This weekend, it is a year since Philip Seymour Hoffman died, with a needle in his arm, in his apartment in New York City -- and this year, it is a century since drugs were first criminalized. These two events are connected. If the war on drugs had never happened, there is a significant chance that his death would not have happened -- and I believe, after researching this subject for over three years for my book Chasing The Scream: The First and Last Days of the War on Drugs, that I can prove it.
I am conscious it will seem distasteful to lots of people talk about a celebrity's death -- a really horrible, distressing loss of a genuinely great actor -- as a way of talking about wider drug policy. I agree. It is. I would rather not do it. But there is one thing that would be even more distasteful -- and that would be to leave huge numbers of addicts like Philip Seymour Hoffman to die over another century of drug war, because we refuse to look at the reality of our drug laws straight in the eye. Addicts have been so dehumanized in our culture that many people react to their deaths with indifference. Philip Seymour Hoffman is a rare example of an addict we all regard as fully human -- and whose death we grieve. So I believe there is an obligation to talk about him because, if we don't, we will carry on doing something terrible.
Too often, we talk about the drug laws in an abstract way -- listen to politicians when they talk about why we should crack down, and they will usually talk without referring to any actual people, or any places that have tried alternative approaches. They speak in a sealed-off bubble of pure rhetoric. I wanted to know what would really protect the addicts I loved -- in my family, and my former partner -- so I wanted to look at the drug war in a very different way. I decided to go to see what different drug laws do to real people, on the ground, in practice, and I ended up traveling over 30,000 miles and across eight countries to see all the alternatives.
On my travels, and by reading the best research, I discovered five ways the drug war made it more likely someone like Philip Seymour Hoffman would die -- five killers that are still stalking our streets today.
Killer number one: Contaminants.
If you ban drugs, the actual chemicals people take into their bodies change - they become contaminated. Let me explain how.
Before drugs were banned in 1914, they were sold by pharmacies, or prescribed by doctors. You would go to your local equivalent to CVS and buy opiates, or cocaine-based products. Because pharmacists and doctors are legally regulated, the products were tested, and they were medically pure. An official government study found that before the crackdown got into full swing, the overwhelming majority even of addicts were in work, and were no more likely to be poor than the general population.
When the federal government banned drugs, they did not disappear. They were simply transferred to the control of armed criminal gangs. Those gangs cannot be inspected to make sure their product is medically pure. There are no health and safety inspectors in their labs, or in the bowels of the drug mules who carry it into the country. On the contrary -- it is guaranteed that the dealers will slice it with all sorts of contaminants.
So the 'heroin' that Philip Seymour Hoffman was buying will -- as street heroin -- very likely have contained many contaminants. Often these are whatever somebody along the supply chain could find that looks like the drug -- laxatives, say, or talcum powder. Users can end up ingesting all sorts of crap -- including anthrax, which killed a large swathe of Scottish drug users not so long ago. This is the cause of the abscesses and wounds that terribly damage lots of heroin users. It has nothing to do with heroin itself -- when you give heroin to people in a hospital, for example, none of this ever happens. That's why the academic Dr. Russell Newcombe told me he calls them "drug war wounds."
The same thing happened with alcohol prohibition -- in one incident alone, five hundred people were permanently crippled by a poisonous batch of alcohol in Wichita, Kansas, and it wasn't regarded as that unusual. Banned products become terribly dangerous.
Killer number two: You can't tell the dose.
Because of the same dynamic, addicts are not able to tell how much of their drug they are ingesting. Ethan Nadelmann, the head of the Drug Policy Alliance and one of the most articulate decoders of the drug war in the world, has explained: "People overdose because [under prohibition] they don't know if the heroin is 1 percent or 40 percent ... Just imagine if every time you picked up a bottle of wine, you didn't know whether it was 8 percent alcohol or 80 percent alcohol [or] if every time you took an aspirin, you didn't know if it was 5 milligrams or 500 milligrams."
Philip Seymour Hoffman couldn't know what he was really taking with any certainty, because no drug user can under prohibition. This is a recipe for accidental overdose.
Killer number three: We drive addicts away from doctors who can help addicts towards criminals who can't.
In Chasing The Scream I tell the story of a doctor called John Marks, who discovered something remarkable. He was assigned in 1982 to the gray town of Widness in the North of England. Taking over his new practice, he was amazed -- and appalled -- to discover that a few dozen of his patients were being prescribed heroin, free, by the government. It was an old loophole left over from the 1920s. John called them in to see him, with an eye to cutting them off.
But what John saw startled him. These patients didn't look anything like any heroin addict he had ever seen before. They had jobs. They had normal lives. They didn't have any abscesses, or wounds. They were highly functional. As he looked deeper, he started to see that much of the harm we associate with heroin -- not all, for sure, but much -- is caused not by the drug itself, but by the decision to ban it.
He was so impressed he decided to massively expand the program, to cover 450 people. The results were striking. The local police Inspector, Mike Loftus, told a local newspaper: "You could see [the addicts] transform in front of your own eyes... They came in in outrageous condition, stealing daily to pay for illegal drugs; and became, most of them, very amiable, reasonable law-abiding people." John's program was so successful he began to tour internationally to promote his results -- and he came to the US. Suddenly, massive diplomatic pressure was put on the UK government to shut down this experiment. John's clinic was handed over to Christian evangelicals who ended the heroin program.
In all the time Dr. Marks had been prescribing, from 1982 to 1995, he never had a drug-related death among his patients. But after the program closed, of the 450 patients Marks prescribed to, 20 were dead within six months, and 41 were dead within two years. More lost limbs and caught potentially lethal diseases. They returned to the death rate for addicts under prohibition: 10 to 20 percent, similar to smallpox.
Apply these figures to Philip Seymour Hoffman, and you see how the drug war made his death considerably more likely. I went to a heroin-prescribing clinic in Geneva, where there have been no deaths among their patients at all in the more-than-a-decade they have been running. Some people think that because Philip Seymour Hoffman was rich, he had access to the best treatment. But one of the most effective treatments -- prescribing a safe maintenance dose of the drug, while people get their lives together -- is a serious crime in the US. He couldn't access it because nobody can.
Killer number four: You are much more likely to use alone, where nobody will see you OD.
When drug use is a crime that can get you thrown into Riker's, you will use in secret, alone. If you are alone and you start to overdose, there is nobody to revive you. There is an alternative. In Vancouver, I went to InSite -- the safe injecting room that was opened there over a decade ago. It looks like a branch of Tony and Guy's, except the little gently-lit booths offer needles, rather than scissors. You can shoot up, with clean needles provided, and there are doctors there to monitor you, and if you overdose, you are helped. Nobody has ever died there. In the decade since it opened, in the neighborhood where it is based, average life expectancy has improved by ten years, and overdose is down by 80 percent.
Some people might think Philip Seymour Hoffman would never have gone to such a place, because a celebrity would stand out. He reportedly went to Narcotics Anonymous -- he would have been no less conspicuous there.
Killer number five: If you start to overdose and you are with friends, they will be afraid to call the emergency services -- because they might be arrested.
In the United States, if you are using drugs with a person and they start to OD, if you call for an ambulance, the police will arrive too -- and they may arrest you. Elizabeth Owens -- a remarkable former drug user who campaigns on this issue -- explained to me that people don't call for help "because you don't want to go to jail. You don't want that extra charge. You get charged with possession, then you [are] getting a body count. They'll charge you with murder... If you got children you might lose your children. Nobody wants to be locked up like a caged animal and the key thrown away... You just don't call 911."
This means that people try crude ways to revive overdose victims; for example, there are popular (and false) beliefs that putting ice on an overdosing person will revive them, for example. And every moment you delay, they are more likely to die. We don't know if there was somebody with Philip Seymour Hoffman when he started to OD who was too terrified to call for help. If there was, it would not be unusual.
Elizabeth Owens led a campaign in New York State to introduce something called a "Good Samaritan Law" -- a guarantee that if you are with a person who is overdosing and you call the cops, you won't be busted. That law has now passed in New York State -- but hardly anyone knows it, so people are still terrified to call.
Each of these killers made the death of Philip Seymour Hofman more likely. Together, you can see how they radically increase the odds of him dying. The drug war takes something already dangerous, and makes it far more dangerous.
It is important to be candid about this -- there is no solution that guarantees good outcomes. Even if we had the most compassionate drug laws in the world, there would still be some people who would be killed by these drugs. There is an inherent danger to these substances -- as with alcohol -- that the best policies can massively reduce, but cannot eliminate entirely. That is why I will only say that it is likely that Philip Seymour Hoffman would have survived if we ended the drug war -- not certain. To go any further would be wrong. What we can say with confidence is we have a system that super-charges every risk associated with drugs.
Next time you hear somebody talking about the war on drugs, don't let them be abstract. Ask them What real places have followed the approach you are advocating, and what was the result? I have seen it for myself, in the last stop on my long journey. In Portugal nearly fifteen years ago, they decriminalized all drugs, and transferred all the money they used to spend on busting drug users into helping addicts. The result? Injecting drug use is down by 50 percent. Every study shows deaths from overdose and HIV among addicts have been slashed.
I have seen the future. I have seen it working. Philip Seymour Hoffman deserved to live to see it too.
Today, one hundred years into the drug war, we have a decision to make. We can wait for the next death, and the next death, and the next after that -- or we can decide to choose to let addicts live. It's up to us.
Please share your stories of addicts you have known, or addicts who have been killed by our wrong approach, with the hashtag #AddictsLivesMatter.
Johann Hari's book 'Chasing The Scream: The First and Last Days of the War on Drugs' is published by Bloomsbury as a hardback, ebook and audiobook. To find out where to buy it, or for more information, click here.
The sources for this article can be found in the book.
Johann will be speaking and signing books at Red Emma's in Baltimore on the 4th Feb, and at Ben McNally bookstore in Toronto (with Naomi Klein) on the 11th Feb.