Drugs, Illicit. In the beginning there were no illicit drugs. From the seventeenth through the early nineteenth centuries, narcotics were simply part of medical practice, as they had been for millennia. A few patients—and doctors—exhibited symptoms of what would today be called addiction, but they were never numerous and posed no threat to the social order. The one controversial drug, alcohol, was cheap, ubiquitous, and liberally prescribed as a “stimulant.”

Concerns about opium centered on overdose and adulteration. Imported from the Middle East, opium often contained sand, fruit pulp, flour, beeswax, lead, and the like. Indeed, the first national drug law, enacted in 1848, was intended to bar adulterated foreign drugs, not drugs per se.

In the later nineteenth century, narcotic addiction took on a more visible and sinister aspect. Morphine, the principal alkaloid of opium, available commercially after 1827, came into wide use with the spread of hypodermic medication in the 1860s and 1870s. Morphine injected hypodermically was much more powerful and potentially addictive than opium taken orally. By 1900 there were perhaps as many as 220,000 medical addicts. Contrary to legend, most of these addicts were not Civil War veterans, but rather ailing women introduced to morphine by their physicians or through patent medicines, which often contained narcotics and alcohol.

They were joined by as many as ninety thousand opium smokers, mostly Chinese laborers and members of the white underworld. Habitués of the opium pipe, regarded much less sympathetically than medical addicts, were subject to restrictive local and state legislation, typically designed to outlaw public opium dens. The possibility of sexual relations between white women and Chinese men in the dens stirred fears, though in fact Chinese smokers usually kept to themselves.

Sexual anxieties also surrounded the nonmedical use of cocaine. Like morphine, cocaine began as a promising new alkaloid drug. In the mid‐1880s Parke, Davis, its leading U.S. manufacturer, promoted it for a range of illnesses, from hay fever to alcoholism. Sigmund Freud relayed these glowing American reports to a European audience in his 1884 paper, “über Coca.” Cocaine's outstanding therapeutic property, that of local anesthesia, first noted by Carl Koller, helped to revolutionize surgery and dentistry. But overdose cases soon appeared in the medical literature and, as early as 1886, warnings of addiction resulting from medical treatment.

In the 1890s, concern shifted to underworld sniffing and injection of cocaine. Alcohol, cigarettes, and opium smoking were well established among prostitutes, pimps, and gamblers, and now cocaine, reputedly a potent aphrodisiac and stimulant, joined the list. In 1900, half the prostitutes in the Fort Worth, Texas, jail were said to be cocaine addicts.

With the wholesale price fluctuating at about two dollars an ounce in the late 1890s, cocaine was affordable by ordinary laborers, including African Americans who toiled in work camps throughout the South. Although the actual extent of its use remains uncertain, a racially charged folklore linked cocaine use by African Americans to violent rampages and “increased and perverted” sexual desires.

Alarmed city councils and state legislatures passed laws restricting cocaine's purchase to those holding a prescription from a licensed physician—a provision increasingly applied to opiates as well. Had this legislation succeeded, the emerging drug subculture might have been thwarted. But economic and competitive considerations tempted physicians, particularly older and marginal practitioners, to continue to prescribe liberally. Pharmacists criticized such overprescribing but shared the blame for the problem. Retail sales were highly profitable, though “certainly the most disagreeable feature of the apothecary's business,” as one New York pharmacist lamented.

Sales to addicts were rationalized by the realization that spurned customers could simply go to another druggist—or a street dealer. Drugs diverted from legal sources were resold illegally by peddlers to those underage and without prescription. Teenage boys were avid customers for “decks” of cocaine and heroin (a semisynthetic derivative of morphine) peddled in slums and vice districts. Opium prepared for smoking was also available, though more often supplied by smugglers and illegal manufacturers who dodged the heavy customs duty. The cliché that the 1914 Harrison Narcotic Act created the black market and drug subcultures of twentieth‐century America is a political myth. Illegal sales, smuggling, and underworld use flourished decades before the Harrison Act. Drug abuse and trafficking spawned legislation, not the other way around.

The catalyst for national legislation, however, was the diplomatic situation in the Far East. American missionaries, notably Episcopal bishop Charles Henry Brent, had long deplored the British opium trade in China. In 1905 they helped secure a policy of suppressing opium smoking in the Philippines, which had become a U.S. possession. In 1906 Brent asked for President Theodore Roosevelt's help in setting up an international opium conference, which finally convened in Shanghai in February 1909. Representing the United States were Brent; Charles Tenney, a missionary and educator; and Hamilton Wright, a physician who subsequently became the chief architect of federal drug laws.

But while the U.S. government was calling for suppression of the Asian opium traffic, it continued to tolerate (and tax) opium smoking at home. To refute charges of hypocrisy, Roosevelt's secretary of state, Elihu Root, persuaded Congress to prohibit imports of smoking opium. (A later amendment also forbade its domestic manufacture.) This legislation, signed into law a week after the opening of the 1909 Shanghai conference, represented the first nationwide ban on a particular type of drug. In this sense, smoking opium was America's first “illicit drug.”

In 1910, Hamilton Wright turned his attention to a comprehensive narcotic control bill, which he wanted passed before the Hague Opium Commission, a follow‐up to the Shanghai conference, convened in 1911. Wright missed the deadline by three years, owing to prolonged negotiations and compromises with medical groups, the pharmaceutical industry, and patent‐medicine manufacturers. The 1914 Harrison Narcotic Act, named for its sponsor, Congressman Francis Harrison of New York, was a watered‐down version of what Wright sought. It required dealers in opiates and cocaine to register, pay a nominal tax, and keep accurate records of their transactions. Unregistered dealers faced prosecution. Thus narcotic distribution would be confined to legitimate medical channels and made a matter of public record.

The Harrison Act was ambiguous on a key point: whether registered doctors and pharmacists could maintain a supply of drugs for those who were addicted. In 1919 the U.S. Supreme Court, in the five‐to‐four Webb decision, ruled that they could not. This was the key precedent for the antimaintenance policy. It would have lasting implications, particularly after the Treasury Department quickly closed more than thirty experimental public clinics designed to provide a legal supply of drugs for addicts, forcing them into the black market.

In the 1920s, street drugs, mostly diverted from surplus European manufactures, were still relatively pure. However, international agreements in 1925 and 1931 made the large‐scale diversion of legally manufactured drugs more difficult. Smuggled and adulterated heroin became the mainstay of the black market, which centered on New York City, home to approximately half the nation's nonmedical narcotic addicts. In 1924 Congress effectively outlawed heroin, which, like smoking opium, was associated with vice and crime.

The Bureau of Narcotics, under the direction of Harry J. Anslinger from 1930 to 1962, was the federal agency most responsible for suppressing the illicit drug traffic. Anslinger was a hardliner who wanted traffickers behind bars and addicts in jail or in institutional treatment programs. Two large prison‐hospitals, at Lexington, Kentucky, and Fort Worth, Texas, were built in the 1930s for the latter purpose. A skilled bureaucrat and lobbyist, Anslinger increased the scope and penalties of drug laws during his long tenure. He played a key role in passage of the 1937 Marijuana Tax Act, which added a national ban to state and local legislation. This legislation was inspired by the fear that marijuana use was spreading, as indeed it was among jazz musicians, Mexican laborers, Caribbean sailors, and soldiers returning from Panama. Unknown before 1910, marijuana smoking became a subcultural ritual by the 1930s. It was a cheap high: fifteen cents a “reefer” in Harlem “tea pads.” Anslinger and other authorities condemned it for inciting wild violence. This rationale, never plausible, was later replaced by the stepping‐stone hypothesis. “Over 50 percent of young addicts started on marijuana smoking,” Anslinger testified in 1951, and “graduated to heroin when the thrill of marijuana was gone.”

Concern over the post–World War II resurgence of heroin trafficking and addiction prompted Congress to enact the 1951 Boggs Act and 1956 Narcotic Control Act, which provided progressively stiffer mandatory sentences, all the way up to the death penalty for selling heroin to minors. States followed suit. Texas made marijuana possession punishable by life imprisonment. The prison‐mindedness of drug policy provoked a reaction among those who viewed addiction as a public health problem. In 1958 a joint committee of the American Bar Association and the American Medical Association criticized the police approach and suggested the possibility of a controlled legal supply. In the 1960s, two physicians, Vincent Dole and Marie Nyswander, showed that heroin addicts could be maintained indefinitely on oral methadone, a synthetic narcotic. Their work challenged both the antimaintenance policy and the reigning explanation of addiction, popularized in the 1920s by Lawrence Kolb, a physician with the U.S. Public Health Service. Kolb and his disciples held that addicts suffered from defective, even psychopathic, personalities. But for Dole and Nyswander, addicts were more or less normal persons whose drug use triggered a permanent metabolic change. They needed narcotics the way a diabetic needed insulin. Methadone maintenance satisfied that need and kept them out of the illicit market.

Methadone maintenance was, and remains, a cost‐effective treatment for narcotic addiction. Its heyday came during the heroin epidemic of the late 1960s and early 1970s, when the country had an estimated half‐million addicts. After 1974 methadone's star faded, owing to restrictive federal regulations, local resistance to clinics, and its irrelevance to other popular countercultural drugs. Among these were marijuana, a revival of cocaine sniffing, and experimentation with lysergic acid diethylamide (LSD), a powerful hallucinogen. The causes of the drug explosion of the 1960s and 1970s were various: affluence; Vietnam; paraphernalia shops; media coverage; youthful disenchantment with mainstream culture; proselytizing gurus like poet Allen Ginsberg, novelist Ken Kesey, and one‐time Harvard psychologist Timothy Leary; growing consumption of alcohol and other “gateway” drugs; new sources of supply in Asia and Latin America; and, not least, the entry of tens of millions of baby boomers into their teens and twenties, the prime drug experimenting years.

The Richard M. Nixon administration responded with a multifaceted drug war. International enforcement efforts increased, with notable successes in Turkey and France. More funds were appropriated for research and new treatment approaches, including therapeutic communities modeled on California's Synanon Foundation. Federal antidrug spending increased from $80 million in 1969 to $730 million in 1973. Six decades of piecemeal legislation was rationalized by the 1970 Controlled Substances Act, which sorted drugs into five schedules, depending on their abuse potential and therapeutic value. Drugs commonly regarded as “illicit” fell into either Schedule I (heroin, marijuana, LSD, peyote, and other hallucinogens) or Schedule II (cocaine, methamphetamine, morphine). Schedule I drugs were forbidden to everyone, doctors included. Schedule II drugs were allowed in medicine but tightly regulated. Other therapeutically useful drugs such as barbiturates and tranquilizers were placed in Schedules III through V and subject to looser controls.

Most post‐1970 federal legislation took the form of incremental amendments to the Controlled Substances Act, as when the synthetic hallucinogen MDMA (Schedule I) or anabolic steroids (Schedule III) were added to the list. More far‐reaching amendments were enacted in 1986 and 1988, in the midst of the crack epidemic. An inexpensive, smokable form of cocaine, crack exploded in the inner cities in the mid‐1980s, culminating a sustained fifteen‐year increase in cocaine consumption. Like heroin, crack had pronounced ethnic and class overtones and was associated with prostitution, sexual degradation, and violence. The 1986 and 1988 legislation, centerpieces of the Ronald Reagan administration's drug war, substantially increased criminal and civil penalties. Crack was singled out for the heaviest punishment. Possessing five grams with intention to distribute brought a mandatory minimum sentence of five years, the same penalty prescribed for five hundred grams of powder cocaine. Federal penitentiaries became crowded with crack dealers, 95 percent of whom were black or Latino.

As in the 1950s, the vogue of imprisonment sparked a counterattack. Libertarians proposed “controlled legalization” as an alternative to the fifty‐billion‐dollar black market and a ballooning federal antidrug budget that reached fifteen billion dollars by 1997. The idea was to replace the costly and intrusive “drug war” with a regulated adult market in psychoactive drugs. Liberals and public health advocates espoused less radical harm‐reduction measures, such as needle‐exchange programs, which proliferated during the 1990s. Drug courts, a means of diverting nonviolent drug offenders into mandatory treatment, also became more common. The basic policy of the Bill Clinton administration (1993–2001) nevertheless remained that of its predecessors: drug abuse was defined, suppressed, and managed principally, if no longer exclusively, by criminal statutes and law enforcement.
See also Alcohol and Alcohol Abuse; Foreign Relations: U.S. Relations with Asia; Foreign Relations: U.S. Relations with Latin America; Medicine; Prisons and Penitentiaries; Progressive Era; Prostitution and Antiprostitution; Sexual Morality and Sex Reform; Sixties, The; Tobacco Products.

Bibliography

Charles C. Terry and and Mildred Pellens , The Opium Problem, 1928.
Richard J. Bonnie and and Charles H. Whitebread II , The Marijuana Conviction: A History of Marijuana Prohibition in the United States, 1974.
Edward M. Brecher et al. , Licit and Illicit Drugs, 1974.
David T. Courtwright , Dark Paradise: Opiate Addiction in America before 1940, 1982.
David F. Musto , The American Disease: Origins of Narcotic Control, 3d ed., 1999.
David Courtwright,, Herman Joseph,, and and Don Des Jarlais , Addicts Who Survived: An Oral History of Narcotic Use in America, 1923–1965, 1989.
John Burnham , Bad Habits: Drinking, Smoking, Taking Drugs, Gambling, Sexual Misbehavior, and Swearing in American History, 1993.
Jill Jonnes , Hep‐Cats, Narcs, and Pipe Dreams: A History of America's Romance with Illegal Drugs, 1996.
Joseph Spillane , Cocaine: From Medical Marvel to Modern Menace in the United States, 1884–1920, 2000.

David T. Courtwright

ILLEGAL DRUGS (ISSUE)

One of the most serious social problems in the United States since World War II (1939–1945) has been the trafficking in illegal drugs. These drugs— mostly derived from the opium poppy or from coca leaves—have powerful psychotropic (mind-altering) effects and are very addictive.

The U.S. government's attempt to deal with the drug problem has few defenders. The devastation that heroin and "crack" cocaine have imposed on the nation's already disorganized central cities and even on its affluent suburban high schools are widely acknowledged. There is less agreement on the root causes of this policy failure. Critics differ widely. Conservatives point to the weakening of family values. Liberals have no consolidated position on the drug problem. Some counsel a "get tough" policy of more vigorous enforcement of existing drug laws. Others go to the other extreme and favor the decriminalization of drugs. They point to the fact that the greatest growth in the U.S. prison population is from non-violent drug offenders. They argue that the result of the official U.S. policy banning drugs has been to turn addicts into criminals and to create a world-wide "black market" in illegal drugs.

As Adam Smith (1723–1790), the eighteenth century spokesman for free market economics, might have predicted, the constricted supply and growing demand of a banned substance inevitably increases the price and attracts entrepreneurs—in this case, organized crime. Or, as novelist William Burroughs once ironically remarked, the economic marvel of heroin is that the problem of slack demand never arises. Heroin is a very salable product: once introduced into the population, it needs no advertising; it not only sells itself, it drives the buyer to sell himself or herself.

As early as the second half of the nineteenth century, medical researchers recognized that opium and morphine combined beneficial pain-killing qualities with problems of addiction. In fact, when the German pharmaceutical company Bayer introduced heroin into the United States, it called the drug a nonaddictive substitute for morphine. By the time government regulation arose during the Progressive period (1900–1920), the addictive qualities of these drugs were better understood and the government banned them in the Pure Food and Drug Act of 1906 (which prevented Coca-Cola Co. from adding its most potent ingredient). By World War II, a growing number of drugs were ruled illegal. Still, the use of illegal drugs before World War II was minuscule by late twentieth century standards and confined to the margins of society.

In the first few decades after World War II the worldwide black market in illegal drugs grew steadily and sustained the profit margins of organized crime. Not since the Eighteenth Amendment to the U.S. Constitution prohibited alcohol in 1918 (followed by the repeal of Prohibition in 1933) had organized crime been able to corner the market on such an attractive commodity. Still, in spite of a growing underground drug culture in the 1940s and 1950s, there was little panic concerning drugs in mainstream society.

This all changed suddenly in the 1960s and 1970s, as rampant drug use (both marijuana and hallucinogenic drugs) by the young and a "tidal wave" of heroin inundated the United States. In contrast to earlier heroin, which originated in the opium poppy fields of Afghanistan, most of this new wave of drugs came from the "golden triangle" area of Laos, Burma, and Thailand in southeast Asia.

This was made possible by a remarkable set of military and political alliances between the Central Intelligence Agency (CIA) and the warlords that it recruited to fight covert anti-communist campaigns in Laos, Cambodia, Thailand, and Burma during the Vietnam War (1964–1975). At that time, Congress had granted authority to President Lyndon Johnson (1963–1969) to wage limited war in Vietnam, but nowhere else. In order to generate funds for covert anti-communist warfare, the CIA allowed the Meo tribesmen of northern Laos, among others, to cultivate opium and to sell large quantities of drugs. Beginning in 1965, "Air America," a CIA-front operation, even participated in transporting drugs. A large portion of the drugs made their way into the United States, and through corruption among individual agents as well as South Vietnamese government officials, some went directly into the veins of U.S. soldiers in Southeast Asia,. The Corsican Mafia (the "French Connection") in Marseilles, France, also prospered from this glut of heroin.

In the late 1970s youth-culture drugs like LSD faded from the U.S. drug scene and the more addictive heroin once again become popular. The Sicilian Mafia, facing competition from the Corsican Mafia, stepped up its own drug operations, smuggling heroin from anti-communist guerrillas in Afghanistan. Thus, the connection between opium trafficking and Cold War anti-communist crusades clicked into place again as much of this new opium product was generated by the rebel Mujahadeen to fund their CIA-supported war against the communist government of Afghanistan. Anti-communist warlords needed money to fund their operations, and the CIA was willing to "look the other way" as they grew and sold prodigious quantities of drugs. These banner crops needed outlets, and U.S. organized crime was there to service the market.

Late in the 1970s the U.S. heroin market seemed finally to have reached its saturation point. New organized crime rings in Latin America began to step up production and distribution of a different, but equally addictive and destructive drug, cocaine. By the mid-1980s new, more potent methods of ingestion (freebasing) and forms (crack) appeared. Whereas heroin never lost its association with a low socio-economic consumer profile, cocaine appealed to a more "upscale" public. Hollywood stars like Richard Prior were quite open in their acceptance of the drug. Because of the few short-term side affects associated with its use, cocaine became the "drug of choice" during the 1980s. Sex was reportedly more enjoyable on cocaine. Long-term side effects like heart problems and sexual impotence did not become apparent until later, when millions of Americans found themselves addicted.

On January 30, 1982, President Ronald Reagan (1981–1989) mobilized his forces and announced a war on drugs. The First Lady, Nancy Reagan, took a high-profile position and sternly advised America's youth to "Just say no!" Vice President George Bush became the chief coordinator of drug policy. As former head of the Central Intelligence Agency, Bush was no doubt familiar with the problem. He targeted a prominent center of narcotics distribution, south Florida. Bush incorporated the U.S. Attorney's Office, the Drug Enforcement Agency, the U.S. Customs Service, the Federal Bureau of Investigation, the Bureau of Alcohol, Tobacco and Firearms, the Internal Revenue Service, the U.S. Border Patrol, and the Army, Navy, and Coast Guard into the fight. These agencies pooled resources, shared information, and coordinated a strategic assault to rid the United States of what many believed was a drug plague that caused crime, social dislocation, and demoralization.

During the first year of the war, the U.S. Attorney's Office reported a 64 percent increase in drug prosecutions. In 1983 six tons of cocaine were seized in south Florida; by 1985 such seizures snared twenty-five tons; in 1986, thirty tons. According to the DEA, this represented more cocaine than the drug cartels in Colombia had produced in 1980. While these arrests and seizures were touted as successes, many realized that more people were using cocaine, heroin, and other drugs than ever before. Even in south Florida, the primary theater of combat, illicit drugs were as easily available as over-the-counter varieties, and were often sold in the same places—openly and without fear of the law.

At the same time the new Latin American cocaine cartels were growing in power, the Reagan administration began to wage a covert war against the Cubansupported Sandinista government of Nicaragua and to oppose all Marxist and communist influence in Latin America. In a post-Vietnam mood of disgust with waging wars against Third World countries, Congress forbid the use of public funds to overthrow the Sandinistas. The Reagan administration used covert methods, paid for with predominantly private funds. The resulting congressional Iran-Contra hearings investigated relations between the United States government, the Islamic fundamentalist regime in Iran, and the anti-Sandanista Contra forces in Nicaragua. Buried in this investigation was the question of whether drug sales helped fund the Contras.

Responding to public pressure, the Senate Foreign Relations Committee set up a special Subcommittee on Terrorism, Narcotics, and International Operations, chaired by Senator John Kerry, to conduct hearings into these matters. Its findings were clear: at the very least the CIA (and other U.S. agencies) had again looked the other way while the Colombian drug cartels provided millions of drug-generated dollars to arm the Contras.

The Kerry Committee also found instances of drug activities on the part of U.S. allies in the region, the most important of whom was General Manuel Noriega of Panama, known by U.S. drug enforcement agents since 1971 as a drug trafficker linked to the Colombian cartels. The Kerry Committee learned that the CIA had used Noriega to funnel secret arms to the Contras. As evidence uncovered by the Kerry Committee showed, Noriega had been on the payroll of the CIA since 1976, when he collected an annual fee of $110,000. By 1985 he was collecting $200,000 per year, all in secret cash deposits in the Bank of Credit and Commerce International (BCCI—which would figure prominently in new scandals in the early 1990s, including drug-money laundering). Ostensibly Noriega was "our man" in Central America serving in the war against communism. Yet in 1986, when the DEA proposed an under-cover plan to unravel the mysteries of a multibillion-dollar drug money-laundering scam in Panamanian banks, it had to seek CIA approval. The go-ahead was given by the CIA, but with the stipulation that any information that exposed Panamanian government officials be dropped.

The DEA's findings in this regard may have been ignored, but the Kerry Committee's revelations were not. In 1988 the U.S. District Court in Miami issued an indictment against Noriega and a warrant for his arrest. Eventually Noriega was caught, tried, convicted, and imprisoned. During his trial, both the CIA and the National Security Council (NSC) refused to hand over files on Noriega, saying that to do so would compromise national security.

In late November 1997, under the administration of President Wiiliam Clinton (1993–2001), the United States and Mexican governments entered into an agreement to help control the weapons smuggling from the United States into Mexico. Under the agreement, the U.S. Federal Bureau of Investigations (FBI) and the Office of Alcohol, Tobacco, and Firearms (ATF) were to coordinate efforts with Mexico's Procuraduria General de la Republica (PGR) to stop illegal trafficking of arms. A U.S.-based ATF office and U.S. Customs personnel at the American Embassy in Mexico City were called upon to oversee the effort. Experts from the two countries conducted investigations to determine whether weapons sold legally in the United States were diverted to the black market, where drug traffickers in Mexico acquired them. The new accord was part of a sophisticated joint strategy to combat drug trafficking, a strategy which included the creation of a hotline between the U.S. Pentagon and Mexico's Secretary of National Defense to coordinate efforts to intercept drug shipments moving into the United States.

The joint U.S.-Mexico effort to control illegal sales of firearms was part of an ongoing campaign embraced by the Organization of American States (OAS) to reduce gun smuggling and reduce violence both in the United States and in Central and South America. The campaign, which was first proposed by Mexico, sought to tighten controls on weapons trafficking across national borders and impose restrictions on weapons production. According to a report from Mexico's drug enforcement campaign, customs and other law enforcement authorities confiscated almost 23,000 illegally imported weapons and 1.2 million munitions during 1996 alone. The report said at least one-third of the weapons and almost one-fifth of the munitions were destined for drug traffickers in the black market.

Ironically, the joint U.S.-Mexico effort followed reports that the Clinton administration had requested a threefold increase in the budget for exports of weapons and military equipment to Mexico. According to the non-governmental Federation of American Scientists (FAS), the Clinton administration requested $9 billion for sales of weapons, aircraft, radar units, and other military equipment to Mexico in the 1998 budget. The FAS, whose board of sponsors includes over 55 American Nobel Laureates, claimed that the United States domestic gun market was the principal source of weapons for the drug traffickers, and that both the Mexican government and the drug traffickers were dependent upon the United States for guns. The FAS also warned that weapons originally exported to Mexico to combat drug trafficking would soon be diverted for other purposes.

Thus, as of the late 1990s, the ability of the U.S. government to control the black market in drugs and guns appeared to be limited by a set of strategies, reflexes, and relationships in place for generations.

FURTHER READING

Allen, David F. and Jekel, James F. Crack: The Broken Promise. New York: St. Martin's Press, 1991.

Belenko Steven R. Crack and the Evolution of Anti-Drug Policy: Contributions in Criminology and Penology, no. 42. Westport, CT: Greenwood Press, 1993.

McCoy, Alfred. The Politics of Heroin in Southeast Asia. New York: Harper & Row, 1972.

Harris, Jonathan. Drugged America. New York: Four Winds Press, 1991.

Scott, Peter Dale and Marshall, Jonathan. Cocaine Politics: Drugs, Armies, and the CIA in Central America. Berkeley: University of California Press, 1991.

Illicit Drugs

Some chemical substances are dangerous to health due to their addictive nature, impact on the central nervous system metabolism, life-threatening side effects, and associate behavioral and mood changes. Drugs classified by the U.S. Drug Enforcement Administration (DEA ) under Schedule I are considered illicit drugs when sold to or consumed by the public, except for some chemical derivatives with restricted and controlled medical applications. These are also known as psychoactive drugs of abuse, due to their effects in mood, sensory perception, and behavior. Substances of the following classes are considered illicit drugs: opiates, hallucinogens, depressants, and stimulants under Schedule I (tightly regulated use and supply), as well as the controlled substances under Schedules II, III, IV, and V, when used or sold without medical prescription. Among the most common illicit drugs in use are:

• cannabinoids (such as marijuana and hashish oil)
• hallucinogens (LSD, mescaline, peyote, MDMA)
• dissociative anesthetics (PCP, ketamine, dextromethorphan)
• stimulants (amphetamines , methamphetamine, cocaine)
• depressants (GHB, rohypnol, barbiturates , benzodiazepines)
• narcotics (opium, heroin, methadone, codeine)
• inhalants (nitrous compounds, glues, solvents, ether).

Drugs of abuse affect the brain structures that regulate feelings of reward, personal empowerment, and pleasure, which constitute an important component of their addictive properties, along with developed tolerance.

The initial effects of cannabinoids, such as relaxation, euphoria, and diminished concentration, are similar to alcohol. The active chemical of cannabinoids (the alkaloid THC or tetrahydrocannabiol) apparently interferes with nerve cells access to glucose (an essential source of energy for brain metabolism and function), inducing an aftermath sensation of acute hunger. Addiction is followed by increased tolerance, which leads to more frequent consumption and/or to increased doses. The speed of signal transfer between nerve cells (synapses) is reduced with long-term use, as a consequence of the loss of neurons (nerve cells) and components of nerve cells. Poor memory, learning difficulties, and a general apathy are the results of prolonged, frequent use of cannabinoids. Respiratory complications are also common, because cannabinoids are usually inhaled through smoking. High levels of THC in the brain may induce toxic psychosis and hallucinations, especially when the leaves are consumed in foods or infusions. In food or drinks, marijuana effects take about one hour to begin and last for approximately four hours. Flashbacks sometimes occur in some individuals in the three days following a high-dose intake.

Hallucinogens such as LSD, MDMA, mescaline, psilocybin, psilocin, and muscimol are drugs that interfere with neuronal pathways that process sensory information, and also affect the metabolism and levels of chemical messengers known as neurotransmitters , such as serotonin and dopamine. Hallucinogenic plants such as psilocybin, and peyote cactus, along with psilocin mushrooms have been taken by tribal medicine men in search of "visions" for centuries. Hallucinations are altered states of sensory perception that lead to all kinds of pleasant or unpleasant sensory experiences. They affect several functional brain structures that control emotions, behavior, body temperature, cardiac rate, blood pressure, sensory-motor coordination, and breathing. LSD (lysergic acid diethylamide) is a strong hallucinogen with unpredictable effects that may last for approximately 12 hours and create frequent occurrences of flashbacks in the following two days. However, it is not an addictive drug and most users stop using it over time. LSD induces tolerance in frequent users, however, leading to ingesting increased amounts of the drug. The results could include long-lasting mood disorders, psychotic episodes, severe depression, and suicide. These adverse effects may persist for years after the individual has stopped LSD consumption, suggestive of some forms of brain damage.

Mescaline is extracted from the peyote cactus, and also induces hallucinations along with physiologic changes similar to those caused by LSD. Effects last between 8 and 12 hours and its metabolites are detectable in urine for two or three days after use. Hallucinogenic mushrooms such as Psilocybe cubensis and Amanita muscaria, are highly toxic for liver and kidney cells. They induce drowsiness alternating with psychomotor agitation, distorted auditory and visual sensory perceptions, and lack of concentration, as well as nausea, paranoia, and chronic mental disorders.

MDMA, or ecstasy, is both a hallucinogen and a stimulant drug that dramatically increases the levels of serotonin in the brain, causing a sensation of immense joy, amplification of tactile sensations, altered body temperature, and increased sexual drive. MDMA interference with the metabolism of the neurotransmitter serotonin results in nerve cell toxicity that may cause brain damage. Cases of coma and death are also reported in association with MDMA. Frequent use of ecstasy has also indirectly influenced the spread of sexually transmitted diseases including HIV because of its ability to decrease sexual inhibitions and its frequent use in nightclubs.

Dissociative anesthetic drugs were first developed as pharmaceutical products for sedation or for general anesthesia. Dextromethorphan is a sedative of certain autonomous brain functions. Ketamine and PCP (or phencyclidine) are drugs for general anesthesia that present side effects of auditory and visual distortion, and sensations of "floating" above the environment or above oneself (out-of-body sensation). These two substances block glutamate pain receptors in the brain. The neurotransmitter glutamate is responsible for signaling pain sensation, and is also involved in memory formation, the learning process, and mood modulation. PCP inhibits dopamine, serotonin, and norepinephrine reuptake from cell receptors. These neurotransmitters control the modulation of feelings of reward, joy, euphoria, and physical energy. Phencyclidine is also a dissociative drug of potential abuse that induces dissociative anesthesia, a state in which the patient is conscious without feeling pain. In surgical centers, physicians carefully monitor the vital signals of a patient under PCP, ketamine, or other CNS depressant anesthetics, due to their dangerous and sometimes unpredictable side effects on blood pressure, elevation of body temperature, and heartbeat. When these drugs are illegally taken, users frequently end up in emergency rooms with convulsions, coma, hyperthermia (high core body temperature), or cardiac arrest. Addicts also undergo mood disorders, such as violent behavior, hallucination, panic episodes, paranoia, disorientation, memory loss, depression, and suicidal tendencies.

Depressant drugs, such as flunitrazepam (e.g., rohypnol) and gamma-hydroxibutyrate (or GHB) are frequently mixed with alcoholic beverages, a combination that is sometimes lethal. Rohypnol, often called the "date rape" drug, belongs to the family of benzodiazepines, drugs introduced in medical practice to control anxiety and nervousness. Because rohypnol markedly depresses the central nervous system (CNS), slows motor reflexes, causes disorientation and temporary amnesia, it is used by some who mix the drug in their victim's drink. As the drug is tasteless, odorless, and colorless, sexual assailants use it in nightclubs and parties, without the knowledge of their targets. GHB is now an illegal anabolic drug that was largely used by body builders between 1980 and 1992, when its use became forbidden in the United States. It has a sedative and euphoric effect, may induce coma, convulsions, breathing difficulties and vomiting, especially when mixed with alcohol or cannabinoids.

Stimulants affect the brain reward centers, inducing sensations of euphoria, boldness, and aggressiveness because they accelerate basal metabolism, cardiac rate, and increase blood pressure and sensory motor response. They also cause dizziness, insomnia, behavioral and emotional disorders, sexual inhibition, and lack of concentration. Cocaine is a strong stimulant and highly addictive drug that is trafficked in two chemical forms, hydrochloride salt (powdered cocaine), and freebase form (or crack). Powdered cocaine is inhaled into the nasal passages or diluted in water and intravenously injected, whereas crack is smoked. Cocaine and crack affect the dopamine pathways by attaching to the molecule that transports dopamine to cellular receptors, preventing dopamine reuptake from receptors. Therefore, it prolongs the effects of dopamine in the brain. Both forms of cocaine induce tolerance, leading to increased doses and more frequent consumption. Irritability, mood swings, restlessness, auditory hallucination, and violent behavior develop and tend to worsen through long-term cocaine abuse. Cardiac arrest or coma is a common cause of death when these and other stimulants are mixed with other drugs or alcohol, or taken in high doses.

Narcotics are chemical derivatives from opium, such as codeine, morphine, and heroin, with very effective analgesic activity in relieving intense pain. However, because of their highly addictive properties and some dangerous adverse effects, a total of 23 opium derivatives are classified under Schedule I. Morphine is the most powerful analgesic found in natural opium, but both natural and synthetic opioid compounds are effective intense-pain inhibitors. Morphine causes analgesia without inducing loss of consciousness, along with a sense of wellbeing. Normal doses of morphine and other opioids depress the brain centers that regulate breathing by diminishing their sensitivity. With doses progressively higher, respiratory depression occurs, thus leading to death from acute overdose, a common result of opioid abuse. Other effects of chronic use of opioids are low blood pressure (hypotension), vomiting, constipation, and depression. Repeated use induces tolerance to the respiratory centers as well as decreased analgesia and euphoria, leading to dependency of higher doses and more frequent use, which increases the risk of accidental overdose.

Inhalants are chemical vapors derived from substances and solvents used in glues, wax, and domestic household products, as well as nitrous compounds and ether. They usually either depress the CNS or block oxygen access to the brain. Inhalants are often the first drugs that children experiment with. A study by the National Institute on Drug Abuse (NIDA) of 2003, named "Monitoring the Future," has shown that 12.7% of 10th graders and 11.2% of 12th graders had used inhalants at least once.

see also Amphetamines; DEA (Drug Enforcement Administration); Hypothermia; Hypoxia; Narcotic; Nervous system overview; Psychotropic drugs; Toxicological analysis.