Peter Hitchens explains how he started an argument that “will probably still be going on when I die”.
I never meant to start an argument about addiction. I had carried my private doubts on the subject around in my head for years, in the “heresy” section where I keep my really risky thoughts. And I don’t recommend disagreeing in public with Hollywood royalty, either, which is how it happened. In such a clash, most people will think you are wrong and Hollywood is right, especially if your opponent is Chandler Bing, the beloved character from Friends. Of course, he wasn’t really Chandler Bing, just an actor called Matthew Perry — but an actor with an entourage so big it filled an entire elevator at the BBC’s new studios in central London where we quarreled.
Our debate wasn’t even supposed to be about addiction. I’d been asked onto the corporation’s grand but faded late-night current affairs show Newsnight to talk about drug courts, one of many stupid ideas suggested by the idea of addiction. I reckoned my main opponent would be the other guest, Baroness (Molly) Meacher, whose name sounds like something out of The Beggar’s Opera. While she looks like the sort of harmless, kindly housewife who knits next to you on the bus, she is in fact a campaigner for the wilder sorts of drug liberalization. If this Chandler Perry wanted to horn in, well and good. Who cared? Yet when I began to sense sarcasm mingled with unearned superiority oozing from the character from Friends, I decided to let my impatience show.
Hence my rash, irreversible plunge into an argument which has been going on ever since, consuming billions of electrons on social media, and which will probably still be going on when I die. I heard myself using the words “the fantasy of addiction.” There. I’d done it. Let the heavens fall.
Chandler Bing called me various names and was even more sarcastic than before. He is extremely good at sarcasm, even if he understands very little about the drug problem. I have never heard the words “your book” pronounced with such eloquent contempt. The final “k” seemed to contain two whole syllables. Is this a Canadian thing? He was referring to my modest volume on the topic The War We Never Fought, so energetically ignored by reviewers and booksellers that it is known among London publishers as The Book They Never Bought.
Scott Alexander finds, to his surprise, that two of the candidates for the post of FDA commissioner in the Trump administration are following his blog or social media profile. To mark that, he offers five easy-to-implement policy fixes that would make a difference:
1. Medical reciprocity with Europe and other First World countries […] Right now, Europe has a licensing agency about as strict as the FDA approving medications invented in Europe. Any pharma company that wants their medication approved in both the US and Europe has to spend a billion or so dollars getting it approved by the FDA, and then another billion or so dollars getting it approved by the Europeans. A lot of pharma companies don’t want to bother, with the end result that Europe has many good medications that America doesn’t, and vice versa. Just in my own field, amisulpride, one of the antipsychotics with the best safety/efficacy balance, has been used successfully in Europe for twenty years and is totally unavailable here despite a real need for better antipsychotic drugs. If the FDA agreed to approve any medication already approved by Europe (or to give it a very expedited review process), we could get an immediate windfall of dozens of drugs with unimpeachable records for almost no cost. Instead, in the real world, we’re cracking down on imported Canadian pharmaceuticals because the Canadians don’t have exactly our same FDA which means that for all we know they might be adding thalidomide to every pill or something. This is exactly the sort of silly anti-competitive cronyist practice that a principled intelligent libertarian could do away with.
2. Burdensome approval process for generic medications […] How come Martin Shkreli can hike the dose of an off-patent toxoplasma drug 5000%, and everyone just has to take it lying down even though the drug itself is so easy to produce that high school chemistry classes make it just to show they can? The reason is that every new company that makes a drug, even a widely-used generic drug that’s already been proven safe, has to go through a separate approval process that costs millions of dollars and takes two to three years – and which other companies in the market constantly try to sabotage through legal action. Shkreli can get away with his price hike because he knows that by the time the FDA gives anyone permission to compete with him, he’ll have made his fortune and moved on to his next nefarious scheme. If the FDA allowed reputable pharmaceutical companies in good standing to produce whatever generic drugs they wanted, the same as every other company is allowed to make whatever products they want, scandals like Daraprim and EpiPens would be a thing of the past, and the price of many medications could decrease by an order of magnitude. […]
3. Stop having that thing allowing companies to “steal” popular and effective drugs that have been in the public domain for years, claim them as their private property, shut down all competitors, and jack up the price 10x just by bringing them up to date with modern FDA bureaucracy.
4. Stop having that thing where drug companies can legally bribe other companies not to compete with them. I like this one because it sounds anti-libertarian (we’re imposing a new regulation on what companies can do!) but I think it’s exactly the sort of thing that the crony capitalists would never touch but which principled intelligent libertarians like O’Neill and Srinivasan might be open to, in order to bring more actors into the marketplace.
5. Stop thwarting consumer diagnostic products and genetic tests […] Srinivasan comes from the genetic testing world himself, so he’s likely to be extra sympathetic to this.
My classmates [destroyed themselves on drugs]. The authentic imaginations, the really innovative people of my generation, the most daring of my generation took the drug. Now I, for some reason, felt that the LSD was untested, and I did not want to experiment with it. But I was very interested in it. I was interested in all types of vision quests at the time. I went up with fellow students [from SUNY-Binghamton] to see Timothy Leary speak at Cornell. I saw him, and it made me uneasy that here was the guru with such a crowd around him, but his face was already twitching. I could see that this was not going to end well, and it did not.
So when I got to graduate school in 1968, I can attest to the fact that no authentically radical student of the 1960s ever went to graduate school. So all that were left were the time-servers, who parasitically [lived] on the achievements of the 1960s, for heaven’s sake. Any authentic leftist who had a job at a university in the 1970s or ’80s or ’90s should have been opposing the entire evolution of the university — that is, toward this administrative bureaucracy that has totally robbed power from the faculty. The total speciousness and fraud of academic leftism is proven by the passivity of these people in every department of the university to that power play that happened.
Breakfast is the only meal of the day that I tend to view with the same kind of traditionalized reverence that most people associate with Lunch and Dinner.
I like to eat breakfast alone, and almost never before noon; anybody with a terminally jangled lifestyle needs at least one psychic anchor every 24 hours, and mine is breakfast. In Hong Kong, Dallas or at home – and regardless of whether or not I have been to bed – breakfast is a personal ritual that can only be properly observed alone, and in a spirit of genuine excess. The food factor should always be massive: four Bloody Marys, two grapefruits, a pot of coffee, Rangoon crepes, a half-pound of either sausage, bacon or corned beef hash with diced chilies, a Spanish omelette or eggs Benedict, a quart of milk, a chopped lemon for random seasoning, and something like a slice of key lime pie, two margaritas and six lines of the best cocaine for dessert……. Right, and there should also be two or three newspapers, all mail and messages, a telephone, a notebook for planning the next 24 hours, and at least one source of good music….… All of which should be dealt with outside, in the warmth of a hot sun, and preferably stone naked.
Order the limited edition Opium Wars wall scroll before it leaves forever on July 27! http://bit.ly/2a138ur
James talks about our mistakes, and adds additional stories, for Federico da Montefeltro and the First Opium War!
Quick story about Federico da Montefeltro: after losing an eye in a jousting accident, he ordered his doctor to cut a divot out of his nose so that his remaining eye had a better view and he could still fight in battles.
Now on to the Opium War! The Macartney expedition did not draw on the knowledge of Jesuit missionaries or even merchants who were familiar with Chinese court customs, because the British felt that a noble like Macartney was the only fitting representative. He didn’t come prepared to handle the kowtow, and he didn’t understand that the Chinese would have been more interested in British agricultural tech than they were in trinkets. James reads the disdainful letter which the Daoguang Emperor wrote to King George III in response to the embassy. There also happened to be a political upheaval in the Chinese palace at the time, so if the British had arrived sooner, they may have met with a different result and avoided the Opium Wars entirely. Once the war came to a head, it caused great division in Britain. Even though it was a war to sell illegal drugs, it was often recast as a war the Chinese provoked by insisting on the kowtow and treating other nations as vassals. Two traders by the names of James Matheson and William Jardine helped tip the scales for war because it helped their business, which had gotten a huge start in the opium trade. The Jardine-Matheson trading firm still exists today, and is a multibillion dollar company. Back in China, the British blockade of Canton’s port led to an odd first confrontation. A British ship called the Royal Saxon ran the blockade, so the British fired a warning shot to make it turn back. The Chinese, to prove they still controlled their sovereign waters, took this as an opportunity to challenge the blockade. Thus, their defense of a British smuggler led them into a war that, ironically, was about stopping British smugglers. The British official directing the war efforts, Charles Elliot, found himself in an awkward situation. He loved his country, but he morally objected to the British agenda in China. He tried to pave a moderate path, only to be fired and reviled as a failure. But after he left, the war truly got vicious. The British committed many atrocities in their campaign. They never sought to hold China, however, because their wars in India had taught them how impossible such an undertaking would be. Thus they settled on the unequal treaty. And as for Walpole… well, he started it, of course. Tea became such a large part of Britain’s economy because of the large tax levied on it. And who levied that tax? It was Walpole. He actually repealed an earlier, heavily resented tax and got political accolades for doing so, then introduced a much higher tax under a different name that flew under the radar even while it brought in hundreds of thousands of pounds for the government every year. The government’s reliance on tea for funding would later propel them to take such extraordinary measures to secure access to tea via Chinese trade. So who really started the Opium War? Well. It was Walpole.
The Chinese attempt to retake Canton by force failed. New British commanders took charge and would accept nothing less than total Chinese capitulation. They captured cities all the way up to Nanking, forcing the Emperor to negotiate. He had no choice but to accept an unequal treaty, kicking off a period of subservience to Europe which China still remembers today as the Century of Humiliation.
Disappointed in the treaty, the Daoguang Emperor replaced Qishan with three new commanders. One of them wanted to buy time and modernize the army, but the Emperor insisted the British be repelled immediately. They assaulted Canton from across the river, firing cannons and sailing fire ships at the British fleet. Their efforts fell far short, and soon the British controlled the river again. The Chinese were forced to pay them an indemnity to leave Canton, but in their wake riots and looting plagued the city anyway. Elliot still led the British forces, but upon returning to Hong Kong, he learned that he was now being replaced. His replacements had no interest in the compromises he’d tried to establish. They pushed immediately towards Beijing. In each new fort they captured, they found evidence that the Chinese resistance had ironically been weakened by crippling opium addiction. As the Chinese attacks grew more desperate, British retaliation grew more brutal. Finally, they stood ready to seize Nanking. With it would come control of the Yangtze River on which all of China depended, so the Emperor was forced to negotiate. They had no bargaining power, and gave the British nearly everything they wanted: a huge indemnity, new trade ports, no more Hong monopoly, generous tariffs, consulates, and sovereignty over Hong Kong. The only two matters they refused were Christian missionaries and legalizing opium, but the latter would only lead to the Second Opium War with similar results. These “unequal treaties” would go down in Chinese history as the beginning of what the Communist government later called “The Century of Humiliation.” The spectre of this shame and forced subservience to European interests continues to shape politics today, as this history is often invoked or used as a rallying cry during dealings with the West.
The British set up a blockade outside Canton, but one of their own private merchant ships tried to run through it. When the Chinese came to its defense, war began in earnest. Since the British had far superior firepower, they easily conquered Chuenpee and Chusan. Elliot and the Emperor’s new envoy, Qishan, soon sought a treaty and agreed on generous terms… which their overseers harshly rejected.
The British responded to the Chinese halting their ships by erecting a blockade outside Canton. They fired a warning shot to turn back a private British merchant ship, the Royal Saxon, which attempted a blockade run, and the Chinese sent out their own navy to defend the runner. They were demolished. The British had better ships and better firepower. They made to discuss a treaty, but the Chinese refused to give in to the British demands regarding ownership of Hong Kong. The British moved on to capture Chusan, an island near Shanghai. Then a rumor prompted them to believe that China planned to strike against them, so they acted pre-emptively and kicked off the Battle of Chuenpee. Again they won, but the slaughter was so horrifying that Superintendent Elliot was glad to seek a peace treaty with the emperor’s envoy, Qishan. Finally Qishan agreed to give up Hong Kong, to give the British better trade status, in exchange for which Britain returned the land they’d taken. But Elliot’s supervisor back in London, Lord Palmerston, felt the treaty didn’t go far enough, especially since it didn’t re-establsih opium trading rights. And the Emperor found Qishan’s capitulation disgraceful, even threatened to have him hanged for it. What had looked like moderate wins for both sides suddenly threatened to fall apart.
Opium was illegal in China, but that didn’t stop the East India Company from manufacturing it for the black market. The Chinese emperor appointed an official, Lin Zexu, to stop it. He seized and burned huge opium caches held by British merchants, and ultimately ordered the British out of China entirely. Instead, they set up base on a barren island that would become known as Hong Kong.
The tea trade flowing from China had left the British government in staggering debt. They had loaned huge amounts to the Honourable East India Company (EIC) to conquer India, and to pay their debts, the EIC turned that land into poppy fields and manufactured opium in huge quantities. Since China had banned the opium trade, the EIC set up a market in Calcutta (part of their Indian territory) and turned a blind eye to the black market traders who smuggled it into China. By 1839, over 6.6 million pounds of opium were being smuggled into China every year. The Chinese DaoGuang Emperor appointed an upright official named Lin Zexu to halt this opium trade. Lin orchestrated a massive campaign to arrest opium traders, force addicts into rehab, and confiscate pipes. He even laid siege to British warehouses when the merchants refused to turn over their opium supply, instead taking it all by force and burning it. The outraged merchants sought redress from their government, but although the Chief Superintendant Charles Elliot promised them restitution, the government never had any intention of paying them back. Amid the unrest, two British sailors brutally murdered a Chinese man. Lin Zexu demanded their extradition, but Elliot insisted on trying them aboard his ship and sentencing them himself. Lin Zexu had enough. He halted the British food supply and ordered the Portuguese to eject them from Macau. They retreated to a barren island off the coast (now known as Hong Kong). Since the island could not support them, Elliot petitioned the Chinese to sell them food again. He received no response. Then he sent men to collect it directly, but on their way back they were halted by the Chinese navy, and the first engagement of the Opium Wars began.
The British Empire’s grasp on the Americas was slipping right at the time when they needed those resources most. The massive amounts of tea they imported from China had created a huge trade deficit, but the Chinese were reluctant to let any Europeans trade outside of the Canton port strictly controlled by the Hong. So Britain sent a formal embassy led by Earl George Macartney.
In 1792, Great Britain had just come out of an expensive war that cost them their control over many of their colonies in North America. Other wars had also cost them their access to the silver mines of South America, which had been helping fund so much of their trade with the Qing Dynasty of China. European traders all wanted greater access to China, but the Emperor was wary of letting outsiders too far into his country and kept them all penned up at the port of Canton, which was strictly regulated by the Hong business group. A flourishing blackmarket trade grew, but Britain wanted more. One trader, acting on his own initiative, grew bold enough to approach Beijing and attempt to get a hearing over his trade grievances, but the Chinese considered this a huge breach of protocal and an offense to the Emperor. Britain had to do something, however: they imported over 10 million pounds of tea each year, equal to 10% of the government’s annual spending, and the fact that China did not have anywhere near as great an interest in British products meant that they were running an enormous trade deficit they could no longer sustain. The Crown appointed an official envoy, Earl George Macartney, with orders to end the Canton system, establish an embassy, and acquire rights to an island that would be under British control in the same way that the Porutuguese controlled Macao. The mission failed spectacularly. Although Macartney got permission to sail north and meet the Qianlong Emperor in his summer palace at Jehol, he refused to perform the traditional kowtow which was required upon meeting the Emperor. He presented gifts from the British court, but the Chinese interpreted these gifts as tribute, not trade enticements, and decided they had no need for nor interest in what he offered. Since he failed to get them to agree to any of his three requests, Britain wanted to find another way to address the trade imbalance with China. Soon, this would lead them to start bringing in opium.
It’s also a big deal scientifically. Ketamine is a strong NMDA receptor antagonist; the metabolite is an AMPA agonist – they have different mechanisms of action. Knowing the real story behind why ketamine works will hopefully speed efforts to understand the nature of depression.
But I’m also interested in it from another angle. For the last ten years, everyone has been excited about ketamine. In a field that gets mocked for not having any really useful clinical discoveries in the last thirty years, ketamine was proof that progress was possible. It was the Exciting New Thing that everybody wanted to do research about.
Given the whole replication crisis thing, I wondered. You’ve got a community of people who think that NMDA antagonism and dissociation are somehow related to depression. If the latest study is true, all that was false. This is good; science is supposed to be self-correcting. But what about before it self-corrected? Did researchers virtuously say “I know the paradigm says NMDA is essential to depression, and nobody’s come up with a better idea yet, but there are some troubling inconsistencies in that picture”? Or did they tinker with their studies until they got the results they expected, then triumphantly declare that they had confirmed the dominant paradigm was right about everything all along?
The strange American ardor for passing laws, the insane belief in regulation and punishment, plays into the hands of the reformers, most of them quacks themselves. Their efforts, even when honest, seldom accomplish any appreciable good. The Harrison Act, despite its cruel provisions, has not diminished drug addiction in the slightest. The Mormons, after years of persecution, are still Mormons, and one of them is now a power in the Senate. Socialism in the United States was not laid by the Espionage Act; it was laid by the fact that the socialists, during the war, got their fair share of the loot. Nor was the stately progress of osteopathy and chiropractic halted by the early efforts to put them down. Oppressive laws do not destroy minorities; they simply make bootleggers.
H.L. Mencken, Editorial in The American Mercury, 1924-05.
Since we love our comment section so much, we came up with a new format that we call Out Of The Ether. Indy reads out the best comments we got under our recent episodes. This time we are talking about Luigi Cadorna, Cocaine and Food. Let us know what you think about our new format in the comments.
Today during an otherwise terrible lecture on ADHD I realized something important we get sort of backwards.
There’s this stereotype that the Left believes that human characteristics are socially determined, and therefore mutable. And social problems are easy to fix, through things like education and social services and public awareness campaigns and “calling people out”, and so we have a responsiblity to fix them, thus radically improving society and making life better for everyone.
But the Right (by now I guess the far right) believes human characteristics are biologically determined, and biology is fixed. Therefore we shouldn’t bother trying to improve things, and any attempt is just utopianism or “immanentizing the eschaton” or a shady justification for tyranny and busybodyness.
And I think I reject this whole premise.
See, my terrible lecture on ADHD suggested several reasons for the increasing prevalence of the disease. Of these I remember two: the spiritual desert of modern adolescence, and insufficient iron in the diet. And I remember thinking “Man, I hope it’s the iron one, because that seems a lot easier to fix.”
Society is really hard to change. We figured drug use was “just” a social problem, and it’s obvious how to solve social problems, so we gave kids nice little lessons in school about how you should Just Say No. There were advertisements in sports and video games about how Winners Don’t Do Drugs. And just in case that didn’t work, the cherry on the social engineering sundae was putting all the drug users in jail, where they would have a lot of time to think about what they’d done and be so moved by the prospect of further punishment that they would come clean.
And that is why, even to this day, nobody uses drugs.