High Price

methamphetamine. They were white but gay, poor, or rural. In 2005, about a half million people reported that they had used methamphetamine in the past thirty days (an indication of “current use”). This number is small when compared with the 15 million people who smoked marijuana within the same period. Whenever a “new” drug is introduced to a society and a relatively small number of marginalized individuals use that drug, incredible stories about the drug’s effect can be told and accepted as fact. This is so because few people have the experience with the drug to challenge questionable claims. We saw this in the 1930s when authorities said that marijuana caused people to become psychotic and commit murder. These claims were often unchallenged and taken as fact. In fact, they were a major reason that the federal law (Marihuana Tax Act of 1937) essentially banning marijuana was passed. At the time, marijuana use was confined to a small number of minorities and “hipsters.” Of course, today, if an individual says that marijuana use leads to insanity and murder, he or she would not be taken seriously.
    Another similarity with the “crack scare” of the 1980s was the increasing number of stories written about methamphetamine in the national press. On August 8, 2005, Newsweek ran a dramatic cover story called “The Meth Epidemic.” Use of this drug, according to the magazine, had reached epidemic proportion. The evidence suggested otherwise. At the height of methamphetamine’s popularity, there were never more than a million current users of the drug. This number is considerably lower than the 2.5 million cocaine users, the 4.4 million illegal prescription opioid users, or the 15 million marijuana smokers during the same period. The number of methamphetamine users has never come close to exceeding the number of users of these other drugs. 4
    Coverage was filled with accounts of desperate users turning to crime to support their use of the “dangerously addictive” drug. Many articles focused on the “littlest victims.” The New York Times headlined one story, DRUG SCOURGE CREATES ITS OWN FORM OF ORPHAN , describing an apparent rise in related foster care admissions and reports of addicted biological parents who were impossible to rehabilitate. The paper quoted a police captain who said methamphetamine “makes crack look like child’s play, both in terms of what it does to the body and how hard it is to get off.” 5 The paper also claimed, “Because users are so highly sexualized, the children are often exposed to pornography or sexual abuse, or watch their mothers prostitute themselves.” 6 Attorney General Alberto Gonzales called it “the most dangerous drug in America,” and President George W. Bush proclaimed November 30, 2006, National Methamphetamine Awareness Day. Back in 1986, President Ronald Reagan proclaimed the entire month of October Crack-Cocaine Awareness Month. The parallels were frightening.
    At the end of the ONDCP discussion, we were asked to meet with writers in small groups to answer any lingering questions. Dozens lined up to meet with the police officer and attorney. They wanted to hear more about how methamphetamine caused gay men to engage in sexual practices that increased HIV rates; how it kept people up for consecutive days without sleeping; how the drug made people behave irrationally; and how it ruined people’s teeth and made them unattractive. While some of the writers were undoubtedly there simply seeking a sexy story to sell, I think most genuinely wanted to learn about the drug and, if needed, to warn the public about its dangers. They weren’t thinking about separating anecdote from evidence. They had just heard from a U.S. attorney and a cop that this drug was nasty stuff. The government invited both of these individuals as experts on the topic. As a result, there didn’t seem to be a need to separate fact from fiction. Of course the information was factual. Otherwise, it would not have been presented in a forum sanctioned by the government, would it?
    I pondered this and other questions as I rode the subway back to my lab. Why was my data so inconsistent with the stories told by the other panelists? Was I out of touch with the way people use drugs in the real world? Maybe the doses that I tested were too low, I thought. I had intentionally started off with low doses to ensure the safety of my research participants. At that point, the largest dose I had