Thursday, November 23, 2006

The one reason I will miss Milton Firedman

A nice opinion piece in today's Independent from Johann Hari - a long time advoicate of drug law reform andsupporter of Transform (you can read his archive of drug articles here)

Normally we would just post a link but since he rang up to check a few facts in the piece, I hope he wont mind us posting the complete article. For the record Transform doesnt have a view on Milton's political position beyond the drugs issue, but he did once send us a very nice letter offering his support.


The one reason I will miss Milton Friedman
Johann Hari, The Independent, 23 Nov 2006
He offered the most devastating slap-downs of the “war on drugs” ever written

Even in death, the right misses the point. Milton Friedman – the Messiah of Monetarism, saviour of small-state conservatism – is about to be buried, but his mourners have conspicuously failed to laud his one great argument.


In the past week, his conservative obituarists have concentrated on the slew of issues he got wrong, lathering praise on his demonstrably false belief that a limp, slashed-back state delivers greater social mobility and a broader middle class than a mixed social democratic economy. Just compare Sweden to Texas to test that one – or look at the collapse in Latin American growth since Friedmanomics forced out Keynesianism. Yet on one issue, Friedman applied the forensic brilliance of his brain to a deserving purpose. Over forty years, he offered the most devastating slap-downs of the “war on drugs” ever written.


Friedman was a child when alcohol was criminalised in America. The Prohibitionist crusade to banish the “demon rum” and dry out the United States lasted until he was in his twenties. The lessons lasted his lifetime. He saw that even when you use force – the police and army – to try to physically prevent people from using a popular intoxicant, you don’t actually reduce its use very much. “I wasn't very old and was not much of a drinker but there was no difficulty in finding speakeasies,” he explained. The most generous estimate is that alcohol consumption fell by a fifth initially, and then rose to pre-prohibition levels as people discovered surreptitious channels for a mouthful of moonshine.


But while prohibition didn’t succeed in the fantasies of its fans that it would “end alcoholism”, it did succeed gloriously in one respect. It handed a massive, popular industry to armed criminal gangs, who succeeded to ramp up the murder rate up by 78 percent and make a mockery of the rule of law. “We had this spectacle of Al Capone, of the hijackings, of the gang wars...” Friedman wrote. “Prohibition is an attempted cure that makes matters worse - for both the addict and the rest of us.”


Friedman saw – way ahead of almost any other commentator – how prohibiting cannabis, cocaine and heroin would spawn a thousand Capones. He warned, “Al Capone epitomizes our earlier attempt at Prohibition; the Crips and Bloods epitomize this one.” The old Chicago gangster famously gunned down six of his alcohol-hawking competitors on the St Valentine’s Day Massacre in 1929. But in the age of drug prohibition, there are equivalent dealer shoot-outs every minute of the day in South Central Los Angeles – and Hackney, and Bogata, and Kabul. People without recourse to the law will protect their property with hard ammunition. Late in his life, Friedman calculated that 10,000 people were dying every year in the US alone as a direct result of these killings, equivalent to more than three September 11ths. Most were bystanders caught in the cross-fire.


And by globalising this Puritan war on drugs, the US government has globalised this gangsterism. Friedman warned that the war on drugs has “undermined the very foundations of Colombian society” and “condemned hundreds, perhaps thousands, of Colombians to violent death.” I have just returned from Mexico, which is rapidly Colombianizing, with whole areas controlled by dealers who bribe or out-gun the police force and terrorize the local population. The same thing is happening on a huge scale in Afghanistan. “By what right do we destroy other people’s countries just because we cannot enforce our own laws?” Friedman asked.


But armed gangsters are not the only species of crime generated by prohibition. In his careful, methodical style, Friedman proved that criminalising drugs causes an explosion in muggings and burglary, making us all victims of this war at some time in our lives. How? A kilo of heroin passes through six different dealers in the supply chain before it reaches the veins of a Londoner. Each link in the chain demands a fat fee for risking jail. This means heroin costs 3000 percent more than it would in a legal, risk-free market – and a heroin addict must steal 3000 percent more to buy it. 3000 percent more grannies mugged, 3000 percent more homes burgled.


That’s why so many police officers are now coming out in favour of unpicking hardline prohibition and prescribing heroin to addicts, with Howard Roberts, the deputy chief constable of Nottinghamshire, joining the queue yesterday. They know from the experience in Switzerland – an ultra-conservative country that now nonetheless prescribes heroin – that it a silver bullet (or syringe?), bringing crime rates crashing down.


This does not mean Friedman was in favour of drugs. One of the biggest problem with the legalization brand is that it is still contaminated by the legacy of idiots like Timothy O’Leary, who though drugs use was an active good, an act of liberation. (Go visit a heroin addict in rehab and tell them how liberated they are). By contrast, Friedman thought (rightly) that heavy drug use – whether it was alcoholism, cannabis-addiction or junkiedom – was a human disaster. He once told Bill Bennett, Bush Snr’s drugs tsar, “You are not mistaken in believing that drugs are a scourge that is devastating our society. Your mistake is failing to recognize that the very measures you favour are a major source of the evils you deplore.”


Friedman proved, for example, that prohibition changes the way people use drugs, making many people use stronger, more dangerous variants than they would in a legal market. During alcohol prohibition, moonshine eclipsed beer; during drug prohibition, crack is eclipsing coke. He called his rule explaining this curious historical fact “the Iron Law of Prohibition”: the harder the police crack down on a substance, the more concentrated the substance will become.


Why? If you run a bootleg bar in Prohibition-era Chicago and you are going to make a gallon of alcoholic drink, you could make a gallon of beer, which one person can drink and constitutes one sale – or you can make a gallon of pucheen, which is so strong it takes thirty people to drink it and constitutes thirty sales. Prohibition encourages you produce and provide the stronger, more harmful drink. If you are a drug dealer in Hackney, you can use the kilo of cocaine you own to sell to casual coke users who will snort it and come back a month later – or you can microwave it into crack, which is far more addictive, and you will have your customer coming back for more in a few hours. Prohibition encourages you to produce and provide the more harmful drug.


For Friedman, the solution was stark: take drugs back from criminals and hand them to doctors, pharmacists, and off-licenses. Legalize. Chronic drug use will be a problem whatever we do, but adding a vast layer of criminality, making the drugs more toxic, and squandering £20bn on enforcing prohibition that could be spent on prescription and rehab, only exacerbates the problem. “Drugs are a tragedy for addicts,” he said. “But criminalizing their use converts that tragedy into a disaster for society, for users and non-users alike.”


Some people imagine that after drug prohibition ends, drug use will become rampant, with Chigwell housewives shooting up next to the chintzy ironing board. No historical analogy is perfect, but with one of his extraordinary dense statistical analyses, Friedman showed that the fears at the end of alcohol prohibition – that everyone would be glugging gin the moment they could freely buy it – proved to be false. In fact, alcohol use went back to pre-Prohibition levels, and has been falling since, with a brief spike in the Second World War. He also showed that the vast majority of criminals who had bartered in alcohol did not simply move into another form of crime, but went legit when the temptations of such a profitable criminal market disappeared.


Today, an end to drug prohibition seems like a distant fantasy. But in 1924, even as vociferous a wet as Clarence Darrow was in despair, writing that it would require “a political revolution” to legalize alcohol in the US. Within a decade, it was done. We are approaching a tipping-point in the drugs debate, when failure becomes undeniable. As we wait, I can still hear Milton Friedman in one of his last interviews: “In the meantime, should we allow the killing to go on in the ghettos? 10,000 additional murders a year? In the meantime, should we continue to destroy Colombia and Afghanistan?”


POSTSCRIPT: You can send comments on this article for publication in the Indie to letters -at- independent.co.uk or j.hari -at - independent.co.uk

12 comments:

Anonymous said...

Thank you for putting Johann Hari's excellent article onto your site.
I am not completely out of sympathy with Johann's or Tranform's positions but I am troubled by some implications legalising those drugs which are at present illegal. I have in mind our experiences of drugs which have always been legal: tobacco & alcohol, especially the latter which is arguably the least regulated of the mood-altering drugs available to us.
It seems to be axiomatic among alocohologists that the various harms caused alcohol are not confined to a minority of alcoholics but that, paradoxically, moderate drinkers incure the greatest number of harms by virtue of the fact there are more of them. The most effective ways to reduce harm are whole population approaches like using taxation to raise the price, limiting availability & drink-driving countermeasures.
If those drugs that are currently illegal ceased to be, one reasonable certainty is that consumption, in most cases, would rise. This would have a serious impact in the cases of opiates & benzodiazepines.
The Government would then be on the horns of a dilemma: should they manipulate price to restrict demand but by doing that, find that they are in competition with rejuvinated illicit supply networks who could start to pick-up business in their old markets perhaps by offering a personaised service that legitimate suppliers could not? With increasing stocks of drugs being manufactured legally, there would be more scope for selling pills or injectables that had fallen off the back of a lorry tax-free.
There is also the question of advertising. Should all drug-sellers have equal rights to market their produts through normal adverising (which despite claims to the contrary, we all know is effective in incresing sales & preparing new customers by appealing to those not yet of legal age)but also through promotions, sponsorship & product placement? Or should none?
It is surely wrong to assume that if bussinesses are legal that they will always act responsibly. British American Tobacco have been complicit in smuggling, tobacco interests generally tried to subvert research on tobacco & health as have alcohol interests. The alcohol industry has a cosy relationship with Government & is able to influence policy; it's difficult to imagine that newly-legalised heroin wholesalers & distributors --who will comprise a fair proportion of those who learned their trade before legalisation-- not trying to do the same thing.
A piece from The Times that appeared on this morning's Daily Dose states, with alarm, that there are about 324 000 people (?in the UK) who have problems with illicit drugs. This compares with more than 8 million people in England & Wales who have some sort of alcohol use disorder (source: Colin Drummomnd's Alcohol Needs Assessment, 2004). Imperfect as the law is it does, as these comparisons show, act as a crude rstriction on both supply & demand & has the effect of keeping casualties lower than they might otherwise be.

Anonymous said...

PS: My response was only anonymous by default!
I remain a big fan of the Transform site & very appreciative of your contributions to the various drug debates.
Richard Lee
Alcohol Education Officer
West Sussex PCT
Goring-by-Sea BN12 6BT

aahpat said...

The economics that inspired Milton Friedman's ruminations on drug prohibition have been proven out a thousand fold since he warned the world against the drug war in 1972. Prohibition and Drugs

Even the chaos of the proliferation and expansion of stateless world terrorism can be traced directly back to the growth of the global black market created by prohibition.

"Our drug policy grants huge subsidies to our enemies"

"The international drug control regime, which criminalizes narcotics, does not reduce drug use, but it does produce huge profits for criminals and the armed groups and corrupt officials who protect them. Our drug policy grants huge subsidies to our enemies." New York University Professor Barnett Rubin to the Senate Foreign Relations Committee, Sept. 2006.

Dr. Rubin concluded: "If it were not illegal, it would be worth hardly anything. It's only its illegality that makes it so valuable."

daksya said...

It seems to be axiomatic among alocohologists that the various harms caused alcohol are not confined to a minority of alcoholics but that, paradoxically, moderate drinkers incure the greatest number of harms by virtue of the fact there are more of them.

The fallacy with this thinking is twofold:

1)The ability of a person to manage & cope with harm is related to only the harm incident upon him/herself. The "greatest harm" is distributed over all the moderate drinkers, so that harm incurred by an individual drinker is modest, whereas harm incurred by an alcoholic is not.

2)A more serious fallacy is that moderate drinkers do not, in fact, suffer much harm, even in aggregate. This is because the definition of "moderate drinkers" is indexed to gross annual consumption or the like. Various studies show that drinkers whose drinking behavior is 1-2 drinks per day for 6-7 days a week show better health outcomes than those who drink 5-7 drinks per day for 1-2 days a week i.e. the difference between a wine with dinner daily and getting trashed on Friday night. Obviously, if the latter occurs among those who do control their aggregate drinking frequency and behavior, they won't be classified as abusers and will be included as "moderate drinkers". These drinkers may not suffer much health harms in the long run but their risk of incurring behavioural harm such as injuries is greatly increased over the one glass of wine consumer.

It's my firm belief that the most productive way to foster harm reduction is not by examining & tweaking macrovariables like taxes and availability. Psychoactive substance use is inherently a phenomenological activity that is self-centered. Truly qualitative assessment of acute use episodes & use careers is needed to develop intelligent & efficient heuristics that promote harm reduction. The ecological momentary assessment studies published over the past few years with cigarettes, alcohol, cannabis and ecstasy are a rough step in that direction. Of course, the key obstacle here is that with a consuming base of millions, quantitative analysis is preferred for logistical and sampling reasons. But I don't think that changes the fundamental advantage of phenomenological analysis or the deficit of brute covariance detection which is the norm.

Steve R said...

this is some draft text from an upcoming Transform publication that considers the role of alcohol in this debate:

Alcohol and Tobacco – how to discuss them usefully

There are many important lessons from the successes and failures with legal regulation of alcohol and tobacco that we can take into the debate around prohibited drugs. These will inevitably crop up so it is useful to have a grasp of the key arguments so you can turn any mention of the legal stuff to your advantage.

Both tobacco and alcohol are often talked of as if they ‘aren’t real drugs’ or sometimes not drugs at all, underlined by the frequent use of phrases such as ‘tobacco and drugs’ or ‘alcohol and drugs’. These are about as meaningful as saying ‘orange juice and drinks’. Obviously they are both powerful psychoactive drugs – toxic, potentially addictive and associated with high mortality rates. Were they to be classified under the Misuse of Drugs Act they would certainly be class A or B (ref). Do not hesitate to point this fact out.

However, for reasons that have no bearing on actual risk, tobacco and alcohol are both legally produced, supplied and consumed, albeit within a reasonably strict regulatory framework – outside of which some prohibitions remain.

The distinction between tobacco/alcohol and illegal drugs is not justifiable under any scientific, logical or public health criteria and is purely an artefact of quirks in our social and political history. The argument that ‘its not fair’ people are allowed to use one drug and not another is a strong one – but needs to be deployed carefully (see ‘When is it useful to talk about personal rights p….)

For all the health and social problems associated with alcohol and tobacco use, the key difference with illegal drugs is on the production and supply side. Alcohol and Tobacco are produced under licence, are liable to taxation, are not profiting criminals, are sold in licensed shops and premises, provide information on strength - and with tobacco at least - health warnings on the packaging. We have none of the criminal market problems that we have for currently illegal drugs (see tobacco notes below re smuggling).

Tobacco

• The high prevalence of tobacco use is due to a number of factors including its long history of use, its aggressive promotion as an aspirational lifestyle product over the last century, and the nature of nicotine intoxication – that enables people to function normally at the same time as being addicted, lending itself to long term frequent use.
• Effective regulation of tobacco (including recent bans on advertising and smoking in public spaces), and more importantly, well funded health education on the risks of smoking have seen a steady reduction in smoking over the past 3 decades. Admittedly this was from a very high point in the post war era (before which advertising was aggressive and unfettered, and the medical consequences poorly understood), but it does illustrate how prevalence of a legal drug can change positively in response to sensible regulation and public health education.
• The illegal market in smuggled tobacco is the direct result of taxation policy. If tobacco taxes were reduced smuggling would fall (where there is no tobacco tax there is no smuggling) but use would probably rise with falling prices. The Government has too balance these two factors, but at least with tobacco, because it is legal and regulated, they are in a position to intervene, an impossibility with illegal drugs that are entirely at the whim of supply and demand in an unregulated criminal market. It is also worth noting that most smuggled tobacco is at least legally produced in the first instance.

Alcohol

• Prevalence of alcohol use is high because it is the oldest and most culturally established of all drugs, combined with fact that it is, for the most part, very pleasurable to consume. Prevalence of alcohol use, risky patterns of consumption (binge drinking) and related crime and disorder problems are getting worse chiefly due to poor regulation and a lack of effective public health education. Alcohol is still allowed to advertise with few restrictions, often directly aimed at young people and children through sport sponsorship such as premiership football and Formula 1 racing. Sums spent on public health education are eclipsed by spending on advertising and promotion. New products are being developed and marketed (such as ‘alcopops’) that target younger markets and encourage risky patterns of use.
• If the Alcohol issue is to be tackled there needs to be strict controls over advertising and promotion starting with minimum prices and a ban on sports sponsorship – possibly leading to an outright advertising ban, similar to tobacco. Far greater investment needs to be made in effective targeted health education (ref ACMD report how weird that we produced this just before that report came out). These are both policies that would apply to any legalised and regulated drug in the future
• With alcohol we have a unique and brilliant example of where prohibition was tried (in the US 1920-1933) failed horribly (for the same reasons drug prohibition is failing now) and was ultimately repealed.

Anonymous said...

Perhaps my asertion that moderate drinkers, paradoxically, incur the greater number of harms wasn't as clearly expressed as it could have been but if Kreitman's "preventive paradox" is a fallacy, it's one that seems to have taken in a good deal of informed opinion in the alcohol world.
To respond briefly to Daksya's 2 objections:
1. "The ability of the person to manage & cope with harm is related to only the harm incident upon him/herself" While struggling to work out precisely what this means, it's fair to say that when drinking most people form different --& arguably less rational-- judgements about the impact of their behaviour on both themselves & others than when they are not drinking; the actions of a person when in drink have an impact on others as well as themselves; when drinking we are more likely to be subject to a number of harms by others.
To suggest that, even if these are rare, they are always "modest" is surely wrong. A one-off event, being glassed is just one example, has lifelong consequences.
2. Those drinking roughly the same amount of alcohol over any period of time cannot be divided neatly into 2 camps. Drinking patterns are dynamic-- regular light drinkers will sometimes get drunk, episodic boozers will also drink responsibly.
"It is my firm belief that the most productive way to foster harm reduction is not by examining [is Daksya suggesting that all research in this area should cease forthwith?]& tweaking macrovariables like tax & availability." It seems as though alcohol policy has now become a faith position! Given the choice between a "firm belief" & a wealth of international research that makes clear the relationship between price, availability, consumption & harm (a relationship that has been known about for almost as long as the relationship between smoking & lung cancer), I would always choose the latter.
Some of the arguments put forward by Daksya sound very similar to the sort of things the alcohol industry is fond of saying. Perhaps Daksya should come from behind the mask of anonyminity & declare an interest.
The main point of my post was to argue that one useful way of anticipating the impact of the legalisation of most psychotopic drugs is to look at what we already know about our legal drugs. This is why a public debate is so important & also why we have to carfully think-through possibly irrevesible changes.
Yours, not at all annonymously,
Richard Lee
Goring-by-Sea
W. Sussex
UK BN12 6BT

daksya said...

While struggling to work out precisely what this means

It means that the impact of harm is determined by its magnitude and that the "greatest harm" is distributed over the greatest group of drinkers ('moderate') and hence is modest in the average individual instance of harm.

it's fair to say that when drinking most people form different --& arguably less rational-- judgements about the impact of their behaviour on both themselves & others than when they are not drinking

There's a dose-response relationship in this regard. And the environment and conditions are an important modulator. So, it's not drinking per se, that's a problem.

Drinking patterns aren't regular but users tend to fall into clusters. Because the wine drinker gets trashed once in 3 months, doesn't invalidate my point.

A one-off event, being glassed is just one example, has lifelong consequences.

Public policy shouldn't be aiming for a utopia. 'Modest' obviously refers to the average harm, not the upper limit. No policy will eliminate all incidence of severe harm, hence one has to fall back on their prevalence as the metric rather than complete elimination.

is Daksya suggesting that all research in this area should cease forthwith?

I'll start by suggesting that you avoid the strawmen.

a wealth of international research that makes clear the relationship between price, availability, consumption & harm

Your rebuttal completely misses the point. As I said, drug taking is a psychological activity, hence research should primarily (but not completely) focus on the phenomenological logic of drug-taking. Running regressions..etc on numeric datasets, which is understandably a bulk of the research modus, will demonstrate covariances between variables, but the mechanism is wanting, and the policy is crude, not sharp or efficient. The optimal harm reduction policy has to appreciate the mechanics of drug-taking, which is inherently phenomenological.

Some of the arguments put forward by Daksya sound very similar to the sort of things the alcohol industry is fond of saying. Perhaps Daksya should come from behind the mask of anonyminity & declare an interest..

You certainly sound like a fair-minded researcher, with the ad hominen and all. For the record, I have nothing to do with any drug-related industry.

Anonymous said...

Daksya suggests that my observations about her or his anonymity & the similarity of some of her or his views to those espoused by the alcohol industry's social aspects groups represent an ad hominem attack. However, given these similarities & what we know about these organisations, I don't think that it is at all unreasonable to ask for clarification.
The use of ecological momentary assessment as a means of understanding the experience of drug use is a fascinating but still young area of research and the case for how a appreciation of the mechanics of drug-taking could lead to an optimal harm-reduction policy at any time in the near future has still to be made.
The greater availability of legalised drugs would force us to consider the distribution of harms (in this regard I found Daksya's response unconvincing & would refer her or him to Gmel, Klingermann & others consideration of the preventive paradox in the Feb 2001 edition of Addiction) & the feasibility of controlling the overall supply (which despite Daksya's theoretical reservations about this brute or crude method is the most cost-effective way of reducing harms from alcohol we have at present).
Richard Lee
Goring-by-Sea
UK BN12 6BT

daksya said...

However, given these similarities & what we know about these organisations, I don't think that it is at all unreasonable to ask for clarification.

The clarification is not the problem, but the insinuation that an argument can be prima facie disregarded depending on the source. One could use the same tack for almost any source. The current government has an interest in maintaining prohibition for various reasons, does that mean research by NIDA ought to be prima facie considered biased? There is this bizarre notion that seems to be implicit in public considerations of credibility that only financial or other material interests are corrupting, whereas in actuality, any influence is corrupting where some cognitive stake is involved, like in treasuring one's beloved theory.

the case for how a appreciation of the mechanics of drug-taking could lead to an optimal harm-reduction policy at any time in the near future has still to be made.

Such research is pretty limited right now, and so I'm asking for it to be adopted. My case for why it is the best method is very simply the personal experience and observation of drug use.

Looking at Addiction, Feb 2006.

This comment by Skog encapsulates the lack of paradox:
---
However, the result also depends on how the risk groups are delineated. In the studies mentioned above, drinkers were classified according to annual intake. Obviously, other criteria could be used. In their critique of Kreitman's contribution, Stockwell et al. (1996, p. 7) claim that the 'preventive paradox disappears when consideration is given to the amount of alcohol consumed either (i) the day of highest alcohol intake out of the last four, or (ii) the day on which acute alcohol-related harm occurred'. They find the majority of the problems among those who engage in binge drinking. This result is quite natural, as the problems under study are related to drunkenness, and the finding has been confirmed in several of the above-mentioned studies.

Furthermore, it has been suggested that the two observations—(i) the majority of acute social problems are found among consumers who drink moderately in terms of annual intake and (ii) the majority of such problems occur in the high-risk group, when defined in terms of amount per occasion—are easily reconciled (Skog 1999a). It simply means that most of the binge drinking is found among consumers with a moderate annual consumption level. This so-called second-order 'prevention paradox' has been confirmed by Gmel et al. (2001) and Rossow & Romelsj√∂ 2006).

---


this brute or crude method is the most cost-effective way of reducing harms from alcohol we have at present

That's a comparative assessment and says nothing about how good it is in reference to theoretical maxima.

spiral said...

To my knowledge Leary didn't advocate heroine use. LSD is a completely different thing. Tell me if you've seen LSD-addicts anywhere. I think Leary was one of the wisest thinkers of the 20th century, not an idiot.

Otherwise a good article.

Anonymous said...

Unfortunately, I didn't have the most recent Skog paper referred to by Daksya to hand when I wrote my last response. I thought that the Gmel, Klingermann et al, 2001, paper worth mentioning because their research takes place in Switzerland, a country with an "integrated" drinking culture, in contrast with the more ambivalent drinking cultures of Scandinavia, & they concluded that:
"Moderate drinkers in terms of volume reported more problems than hazardous drinkers, which confirms Kreitman's view. Binge drinkers reported more problems than non-binge drinkers confirming the view of Stockwell & colleagues. Binge drinkers were more numerous in the moderate drinking group, which constituted the majority of drinkers, in accordance with Skog's view [in an earlier paper]. Binge drinkers in the moderate volume & hazardous drinking groups did not differ significantly as to severity or number of problems ..."
This does not detract from my original assertion that "..the various harms caused by alcohol are not confined to a minority of alcoholics ....".
I also think that a point made by Tim Stockwell --a long-time critic of the preventive paradox-- in his Commentary on the Feb 06 Skog paper is interesting, especially in the light of Daksya's contention that drinkers fall into clusters (true enough, although clusters are just that, not fixed categories; the example of the of the wine drinker who gets trashed once every 3 months without invalidating her or his point is a red herring). Stockwell observes that:
"..when the measures of harm are are of acute problems associated with intoxication, then (a) these are best predicted by measures of drinking to intoxication ... rather than overall volume of drinking; & (b) most of the episodes of harm are experienced by the large number of people whose overall volume of drinking is low but whose drinking pattern is 'spikey', i.e. they are occasional binge drinkers... However, being able to show that many young adults drink regularly in excess of the above risk levels ...[women >40g & men >60g of pure ethyl alcohol on 'risky' drinking days] ... do so when on licensed premises ... & that most alcohol is consumed in a hazardous fashion strengthens the case for 'universal' strategies [e.g.'tweaking macrovariables like price & availability']for which there is strong empirical evidence".
At the risk of seeming to use either excessive or selective quotations I would recommend the Commentaries, which are available free of charge on the Addiction web-site, where any one can see for themselves the issues involved argued lucidly & I thank Daksya for highlighting them.
I don't think it's necessary to labour the point about the probability of similar patterns of risky use of other drugs emerging, post legalisation, while the truly qualitative assessments of acute use episodes & use careers needed to develop intelligent & efficient heuristics that promote harm reduction are still some way off.
The assertion that the source of an argument is not, at first sight, a good reason for rejecting it is true but only to a point & made in this context sounds not so much like a red herring as a herring that glows in the dark.
There is a world of difference between a beloved theory -or even a religeous conviction-- & the wilfull distortion of public debate by powerful economic interests. The best example must surely be the tobacco industry's secret payments to academics to create an entirely unjustified climate of doubt about the addictiveness & lethality of cigarettes, facts of which industry was fully aware all along. If we fail to treat the alcohol industries' social aspects organisations with appropriate scepticism, we will only end-up demonstrating the truth of the adage that the only lesson history teaches us is that no one ever learns the lesson of history.
Richard Lee
Goring-by-Sea
UK BN12 6BT

daksya said...

There is a world of difference between a beloved theory -or even a religeous conviction-- & the wilfull distortion of public debate by powerful economic interests. The best example must surely be the tobacco industry's secret payments to academics to create an entirely unjustified climate of doubt about the addictiveness & lethality of cigarettes, facts of which industry was fully aware all along.

You can't be serious. I'm from India and can tell you without doubt that the strongest motivator is religion. The initiation of religion requires a conducive environment (poor conditions, lack of hope..) but once it sets in, it maintains its hold like no other. Money is a distant second.

The simple fact is the brain doesn't discriminate: whatever gets the dopamine upregulated, acts as a reinforcer. That is what can corrupt. Money, drugs, religion, ego/pride are all instruments. There's nothing special about money.