Hep-Cats, Narcs, and Pipe Dreams: A History of America's Romance with Illegal Drugs.

By Jill Jonnes (New York: Scribner, 1996. 510pp.).

Patterns of illicit drug use reflect a multiplicity of factors. Socioeconomic status, structures of opportunity as they interact with race and class, dynamics of markets in illicit substances, adolescent desire to experiment with thrills and push the borders of adult norms, cultural messages about drugs, and more influence ways that groups use drugs and the meanings with which they invest this use. To attempt to explain our national experience with illicit drugs is an ambitious task, though one that increasingly becomes manageable as a recent welter of historical articles, dissertations and monographs on America's drug history provides a growing basis for a broad, synthetic history of drug use in America.

In Hep-Cats, Narcs, and Pipe Dreams: A History of America's Romance with Illegal Drugs, Jill Jonnes, a journalist who completed a Ph.D. in history at Johns Hopkins University, has cast a suitably broad framework. Drawing both on the secondary literature and on her own archival research, she covers an impressive array of themes: shifting patterns of use with attention to individual drugs and demographics of using groups; international drug trafficking; U.S. drug policy, especially enforcement efforts; cultural attitudes toward drugs among using groups and in the larger society; and physicians' views on drugs and drug dependence. Her work makes its most significant contribution to the historiography in her narrative of drug control efforts within and beyond our borders. However, the overall result is a unidimensional interpretation of a complex phenomenon.

Jonnes structures her chronology on the interpretive framework developed by historians David Musto and David Courtwright: in the Progressive Era, widespread quasi-medical use of opiates was brought under control while a young pleasure-seeking cohort began sniffing heroin and cocaine in the social juncture between new urban entertainment venues and vice markets; this pattern of recreational use waned in the 1930s and 1940s, only to begin rising again after World War II with trafficking centered in inner cities; use by middle-class youth exploded in the 1960s and contributed to the entrenched markets and patterns of heavy use that constitute iconic social problems in the 1980s and 1990s. A separate narrative thread describes the growth of international black markets in opiates and cocaine, including the French connection and the cocaine cowboys of Colombia. Drawing on State Department and Drug Enforcement Administration files (some not seen by other historians), she describes the enforcement attempts to eradicate these drug markets. One of her most emphatic conclusions is that corruption and, to a greater degree, a willingness to sacrifice the aims of drug policy to Cold War exigencies hampered enforcement and resulted in failure to bring drug markets under an acceptable degree of control.

Jonnes paints illicit drug use in almost any form as deeply offensive to middle class values of hard work, thrift, and deferral of pleasure for the good of the individual, the family, and the community. In doing so, she aligns herself with the middle class Progressive Era reformers who created the legal basis of American drug policy and with zero-tolerance conservatives of the present day. She argues that recreational drug use became entrenched in deviant groups unwilling to make any investment in the larger society and unmotivated by any morally energizing social vision. The tragic dimensions of the story, in her view, are two: first, these destructive patterns of use swept over much of the country in certain periods when misguided Americans engaged in a "romance" with "hipsterism," or heedless thrill-seeking connected with a pose of cool detachment from restrictive bourgeois ideals; second, the harshest impacts fell on minority communities as illicit markets became entrenched in impoverished urban neighborhoods, while affluent whites were able to escape the heaviest consequences of drug use.

"Hipsterism" becomes Jonnes's all-purpose explanation for drug use, whether by Bohemians smoking opium in the 1890s, African Americans smoking marijuana in Harlem in the 1930s, or stock brokers snorting cocaine in the 1980s. There are nuances: African Americans were more likely to embrace such an attitude after finding racism in and rejection by the white world of wider economic opportunity; middle-class whites, however, adopted drug use and its accompanying poses chiefly out of self indulgence. Jonnes also stresses that both government and American society in general have cared little when drug problems occurred mainly among isolated deviant groups or in minority communities and only became aroused when middle-class youth were getting high. This point of view is consistent with her arguments against any relaxation in prohibitionary drug laws: she cites fierce opposition to legalization proposals by those who in her view best know the realities of drug use and its effects: drug treatment professionals and leaders in the African American communities bearing the destructive brunt of drug sales, the associated violence, and high levels of crack use.

Jonnes's insistence that illicit drug use constitutes deviance plain and simple means that social contexts for drug use are given short shrift. Thus, her account of the opposition to opium use in San Francisco's Chinatown in the 1870s cites lurid accounts of opium dens but makes no reference to the white laborers' campaign to demonize the Chinese so as to sustain their exclusion from job markets. Similarly, she discards a substantial historiography showing how racial and ethnic prejudices have informed people's views on specific drugs, arguing that mainstream Americans condemned cocaine use in the early twentieth century not because fear mongers conjured lurid images of coke-crazed Negroes, but because people witnessed the very real dangers of cocaine use. While the earlier historiography paid insufficient attention to these concerns, it is no more accurate to deny the role of racism in shaping America's drug laws.

The larger picture is filled in with detailed small-scale stories that bring individuals and social scenes to life. The best of these juxtaposes the experiences of two Baltimore men, an African-American World War II veteran and a somewhat younger Italian American, to illustrate the spread of opiate use in the 1950s, the prelude to the dramatic upsurge of drug use in the 1960s. Other portraits, such as those of addicted Hollywood stars, canny traffickers and daring enforcement agents play on more familiar images of celebrity debauchery and drug market violence.

Jonnes repeatedly singles out individuals around which to build sections of her story. While this tactic makes for readability, drama, and coherence, the result is often to ascribe far too much influence to certain individuals, at the expense of probing broader social contexts or of accurately charting shifts in medical and professional understandings of addiction. Thus, she accepts uncritically Mezz Mezzrow's claim that he single-handedly introduced marijuana into black Harlem in the 1930s, even as she outlines urban black culture in which marijuana was associated with hipsterism and rejection of a racist mainstream.

Similarly, Jonnes credits Dr. Arnold Washton of New York with realizing in 1983 that cocaine was addicting. Her tone is especially harsh toward physicians and writers of the 1970s who portrayed cocaine as a chic but benign party drug. She notes that any professional spending a little time reading medical texts and journals of the late nineteenth century might quickly have perceived the dangers in this trend. As historian Joseph Spillane has convincingly shown (and Jonnes cites his work liberally), little has been learned about human responses to cocaine in the last twenty years that had not been previously reported by physicians of the late nineteenth century, when early medical enthusiasm about cocaine shifted to concern about dependence and other health effects. But Jonnes ignores the historical question of why twentieth century observers were unaware, or heedless, of this earlier literature. For one thing, it was based on unsystematic clinical observation, not on the kind of pharmacological laboratory research that late-twentieth-century physicians had come to rely on for knowledge of drug effects. Moreover, few late-twentieth-century physicians had any clinical experience of their own with patients who used cocaine. Finally, twentieth century physicians were likely to be dismissive of nineteenth century medicine for the same reasons that Jonnes characterizes it as "primitive" and based on "gross medical ignorance" when her purpose is to explain indiscriminate medical use of opiates in that period.

In fact, not just Washton's hot line, but drug and crisis hot lines all over the country were getting distress calls from about 1980 in which people reported extreme mood swings, social withdrawal, and paranoid ideation and behavior in their cocaine-using friends and relatives. And at least as early as 1976, researchers at the Haight-Ashbury Free Clinic in San Francisco, whom Jonnes chides for glamorizing cocaine, noted pharmacological similarities between cocaine and amphetamines - a drug to whose dangers the clinic had already alerted the community with the Speed Kills campaign of the late 1960s. Jonnes quotes Washton as offering, at last, an accurate characterization of addiction in 1985: "The definition [of addiction] has three major components.... First is a lack of control over use; second is a craving and compulsion to use the substance; and third and perhaps most diagnostic, is continued use despite adverse consequences." But this definition, which did emerge in part from observation of patterns of cocaine use, and did overturn older ideas based on experience with opiates, was being widely publicized by the Haight-Ashbury Free Clinic from about 1979. Such distortions arise from Jonnes's positivist approach to science, a tendency to judge physicians according to how closely their ideas about drugs accord with her own, and an almost exclusive focus on the east coast.

Small errors are inevitable in a book of this size and scope, but surely a blue pencil should have caught the attribution of The Jungle to Sinclair Lewis. Of greater concern are a number of errors or imprecisions regarding drugs and pharmacology (for example, peyote is a cactus, not a mushroom, and it is inaccurate to call heroin an "essence of morphine"). Some contentious positions are given as fact. Are illicit drugs clearly more dangerous than alcohol, as she states repeatedly? There are compelling reasons to think so, but also well-accepted perspectives that would deny this claim. Counterarguments are not engaged, merely dismissed. For example, she states that drug addicts are virtually incapable of being functional at work or at home while alcoholics can perform adequately when not acutely intoxicated. Yet, a central plank of the late nineteenth century temperance and prohibition movements was that alcoholism rendered men incapable of functioning as fathers and providers; and some heroin addicts are capable of working productively and stably for long periods.

Jonnes's policy recommendations are straightforward: strict enforcement of laws against drug use and trafficking, uncontaminated by corruption or competing policy imperatives, as well as enforcement of gun laws (to reduce violence) and immigration laws (to keep foreign traffickers out of the country). Further, she rightly points out that cultural norms stigmatizing drug use are more powerful than laws in influencing many kinds of behavior. Thus, she hopes that the attitudes inculcated by Nancy Reagan's Just Say No campaign, and what she calls the restigmatization of drug use among many youth in the 1990s who watched older friends and siblings get into trouble with drugs, will contribute to an enduring national consensus condemning the use of illicit drugs.

Such stigma is a double-edged sword, however, since people, as well as behaviors, can be stigmatized. As Jonnes correctly points out, the declines in drug use in recent years have occurred among casual users; numbers of addicted users, and the levels of harm associated with their use, have not changed much. Among those harms is the spread of HIV through needle sharing, through drug-influenced sexual behavior, and through sex with infected injection drug users. The intertwining of destructive drug use patterns with the AIDS epidemic has compounded the stigma aimed both at people who are HIV positive and at drug injectors and crack users. The epidemiological pattern of HIV continues to shift so that it maps over the population of injection drug users and over populations already structurally disadvantaged in American society: African Americans, Hispanics, women of color. AIDS increasingly seeks out those who are least connected to the larger society, whether through workplace involvement, nurturing families and communities, or access to health, social and educational services.

Ironically, Jonnes finds hope in the statistic that up to half of American addicts may be HIV positive and thus "that much of America's big addict population will die of AIDS in the next decade." If we move vigorously to educate our younger generations about the dangers of drug use, she argues, then the die-off of the current generation of addicts and the rise of a new cultural attitude condemning drug use may end America's "foolish romance" with illicit drugs. "It may be ghoulish to view AIDS as easing the drug problem" she says, "but in fact it will."

There are many problems with such an attitude. In terms of Jonnes's own account of the last century, the end of the first drug epidemic created the grounds for the historical amnesia that left new generations of users in the 1960s ignorant of what had been learned around the turn of the century. That American society and its government would keep drugs at the highest priority level in the absence of significant drug problems is dubious. Moreover, powerful new psychoactive drugs will continue to enter the licit and illicit marketplaces as researchers continue to probe brain function and seek both treatments for illness and drugs to enhance human mood and performance. Initial enthusiasm and failure to recognize problems of regular use are likely to occur repeatedly as new drugs are developed and tested.

More significantly, however, any suggestion that an epidemic might perform a socially useful purpose by killing off a cohort of undesirables is perverse in the extreme. Jonnes argues that two kinds of social conditions, combined with availability of drugs, are likely to lead to widespread use: social turmoil in the absence of positive opportunities for employment and advancement; or youthful anomie lacking a socially positive vision to organize lives around. These conditions, together or separately, have helped account for the prevalence of illicit drug use among impoverished urban populations and among disaffected middle class youth. Jonnes repeatedly expresses compassion for minority communities wrestling with the ravages of drug use among their members, while she judges harshly those middle class whites who enjoyed their thrills with marijuana and cocaine and helped build a market for the latter drug that, with the advent of crack just as many middle class whites were moving away from cocaine, landed with special viciousness on urban African American and Hispanic communities. It is precisely African American and Hispanic drug users, their sex partners, and their children who are most likely to die of AIDS and, thus, in her view, ease the nation's drug problems.

The situation is not as fatalistic as Jonnes suggests. HIV seropositivity varies widely among injection drug using populations in different American cities, and HIV prevention efforts aimed at injection drug users can reliably keep prevalence in that group low where it has not yet soared above ten percent. Although protease inhibitors may not have been available when Jonnes wrote her manuscript, the HIV disease treatment picture has been a dynamic one, and it is only reasonable to expect continued improvements in treatment. Death rates from AIDS among injection drug users are likely to reflect access to health care and life-prolonging treatments as well as the fact of HIV infection compounded by the health problems associated with heavy drug use.

Jonnes's qualifications as a historian notwithstanding, this is primarily a work of advocacy whose tone is more often journalistic than scholarly. Full citations are provided, and new material about federal enforcement activities makes a welcome addition to what we know about American drug policy. Too often, though, the policy views shape the analysis. Readers wanting a balanced scholarly synthesis of America's drug history will need to wait a while longer.

Carnegie Mellon University