Johann Hari’s Key to Humanizing Drug Addiction — Transcript

Johann Hari: And if at any point I speak too fast, just tell me, because I’ve had enough caffeine to kill a rhino today, so.

Terence: Welcome to “Self? Help!,” the podcast for anyone who thought: Who am I? What in God’s name am I doing? How did I get here of all places? And then, to figure it all out, you turned to a book because that’s the kind of person you are. And so is your host.

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Johann Hari: My name is Johann Hari, and my publishers keep telling me I have to introduce myself as the New York Times bestselling author of Chasing the Scream, and I always think I sound like a bit of a dick if I do that, but okay.

Terence: The book that helped Johann Hari was one he stumbled upon in the stacks of the Senate library in Washington, DC.

Johann: I found a book that almost vanished, as far as I could tell, called Drug Addicts Are Human Beings.

Terence: Johann pulled this book out from oblivion on his quest to understand the War on Drugs, which is over a hundred years old. The book was written by a doctor, Henry Smith Williams. It was published in 1938. And it was a book that told the future.

Johann: Drug Addicts Are Human Beings is an eerie book because you read it and you see that there was a man who saw everything that was coming down the line. He saw exactly what the drug war would mean. He saw it exactly how many people it would kill. He saw that there was an alternative that would save their lives. These were insights that were widely known and that were systematically destroyed and dismantled.

Terence: And they were systematically destroyed and dismantled primarily by one man: Harry Anslinger.

Johann: I think if you want to understand why the drug war started, and why it continues today, it’s really important to understand this man: Harry Anslinger. I think he’s the most influential person who hardly anyone’s ever heard of.

Terence: In the 1930s these two men, Henry Smith Williams, the doctor, and Harry Anslinger, the bureaucrat, were at odds with one another about how to deal with the problem of addiction.

Johann: One of the things that was so shocking looking at the early history of the drug war was to realize, “Oh! This was massively contested, right? This did not just slide into history.” That was a huge fight about what this thing was ever going to happen and it could have gone the other way.

Terence: Before Johann Hari even knew these two men existed. He had a similar conflict in himself. He could relate to both the bureaucratic judgment, through which Anslinger saw drug addicts, and the empathy at the heart of Henry Smith Williams book Addicts Are Human Beings.

Johann: Yeah, this was a really personal journey for me because one of my earliest memories is of trying to wake up one of my relatives and not being able to, and I was too small then to understand why or what was going on. But as I got older I realized we had drug addiction in my family, several members of my family, and like a lot of people who grew up with addiction in the family I was drawn to people with diction problems someone I really love was in a really bad state, and like a lot of people in that position, I felt really conflicted.

If you’re really honest, if you love someone who’s got an addiction problem, there’s a part of you that is really angry, that looks that person and thinks “I wish someone would just stop you. Why are you doing this thing?” And then there’s another part of you that’s like, “I can see the anger doesn’t help you. In fact, it makes the problem worse. I can see that you’re doing this because you’re in terrible psychological pain, how can I help?”

And I was really torn, not even torn, I was oscillating between those two impulses. I didn’t know what to do. So. And I couldn’t really find the answers in what I was reading. So one way of resolving an internal conflict is to go on a journey out into the world and see these different impulses in you being acted on.

Terence: And that’s exactly what Johann did. He took a journey around the world to better understand how addiction was treated in different places. But before he interviewed doctors and addicts, experts and hitmen, Johann wanted to understand the origins of the drug war. How did we get here? And when he read through the early Congressional testimonies that determine the fate of drug enforcement in the US, it became clear to him that one voice dominated the conversation.

You guessed it: Harry Anslinger.

Johann: So Harry Anslinger was a government bureaucrat who took over the Department of Alcohol Prohibition just as alcohol prohibition was ending.

Terence: With alcohol legalized, the Department of Prohibition became the Federal Bureau of Narcotics. The men under Anslinger had been in a war with alcohol, and they lost that war. Now, Anslinger had to rally the troops to fight a new enemy: Drugs.

But he had a few obstacles. Many drugs, including marijuana, were legal at the time, and the Supreme Court had recently ruled that people addicted to harder drugs — cocaine and heroin — should be dealt with by doctors and not by law enforcement. If those challenges were not enough, shortly after he started in the new position the Department’s budget had been significantly cut.

Johann: And he wants to keep his government Department going.

Terence: So what’s a bureaucratic genius to do when his department is in jeopardy?

Johann: And he effectively designed the modern War on Drugs and championed it and argued for it and succeeded.

Until 1914, all drugs were legal in the United States. So, for example, if you wanted to buy opium, you would go to your local pharmacy and you would buy something called Mrs. Winslow’s Soothing Syrup. You could buy cocaine-based products.

If you’d ask me at the start of this research, why were drugs banned nearly a hundred years ago, again I would have assumed that they were banned for the reasons that if you stop someone in the street and said hey, why are drugs banned, most people would say, “Well you don’t want people to become addicted. You don’t want kids to use drugs.”

And actually those arguments were barely advanced when drugs were being banned. Overwhelmingly, It was a hysteria around race and addiction.

Terence: And the race hysteria led authorities to revisit the Harrison Narcotics Act of 1914, which criminalized opiates and cocaine. Ansligner basically wanted to revive an old law to discriminate against various people.

Johann: In San Francisco, the city authorities wanted to evict the Chinese from the center of the city and send them out of the city, and this was appealed through the law and it was ruled they couldn’t do this. So that point the city authorities shifted tack and they said “Ah, well, the Chinese are peddlers of opium. And it’s true that Chinese Americans disproportionately did use opium at that point. And then they’d said, “Oh, they’re enslaving white women.” This was a very popular theme of Harry Anslinger is later turning them into prostitutes, and so on.

So they shifted to say what we need will just crack down on them through using this legal tool rather than the more full frontal and obvious racism. And that of course succeeded. They did in fact crack down on them. They did in fact arrest huge numbers of people and they cleared out that part of San Francisco using that pretext instead, and I think that’s a microcosm of what was happening. There was a desire to crack down on African-Americans, Latinos…

Terence: And Harry Anslinger used this desire to his advantage.

Johann: He really built the modern War on Drugs around two intense hatreds that he had. One was a really intense hatred of African-Americans and Latinos. I mean, he was so racist that he was regarded as an extreme racist in the 1920s, right? He used the n-word so often in official police memos, his own Senator said he should have to resign.

And the other group he really hated was people with addiction problems, because he’d had some bad experiences as a child with a neighbor who had an addiction problem.

At first he says, you know people with addiction problems are contagious right there like lepers. They need to be separated from the rest of humanity. He really builds this belief how if the United States doesn’t crackdown on drugs, doesn’t criminalize these drugs and doesn’t use all the forces of the state to wage war on them, these two groups will get out of control.

Well, Ansligner’s relationship with reality and truth was very tenuous. He would literally just invent government figures. So for example, he claimed after his big crackdown in the 30s that the number of addicts in the United States have been reduced to 20,000 and the Department of Treasury who were overseeing is just “This is truly just fabricated, made up.”

One thing that’s very striking about Harry Anslinger is his relationship with reality is very tenuous. He’s extremely paranoid. He thinks the Chinese are deliberately flooding the United States with heroin, as an attempt to weaken the United States, to prepare it for invasion. He comes up with all sorts of absolutely bonkers ideas, for which his own staff keep saying there’s no evidence for this, right.

Terence: And when there’s no evidence. There is always propaganda.

Johann: So cannabis was not banned in the United States until the 1930s. Until the early 30s, Anslinger has said we shouldn’t ban cannabis. It’s not very harmful. There just wasn’t that big a trade in heroin and cocaine in the US at that time. To keep his Department going, he needed a much bigger enemy.

He suddenly announces that cannabis is literally the most evil drug in the world, that it’s more dangerous than heroin. So he sent his agents to jazz clubs and said, you know bring back evidence about how cannabis is destroying people.

One of the things they would do is, they assumed that Jazz lyrics were meant literally. So there’s a song called That Ocean Man where there’s a line where “When he gets the notion / He thinks he can walk across the ocean” and they write like in you know warning to Anslinger “When people use cannabis, they think they can walk across the ocean and the will have mass drownings.”

And Anslinger starts warning people, “Ah, we’re gonna have more people drown if we have more cannabis and people think they can walk across the ocean.” This was the level of the scientific analysis, by the way that led to the banning of cannabis. But Anslinger, in particular, honed in on one case.

In Florida, there was a young man, aged 21, called Victor Licata, who hacked his family to death with an axe. Anslinger, in alliance with the Fox News of its day, which was William Randolph Hearst newspapers, announces that this is what will happen if you use cannabis, you’ll hack your family to death with an axe. This sounds like I’m comically hyperbolising and I’m not. You can look it up. This is literally what he said. And this idea is spread throughout the United States.

Years later historians went and actually got the psychiatric files for Victor Licata. There’s no evidence even used cannabis. His family had been told that he had psychosis and was very unwell. More than a year before. They tried to keep him at home. It was a terrible tragedy, but these are the stories that are sold and promoted that lead to the ban, which persists to this day.

Terence: Anslinger’s propaganda was highly effective. So effective that even Henry Smith Williams, before he wrote Addicts Are Human Beings shared Anslinger’s perception of addicts as vile and repulsive and not worth the air they breathed.
Yes, the guy who wrote Addicts Are Human Beings once thought addicts were sub-human.

Johann: So Henry Smith Williams was one of the most prestigious scientists in the United States in the 1920s. He’d edited over 30 volumes of the main scientific encyclopedia in the United States. Super prestigious guy.

When Harry Anslinger starts talking about people with addiction problems in these cruel and annihilatory ways, Henry Smith Williams agrees. He was part of this movement at that time kind of Social Darwinist movement that believe that people with addiction problems and plenty of other people like disabled people were kind of defective, that if we really followed survival of the fittest, these people would have been left to die or even finished off. As he put it, you know, they were weaklings and that we would have been better off if they’d never been born right see a very harsh view about people with addiction problems.

His brother was a doctor in Los Angeles called Edward Smith Williams.

Terence: Okay to keep track of these brothers, Henry is the Social Darwinist who would later write Addicts Are Human Beings, and Edward is the brother who will land in jail because of Henry Ansligner.

Both brothers, as doctors, had treated addicts over the years, but with Ansliger’s increased reinforcement of the drug laws, the brothers noticed a shift:

Johann: They noticed a massive change in the nature of the addicts they got.

So prior to the ban, 22% of addicts were wealthy only 6% were poor, mostly middle-class, almost all of them had jobs. Very few of them were criminal, were no more likely to be criminal than the rest of the population. They were diminished by their addiction certainly, but they had reasonable lives, right? They were still in the society.

And then the War on Drugs begins, and they noticed a really big increase in deaths among people with addiction problems, and a really big, a really terrible deterioration in just the physical and mental health of people with addiction problems.

Terence: Now for Edward, the doctor who would land in jail, he wanted to understand the shift:

Johann: Edward Smith Williams is like trying to figure this out. “Why is this?” When it was legal, a grain of morphine had cost from a pharmacy in liquid—you get it in liquid form—three cents. the equivalent after the ban was a dollar. Huge numbers of them start turning to crime. The men often turned to property crime. A lot the women turned to prostitution.

When it was legal, you would go to your local pharmacy and buy the drug you were addicted to, and it would be actually a pretty weak version of the drug as well. When it was banned, it’s transferred to armed criminal gangs. Suddenly you have these violent gangsters selling the drug. And this is really the moment when this picture of the kind of the chaotic street addict, the forced into crime to pay this exorbitant prices. This is really when that is born and when it begins.

And Edward Smith Williams is really uncomfortable with what he’s seeing happen. He remembers what it was like when it was legal. It wasn’t perfect. There were a lot of problems, but then he sees what it’s like when you got this brutal prohibition, because it’s been a real problem and he notices there’s a loophole written into the drug laws and it was written very specifically.

Terence: Now the Harrison Act declared drugs illegal, but it says if a person is addicted doctors can prescribe them a drug.

Johann: So Edward Smith Williams thinks, “Well, I’m going to try doing this. Let’s see what happens.”

He starts to prescribe, for example, opioids and heroin to people with heroin addictions, and he notices a huge decline in their deaths and a huge improvement in their health. A lot of them had fallen to this chaotic criminal life now get to go back to where they were before the ban right again, it’s not perfect the still problems. This is a really significant improvement.

Terence: Edward’s model for drug rehabilitation becomes wildly popular, and he opens a large clinic in Los Angeles.

Johann: The mayor of Los Angeles comes and stands outside that clinic and said, these were his exact words, “This clinic accomplishes more good in one day than all the prosecution’s do in one month.”

Terence: Just in case you were wondering, that did not sit well with Anslinger.

Johann: So Harry Anslinger resolves that he has to destroy this model. As one of his own agents, Howard Diller, said, anybody that came out with any academic work that could be critical of him, his bureau, his philosophy, had to go to prison or be beheaded. And Anslinger resolves to destroy these doctors who are prescribing these drugs, even though it is legal. And even though the Supreme Court upheld the legality of it.

He starts saying that they’re just cynics, they’re doing it to make money out of these vulnerable addicts. So he sends what are called stool pigeon, so he sends people who’ve got addiction problems who hadn’t been to Edward Smith Williams before. To go, so I’ve got heroin addiction, and get him to give them drugs, at which point Anslinger orders his agents across the country to swoop down on these doctors, using these stool pigeons and bust them, charge them with drug dealing.

So in Portland, Oregon, for example, there was a clinic that was prescribing heroin. The narcotics officers come. They break up. They arrest the doctors, and one of the doctors said, “But what are we meant to do?” and the quote is here the narcotics officer said, “Hey sure, there’s plenty you can do. Run the whole bunch of them down to the ocean and kick them in. They’ll make fine fish food. That’s all any of them are good for.”

Now, this is the approach that Anslinger imposes. And by the way, his own agents rebel, right? So one of them, one of his leading agents, William G. Walker, resigns. He says if anyone could see the suffering of these poor devils—meaning people with addictions—they would understand why we should have a change.

Here is the birth of the drug war and here are two models. There is one model that says these people are like lepers. We need to punish them, shame them, drive them out of the society, deprive them of the drug, and so on. And there’s a doctor saying no, actually, we need to be compassionate. We need to give them help. We need to provide them with clinics. We need to give them the drug they’re addicted to and give them help.

This is the biggest round-up of doctors in the history of the United States. 20,000 doctors are rounded up and charged with being drug dealers. This has a really profound effect on Henry Smith Williams. So remember Henry Smith Williams, the brother, very prestigious scientist, has had these very annihilatory views about people with addiction problems. But when his brother is arrested, is swept up, he starts to learn about this, and it really gives a change of heart to Henry Smith Williams. And after Anslinger has all these doctors arrested and Edward Smith Williams is convicted and selling a boasts in one of his letters that I found doctors now cannot treat addicts even if they wish to.

Terence: With his brother in jail for selling drugs, Henry Smith Williams started to take a closer look at Anslinger and his treatment of addicts.

Johann: When Henry Smith William starts investigating this, right, he is horrified. He explains that the United States government has effectively created an army of criminals. He says that, you know, that obviously everyone knows this demand for drugs. Everyone knows it’s not going to go away, especially when you have this cruel treatment of people with addiction problems. This is a quote from him. He said, “the US government became the greatest and most potent maker of criminals in any recent century.”

So Henry Smith Williams is so puzzled by the fact that the US is doing something so irrational that he begins to have a hunch. So, he could see that the war on drugs is having a disastrous effect. It is increasing the deaths of people with addiction problems. It is massively empowering the mafia. It’s massively increasing in crime. So he’s like, they can’t be this dumb. There must be something more going on here. So he begins to believe that Harry Anslinger must be in league with the mafia.

Who benefits from this policy? It is only the mafia, right, they’re the only people who benefit—and they benefit enormously—so Harris Williams thinks, well, it must be that Anslinger is being paid by these guys, right. That is not true. Anslinger was not being paid by the mafia. He really was as dumb as Henry Smith Williams thought he couldn’t be, but Henry Smith Williams was right about one thing in relation to one thing, which is something happened in California that I think is so interesting and tells us something so important about the drug war.

As we said before, there’s a loophole that allows doctors to prescribe drugs, even though the drugs are illegal in other contexts, and Anslinger’s men shut down this loophole state-by-state, and different states resisted more to it. California actually resisted quite strongly in the end. California did shut down the clinics in LA and other parts of California and it was established at trial a few years later why.

The head of the Federal Bureau of Narcotics in California was a big redheaded guy called Chris Hansen. And he did it for a very specific reason. The local Chinese drug gangs were really pissed off because in Nevada they had already shut down the clinics, and so of course all the people who had addiction problems who were used to getting the drugs from the clinic had to go to the Chinese drug gangs. And they were really annoyed that in California people could still go to the doctor. So they bribed the local authorities, including Chris Hansen, to introduce the drug war in California to shut down these clinics because then they would get all the business.

Who benefits from the drug war? The only people who benefit are armed criminal gangs and they benefit so much that they paid for it to be sped up in its introduction?

Henry Smith Williams says in 1938, we’re not going to continue with this approach. Because that would be crazy. But if we did, 50 years from now, we’ll have a five-billion-dollar smuggling industry in the United States. He was right to almost the exact year. To realize that the catastrophe of the drug war, which had a disastrous effect on some of the people I love with addictions, to realize that none of it had to happen, that we could have had this an approach based on love, compassion, and regulation right from the start, was, it was gut-wrenching.

Henry Smith Williams’s words were successfully wiped from history by Harry Anslinger for more than 60 years. But the insights that Henry Smith Williams, and his brother Edward Smith Williams, discovered were not forgotten, and I actually saw them in practice.

Some people will remember in the 90’s, Switzerland had a horrendous opioid crisis, and Swiss people are obsessed with order. It’s not coincidence they invented clocks. And to them, having like nightmarish scenes of people injecting in the neck and all sorts of things, was just horrendous. Switzerland tried initially the American way: they arrested loads of people, they imprisoned loads of people. And it was a disaster, and Swiss people are quite pragmatic, so they decided to cast about for other solutions.

They got their first ever female president, a woman called Ruth Dreifuss and Ruth explained to Swiss people, when you hear the word “legalization,” what you picture is anarchy and chaos, but what we have now is anarchy and chaos. We have unknown criminals selling unknown chemicals to unknown drug users all in the dark, all filled with violence, disease, and chaos.

And what she proposed was to legalize heroin, and she explained to Swiss people, this will be the way that we restore order to this chaos. The way it works is they went back to unconsciously, they didn’t know this history, they went back to the model that Henry Smith Williams and Edward Smith Williams had championed and pioneered and that have been stamped out by Anslinger.

They set up heroin prescribing clinics. So I went to the one in Geneva.

The way it works is, if you’ve got an addiction problem you’re assigned to this clinic. You have to go early in the morning because people believe in doing some things insanely early. You turn up at 7 a.m. You go in. You’re given your heroin there. You can’t take it out with you. You’re given a medically pure heroin, not the contaminated shit you buy on the street.
You have to use it there, because it partly, because they don’t want people to sell it on and partly because they want to make sure you’re okay. You’re watched by a nurse and then you leave to go to your job because you’re given a huge amount of practical support to get employment, to get housing, to get therapy.

And the results are very clear. In those 14 years on legal heroin there have been zero deaths.

Not a single person has died on the legal heroin program in Switzerland since it began. There’s been an enormous fall in heroin deaths outside the legal program because people transfer into the legal program. After this program had been in place for a couple of years, had a referendum on it, and 70% of Swiss people voted to keep heroin legal.

It was that crime fell so much. Street crime, property crime, street prostitution ended.

Terence: Seeing the success of the approach in Switzerland Johann couldn’t help but reflect on Henry’s book Addicts Are Human Beings.

Johann: I remember one afternoon. I was in the clinic in Geneva and I was with an amazing woman called Rita Mange, who’s the chief psychiatrist at the addiction clinic.

And I told her the story of Edward Smith Williams. I said to her, you know, this has all happened before. And I told her that story, and she looked at me very seriously and she said: “Maybe what we all learn together about addiction is a bit like the way that individual people with addiction problems gain insight. We have a step forward, then we have a relapse. Then we have a step forward, and then we have a relapse. But every time you take the step forward in your relapse, you learn something new.”

As a society, we had steps forward. You know, Edward Smith Williams pioneers compassionate and loving treatment for people with addiction problems. And then as a society, we have a horrendous relapse. It causes the death of many people. It didn’t have to happen. But now we have other steps forward in places like Switzerland.

Everywhere I went there was something very clear. Approaches towards addiction and drugs based on shame and punishment have disastrous outcomes that make addiction crises worse. And everywhere I went I had approaches based on love and compassion and restoring order to the drug trade, saw those problems radically diminished. They didn’t totally vanish. They’re still problems, but radically diminished at some point.

We have to go back to the insights that Henry Smith Williams had so long ago and realize that drug addicts are human beings.

Terence: Thank you for listening. Today’s episode was produced and edited by yours truly, with audio engineering help from Dominick and production assistance from Nat.

Please tweet me your book recommendations. I’m at Terence_Mickey. And on Instagram, I’m at terence.p.mickey. I look forward to hearing from you.

And if you’re dying to read the books mentioned in today’s episode, Drug Addicts Are Human Beings is in the public domain and can easily be found in a Google search.

And to check out Johann Hari’s work, we have a special treat for you from our sponsor.