In this book, Benjamin Fong argues that the high level of drug use in America relative to other countries is tied to a stressed and depressed workforce in the extreme brand of American capitalism, and that drug policy is less about the substances themselves, and more about race, politics, and controlling the workforce. He takes the long view which is helpful, pointing out the historical cycle of the temperance movement leading to Prohibition, to more sanctioned drug use in the 50’s (amphetamines, barbiturates, etc), to the “war on drugs,” during the neoliberalism of the 80’s, to recent relaxation with the failures of neoliberalism. Somewhat bizarrely, America’s drug use is also accompanied by an “equally unique fearmongering about drugs,” making it an interesting study.

We get a glimpse early on of a writing style that falls short of ideal, as between some pretty keen insights, Fong will make statements without completely backing them up. The way he lays out his arguments often seem a little clunky. He seems to have taken the evils of capitalism in America as the central issue, but then doesn’t address the obvious question, what about capitalism in other countries, like Japan? In his response to Herbert Marcuse’s statement (cited by him) that “capitalism is not responsible for your problems with your girlfriend;” he says: “He was right that we are not excused from our personal failings, but wrong that social structure cannot be mined from the psychic depths,” then ending the section. It just feels a bit cryptic and incomplete, and there are many examples of this throughout the book.

Editing would certainly have helped, as Fong at times belabors points that he probably shouldn’t. For example, in the introduction, he oddly defends drug-related violence as logical per “market logic,” spending paragraphs explaining violent behavior as rational and not barbaric, when it seems he should have excised all this and focused on the other points he made, that drug incarceration in America is predominantly for nonviolent offenses. While admitting “the ravages of physical dependency and long-term use are real,” he doesn’t provide any statistics or comments about the casualties of drug use, those whose lives were ended or ruined because of them. As he puts it, “the ‘problem’ of drugs is never really about drugs, and so it’s always a mistake to linger too intently on either the substances themselves or the rules of their engagement,” which seems too one-sided, as if this were all just an exercise in economic theory and racism in America.

The chapters following the introduction walk through various drugs one by one, including coffee, cigarettes, alcohol, opiates, amphetamines, psychotropics, psychedelics, cocaine, and marijuana. I had a similar experience reading each: I loved the tidbits of information that Fong included about the history of all these substances and at least some of his larger points, but also felt that he had tunnel vision relative to the idea that capitalism is the great evil, and made statements without supporting evidence, or a more balanced critical evaluation.

For example, in his chapter on alcohol, Fong quotes Friedrich Engels as saying of the working man “…he urgently needs something to restore him, he must have something that compensates for his toil and makes the prospect of the next day tolerable…” It’s just not clear how accurate this viewpoint is, rooted as it is in a political viewpoint from 170 years ago, and lacking in actual data. His chapter on cigarettes includes a rather pedantic quote from Sartre and a conclusion that it’s “an internalization of the burning earth in miniature.” Here it would have been nice to see some statistics gathered from actual smokers, rather than the simplistic, unsubstantiated point that “People today smoke because they are nervous, and they smoke to lend sense to the day. But they also smoke because they are hastening an end.” In the chapter on opioids, he surprisingly avoids linking use to capitalism, but somewhat weakly states in the final paragraph that their use is due to “mostly some combination of happenstance, early trauma, and adult tragedy,” which wasn’t very satisfying.

Fong makes the point in the conclusion that between conservative movements seeking to ban various drugs and liberals seeking to naively legalize them despite big predatory corporations circling, that both are “quick fixes,” and the underlying issue needing to be addressed is people’s misery stemming from capitalism. While he proposes putting people to work on infrastructure and Medicare for all, things I happen to agree with, he never put forth alternate political solutions or addressed the failures of communism in its authoritarian forms in the 20th century. His central assertion of the root cause driving drug use is intriguing and I have to believe a piece of the puzzle, but he never examined data from other countries over time (degree of capitalism, degree of poverty or misery, and resulting degree of alcohol or other drug use), or other aspects of American culture (individualism, its naïve optimism following WWII and belief in its exceptionalism, or simply its accessibility to drugs). It just seems it’s a very complicated problem, and Fong is naïve in trying to pin everything on capitalism and wealth distribution. I have to say, I also didn’t agree with his frequent criticisms of the progressive movements of both the 60’s and today’s generation.

With all that said, it was a worthwhile read, as there were many nuggets of information I liked gleaning:

- The quote from Alasdair MacIntyre that one of the central objections to marijuana in the 60’s was that to conservatives it was a “source of pure pleasure which is available for those who have not earned it, who do not deserve it.”

- The state of the world before coffee was introduced to Europe, and the extraordinary amount of beer that the average English family consumed in the 17th century – 3 liters a day, children included, and even “beer soup” at breakfast, consisting of beer, eggs, and butter.

- In the Reagan and Bush years, as cigarettes had transitioned from “glamorous” to a “loser’s drug” in America, this was counterbalanced by pushing the tobacco trade abroad, “a move that has been rightly compared to the opium wars of the nineteenth century.”

- The shameful history of Britain forcing opium on China in the 19th century, as is the bitterly ironic demonization of Asians in “yellow peril” propaganda in American in the 20th.

- The incompetent, racist, and corrupt tenure of Harry Anslinger as the head of the Federal Bureau of Narcotics from 1930 to 1962.

- His fantastic analysis of constitutionally shaky RICO and Comprehensive Crime Control Acts, which when coupled with the Supreme Court decisions in Illinois v. Gates and United States v. Leon, meant that the “Fourth and Fifth Amendments effectively became optional,” and that the police, based on their own “reasonable belief,” can seize assets (including one’s home) and never return them.

- The military spend on amphetamines and more recent drugs, like eugeroics (“good arousal”) or “nootropics,” the “smart drugs” that also promote alertness, and in some cases keeping soldiers awake for an astonishing 85 hours straight.

- The massive hypocrisy in a system where Big Pharma have lied about their products and bribed FDA officials for decades (certainly dating back to Senator Carey Kefauver’s work to begin exposing them in 1959), while the “war on drugs” targets people at the bottom (for example, the 49 convenience store clerks in Georgia who were charged with selling materials to make meth, 44 of whom were South Asian immigrants with little command of English).

- The shift over the last four decades to “manipulate the brain with the aid of pharmaceutical drugs” based on a simplistic, “biological” reductionist view of the brain where individual neurotransmitters and hormones like serotonin, dopamine, and norepinephrine can be tweaked to create understood responses, and a latest iteration of the DSM that “is so broadly pathologizing of normal human behaviors that even its previous authors have come out of it in disgust.” Along with it, a shift from diagnosing neurasthenia over 1880-1930s and anxiety since the 1940s, with both “society” as the root cause, to diagnosing depression since the 1980’s, with the brain as the root case.

- The fact that “in a majority of double-blind studies, sugar pills equaled or outperformed Prozac and similar antidepressants,” but despite that, the FDA having approved the drug because they don’t need to be shown to be more effective than a placebo. The prevalence of SSRIs to treat depression, despite studies experts have shown as “clinically meaningless,” and the evidence in the incidence of depression having increased since their introduction, is mind-boggling, particularly in light of the serious possible side-effects of these medications.

- The hypocrisy and projection of the CIA in the 1950’s, accusing communist countries of using brainwashing drugs when in fact they were involved themselves in horrifying experiments with LSD and other psychadelics themselves. In one study by Ewen Cameron at McGill, patients who came for help with relatively minor issues were subjected to cruel “psychic driving” experiments, which involved ECT at 30-40x the normal strength, solitary confinement, LSD with minimal food, water and oxygen, and then messages like “My mother hates me” piped into earphones hundreds of thousands of times. If there is a hell, one only hopes Cameron is in it.

Just a couple of quotes:
On Big Pharma, from Senator Mike Gravel in 1972:
“If tomorrow, by some miracle, every source of illegally grown or manufactured drug were cut off, the U.S. would scarcely feel any withdrawal symptoms, nor would the current drug-abuse epidemic be ended. The sad truth is that our most sophisticated and profitable pushers are the nation’s largest pharmaceutical corporations.”

On politics, this from John Ehrlichman in an admission in 1994:
“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or blacks, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing them both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.” ( )