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Epilogue to the 2012 Edition: America’s Longest War One day in 1980, as we were returning from an interview in Queens, a stranger approached us on the subway. He had the look of an out-of-town businessman: coat, tie, baffled expression. “Can you tell me,” he asked, “what has happened to my city?” “What do you mean?” one of us replied warily. He didn’t look like a crazy person. He wasn’t. He had grown up in New York and moved away in the early 1960s. He had just made his first trip back to his old neighborhood, abandoned by manufacturers and blighted beyond recognition by drugs and crime. The encounter came back to us when we wrote, in the original epilogue, of the extraordinary changes in the American drug scene after 1965. In 1980, when we began our interviews, rates of consumption for illicit drugs and alcohol had just reached their twentieth-century peaks in the United States. In the inner cities, where the rates were higher still, the consequences were obvious and devastating. By the time Addicts Who Survived appeared in print in 1989, the rates had begun declining, but the drug war had expanded beyond anything in Harry Anslinger’s wildest dreams. Narcotic agents targeted not just heroin, but marijuana, cocaine, amphetamines, barbiturates, hallucinogens , and a host of other psychoactive drugs of minor concern before 1965. As we composed the narratives we realized that, like archaeologists scouting in a jungle, we had stumbled upon a lost world. Although drug use in the “classic era” was hardly innocent—our second interviewee was a convicted murderer —it was simpler and more contained than anything in 1980s America. Now nearly another quarter century has passed. Despite many hopeful developments —new treatment and harm-reduction strategies, new therapies for HIV/AIDS patients, new scientific understanding of addiction—the American drug problem has become even more complex and politically fraught. The reissue of Addicts Who Survived has given us a chance to describe these developments and to revisit the question posed in the original epilogue: What have been the most important changes in drug use, policy, and treatment in the recent past? A d d i c t s W h o S u r v i v e d 3 7 0 Marijuana’s comeback would have to rank at or near the top of the list. By virtually any measure—arrests, incidence, peer disapproval—adolescent marijuana use fell steadily during the 1980s. In 1979 about 3 million Americans tried marijuana for the first time; in 1990 only 1.5 million did so, a decline of 50 percent. Pot looked like the drug war’s biggest victory. Unquestionably , it was the one most pleasing to suburban parents worried about their children drifting into a countercultural lifestyle. Then, to the dismay of federal officials, the 1990s turned into the 1960s. Incidence began rising until, in 2000, there were as many new marijuana users (3 million) as there had been back in 1979. In 1986, when Ronald and Nancy Reagan declared war on drugs, just one in four Americans favored marijuana legalization. By 2000 one in three favored legalization; by 2011 one in two. The young and socially liberal were the most supportive, the old and socially conservative the most opposed—though Pat Robertson, the octogenarian televangelist, proved a notable exception. “If people can go into a liquor store and buy a bottle of alcohol and drink it at home legally,” Robertson said in 2012, “then why do we say that the use of this other substance is somehow criminal?”1 The same logic applied to medicine. If patients could alleviate symptoms with other drugs, why not with marijuana? Medical marijuana advocates, as they came to be known, disputed the plant’s legal classification as lacking any medicinal value. They presented case stories of sympathetic patients who benefited from using marijuana. And they pointed out that the denial of legal purchase for such patients produced no public health or safety benefit. These were plausible arguments, or plausible enough that, in 1996, voters in California and Arizona approved initiatives intended to let physicians authorize patients to smoke marijuana. Critics called the medical marijuana movement a stalking horse for full legalization and a means of diversion to recreational users. Both charges contained an element of truth. No one supposed California’s two hundred thousand physician-approved marijuana smokers were all chronically ill, or that all the state’s lucrative marijuana crop was...

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