Snow Job

The demonization of cocaine

In Annie Hall, Woody Allen encounters cocaine at a Manhattan cocktail party. He dips his finger in the white powder, dabs a bit in his nostril, and sneezes violently, blowing the expensive stash all over the room.

George W. Bush has tried the same approach with rumors of cocaine use, but sneezing at them has not dispelled the questions. Other politicians–including Al Gore–have admitted without injury the use of marijuana in their youth, but the conventional wisdom says cocaine is different. Probably speaking for many, an 80-year-old Michigan woman told the Detroit News that past cocaine use "would be more troublesome to me as a voter than if a candidate had used marijuana. It's a more serious drug."

How serious, exactly? Despite its reputation, cocaine is neither irresistible nor inescapable. The typical cocaine user, like the typical marijuana user, does not become addicted and does not harm himself or others. Consequently, it is hard to see why voters should distinguish between former pot smokers and former coke sniffers.

In deciding how we should feel about a politician's cocaine use, a little historical perspective may be useful. Natives of South America have cultivated coca for thousands of years, chewing its leaves to relieve fatigue, hunger, and thirst. In the late 19th century, coca-laced beverages, including Coca-Cola and Vin Mariani wine, became popular in the United States and Europe. Cocaine, the leaf's main active ingredient, was first isolated in 1844 but was not widely used by physicians until the 1880s. It was quite effective as a local anesthetic (a use that remains legal today), and doctors prescribed it for more questionable purposes as well, including treatment of opiate addiction and alcoholism. Cocaine was also an ingredient in over-the-counter remedies.

It soon became apparent that some people developed an attachment to cocaine that was hard to break. The precise extent of the problem is difficult to assess. In the 1996 book Hep-Cats, Narcs, and Pipe Dreams: A History of America's Romance With Illegal Drugs, journalist Jill Jonnes cites an estimate of 200,000 "cocaine addicts" in 1902, a figure she attributes to the American Pharmaceutical Association. As the drug-policy scholar Arnold Trebach notes in the 1993 book Legalize It?, this number referred to "users" (not just addicts) of various "habit-forming drugs" (not just cocaine). But let's accept Jonnes's estimate for the sake of argument. It suggests that something like 0.26 percent of the population was addicted to cocaine at a time when the drug was freely and cheaply available. Evidently, almost no one had trouble abstaining from cocaine or using it in moderation. Nevertheless, fears of accidental addiction and of the drug's impact on racial minorities ("cocainized Negroes") helped build support for a federal ban on non-medical use, which was accomplished in 1914.

After a period of relatively little use, cocaine was rediscovered in the 1970s and '80s by the sort of affluent whites Woody Allen depicted in Annie Hall. The invention of crack, a cheap, smokable form of cocaine, spread the habit to poor inner-city neighborhoods. Although the violence that accompanied the crack trade fed public anxiety about cocaine, it was mainly a product of prohibition, not the drug's psychoactive effects. A 1989 analysis of crack-related homicides in New York City found that 85 percent grew out of black-market disputes, while about 7 percent occurred during crimes committed to support a crack habit. Only one homicide out of 118 involved a perpetrator who was high on crack.

To illustrate the addictive power of cocaine, anti-drug warriors cited experiments in which rats and monkeys preferred the drug to food. But as the psychologist Bruce Alexander observed in a 1990 Reason article, "Cocaine self-administration studies isolate such creatures in small cages, where they are surgically implanted with a catheter and tethered 24 hours a day to the injection apparatus. There is virtually nothing for these creatures to do in their solitary confinement but press a lever on the wall that produces temporary euphoric stimulation." These studies tell us little about the behavior of rats and monkeys in a more natural setting, let alone the behavior of human beings.

Data on cocaine use in the real world indicate that what was true at the turn of the century remains true today: For the vast majority of users, cocaine does not cause serious problems. Jill Jonnes, who supports the war on drugs, calls cocaine "thoroughly addicting." Yet later in her book she tells us, "While the middle-class cocaine epidemic proved to many a boomer that even they could get into deep trouble with drugs, the majority emerged unscathed." Even that concession is an understatement. In the 1998 National Household Survey on Drug Abuse, 10.6 percent of the respondents said they had tried cocaine (including crack), 1.7 percent had used it in the previous year, 0.8 percent had done so in the past month, and 0.3 percent were using it weekly or more often. In other words, about 3 percent of the people who had tried cocaine were using it as often as once a week. How "thoroughly addicting" is that?

It's hard to say what percentage of current cocaine users are addicts, because surveys do not usually ask detailed enough questions, and they may exclude groups (such as the homeless) that are especially prone to abuse. But in a 1993 government-sponsored survey of young adults, only 7 percent of past-month cocaine users were daily users. By comparison, about 10 percent of past-month drinkers report heavy alcohol use (defined as five or more drinks in one session on five or more of the previous 30 days), and 5 to 10 percent of drinkers are said to be alcoholics.

Heavy use of cocaine can lead to paranoia, depression, social isolation, family disruption, financial difficulties, and problems at work. But heavy use is not the usual pattern, and the hazards of occasional use–in particular, the risk of sudden death–have been greatly exaggerated. "Both powder and crack cocaine can increase the workload of the heart and cause irregular heartbeats," note Andrew Weil and Winifred Rosen in their 1993 book From Chocolate to Morphine, "but deaths from cocaine are rare, and the body has a great capacity to metabolize and eliminate the drug from the system." In a 1989 Cato Institute paper, James Ostrowski put the annual death toll from cocaine at 4 per 100,000 users. The death rate for alcohol, based on an estimate by the Centers for Disease Control and Prevention, is roughly 25 times as high.

So the one drug that George W. Bush has admitted to using is arguably quite a bit more "serious" than cocaine. Bush says he had such difficulty controlling his drinking that he has not touched a drop since his 40th birthday. If people thought rationally about drugs, they would be more troubled by that admission than by the possibility that he experimented with cocaine in his 20s. But that's a big "if."