The Fix

The Fix

by Michael Massing

With a new prefaceLooking back on the 25-year war on drugs, Michael Massing offers a blistering critique of the politics and narrow-mindedness that have made our national drug policy a failure, and he proposes what must be done--stressing treatment over imprisonment--to begin to rescue addicts from the street and diminish the hold drugs have in this country.

  • Language: English
  • Category: Nonfiction
  • Rating: 4.13
  • Publish Date: May 31st 2000 by University of California Press
  • Isbn10: 0520223357
  • Isbn13: 9780520223356

What People Think about "The Fix"

The dust jacket of Michael Massing's The Fix summarizes his thesis in bold red letters: "Under the Nixon Administration, America Had an Effective Drug Policy. (Nixon Was Right)." That is a pretty extraordinary claim to make regarding an administration that gained office in large part through the "Southern Strategy" that had at its heart Nixon's declaration of a "War on Drugs" and whose policies created the cocaine epidemic that caused so many new concerns a decade later. Given the fragmented state of drug abuse treatment in New York City, and in most other American communities, it is no easy task to connect addicts with appropriate care and even harder to connect them with adequate aftercare. During Nixon's tenure, the government spent more money on treatment (the "demand" side) than on stopping drug trafficking (the "supply" side), which he argues led to declines in both drug overdoses and crime rates. In the third and last section Massing returns to Spanish Harlem, where Hamilton continues a difficult struggle to remain drug-free and Flores struggles to keep his center afloat and to keep from falling into addiction himself. The success of his anti-crime/anti-drug campaign presented Nixon with a serious dilemma when he took office - people were expecting results. Nixon had some ideas of his own, such as a nationwide mandatory death penalty for selling drugs - a strategy that has been tried in Red China and in Singapore and has clearly failed in both nations - but fortunately he was more interested in foreign policy and left the search for a solution to the drug problem in the hands of John Ehrlichman and the White House Domestic Policy Council. In any case, it is true that Krogh played a key role in shaping both the good and the bad in the Nixon administration's drug policies. Donfeld believed that the "mixed modality approach," which he called "different strokes for different folks", by offering a range of treatments that included detoxification, drug-free, and maintenance approaches, effectively masked the methadone program from political criticism. He sidestepped Nixon's idea of the death penalty for dealers and suggested that the one value of law enforcement might be in pushing up the street price of drugs and thus encouraging more addicts to seek treatment - this idea was later taken up by Peter Reuter of the Rand Corporation but his research showed that the effect of aggressive law enforcement on supply was essentially nil and on price was tiny. Jaffe attempted to make four points in his meeting with the President an d each was to bear fruit in shaping the future of drug policy under Nixon. Massing suggests that Jaffe's solution relied for its effectiveness on the GIs' overpowering desire to return to the United States. It appears that as an academic and researcher he was aware of the growing evidence that most heroin users do not become addicted and the early follow-ups showing that most of the troops who were addicted to heroin in Vietnam abstained successfully, and usually without any treatment, after returning home (Jaffe and Harris, 1974). He didn't fool himself into believing that the urine screening program actually deterred heroin use among the troops while serving in Nam. What he expected was that once word of the urinalysis got around heroin using GIs who weren't addicted would stop using for the last weeks before rotation home and only the truly addicted would be unable to do so and thus fail the urine test. (1980) confirmed that most of the GIs who became addicted to heroin while serving in Vietnam recovered fully and permanently after returning to the US and also found that recovery rates were not improved by receiving treatment - a finding the implications of which I discussed in several publications of that period (Duncan, 1974, 1975, 1976 & 1977). As Massing reports, Jaffe was able to convince the Nixon administration to increase funding for drug abuse treatment eightfold over what it had been when Nixon took office. Massing attributes a decline in narcotics-related deaths and in crime rates to this budget increase and a more than 300 percent increase in the number of persons in treatment. Second, was the growing popularity of amphetamines and other stimulants resulting in them replacing heroin as the primary drug of addiction in America. I directed one of the early treatment centers to utilize the "mixed modality" approach that Jaffe advocated and I continue to believe in its value. It certainly cannot be reduced by operating a system in which between a third and two-thirds of the current patients don't need any treatment at all because their drug use is recreational and not addictive. Effective primary prevention of drug abuse, however, has to be something far different from telling people to "just say no" and telling prophylactic lies to kids in D.A.R.E. classes. First of all, effective prevention (primary, secondary or tertiary) must focus on the actual problem of addiction rather than on all use of certain selected drugs. Programs like D.A.R.E. make a strong impression on many preadolescents and early adolescents who swear they are never going to use drugs but by their mid-teens most of them have learned through observation that much the D.A.R.E. officer told them was lies and they are not only ready to experiment with drugs but cynical in viewing any valid warnings they might receive from adults about real risks.

This book is an excellent primer for anyone trying to wrap their refried brains around this tragic, mysterious, and misguided conflict, and Michael Massing puts his annoying journalistic style to great use showcasing the bizarre cast of players driving America's drug policies over the past three decades.

But also, to be fair, I intended to read this book in its entirety and could not bring myself to do it after finishing the first section.