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Iatrogenic Government


Washington. -- Perhaps the 1969 encounter on the helicopter was a meeting of the different political sensibilities of Harvard and the University of Chicago.

Pat Moynihan, President Nixon's domestic policy adviser, with a Harvard man's confidence in the efficacy of government, had just returned from prompting the French government to smash the "French connection" by which most heroin destined for America was refined from Turkish opium in Marseilles.

Mr. Moynihan's companion on the helicopter to Camp David was Labor Secretary George Shultz from the University of Chicago, home of flinty realism about the power of strong appetites to create markets in spite of the disapproval of governments.

Mr. Moynihan happily told Mr. Shultz about his achievement in France. "Good," said Mr. Shultz with deflating dryness. "No really," said Mr. Moynihan, "this is a big event." "Good," said Mr. Shultz, again not interrupting his paperwork to feign excitement.

"I suppose," ventured Mr. Moynihan, "you think that so long as there is a demand for drugs, there will continue to be a supply."

"You know," Mr. Shultz replied, "there's hope for you yet."

Senator Moynihan recalls this in his essay "Iatrogenic Government" in the American Scholar quarterly. (Iatrogenic: "induced inadvertently by a physician or his treatment.") It is a timely story of the unintended consequences of unpalatable choices, and of choices more unpalatable than public policy might have made them.

In 1969 Mr. Moynihan recognized the drug epidemic as yet another instance of "the central experience of modern society," the disruption of society by technology. The environment is injured by technology; populations are displaced by technology; drivers and pedestrians are maimed by technology; cities are choked by technologies. And cities are terrorized by the crime generated by the traffic in drugs that are products of technology.

Products, to be precise, of 19th-century German organic chemists. They produced morphine, a medicine that begat a monster. From it came a distillation that made users feel "heroisch" -- hence the name heroin. From opium to morphine to heroin; from coca to cocaine to crack: We have climbed the technological ladder before, from wine and beer to brandy and gin.

Distilled alcohol became a scourge of the 18th-century when the Renaissance invention of distillation met the abundance of grain produced by the agricultural revolution. The public-health calamity of cheap gin was an important reason why London's population growth stagnated between 1700 and 1750.

The second law passed by the first U.S. Congress imposed a tariff on Jamaican rum to encourage consumption of American whiskey. Not much encouragement was needed. Americans commonly drank whiskey at breakfast and on through the day. Laborers digging the Erie Canal were given a quart of Monongahela whiskey a day, issued in eight four-ounce portions beginning at 6 a.m.

People thought this was healthy. (Not long ago people thought ** cocaine was a non-addictive refresher.) But social learning occurred regarding alcohol. By the end of the 19th century the temperance movement had reduced per-capita alcohol consumption two-thirds. Then came Prohibition, a public-health success (alcohol-related illnesses declined dramatically) but with a high social cost in criminality.

And today? Given current chemical technology -- note this qualification -- drug policy requires a choice between two nasty outcomes, a broad public-health problem resulting from legalization, or a more localized but devastating crime problem, particularly among vulnerable inner-city populations. We have chosen the latter.

However, we persist in pretending that we can make a "cleaner" choice -- interdiction of supply, bolstered by executions of drug "kingpins." But a nation with long coastlines and open borders (and skies) cannot "interdict" a compact substance that is sucked north by a $100 billion demand. (America's demand for cocaine can be supplied from 96 square miles of Latin America -- a patch the size of Milwaukee.) Interdiction may raise drug prices somewhat, but raising the price of a highly pleasurable and highly addictive substance may raise the rate of the crimes committed to procure the substance.

Mr. Moynihan says that "federal drug policy" -- iatrogenic government -- "is responsible for a degree of social regression for which there does not seem to be any equivalent in our history." Today more Americans are imprisoned for drug offenses than for property crimes. However, the senator says, the "failure" of our drug policy is the success of our strategy to avoid the public-health calamity that certainly would result from legalization.

But we may be living with the consequences of another kind of failure. By now, given how much we know about brain chemistry, we probably should have a technological response to the destructive forces unleased by 19th-century chemistry. Government support should have provided the resources (and prestige; that matters in science) for research to discover chemical compounds that block or reverse the pleasure- and addiction-producing effects of drugs. Is it too much to ask that this be taken as seriously by medical researchers as AIDS is?

Senator Moynihan believes that, given the setting of the drug problem amid the collapse of family structure in the inner city ("To use an epidemiological analogy, we have a famine-weakened population attacked by a fierce new virus"), only a neutralizing chemical technology can do much good. But pending fulfillment of that hope, there is one other, drawn from humanity's encounter with alcohol: Given experience, the species learns, adapts, behaves more sensibly.

George F. Will is a syndicated columnist.

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