Chasing the Scream: The First and Last Days of the War on Drugs

Citation

Newcombe, R. (2016), "Chasing the Scream: The First and Last Days of the War on Drugs", Drugs and Alcohol Today, Vol. 16 No. 3, pp. 229-230. https://doi.org/10.1108/DAT-07-2015-0035

Chasing the Scream is a compelling and often moving book. The 18 chapters draw us into the multiple overlapping worlds of people who use drugs and who prohibit drugs, taking us through a kaleidoscope of views, places and times. There is an excellent index covering topics and people, a useful section on narrative technique, and a thorough Notes section detailing sources.

The opening chapter The Black Hand includes the story of jazz singer Billie Holiday, and the campaign of harassment waged against her by Harry Anslinger and his Federal Bureau of Narcotics: “Anslinger is our own darkest impulses, given a government department and a license to kill.” Anslinger comes across as a corrupt and closed-minded bully, while Holiday seemed a lovely but damaged person whose life could have been greatly improved by a diamorphine prescription. Ironically, due to illness on retirement, Anslinger “took daily doses of morphine” and “died with his veins laced with the chemicals he had fought to deny the world.”

Hari’s style is primarily journalistic, making appeals to emotion as well as intellect. He typically deals with evidence in a clear and concise manner, though is selective and often glosses over the fine details – an approach which may be too uncritical for social scientists. For instance, Chapter 15 – Snowfall and Strengthening – tells the legendary story of Dr John Marks in Merseyside. From 1987 to 1997, Marks famously prescribed diamorphine in Widnes and Warrington, two Cheshire towns – not Wirral (Merseyside) as stated. Hari notes Marks “expanded his heroin prescription program […] to more than four hundred.” As Mersey drug strategy research director until 1991, I found no more than 30 percent of the ~400 clients of Marks’ two DDUs were prescribed diamorphine – most received oral methadone. Prevalence across Widnes and Warrington was estimated to be 3,300 (1 percent) – so if only around 120 (4 percent) heroin users were prescribed diamorphine annually, the significant reductions in harm achieved could not be attributed solely to this intervention. Instead, these outcomes were more attributable to the wider regional harm-reduction strategy, based not just on flexible prescribing but also on needle exchange and other services. In Hari’s defence, most writers who have stepped into the murky and myth-laden history of the Mersey harm-reduction movement have emerged with far less clear a picture.

Hari’s book describes the important contributions not just of inspired professionals, but also of user-activist groups such as VANDU. However, there is surprisingly no mention of the International Network of People who Use Drugs – now the leading group representing drug users globally, who are demanding representation on drug policy-making bodies, and a change to the dominant medico-legal discourse on drug use. Indeed, Hari should have questioned his own use of such discriminatory language as “addict” and “clean.” Some of Hari’s key conclusions could also have been brought up to date by relating them to the new psychoactive substances market.

My main theoretical disagreement is with Hari’s conclusion that the primary cause of “addiction” is lack of positive relationships: “the opposite of addiction is not sobriety – it’s connection.” Though this may be true of the most psycho-socially damaged drug users, research consistently shows that the etiology of drug use is complex, incorporating such diverse factors as genetics, personality, social context, hedonism, and self-transcendence.

These criticisms aside, Hari has delivered a very readable book about illicit drug use, presenting persuasive arguments to support a more humanitarian approach. Though social scientists may prefer more purely objective texts, general readers are likely to regard Chasing the Scream as one of the better books advocating for a reformed approach to drug use. I especially recommend it to people who would like a more thorough understanding of human intoxication based on an engaging blend of the personal and political, and the subjective and scientific.