From Small Corners to Big Cartels, the Drug War’s Unintended Consequences

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It is a sign of the complexity of the illicit drug trade that one of the great anti-drug successes of the last decade is regarded today as the beginning of Mexico’s cocaine addiction.

That story was told by Maria Medina-Mora, director of psychosocial research at the National Institute of Psychiatry in Mexico, at a September gathering at Penn’s School of Nursing where she shared the podium with Philippe Bourgois, the Richard Perry University Professor of Anthropology and Family and Community Medicine, to discuss “Narcotics Encounters Across Neighborhoods and Nations.”

As recently as 1999, Medina-Mora explained, the 4.1 million Americans who regularly use cocaine stood at the end of a supply chain that ran through the Caribbean and Mexico in equal measure. But beginning in 2000, increased operations by the Drug Enforcement Administration effectively squeezed off the Caribbean drug trade, and by default, rerouted the balance of South American cocaine through Mexico. In a span of only a few years, the number of Mexican cocaine-smuggling channels nearly doubled, from 54 to 90. And in the wash of cheap cocaine bound for the United States, the number of Mexican cocaine users doubled too.

“They have an expression,” said Bourgois, “‘Poor Mexico: so far from God and so close to the United States.’ And it’s really true: when we sneeze they catch a cold, and they don’t just catch a cold—they catch pneumonia.” The contagious influence was particularly evident in statistics Medina-Mora displayed concerning migrants who, when returning to Mexico from the U.S., often bring a drug addiction back with them. “The prevalence rates of marijuana and cocaine are three times higher if you have a migrant in your family or you are a returning migrant, compared to people who do not migrate,” she said.

The war on drugs abounds in unintended consequences. That’s evident whether you are a population-level researcher like Medina-Mora, who sits on the United Nation’s International Narcotics Control Board, or whether your view is more local. Bourgois shared stories from his decades as a participant-observation ethnographer among destitute addicts in East Harlem, San Francisco, and his current research site in the Puerto Rican district of North Philadelphia.

“Max walks by, and when he sees Hank shivering, he puts his arm around his shoulder and offers to treat him to a taste of heroin,” Bourgois read from his San Francisco field notes. “Max has only one syringe and it is clogged. When he tries to rinse it water sputters out the end.  Hank reaches into his sock and pulls out his needle and hands it to Max.”

Addicts, Bourgois remarked, “are all well educated [about] the risks of propagating blood-borne diseases through injection drug use” and generally avoid the type of high-risk needle sharing Max and Hank subsequently engaged in. But the two casual friends, Bourgois narrated, had been cornered into the practice by a recent police raid that had confiscated their clean needles as drug paraphernalia. “It’s a tremendous waste of public-health resources where you have the police literally sometimes arresting the addicts as they walk away from needle exchanges,” he said. 

While illegal drug consumption is a public-health problem around the world, the United States remains the source of the appetite that sets the industry in motion. Medina-Mora shared a 2008 World Mental Health Survey showing that 16 percent of Americans had used cocaine, a rate four times higher than that of any other country in the world. With respect to marijuana, which is perhaps a better point of comparison given that it is widely available almost everywhere, the U.S. fares little better. Apart from New Zealand, whose residents inhale at the same 42 percent rate, no other country is even close. Only 20 percent of the liberal Dutch have smoked pot during their lives, and fewer than one in 10 Italians.

“I think the U.S. rates are not actually very hard to understand,” said Bourgois. “We don’t have the levels of social protection that other wealthy countries have. So what that does is it pushes a large proportion of the population into the underground economy—and unfortunately the most dynamic dimension of that underground economy is the drug business.”

This, he continued, “creates a labor force that’s very disciplined and willing to work in an economy that a disproportionate number of Europeans aren’t willing to work: the dangerous, unpleasant job that is street selling.  Basically, when you’re living in the inner city you can buy drugs more easily than you can buy fresh vegetables. And a country that has that phenomenon is going to have the highest rates of substance abuse.”

Bourgois fears he is witnessing the leading edge of a new heroin epidemic from his vantage in North Philadelphia, where a single-shot packet of the drug costs $10. The increase in prevalence owes largely to efforts by Colombian cartels to find the next big thing in U.S. drug consumption. “The cocaine epidemic was burning itself out and they shifted to heroin,” Bourgois said. An ounce of heroin costs about $250—compared with $800 a decade ago—and the product is increasingly pure, making injection drug users even more dependent and enticing new addicts into the market. A recent study in the International Journal of Drug Policy reported that between 1995 and 2002, “the number of heroin-related emergency department visits [in the U.S.] increased 34 percent.”

Heroin trafficking has further fueled the Mexican drug wars that have produced what Medina-Mora called “an explosion of violence like we have not seen since the Revolution.” More than 10,000 Mexicans have died since 2006 in drug-related violence. “We need to better understand our shared responsibility,” Medina-Mora concluded, “both developed and developing nations, producing and consuming countries.”

Kevin Hartnett

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