numb their minds; some want to forget things that they cannot otherwise forget; some need drugs to help them cope with the frustrations they encounter every day. Boredom, emptiness, alienation, loneliness, anxiety and depression these are just a few of the reasons why drug abuse is endemic in our apparently rich and successful society.

The truth is that we live in strange, difficult and confusing times. In material ways we are richer than any of our ancestors. But in spiritual ways we are infinitely poorer.

Most of us live in well equipped homes that our great grandparents would marvel at. We have access to (relatively) clean drinking water at the turn of a tap. We can obtain light to work by and heat to cook by at the flick of a switch. Our homes are stuffed with possessions. We have wall-to-wall fitted carpets, automatic ovens. washing machines, tumble dryers, dish washers, food blenders, vacuum cleaners. television sets, video recorders and a whole host of other devices designed either to make our working hours easier or our leisure hours more enjoyable. If we want to travel anywhere we can climb into our own motor cars or we can use public buses, trains or aeroplanes. We are surrounded by the gaudy signs of our wealth and the physical consequences of several thousand years of human ambition and endeavour.

But despite all this, loneliness. unhappiness. anxiety and depression are now commoner than at any other time in our history. There has never before been as much sadness. dissatisfaction and frustration as there is today. We have become so dependent upon the 'things' with which we have surrounded ourselves that when they break down we become aggressive and irritable. We cannot cope without them. The demand for drug-based solutions to our problems has multiplied apparently endlessly.

We have access to sophisticated communications systems and yet never before have we been so aware of our ignorance and never before have so many people felt so lonely. We can fire messages around the world at the touch of a button but we no longer talk to one another. We have more power over our environment than our ancestors ever dreamt of and yet we are regularly and bitterly reminded of our helplessness and our vulnerability. We are materially wealthy and yet spiritually deprived. We have conquered our planet and begun to conquer space and yet we are continually reminded of our woeful inability to look after the planet we live on or to live in peace with one another.

On the face of it. twentieth-century life doesn't look as though it ought to provide us with too much pressure. From the point of view of our ancestors, or indeed of the millions of less fortunate individuals living in less well developed parts of the world, we have few basic worries. Yet, there is little doubt that we suffer far more from stress than our ancestors ever did. Stress is endemic in our society and our use of and dependence on drugs is just one consequence of our inability to cope with the stresses which we have created for ourselves.

The fundamental reason why we suffer so much from stress these days is that our bodies were designed a long, long time ago and are ill suited for modern society. We were designed for the sort of instant world in which there is always likely to be a sabre-toothed tiger waiting just around the corner. And we were designed very well for circumstances like that.

Today, if we are faced with a sudden emergency our bodies respond quickly, dramatically and logically. Our muscles tighten, our hearts beat faster, our blood pressure goes up, adrenaline surges through our arteries, acid pours into our stomachs and our bodies are put on immediate alert. All these physiological changes are designed to help us survive the encounter. They help us fight, run, jump and climb with unusual and quite exceptional agility. The faster heart beat ensures that as much blood as possible reaches our muscles so that they receive a plentiful supply of oxygen. The rise in blood pressure has a similar purpose. The acid pouring into our stomachs ensures that any food that is there will be converted into usable energy, speedily and efficiently.

These basic traits were handed down from generation to generation for the very good reason that anyone who did not respond in this instantaneous way would not survive. Individuals who were not able to run, jump, climb or fight well were eaten up by man-eating marauding tigers. Individuals who did respond in an immediate way lived to produce and raise the next generation. Simple genetics have meant that through ordinary selection processes we are these days particularly well adapted for a world full of dangerous animals and immediate physical dangers.

Unfortunately, these natural, automatic responses are no longer appropriate. Indeed, they are a hindrance rather than a help, for we have changed our world far more rapidly than our bodies have been able to evolve. Instead of being faced with a tiger, a pack of hungry wolves or an angry bear we are far more likely to find ourselves having to face unemployment, large fuel bills or officious policemen. None of these modern problems is easily solved. None can be dealt with by a faster heart beat, a higher blood pressure or tense muscles.

Never before in history have there been such dramatic changes. Attitudes, fashions, fears, feelings and ambitions have all altered rapidly. Revolutionary changes in navigation, medicine, science, military tactics, agriculture, industry and so on have all changed the world a great deal. But our bodies are much the same as they were several thousand years ago. It takes thousands - millions - of years for the human body to adapt and we have moved far too quickly for our own good. Today our protective physical responses are sadly inappropriate. When we find ourselves facing huge bills that we cannot pay; legal threats that we cannot cope with; unemployment caused by factors totally outside our control; officialdom that is backed by authority without being restricted by responsibility; or even the simple need to find a car parking space, we still respond in the simple, physical way: our muscles become tense and our hearts beat faster. But responses designed for a physical threat are of absolutely no help in our world. Indeed, these traditional physical responses are doubly inappropriate, for our modern problems tend to continue for such long periods of time that a dramatic physical response can become positively harmful rather than merely inappropriate. For example, if you are worried about inflation and possible unemployment, then your blood pressure will go up and your heart will beat faster for as long as your worries continue. Since that could well turn out to be months or even years, it is not difficult to see how the damage gets done.

The consequences of all this stress vary enormously. Doctors now agree that nine out of ten physical symptoms are directly caused by stress or else made worse by it. And the massive incidence of anxiety, nervousness, depression and sleeplessness is, without a doubt, a direct consequence of our exposure to, and our inability to cope with, stress. It is hardly surprising that millions of people try to escape from their stresses with the aid of drugs, though the precise type of drug that a sufferer uses will depend very much on the nature of the environment in which he lives and on the people with whom he most commonly spends his time. An international film star may turn to cocaine; a miner to beer and cigarettes; a housewife to one of the widely prescribed benzodiazepines. The type of drug chosen will depend to a large extent on local traditions and expectations. In the east the traditional way of dealing with pressure is to dampen down responses to stress and opium and heroin are both particularly well suited to this because they both make the user feel calm, satisfied and contented. Drives, demands, expectations and ambitions are effectively removed. In the west, however, people feel that they have to keep going and to stay aggressive. And alcohol, which removes the inhibitions, is a much more suitable drug for that sort of response.

As we become materially richer and more powerful so we seem to become spiritually more deprived and individually more afraid. The more we acquire, the more we seem to need; and the more we learn, the more we seem condemned by our ignorance. The more control we have over our environment, the more damage we do to it and to ourselves. The more successful we become in financial terms, the more we seem determined to destroy the qualities and virtues which lead to happiness and contentment. The more we learn about other worlds, the more we seem to forget about our private duties and responsibilities to one another.

As manufacturers and advertizers have skilfully and deliberately translated our wants into needs, so we have exchanged generosity and caring for greed and self-concern. Politicians, teachers, parents and scientists have encouraged each succeeding generation to convert simple dreams and aspirations into fiery no-holds-barred ambitions. In the name of progress we have sacrificed common sense, goodwill and thoughtfulness and the gentle, the weak and the warm-hearted have been trampled upon by hordes of embittered victims who have been taught to think only of the future and never of the present or the past. The society in our global village is a sad one; the cornerstones of our modern world are selfishness, greed, anger and hatred. Too few people talk, listen or help one another. The family unit has been shattered by progress. The driving forces we are taught to respect are greed and ambition.

During the last fifty years or so we have changed our world almost beyond recognition. Advertizing agencies, television producers and newspaper editors have given us new aims to strive for, new hopes, new ambitions and new aspirations. At the same time they have also given us new fears and new anxieties. With the aid of psychologists clever advertizing copywriters have learned to exploit our weaknesses and our natural apprehensions. The advertizers have created ever expanding demands for new and increasingly expensive but worthless products. Our world has been turned upside down. Values and virtues have been turned inside out. Tradition, dignity and craftsmanship have been pushed aside in the constant search for greater profitability.

Our exposure to a type of stress that I call toxic begins at a very early age: it begins in earnest the moment we attend school for the first time. We are taught to take education seriously but we are not told the price we will have to pay. To understand the potential costs to the human spirit and soul it is first necessary to understand the purpose of the education that society is offering. Society does not want to educate people so that they become more thoughtful, more creative or wiser. What would be the point of that? Society doesn't want people to broaden their horizons or enhance their vision. Society doesn't want to instil passion (that can be troublesome and inconvenient) and it doesn't want people to think for themselves (that can be costly and disruptive). What society wants is obedience. Society - the social structure which we have created but which has now acquired a strength and a force of its own - values obedience highly and rewards the obedient more than any other group. Society knows that the obedient will work hard without question. Society knows that the obedient can be relied upon to do work that is dull, repetitive and possibly even dangerous. Society knows that the obedient are unlikely to be troubled by spiritual or moral fears. Society knows that the obedient will fit neatly into whatever hierarchy may exist and will put loyalty above honesty and integrity. Society will always reward those who are obedient because society wants to show other people the value of obedience. If you become obedient then you will also become a good and reliable customer; you will buy things that you don't really need; you will accept shoddy workmanship and unreliability without complaint; you will accept new fashions as necessary and you will buy new clothes and new cars when society wants you to buy these things rather than when you need them. As far as the powerful interests which rule society are concerned, the obedient customer is a passive customer and the passive customer is the best customer. The modern educational system (in its widest sense) is designed to support the structure of our society, but because it inevitably suppresses free thought and encourages the development of frustration it is also a major force in the development of toxic stress. Children, parents and teachers have little or no control over their destiny, which is manipulated for them by the 'system'. Society does not encourage teachers or pupils to think for themselves.

Even as children we are regarded as consumers and from the moment we can sit in front of a television set companies spend huge amounts of money trying to persuade us to buy their products or services. Every day our custom is solicited in a thousand different ways - some subtle and some crude. Every day we will come face to face with an almost infinite variety of messages and exhortations.

The professionals who prepare the advertizements we see are only too well aware that it is no longer enough for them to tell us the value of the product they are selling. These days the competition is so great that advertizing agencies are no longer content to tell us how to satisfy our basic needs; these days they know that in order to succeed they must create new needs; their advertizing must create wants and desires, hopes and aspirations and then turn those wants, desires, hopes and aspirations into needs. They do this through exaggeration and deceit and through the continuing and cynical exploitations of our weaknesses and our fears. Modern advertizing agencies know that it is impossible to sell anything to a satisfied individual. But, in order to keep the money coming in, the agencies must keep encouraging us to buy; they must constantly find new and better ways to sell us stuff we don't want. Any fool can sell us products and services that we need. The trick lies in turning our most ephemeral (and even non-existent) wants into basic needs.

In order to do this, advertizing agencies must use all their professional skills to make us dissatisfied with what we already have. They need us to be constantly dissatisfied and frustrated. They constantly need to create new and more virulent forms of toxic stress.

Modern advertizing raises the intensity of our desires and builds our dissatisfaction and our fears in order to satisfy its own mercenary ends. Modern advertizing is a creative art. The advertizing professional is hired to create unhappiness and dissatisfaction. He is paid to make us want more possessions, excitement or status. He is paid to keep us dissatisfied. The ultimate irony is that he is also paid to sell us many of the drugs we need to take to escape from the world into which we have been plunged by our created needs, frustrations and sadnesses.

Advertizing is designed to make us dissatisfied with anything which cannot be profitable. Advertizers want to take away your appreciation of the simple things in life so that they can sell you complicated and expensive things. They would rather you sat down to watch football on television than that you kicked a ball round in the park. They want you to wash away your natural, sexual odours and replace them with odours taken from the sexual glands of animals. They want you to be in such a hurry that you eat instant foods rather than growing and then preparing your own vegetables. They want you to feel a failure if you don't fill your house with the latest gadgets. They don't want you to be able to wear the old clothes you feel comfortable in. They don't want you to be able to walk freely through your town. They don't want you to enjoy any real freedom. They need your money and so they want your soul.

The advertizing industry is responsible for much of the sickness and the unhappiness in our society. Advertizing may suggest that if you buy such-and-such a product you will become popular and successful. But you will be disappointed. Even if you buy the product you will remain frustrated and dissatisfied. The advertizing professionals make many promises which they know they cannot keep. To the spiritual and mental frustration created by all this disappointment you must add physical frustration too, for the chances are high that the product you buy will soon fail. Obsolescence is built-in and essential to all new products. Built-in mechanical or fashionable obsolescence enables the car companies to keep making and selling us new cars which we cannot easily afford and do not really need. The advertizing professionals do not care about the poor, the disabled, the sick, the frail or the unemployed these people have no money and do not matter, so modern advertizing destroys them. It shows them things they cannot have, and services they cannot buy. It inflames their desires, creates wants and then turns those wants into needs. thereby creating frustration and passion - and violence. The poor do not even have the simple satisfaction of discovering that the products they are offered are never likely to satisfy the promises made for them! Advertizing is one of the greatest causes of toxic stress. Advertizing is built on promises that can never be kept and is a major cause of drug use and drug abuse. Advertizing succeeds by making people unhappy; it represents false temptations, hollow hopes, unhappiness and disenchantment; it inspires values which are based on fear. greed and avarice.

It is hardly surprising that all these pressures have produced new stresses and strains of their own. The pressure to succeed joins with the pressure to conform and the pressure to acquire; as a result we live in a world where the basic levels of stress are fixed at dangerously high levels. Each one of us is confronted with massive amounts of stress every day of our lives. Many of the stresses we are faced with at work and at home can be controlled or avoided. But the stresses which are an inherent part of the world around us - stresses which produce difficult to define frustrations - produce bitterness and a deep sense of ill-defined, unexplained, inexplicable despair. I call these stresses 'toxic' because they produce a deep sense of frustration and unhappiness; the more thoughtful and imaginative an individual is, the more likely he or she is to become a victim.

The sensitive and intelligent respond to toxic stress by becoming unhappy and confused. She feels that she ought to be doing more with her life. He feels that control of his life is slipping away from him. She suffers from a range of symptoms and ailments for which there never seems to be any completely satisfactory treatment. He feels nervous or anxious even though he knows that he doesn't have anything to be nervous about. She feels strangely and inexplicably alone. He feels constantly rushed, unable to find the time to do all the things he feels he ought to do, let alone the things that he would like to do. She worries unreasonably about quite trivial insignificant things that in her heart she knows don't really matter. He feels constantly tired, listless and short of energy. She feels an almost overwhelming and irresistible urge to run away from everything. He feels that life is not as much fun as it used to be - or should be. She feels a complete sense of despair about the future of the world.

The need to start taking drugs is almost entirely a consequence of dissatisfaction and inadequacies, both of which our society deliberately breeds. People are led to believe that life owes them more and more (always more than they have however much that may be); advertizing encourages them to feel resentment, frustration and envy. Individuals who are filled with fear and despair are easy game for those who 'sell' solutions; too late they discover that drugs of whatever kind are no real answer, no real solution; they provide a temporary means of escape but nothing more substantial than that.

Although most developed countries now have some regulations governing the amount or type of advertizing that can be used to promote alcohol and tobacco, the big international companies are extremely adept at getting their message across despite the regulations. And there is no doubt that advertizing - however subtle - is extremely effective. For example, in a report published in the Health Education journal in 1984, Frank Ledwith, research fellow in the department of education at the University of Manchester, reported on a survey which involved 880 secondary school children. Ledwith found that the children he questioned were most aware of those cigarette brands which were most frequently associated with sponsored sports events on television. By testing to see how many children recognized the name of a tobacco company before and after a sponsored snooker competition appeared on television, the research showed that sponsorship of a sport that is going to appear on television acts as very effective cigarette advertizing and gets round the modest legislation in Britain which is, theoretically at least, designed to outlaw television advertizing of tobacco.

There is, indeed, a massive advantage in advertizing a product by associating it with a sport. The people who watch the programmes and see the brand name on television quickly come to associate the name of the product with their sporting heroes. This gives the product glamour and status. There is no doubt that by sponsoring a sporting event a tobacco company can implant its product's name in the minds of young viewers (and they, after all, are the customers of the future) far more effectively than it could by buying straightforward advertizing space.

A growing number of agencies are now aware that it often pays to plan promotional campaigns in unusual ways to attract customers to a product. One market research firm recommended to a tobacco company that in order to sell its product to young people effectively it should forget about advocating low tar brands and should ignore the health question altogether. Instead the company was advised to relate its advertizing to adult activities such as sex and alcohol or to link its products to illegal activities such as pot smoking. The market researchers recommended this aggressive approach because the evidence suggests that it is easier to persuade children to start smoking by telling them that smoking is bad for them and suggesting that it is illegal than by pointing out that a particular brand has less tar in it and is much safer.

One of the big questions about tobacco and alcohol advertizing concerns the effectiveness of the advertizing in attracting new recruits. Both the tobacco industry and the alcohol industry argue that their advertizing is designed to persuade existing drinkers and smokers to switch brands, rather than to encourage non-smokers or non-drinkers to start smoking and drinking. In a publication called 'The Impact of Advertising on the United Kingdom Alcoholic Drink Market' and published by the Advertising Association in 1983, Dr LM. Hagan and MJ. Waterson claimed that 'alcohol advertising is virtually entirely specific brand-orientated advertising: it is promoting a particular name of beer or spirits, etc.; it is never promoting alcoholic drink as a total concept'. The authors also claim that, only a very small fraction of the population can be classed as alcoholics or as abusing alcohol in a serious manner'.

This argument, frequently put forward in a similar way by the tobacco companies, does not stand up well to examination. The fact is that tobacco companies continue to advertize in those countries where they have a sales monopoly and it is extremely difficult to accept that advertizing which shows a man or a woman enjoying a successful or pleasant lifestyle while smoking a cigarette will have no effect on young, uncommitted viewers. I firmly believe that the advertizing of tobacco and of alcohol has had a most powerful effect on the number of people using those two drugs and am appalled at the way in which major, international tobacco and alcohol companies are now enthusiastically promoting their products in underdeveloped and developing countries (using cynical and aggressive marketing techniques that would be banned in much of the world) where there is a considerable envy of the western life style, very little pressure on the authorities to introduce controls or warnings and virtually no understanding among the general population of the hazards associated with these two activities.

The world's major advertizing agencies have helped to create a massive and widespread need for pharmacological support. And, in true cynical style, they have succeeded in satisfying that need by helping to promote two of the world's most dangerous and most addictive drugs. There is a certain absurdity in the fact that, while cocaine and heroin smugglers are hounded and persecuted, the elegant, well educated executives who work for the tobacco industry, the alcohol industry and the advertizing industry receive huge financial rewards and acclaim from society for their destructive and damaging work.

The pressure from advertizers is not, of course, the only source of pressure that causes stress and puts people into a situation where they start taking drugs in order to escape from their world. Some of the pressures which lead to drug taking are unsuspected. Boredom, for example, is one of the most underrated sources of pressure in our society. We tend to think of it as being nothing more than a mild, usually temporary nuisance; a fleeting irritation that can be cured with a good book, an interesting conversation or an amusing film. The truth is very different. There is now considerable evidence to show that boredom is a major cause of distress, anxiety and depression.

Many different groups of people suffer from boredom.

There are the millions who are unemployed and who see no prospects of finding employment. In just about every so-called civilized country a growing number of men and women know that they will probably never work again. And while that is bad enough the horrors endured by young school leavers facing a lifetime of unemployment hardly bear thinking about. As factories become more automated and offices become more streamlined there is a smaller and smaller need for factory workers or office staff. And as the number of people gainfully employed in factories and offices falls, so the demand for service industries falls too. For as long as we continue our love affair with computers and high technology we are trapped in this spiral and the levels of unemployment will continue to rise. Because we live in a job-orientated society where status and self-respect depend on having a job with some position and power, unemployment produces a number of very damaging forces. The individual who has lost a job, or who is unable to find a job at all, will undoubtedly feel a tremendous sense of guilt and failure. But there will also be seemingly endless days of dull, unremitting boredom.

Second, there are those whose jobs are simply undemanding, unrewarding and uninspiring. Not so many years ago just about any job required skills of some kind. A craftsman would be expected to have agile fingers and skilful hands. A clerk would be expected to have a facility with words or figures. Today, however, in shops and offices there are millions of employees whose jobs are quite free of skills or responsibilities. There are computers and word processors which can write letters, add up numbers, check spelling and keep files far more efficiently and rapidly than any clerk. In factories, there are countless thousands whose work demands nothing more than that they act as nursemaids to complex pieces of machinery which can turn out an endless series of perfect objects, created to standards that no craftsman could ever hope to match. The machines have become the principals in just about all working relationships. And instead of doing work from which they can derive satisfaction and pride, men who might have once been regarded as skilled craftsmen simply baby-sit masses of machinery which deny their operators any opportunity for pride, pleasure or self-expression.

Then there are the men and women who have been encouraged to retire early. Trade union officials routinely and noisily campaign for earlier retirement for their members. And yet millions of people regularly complain that they had to retire too soon. Even the simplest and least demanding job offers something in the way of authority, meaning, purpose, companionship and friendship. A man may complain about his job, his working conditions and his employer but at least he has something positive about which to complain. Even that simple pleasure, that fundamental human delight, is denied the individual who has retired too soon.

Next, there are those children at school who can see no prospect for themselves other than years of collecting unemployment money. For them there can be no bright future, no dreams, and no ambitions to nurture. Their school work becomes unbearably dull because they lose heart and see little point in struggling through academic chores that can lead them nowhere.

Finally, there are those housewives who, perhaps more than any other group in our society, are modern day victims of boredom. They may live in comfortable homes and have healthy, good-looking families dressed in attractive clothes. But their lives are too often planned and organized around pieces of household machinery: washing machines, tumble dryers, freezers, microwave ovens and pop-up toasters in relation to which they have no creative role. Their opportunities for self expression or real fulfilment are slim indeed. The women's liberation movement has reminded them of their rights and of their potential but it has done very little to help them achieve those ambitions.

For all these people boredom is a driving force that pushes them relentlessly along a road to one or other of the many forms of addiction - their choice will depend upon their circumstances. The bored housewife may end up taking tranquillizers. The bored school boy starts sniffing glue or, if he lives in an area where heroin use is common, he may become a heroin addict. Other men and women take to tobacco or alcohol.

Boredom remains consistently underestimated as a driving force among addicts. The reality of it all was perhaps best described by William Burroughs in his book Junkie. Describing his childhood, Burroughs wrote:

'At this time I was greatly impressed with the autobiography of a burglar called You Can't Win. The author claimed to have spent a good part of his life in jail. It sounded good to me compared with the dullness of a Midwest suburb where all contact with life was shut out. You become a narcotics addict because you do not have strong motivations in any other direction. Junk wins by default. I tried it as a matter of curiosity. Most addicts I have talked to report a similar experience. They did not start using drugs for any reason they can remember. They just drifted along until they got hooked.'

With boredom behind their need for drugs it is hardly surprising that so many addicts return to drug taking within a year or two of giving up. It is often said that addicts return to their addiction because they cannot stand the uncomfortable symptoms of withdrawal. But that really is not true. The truth is that the depths of boredom are so great that drug addicts take drugs not to ward off withdrawal symptoms but because the modest pleasures afforded by drug taking exceed the pleasures normally available to them.

It has long been established that there is a link between unemployment and depression, and between boredom and the search for risk and excitement provided by drugs. But in recent years it has become clear that in some ways the welfare state itself can be extremely unhealthy, for as it takes away personal responsibility, so it produces a real need for thrills and excitement.

For many years experts around the world have argued about whether or not it is possible to define the type of individual who is most likely to become an addict. It has been suggested that the majority of addicts have personality problems which create social difficulties and that it is these social problems which are eventually responsible for the individual's need to turn to drugs. It has been argued that people who became addicts are invariably shy, sensitive and exceptionally nervous; individuals who are emotionally uncertain and, underneath a veneer of sophistication and strength, in desperate need of love and affection. Potential addicts, it has been said, are people who have difficulty in forming close relationships with other people, people who find that drugs help them by providing them with relief, support or confidence. Drug addicts, it is argued, are lonely and insecure people who derive comfort from the drugs they take.

Other psychologists have argued that addicts are usually inadequate or inferior in some way and need drug support because they find themselves constantly failing to fulfill social expectations. To illustrate their argument they refer to addicts who have turned to drugs when they have been unable to satisfy their parents' ambitions. These people tend to be guilt ridden, hard working and exceptionally vulnerable to criticism. They have little or no self-confidence and although they may be far more successful than they realise they are often driven by a deep sense of continuing despair and personal failure. They may also feel an unexpressed, even subconscious, sense of anger towards one or both parents.

I have also seen it said that the majority of addicts are rather childish in their outlook, that they tend to be depressives, that their behaviour is often excessive, that they are unusually intelligent and frustrated by their inability to make any headway in life, that they are disorganized, exceptionally unruly and unable to cope with pressure and that they are, quite simply, over-demanding both of themselves and of society.

All these explanations can. of course, be summed up in one word: immaturity.

If the experts are to be believed, people take drugs because they cannot cope and they cannot cope because they have not become mature enough to deal with life's problems sensibly and dispassionately.

But this is, of course, only a fraction of the story.

Many immature people get through life quite successfully without ever using drugs. And many apparently mature individuals become totally dependent on drug support. The truth is that very few of us could ever claim to be totally in charge of our lives and always capable of coping with problems and pressures in a sensible way. Most of us would admit that under some circumstances we feel nervous or inadequate, incompetent or rebellious. Indeed, responses of that type can be an asset rather than a liability, an enriching factor rather than one likely to damage the quality of our lives. After all, it is uncertainty and insecurity which drive us onwards and upwards and it is vulnerability and rebelliousness which give us our creative faculties.

I do not believe that personality is normally the decisive influence on an individual's chances of becoming a drug addict; it is not so much the personality of the individual which ultimately determines whether or not he becomes an addict but the circumstances in which he finds himself. In these cases, people are always too willing to blame the victim.

Addiction is above all culturally based: 72 per cent of the heroin addicts among United States servicemen in Vietnam came off heroin with relative ease once they got home and away from the war and from Vietnam. It was being in Vietnam, fighting a confusing war, which led them to addiction. Given the right circumstances we are all potentially vulnerable; we all have weaknesses and fears; there are times when we all need to escape from pain, hopelessness and isolation. The only factor that separates the addict from the non-addict is the fact that the addict has found himself in a situation where his personality has proved too fragile, while the non-addict has not yet strayed from an environment in which he is able to feel competent and in control. Anyone tempted to feel smug or self-satisfied at not being an addict (and remember that most of us are addicted to something) should remember that it is fate which determines our circumstances, our needs and, eventually, our vulnerability. People who become addicts are simply people who have gone too far, who have pushed themselves beyond the limit of their endurance and who need drug support to help them cope with their anger, their shame, their guilt, their isolation and their frustration and, indeed, with life. If the drug is effective then they are likely to become hooked; the stronger the relief the greater the compulsion. Addicts may be weak but they are weak because they have pushed themselves and they have pushed themselves because society has encouraged them to do just that.

The final irony is that we have created a society which breeds addicts. More than that we have created a society which profits from addicts. Back in 1975 American President Gerald Ford seemed to show more than a usual amount of understanding (for a politician) when he said: 'We should stop raising unrealistic expectations of total elimination of drug abuse from or society ... The sobering fact is that some members of any society will seek escape from the stresses of life through drug use'. What he perhaps should have gone on to say is that legal rules will not define or restrict the drugs which those who need the help of drugs choose to use; the existence of laws means that there will always be some drug users forced to break the law. People become addicts because there are problems in their lives which they cannot solve; the fact that the solution they have chosen eventually creates new problems which mask and overtake in significance the original problems is a social irony.

It is hardly surprising that millions of people have taken to drugs to try to deal with feelings inspired by toxic stress. When faced with patients suffering from these very same symptoms doctors have responded in exactly the same way: by prescribing drugs.

For many years now doctors have attempted to treat patients suffering from toxic stress with tranquillizers. And their attempts to treat such patients have frequently made things worse rather than better. Tranquillizers solve none of the fears or anxieties caused by toxic stress. Indeed, because they are themselves frequently addictive and because the list of side effects associated with their use seems endless, tranquillizers have created new problems. Time and time again doctors and drug companies have created new forms of addiction by rash prescribing practices, by a willingness to promote and prescribe drugs which have not been thoroughly tested and by an enthusiasm for the new which is rarely tempered by scepticism or suspicion.

There is, sadly, no doubt that one of the major factors in the rising incidence of drug addiction in recent years has been the role played by the medical profession. (And one of the true ironies of health care in the twentieth century is the fact that a huge speciality within the profession has been formed to deal with problems largely created by doctors themselves). A small part of the problem has been caused by the deliberate and callous provision of drugs for money, but the greater part of the problem results from carelessness and simple ignorance.

The precise size of the part played by doctors in our modern drug addiction problem is impossible to estimate. Too many other factors are involved. But the significance of the medical contribution is well illustrated by specific illustrations; by the way that the heroin problem developed in Britain in the 1960s for example. There were, at that time, relatively few heroin addicts in Britain (no more than a few score) and no one took the problem very seriously. Although steps had been taken in other countries to control the supply of heroin through specialist centres, British doctors insisted on retaining their prescribing freedom. It was argued that if doctors simply gave the addicts they saw the precise amount of heroin that they needed. then the problem could be controlled without too much difficulty. The main advantage of this system was seen as the fact that it would keep the black marketeers out of the country. If heroin addicts could get their supplies without any difficulty there would be no incentive for smugglers to move in (in fact the number of addicts was so small that there was no incentive for drug smugglers anyway).

The system broke down because it relied on doctors prescribing the right quantities. The relatively small number of doctors who were prepared to prescribe heroin for addicts wildly over prescribed ~ sometimes through carelessness. sometimes through gullibility and often through straightforward greed. There were never more than about half a dozen doctors prescribing for Britain's addicts in the 1960s but working mainly in and around fashionable and expensive Harley Street these doctors helped to create Britain's heroin problem by prescribing in such huge quantities that their patients were able to sell their excess supplies. Within a remarkably short time the number of heroin addicts in London had multiplied many times. And by the time the authorities stepped in the situation was perfect for the smugglers: there were now enough addicts to make an illegal business venture worthwhile.

In just one year in the 1960s 42 kilograms of the 46 kilograms used for medical treatment was prescribed by six doctors. Lady Isabella Frankau, a doctor who practised in Wimpole Street in London, was single-handedly responsible for the prescribing of hundreds of thousands of heroin tablets to addicts. In 1967 Dr John Petro took over her practice when she died and in a single month he prescribed 24,906 drug ampoules to 110 patients. Well into the 1960s all the drug seizures which were made by the authorities consisted of pure pharmaceutical heroin or cocaine - none of it had been smuggled into the country or 'cut' with a dilutant because there was no market for drug smugglers to exploit.

Tragically, nothing much has changed. Even in the 1980s a doctor said to have written up to 10,000 private prescriptions a year (and to have charged £10 for every prescription) was suspended from practice. It is hardy surprising that in the early 1980s Mr H.B. Spear, Chief Inspector at the Home Office Drugs Branch in London, wrote that 'the overspill from doctors' prescribing has for many years been a major element in the UK illicit market in controlled drugs'.

Apart from these crude examples of greed and gullibility, doctors as a breed are far too easily corrupted, too willing to accept what they are told by drug company representatives and too quick to leap at the chance to prescribe 'new' drugs. Time and time again they have offered their patients untried compounds as a cure or as an alternative for well established ones, and time and time again doctors have created a new and more vicious form of addiction than was known before. Doctors created and promoted morphine as a cure for opium addiction. Doctors created and promoted heroin as a cure for morphine addiction. Doctors created and promoted methadone as a cure for heroin addiction. Doctors told their patients that bromide was a safe non-addictive treatment for anxiety. When that proved to be untrue (and millions of patients had become hooked on bromide) they recommended the barbiturates as safe and non-addictive. When that proved to be untrue (and millions of patients had become hooked on the barbiturates) they recommended the benzodiazepines as safe and non-addictive.

With all these drugs the major factor behind the development of the problem has been that doctors have sought a medical solution to social problems. Traditionally, doctors are trained to think in simple, straightforward terms. They see all disorders starting as a result of biological, chemical or electrical abnormalities and they invariably regard drugs as the primary treatment of choice. Tragically, many of the symptoms that patients take into the doctor's surgery these days are caused by social problems for which there can be no pharmacological answer. And although doctors will tell a drinker that it is dangerous to take alcohol in an attempt to relieve real life problems (for that is how alcoholism often starts), the same doctors will prescribe drugs such as the barbiturates and the benzodiazepines for patients who have physical or mental symptoms caused by social problems for which, similarly, there is not and cannot possibly be any pharmacological solution. If the drug works and suppresses the patient's symptoms, then addiction is almost inevitable, for the patient will learn that as soon as he stops taking the drug that has been prescribed his original, unpleasant symptoms will recur. Any drug that is given to treat anxiety must, if it works, be addictive.

And, of course, whether an individual becomes an addict through his own poor choices, through ill luck or through the errors of a physician, he will still be regarded as an addict. The stigma is the same. Millions of individuals who have become hooked through absolutely no fault of their own are treated badly by doctors, by society and by employers. During the last two decades I have received tens of thousands of letters from people whose lives have been ruined (in every possible sense of the word) because of benzodiazepine addiction. Most report that the agony of their addiction has been compounded by the feelings of shame and guilt they have been encouraged to bear, and by the sense of outrage they feel at the way they have been treated.

Thousands of patients have died because of the arrogance and stupidity of the medical profession. We hear about the deaths of the movie and rock stars such as Jimi Hendrix, Elvis Presley (when he died Presley was obscenely fat and incoherent and had to wear a nappy because of incontinence caused by his addiction to a wide range of prescribed drugs - one doctor alone admitted prescribing ten thousand pills for the singer in the last twenty months of his life), Janice Joplin, Jim Morrison, Keith Moon, Brian Epstein and John Belushi (most of whom took prescription drugs in addition to illegal substances) but we never hear about the thousands of clerks, mechanics and housewives who die after being given prescribed drugs. Drug companies have repeatedly produced new drugs (and variations on existing products) which are neither necessary nor safe and have then heavily promoted those products to an eager mass market, eventually expressing surprise when their drugs have turned out to be addictive. Drug companies have encouraged expectations about drugs and they have encouraged the acceptability of drug use. Doctors and drug companies have, without a doubt, produced infinitely more addiction and more misery than all the cocaine and heroin pushers of the world combined. In most large cities there are scores of doctors earning huge amounts of money by handing out prescriptions for favourite drugs.

The fact is that drugs - whether prescribed, bought over the counter, bought at an off licence or obtained illegally - are not any sort of answer because neither toxic stress nor the syndrome it produces (which I call 'the twentieth-century blues') are essentially medical problems. The word 'toxic' is a synonym for 'poisonous' and toxic stress is an insidious, morally and spiritually destructive disease. It eats away at the soul but it is not a disease that is ever likely to respond to any pharmacological therapy. The twentieth-century blues is a disorder of the soul rather than the mind; a disease of the spirit rather than the body. Indeed, the additional cruel irony is that by taking a drug a patient will be less and less likely ever to solve his problem. By numbing an individual's mind and slowing down his thought processes (which is what all anti-anxiety drugs do) the doctor damages the patient's ability to deal with his real problems. And so the trap is tightened and complete. The patient's circle of addiction is turned into a restrictive noose from which there is no escape. Most of us will buy a friend a drink if we know he is nervous or anxious. In our hearts we know that it probably is not the sensible thing to do but we do it out of compassion. But that is exactly what has been happening in doctors' surgeries for decades, except that instead of buying their patients a single evening of blissful forgetfulness, doctors are prescribing blissful forgetfulness by the month.

What is perhaps most surprising about the fact that doctors continue to prescribe drugs for the treatment of anxiety is that they persist in the belief that there will one day be a drug available that will work without producing addiction. That suggests an ignorance of the human spirit (and an ignorance about drugs) which should worry us all. For it is not the drug alone that produces the addiction; it is the combination of the drug, the individual's needs and his circumstances. And of those three the nature of the drug is perhaps of least significance. It is impossible to produce any effective relief from anxiety and not run the risk of producing an addiction to the agent responsible for providing the relief.

During the last two decades the demand for drugs has grown so rapidly that doctors have had to introduce more 'efficient' schemes for handing out prescriptions. For example, many now provide tranquillizers and sleeping tablets on repeat prescriptions. This means that patients can get a supply of tablets without going anywhere near the surgery or the doctor. A telephone call or a letter to the receptionist results in a prescription being left out for collection or sent back by return mail. The repeat prescribing of modern drugs is one of the major reasons why there are so many addicts around today.

Most frightening of all is the fact that despite the existence of an enormous amount of evidence to show that new drugs which are described as non-addictive almost invariably turn out to be addictive, many doctors seem consistently enthusiastic about new products, accepting the manufacturers' claims with remarkably little cynicism. The only possible explanation is that doctors are addicted to prescribing just as much as their patients are addicted to swallowing. The reason for this professional addiction is simple: doctors do not know what else to do. Much of the time they spend struggling to deal with problems for which they have never had any formal training. Doctors are trained to deal with physical disorders and physical symptoms but today the high levels of stress that patients are under mean that most of their patients have psychological problems and mental symptoms.

The traditional medical answer to a physical problem is to prescribe a drug. Just a hundred years or so ago, doctors did not get paid anything unless they handed over a prescription - and so doctors prescribe drugs because they have nothing else to offer.

There are two final reasons why drug addiction is so common - and is, despite the war being fought by politicians and legislators, getting commoner.

The first of these is cost.

It may sound obvious but the price of a drug has a tremendous influence on the number of people taking it. Children sniff glue not because it is better than anything else, or even more available, but because it is one of the cheapest psychoactive drugs available. Despite their avowed determination to reduce drug consumption, governments have rarely used price as a serious restricting factor on the sale of addictive drugs. During recent years in Britain the real cost of alcohol has steadily declined. Today it takes roughly half as long to earn the price of a pint of beer as it did thirty years ago. There seems little doubt that a modest increase in the price of alcohol would result in a fall in the amount of alcohol being consumed. A study done by a team of researchers in Edinburgh, Scotland showed that the single most frequently cited reason for cutting down on alcohol consumption was the price. Even heavy drinkers said that they always cut down when the price went up.

There can be little doubt that governments which are reluctant to raise taxes on abused and addictive products such as alcohol and tobacco are unwilling to risk the loss in revenue that they fear might result and are more concerned about their own short-term finances than about the long-term health of their electorates.

The other major influence on drug use and abuse is fashion. There are individual fashions in drugs just as there are fashions in clothes and motor cars. Cocaine is an upper class drug. Benzodiazepines and barbiturates and amphetamines are middle class drugs. Heroin is a lower class drug. At any one time there will be specific drug fashions in specific areas.

But it is the fact that drugs in general are fashionable that we should worry most about. Children grow up in our society regarding drugs as a normal part of everyday life; they see their parents using drugs to avoid conception, to get to sleep and to treat mild headaches. It is hardly surprising that children grow up to accept that drugs can be used to help eradicate boredom, to help deal with pressure and to cope with a heavy work load. Our familiarity with drugs has led to contempt for the dangers associated with them. We have learned to use drugs and to take advantage of their powers but we have not yet learned to fear them.

Our attempts to deal with drug addiction have proved fruitless and ineffective and there can be little doubt that the size of the world's drug addiction problem would be much smaller if those responsible for organizing treatment programmes had put more thought into what they do. The most important mistake they have made has been to concentrate their efforts almost entirely on the period during and immediately after withdrawal. They have assumed that these are the difficult moments when addicts need the maximum amount of support. They are, however, wrong.

Ex-addicts need help to re-establish themselves and to survive without drugs long after the days of withdrawal, not because of any direct physiological hangover effect of the drug they have taken but because of the fact that they usually remain in the same social, financial and personal environment where they first got into trouble. If they are to give up their drug they must also abandon their friends and their adopted culture and return to boredom, emptiness and a sense of worthlessness. With temptation and opportunity remaining and with those around them using the drugs they are trying to avoid, it is hardly surprising that so many people succumb shortly after giving up. Those struggling to help 'cure' drug addicts should remember that at least nine out of ten dieters fail - a worse failure rate than that endured by heroin addicts. This is not because food is even more addictive than heroin but because would-be slimmers have to struggle to eat less in a world where advertizing campaigns are constantly being waged in an attempt to get everyone to eat more.

Way back in 1926 the Rolleston Committee (set up to investigate drug addiction) announced that 'relapse, sooner or later, appears to be the rule' and recommended that addicts who failed to break their addiction should simply be maintained on their drug for life. Alarmingly, this defeatist attitude is still popular among some doctors and many politicians who are either unable or unwilling to understand the link between drug addiction and social circumstances. Our treatment of addicts is illogical, poorly thought out and badly sustained. In The Law and the Treatment of Drug and Alcohol Dependent Persons (published by the World Health Organization) Porter, Arif and Curran list no fewer than twelve different approaches to detoxification from opiates. Whenever the experts are split and cannot decide which type of treatment works best, it is safest to assume that no form of treatment works well.

Our understanding of addiction as a phenomenon is about as far advanced as our understanding of mental illness was two centuries ago. Most governments around the world put most of their emphasis on the harassment of users as much as suppliers rather than on the provision of any sort of effective, constructive treatment programme or any attempt to prevent the development of addiction. Even those involved in the specific treatment of addiction often seem ignorant of the fact that treatment aimed at an addiction itself is worthless without any attempt to deal with the root causes of addiction. And those who organize treatment programmes seldom seem to understand that the absence of a drug frequently leaves an addict with a void in his life; many addicts are addicted to their addiction, hooked on the paraphernalia of their addiction and obsessed by the constant need to fulfill the needs of their addiction.

Programmes for drug addicts seem based on the simple idea of forcing the addict to stop using the drug he is addicted to. This is as logical as forcing someone suffering from anorexia nervosa to eat. If you force an anorexic to eat, you may manage a short-term solution to the symptoms, but you will not find a solution to the basic cause of the problem.

The incompetence of many of those who are paid to help drug addicts is illustrated more than adequately by the type of campaign routinely organized by such groups. Failing to understand that many young users are frightened neither by the physical dangers nor the legal threats, many posters and television advertizements have been prepared showing emaciated James Dean types standing alone, moody, angry and emaciated. The aim is, presumably, to shock and frighten the would-be addict. But such advertizements are more likely to attract the rebellious youth than to repel him. How can you use normal advertizing techniques to induce a sense of fear in someone who injects heroin directly into his penis or the end of his nose? How can anyone hope to use normal techniques to induce anxiety in someone who injects melted cheese and salad cream into his veins when he cannot get hold of his normal drug?

Danger inspires curiosity among the young who have a poorly developed sense of their own mortality. Motorbikes, unprotected sex and bunjee jumping are all popular with the young because of the danger, not despite it. Addicts are notoriously unreliable and anti-authoritarian; they are unlikely to be put off or convinced by authoritarian advertizements. The risks, the danger and the lawlessness are part of the attraction. As Rolling Stone editors Ira Mothner and Alan Weitz point out in their book How to Get Off Drugs, many youngsters keep on using drugs not in spite of their fears but because of them. What we must all remember is that studies performed in the 1960s showed that two out of five smokers were made depressed by their first attempt at smoking cigarettes and most felt sick, but they put up with the unpleasant symptoms and persevered because the peer pressure was greater than the discomfort. Getting high is a puberty rite and youngsters use drugs to boost their self-confidence. Taking drugs helps defy authority, it enables youngsters to show that they are brave and it is something they can do alone. When the police raid drug parties they are encouraging more parties by giving the users of drugs a purpose; drug raids encourage drug use. The demand for mind-altering drugs is age old and irresistible.

It is also worth pointing out here that the tendency in some clinics for those offering help and advice to insist on including a lecture on the hazards of drug use as an essential ingredient of their treatment programme is bound to be counter-productive. If patients visiting sexual disease clinics had to put up with a talk about the perils of promiscuity every time they sought help, there would be a black market in antibiotics.

The final reason why drug use is going up is undoubtedly the hypocrisy exemplified by the double-edged approach to drug use taken by politicians and legislators. The hypocrisy is usually inspired by commercial interest and enhanced by political expediency but it is always initiated by the arbitrary and illogical ways in which drugs are chosen to be put on the 'forbidden' list. Drugs are not banned because of the damage that they do to the individual; they are not banned to discourage their use by others; they are not banned because of the damage users do to other members of society and they are not banned because of the cost to society. If drugs were banned for any of these reasons then tobacco and alcohol would be banned and heroin, cocaine and cannabis might be freely available.

Consider, for example, the way that cannabis got itself listed as a dangerous drug alongside the far more dangerous opiates. It is, indeed, difficult to find a drug which better illustrates the illogicality and pointlessness of drug control legislation or which illustrates more dramatically the hypocrisy of those who are entrenched opponents of drug use.

Back in the nineteenth century cannabis was used in Britain to help opium eaters kick their habit (history is full of these absurdities) and the drug is so mild in its effects that the chances are that it would have remained a fairly obscure drug had not a Dr Warnock, then Superintendent of the Cairo Asylum in Egypt, written a report suggesting that cannabis might be the cause of insanity. Dr Warnock wrote his report in 1895 and it seems likely that he came to his conclusion because many of the inmates in the asylum where he worked were enthusiastic cannabis users. What Dr Warnock seems to have overlooked is the fact that cannabis was extremely popular outside the asylum too.

Dr Warnock was very much out on his own when he wrote his report. Other experts who had studied cannabis had all come to a very different conclusion. For example, the Indian Hemp Drugs Commission of 1893-4 was set up to examine the trade in hemp drugs such as cannabis and their effect on the social and moral condition of the people of India. The Commission had been given the job of deciding whether or not cannabis should be made illegal and its conclusion was that the physical, mental and moral effects of cannabis were not adverse and that there was no evidence of cannabis leading to addiction. All the available evidence suggested that cannabis was no more damaging a drug than tea or coffee.

But Dr Warnock's isolated and rather eccentric and poorly based opinion became of vital importance in 1925 when Britain, together with a number of other countries, signed the International Opium Convention. The Convention was designed to introduce binding international controls on the sale of opium and cannabis was included along with the far more dangerous opiates as a result of pressure from Egypt where people still believed Dr Warnock's solitary report and assumed that the regular use of cannabis could lead to mental illness. Britain and the other signatories accepted Egypt's bizarre request to include cannabis on the list of controlled drugs since it seemed, at the time, to be a fairly modest and almost irrelevant concession. The outlawing of cannabis, one of the world's most harmless drugs, was regarded as a small price to pay for persuading Egypt to sign the international opium ban. Ever since 1925 cannabis has remained on the 'controlled' drug list and, despite the continued absence of any evidence to show that it is a dangerous drug, politicians have steadfastly refused to reconsider its status. And yet cannabis is no more dangerous than caffeine or chocolate, and if Dr Warnock had written his paper about those substances the chances are that they would today be regarded as dangerous drugs and would be sold on street corners in small packages for high prices, while cannabis would be sold in corner shops and advertized freely on television to children.

Compare the way politicians and legislators treat cannabis to the way the same people treat alcohol and tobacco and the contrast is startling.

Some politicians claim that tobacco and alcohol get special treatment because they bring in huge amounts of revenue which are needed to lubricate social services. This is, quite simply, untrue.

Tobacco and alcohol don't simply cost society an enormous amount in damaged lives but they also cost society a vast fortune in cash, for the cost to society of all the damage done by these two drugs far exceeds the revenue. In a paper entitled 'The Taxes of Sin: Do Smokers and Drinkers Pay Their Way?' a team of specialists writing in the Journal of the American Medical Association in 1989 concluded that 'poor health habits, such as smoking and heavy drinking, carry costs not only for smokers and heavy drinkers, but for everyone else as well'. After a careful study of collectively financed health insurance, pensions, disability insurance, group life insurance, fires, motor vehicle accidents and the criminal justice system, they concluded that 'nonsmokers subsidize smokers' medical care and group life insurance' and that excise taxes on alcohol cover only about half the costs imposed on others'. Estimates in the UK support the conclusion that the taxes paid by smokers and drinkers are insufficient to pay for the social costs of their habits.

4 Heroin, cocaine, cannabis and LSD

Heroin, cocaine and cannabis why these drugs are not as dangerous as some people would have us believe

When journalists write about 'drugs' and politicians talk about them they are usually referring to three particular drugs: heroin, cocaine and cannabis. The implication is always that these three drugs are particularly dangerous and exceptionally addictive and it is upon this theory that some of the legislation and most of the law enforcement agencies designed to control the sale and use of these drugs are founded. The principle of the entire illegal drug philosophy would be considerably weakened if it could be shown that these three drugs are no more dangerous or addictive than many other legally available drugs.

In this chapter I intend to show not only how these drugs came to achieve widespread popularity and how, in many cases, laws have had exactly the opposite effect on drug taking to the one intended, but also why I believe that these three drugs are not only no more dangerous or addictive than other drugs but are less dangerous and less addictive than tobacco, alcohol and the benzodiazepines. In the next chapter I will describe some of the drugs which I and other drug experts believe to be more dangerous and more addictive than heroin, cocaine or cannabis - and to cause far more physical and mental distress.

This argument is vitally important, for once it becomes clear that the legislation governing drug use is designed to control three of the least dangerous psychoactive drugs (the legislation was, after all, developed over half a century ago when our knowledge about these drugs was primitive to say the least) the only logical steps are either to decriminalize heroin, cocaine and cannabis or to outlaw alcohol, tobacco and the benzodiazepines. Since the second of these choices would be unworkable (for the same reason that the attempts to control the use of drugs currently made illegal has failed) the only sensible plan is decriminalization.

Heroin, morphine and opium are all narcotic drugs which are derived from the same basic source and produce similar effects on people who take them. Extracted from the oriental poppy plant which grows - very easily and in poor soil - in such varied places as India, Turkey, China, Russia, Egypt and Mexico, these narcotics all depress the central nervous system, relieve pain, induce sleep, cure coughing and diarrhoea and can produce an extraordinary feeling of comfort and well-being. They make stress and worry fade away and create a pleasant, euphoric feeling. Like all psychoactive drugs, opium and its derivatives have a pleasant and mood-altering effect. That is, after all, why people use them. Not many people get hooked on drugs which invariably make you sick and which make your hair fall out.

The basic product obtained from the poppy plant - opium is the dried juice from the plant's pods. When pods are cut open white juice oozes out and quickly turns a deep reddish brown as it oxidizes in the air, eventually hardening into balls of gum which have a sweet smell and a bitter taste.

Opium has been used for thousands of years. The ancient Greeks and Romans called it 'the destroyer of grief', while the ancient Egyptians used it for a variety of purposes ~ including quietening crying children. We tend to associate the opium poppy with the Far East but it was not until Arab traders carried it there in the sixteenth century that the drug became popular in either China or India.

By the seventeenth century opium had reached most of Europe and Thomas Sydenham, one of the great fathers of English medicine and a renowned teacher and physician, recommended it for the treatment of pain and for helping patients to rest and to sleep. British doctors did not have many drugs available at the time and took to opium with tremendous enthusiasm. Within a century or so it was being wildly overused in England and one worried observer pointed out that its use to deal with hysterics and nervous disorders was like giving pills to try and 'purge folly'. Opium was to eighteenth century England what the bromides, barbiturates and benzodiazepines have been to the world in the twentieth century.

But it was in China that the opium drug caught on in a really big way. The poppy plants grew easily in India and so there was no shortage for British companies to export to the Chinese mainland. By the nineteenth century the Chinese rulers had recognized the damage that the drug was doing and twice went to war with the British, whose trade domination of the Chinese mainland was dependent on opium. The British won both wars and in the mid-nineteenth century the opium trade became legal. Those British victories - just a century or so ago - led to major problems around the world. It was the legalization of opium in the Far East that led to its widespread use in the United States a few years later.

For most of the nineteenth century opium was available at modest prices just about anywhere in the world; it could be bought in local stores or by mail order and it was sold for a thousand and one different purposes. In most countries it was sold without any restrictions and was generally regarded as a useful home medicine. People used it to help them sober up when they had been drinking too much (in the history of drug use it is clear that time and time again drugs gain popularity when first used to deal with the after effects, side effects or withdrawal effects of other drugs) and parents used to treat their children with it when they developed gastro-intestinal infections and diarrhoea from drinking foul, infected water. Poor water supplies, inadequate sewage facilities and terrible overcrowding in the cities caused thousands to suffer from disorders such as cholera. Doctors could not cure the medical problems, but opium did ease the pains, control the diarrhoea and help people forget their misery.

When the widespread use of opium led to numerous cases of opium overdosage (and many deaths) the authorities in England introduced the 1868 Pharmacy Act to control the sale and availability of opium. However, at that time physicians and apothecaries were fighting for power within the medical profession and so the 1868 Act was kept weak. In practice all the new legislation meant was that if you wanted to buy opium you had to buy it from someone with an officially accepted qualification. This new law did not affect the number of people using opium at all; it just meant that the profits relating to its sale were channelled into the hands of the medical and pharmaceutical professions. To put it bluntly opium was still easily available but it had to be bought from a registered pharmacist. The 1868 Act was a cynical piece of commercial exploitation which was weakened even further by the fact that pressure from patent medicine manufacturers ensured that patent medicines containing opium were excluded from the Act. (As a result of this amendment to the 1868 legislation some products containing opium were still available in Britain over the counter - without a prescription - as recently as the 1970s).

The popularity of opium and the rapidly developing newly born pharmaceutical industry meant that pharmacists were bound to begin experimenting with 'improvements' on the original drug and that is exactly what happened. Morphine was the first new drug to be obtained from opium; it is a chemically refined version of opium and has very similar qualities but is ten times as powerful as raw opium. When morphine was first introduced it was recommended and widely prescribed as an entirely safe, non-addictive alternative to opium recommended, ironically, as particularly suitable for people who seemed to be hooked on opium. Heroin, which is twenty to twenty-five times as powerful as morphine and twice as addictive came next, and was again promoted as a safe, non addictive alternative to opium (and as a useful aid for patients hooked on morphine).

Heroin has the classic bitter taste of opium but does not have any smell. In its pure state it is a greyish brown in colour but when diluted it becomes white. The main problem with heroin is that the human body becomes very tolerant to it within a relatively short time and to get the same effect it is necessary to take increasingly massive doses. However, another development had enabled heroin users to overcome this problem. On 28 November 1853 the first hypodermic injection was given to an elderly spinster in Edinburgh by a man called Alexander Wood who used sherry as a solvent for the morphine on the grounds that it would be less likely than water to rust the syringe. Doctors quickly became enthusiastic about this new method of using an opium product and many claimed that it was safer and less likely to lead to problems than the old fashioned ways of using drugs of this type. The result was that doctors managed to combine a new and more powerful version of opium with a new and more powerful way of giving it and during the later part of the nineteenth century and the first part of the twentieth century more and more people started to use opium extracts - often without any realization that the amount of drug being used could have a particularly dangerous effect.

Eventually, the politicians and lawyers and doctors in Britain began to realize that the widespread use of opium-related products was beginning to create more and more problems, so a series of laws were introduced in an attempt to control their use. However, it was not legislation but social improvements which led to a reduction in the demand for the opiates. By the time the Dangerous Drugs Act was introduced in 1920, the number of people using opium, morphine and heroin regularly had fallen dramatically, largely because under the leadership of social reformers such as Edwin Chadwick, Britain had built an impressive series of sewage works, water supplies and other public services which had dramatically reduced the incidence of cholera and other gastro-intestinal problems and had therefore reduced the need for the diarrhoea-stopping qualities of the opiates.

Around the rest of the world, however, social problems were still commonplace and the continuing and widespread use of the opiates meant that more and more countries were making attempts to control the use of these drugs not by providing better social facilities but by introducing new laws. Laws are, after all, far cheaper than water purification plants, sewage disposal plants and better housing.

By the middle of the twentieth century it was almost universally agreed that the only real answer was to make heroin (the most concentrated and therefore the most dangerous form of opium) totally illegal. It was argued that making the drug completely illegal would make it much easier for the police to extinguish the drug's use.

There were two snags to this theory.

First, this international attempt to outlaw heroin was left with a single legal loophole. Inspired perhaps by the Far Eastern traders who had encouraged the country to fight a war with China to protect the sale of opium, Britain's doctors argued that heroin's powerful pain relieving qualities made it an essential drug and insisted that they would not allow it to be outlawed.

Second, as soon as the drug became illegal in most parts of the world the international crime industry, which had recently been thwarted by the ending of prohibition in America and left with a massive network of sales outlets and tough employees with nothing much to do, enthusiastically took over the supply of the drug. To increase their profits they began the enormously harmful habit of diluting the heroin they sold and it is this more than anything else which has made illegally obtained heroin dangerous. Users face two hazards: first, they do not know for certain how strong the heroin is that they are using and so it is easy to accidentally take an overdose; second, the chemicals used to dilute the heroin include talcum powder, baking soda, brick dust and other far more poisonous substances.

Because Britain's doctors had retained the right to continue prescribing heroin, Britain remained virtually immune to the gangsters selling the drug. It was not worth their while taking the inevitable risks associated with importing heroin into Britain when British users could still obtain the drug on prescription.

If all British doctors had been sensible and honest, Britain might well have remained aloof from the rapidly growing illegal market. However, the small number of London doctors who were prescribing heroin were so pen happy that Britain's small number of heroin addicts soon found themselves up to their knees in heroin prescriptions and to make extra cash they enthusiastically sold on their unwanted supplies to friends who were not addicts but were willing to try the drug. On one occasion one doctor in Harley Street prescribed 900 heroin tablets for a single addict and then, three days later, prescribed another 600 tablets for the same addict. It was not unknown for doctors to sign prescriptions for over 1,000 heroin tablets at a time. The doctors could not be prosecuted because they were acting within the law and their professional freedom to prescribe could not be questioned.

The British medical establishment had created a perfect situation for an ille