Heroin--Myths and Knowledge: Impact on Public Policy

Public Policy in the United States towards the heroin user and addict has been punitive as well as unsuccessful in deterring drug use or in treatment of the addict. Bias, myths, and prejudices have influenced our policy stance and have made heroin addiction a more serious problem than it otherwise would have been. This is explicated in the article, and contrasted with the British system which in attitude and practice tends to view the addict as ill rather than evil. Since quite early in this century, in the United States, "...we have built our drug control policies around the twin judgments that drug abuse was an evil to be suppressed and that this could most effectively be done by application of criminal enforcement, and penal sanctions." (President's Commission on Law Enforcement and Administration of Justice, 1967:222) As a particular result of this, there is intense debate about each new policy initiative because of the widely held opinions and attitudes about heroin usage and crime. "Attitudes ... have considerable bearing on the formulation and implementation of public policies. American attitudes ... generally are punitive." (Shur, 1964:80) In a process that started over sixty years ago when narcotic use was first repressed by the Harrison Act, these attitudes have led to the ostracism of the chronic drug user. "From being regarded as a deviant, the user became a criminal, then a diseased person, and now a criminally diseased deviant. Addicted, still experienced as an abuse to the American self image ... the drug user remains the archetypal pariah." (Lewis, 1976:32) The condemnation of drug use, and the drug user, often is emotional and powerful. Zinberg and Robertson (1972:14) state accurately that "The public wields fearsome power; by condemning drug use so violently, it has made it a much more serious matter than it would otherwise have been. On the other hand, Roffman (1972:23) indicated that "... it is the policies not heroin that have caused such a false perception of the phenomenon that has come to be a major social problem." Repressive laws, the expression of our attitudes and policies on drug use have not effectively served as a deterrent. (New York Times, April 4, 1976, Sec. 5, page 5) As an example of this, in New York State a much heralded harsh law enacted by Governor Rockefeller in 1973 was dismantled because it was not working, seemed unenforceable, and was clogging the courts with minor offenders (New York Times, July 2, 1976:AIO). Our society tends to want simplistic, familiar solutions, such as the Rockefeller law, rather than address itself to the doubts and ambiguities that are present In as complex an issue as drug use. It would be helpful in formulating policy to understand the increase in contemporary drug use and addiction. No one has suggested a fully accepted theory to explain the increase, but many have been put forth. Wilson et al referred to four speculative possibilities that may have caused the increase in heroin use: (1) the rise in real income during the 1960's may have made it possible to spend more on heroin, just as one could buy more automobiles. (2) The emphasis on personal liberation among the young resulted in greater freedom in dress, mores, the development of a rock culture, and perhaps to greater experimentation with heroin. (3) The war in Vietnam, when soldiers had easy access to drugs, and the alienation, fear and demoralization associated with that experience may have been factors that led to experimentation. (4) The continued disintegration of lower-income, especially Black family life may have strengthened the importance of a peer group in a social environment conducive to heroin experimentation. (Wilson, Moore and Wheat, 1972:6) Isadore Chein et al (1964) described three pressures influencing people in the direction of drug use: the attempt to preserve self-esteem in the face of inadequacy for adult roles, the desire for certain kinds of intense personal relationships, and rebellious feelings against existing social standards. The National Commission on Marijuana and Drug Abuse (1973:100-101) commented that drug use is cyclical, and addressed itself to the broad cultural influences on drug use. They said that acquisition of material wealth has been attained by many, and is no longer a guiding purpose to those lives. Leisure time is considerable with little meaningful activity to fill it. The poor in the midst of affluence also have leisure time, but of a different and demeaning order. The Commission commented on the loss of community, and the loss of the values of that community. For the young, since all the frontiers are settled, the only place left to search is inside themselves, which may be the most difficult endeavor of all. Some, or all of these speculations on the rise of heroin use may be correct. Their range and diversity, however, illustrate the difficulty in creating policy based on a clear understanding of the reasons for