http://www.lewrockwell.com/orig8/starrick1.html?rta

Drug Criminalization Is Neither Compassionate Nor Conservative

In 2000, George W. Bush ran for the Presidency as a Republican under the banner of "compassionate conservatism." However, with respect to the War on Drugs, his actions and his words never met during his time in the White House, as he decided to stay the failed course charted by his predecessors. 2008 Republican Presidential candidate Ron Paul is correct when he speaks to the fact that there is nothing compassionate or conservative about the continuation of America’s failed War on Drugs.

By most surveys taken and estimates made, drug use has remained at steady levels since the War on Drugs was launched in the 1970s and even before that. To be sure, there are occasional fluctuations here and there depending on various trends such as the rise and decline in popularity of one substance versus another. Each year the U.S. increases the federal budget for the DEA and other anti-drug efforts such as television advertisements and DARE programs in the public schools, yet drugs of all types are readily available all over the nation.

Ron Paul understands this with a clarity that seems missing from many of the other candidates in both political parties. In one of Paul’s writings, he noted that:

"For the first 140 years of our history, we had essentially no Federal war on drugs, and far fewer problems with drug addiction and related crimes was a consequence. In the past 30 years, even with the hundreds of millions of dollars spent on the drug war, little good has come of it. We have vacillated from efforts to stop the drugs at the source to severely punishing the users, yet nothing has improved. This war has been behind most big government police powers of the last 30 years, with continual undermining of our civil liberties and personal privacy."

The drug warriors are tied to the idea that criminal justice enforcement is the only solution to the problem. This narrow and simplistic view fails to take into account the myriad situations under which drugs are taken by the American public. What’s the difference between someone who unwinds and relaxes with a glass of wine or scotch and someone who unwinds and relaxes by smoking a little marijuana? According to federal estimates, 100,000 individuals die prematurely every year from alcohol. Not a single human on record has ever died from a marijuana overdose, and drug deaths in general are far fewer in number than alcohol and tobacco deaths. Yet that marijuana user, depending on where he resides, could be subject to harsh criminal sanctions.

Sensible education, harm reduction, and voluntary treatment for those who are truly addicted should be the policy.  Drug use and abuse has no place within the criminal justice system. True drug abuse and addiction is a public health issue. Those who use drugs recreationally, the same way millions of Americans drink alcohol and smoke cigarettes, should be of no concern to the government in a free society. Our current policies fail to make any distinction between drug use and drug abuse, and that is a serious problem. Under the leadership of a true compassionate conservative like Dr. Ron Paul, those suffering from drug addiction would get the help they need through non-coerced rehabilitation that seeks to help the individual get clean, not punish him for his addiction. Getting clean of one’s addiction should be a personal choice. It is not something the government has any right to force the individual to undergo. We don’t force people in the U.S. to get mandatory treatment if they eat too much fast food, smoke too many cigarettes, drink too much alcohol, watch too much pornography, and so on, yet for some these are all addictions just as drugs are. And, by every estimate, fully funding drug treatment and counseling programs across the nation for those who need them would cost far less than we dish out in tax dollars each year to feed, give medical care to, and house non-violent drug users.

The drug warriors claim that the establishment of so-called Drug Courts is a more appropriate method of dealing with drug issues. The problem is that they are still operating from the premise that the use of drugs is a criminal justice matter. Drug Courts are set up so that first and second offenders are kept out of the prison system. This is simply an exercise in futility. Drug Courts are not a solution because, again, they are coercive. They grow bureaucracy further, prevent judges from hearing real cases that need to be adjudicated, and force participants to undergo mandatory drug testing. As soon as the drug user fails a test, he lands right back in the prison system.

The drug warriors act as if most drugs are completely unsafe for consumption and never had a legitimate purpose. Nothing could be farther from the truth. Not only are many currently illegal drugs not as harmful as some like to claim, most had recognized medical and therapeutic uses before they were criminalized.  MDMA, the drug known recreationally as Ecstasy, is just one example. MDMA was used for years by psychiatrists to help patients open up and discuss their feelings with greater ease.  Many individuals who experienced severe life trauma such as victims of sexual assault and abuse were finally able to face their emotions and deal with the pain of their past with the help of this drug. Once MDMA caught on as a recreational drug taken at social gatherings, parties, and nightclubs across America, the government stepped in and had it designated a controlled substance with no recognized value. Today, things have almost come full circle, with the federal government acknowledging that maybe it is useful after all. Right now, FDA-approved studies are underway where researchers are administering MDMA to returning veterans from Iraq and Afghanistan who are suffering from Post Traumatic Stress Disorder (PTSD) to help them deal with their emotions and talk about the horrors they experienced. The Multidisciplinary Association for Psychedelic Studies has a wealth of information on MDMA, including physicians who refute the inaccurate portrayal of MDMA painted by the federal government.

Marijuana is another recreational drug that has a legitimate place in medicine. Medical marijuana is a hotly debated topic, as states across the nation move to lift restrictions on marijuana possession and consumption by those who are terminally ill or suffering from debilitating physical pain. This is an issue that belongs within the states. Ron Paul is one of the few candidates who has stated unequivocally that he will end all DEA raids on medical marijuana clinics and medical marijuana users. Dr. Paul’s response to a medical marijuana patient in New Hampshire on November 9, 2007 said it all: There is nothing compassionate about rounding up people who are dying of cancer or AIDS and throwing them in prison. Patients living in states where marijuana is legal should be free to exercise control over their own bodies.  DEA raids on medical marijuana users are a tremendous waste of federal tax dollars. The drug warriors will claim that marijuana should not be allowed for pain relief and appetite stimulation, and that sick patients should be prescribed pharmaceutical drugs like Marinol instead. This is a losing argument because it is simply replacing one drug with another. And, let’s face it, if a doctor gives you six months to live, would you rather take more pills or would you prefer to relax on your couch and smoke a joint?

The drug warriors have mastered the dissemination of false information to scare the public about drugs in America. They argue that if decriminalization or legalization were to occur, drug use and violent crime would skyrocket. However, just the opposite is true. Those who do not use drugs to begin with will not start using them just because they are no longer criminalized. Alcohol drinking levels were in fact much higher during alcohol prohibition than after the law was repealed and alcohol legalized.  If you tell someone they can't do something, they are going to want to do it more.

Under our current system, crime, violence, and drugs go hand in hand. As a result of drug criminalization, gang violence in America has skyrocketed as groups of individuals wage war with each other for territorial control of the lucrative drug trade.  Addicts on the street often commit robbery and other crimes in order to get the money needed to pay for the drugs they're hooked on. The great economist and conservative thinker Milton Friedman pointed out that, in a free-market scenario, drugs that are now illegal would be easily affordable and obtainable without addicts inflicting harm on anyone else's person or property. The day that U.S. politicians face reality and declare an end to the War on Drugs, the crime rate will plummet in a way the nation has never witnessed before.

The drug warriors want the public frightened at the thought of drugged drivers operating cars on the roads. The only problem is that the drugged drivers are already there. Millions of people drive each day on cold and flu medicines, anti-histamines, Prozac, Ritalin, and a host of other pharmaceuticals.  Is that somehow alright simply because a doctor wrote them the prescription or because they bought it off the supermarket shelf?  According to a recent article in Slate, there isn't much difference in terms of physical effects between an individual taking the pharmaceutical drug Ritalin and someone using Cocaine. Both Ritalin and Cocaine produce the same effects in the body when ingested.  The only difference is that one is prescribed in droves by physicians and the other is considered a street drug.  As the author points out, this is because the pharmaceutical industry has developed a litany of substitutes for illegal drugs in order to treat depression, anxiety, and pain – real conditions that affect real people every day. Anyone who believes that a drug free society is achievable is sadly fooling themselves.

When they denounce easing criminal sanctions on drugs here at home, the drug warriors disapprovingly point to European nations where they perceive drug laws to be more relaxed. However, for the most part, the drug policies of most European nations aren’t much more advanced than our own. Places like Holland are often cited as being tolerant of drug use, yet most drugs other than marijuana are still illegal there.

Meanwhile, as Ron Paul has rightly decried, the federal government here in the U.S. has squandered enormous financial resources going after pain management doctors who prescribe drugs like OxyContin to individuals suffering from chronic, debilitating pain.  Here’s how Congressman Paul described the situation in a column he authored back in May of 2004:

    "When we talk about the federal war on drugs, most people conjure up visions of sinister South American drug cartels or violent urban street gangs. The emerging face of the drug war, however, is not a gangster or a junkie: It’s your friendly personal physician in a white coat. Faced with their ongoing failure to curtail the illegal drug trade, federal drug agencies have found an easier target in ordinary doctors whose only crime is prescribing perfectly legal pain medication. By applying federal statutes intended for drug dealers, federal prosecutors are waging a senseless and destructive war on doctors. The real victims of the new campaign are not only doctors, but their patients as well."

These bureaucrats don't know the first thing about healthcare or pain management, yet they profess to know better than a licensed medical doctor what amount of a drug is too much.  Physicians have been sentenced to decades behind bars for doing their best to make patients comfortable and help them cope with their conditions.

The drug warriors would have the public believe that the prisons are filled with violent criminals that need to be segregated from society. Yet, according to the Sentencing Project, 60 percent of all Federal inmates are currently imprisoned on drug charges, and one-fifth of all state prisoners are serving time for drugs, a thirteen-fold increase since 1980.  The overwhelming majority of these offenders are non-violent. Not to mention, according to federal statistics, one-third of all federal inmates are illegal aliens who don't even belong in the U.S. to begin with, many of whom are imprisoned for drug smuggling. Just imagine, if all those non-violent prisoners were removed from the system, we would have room to house the murderers, rapists, child molesters, and thieves who actually do belong behind bars, many of whom are currently released far too early because of overcrowded conditions.

The collateral damage from the War on Drugs has been astounding. Hundreds of billions of dollars have been spent over the past 35 years trying to achieve the myth of a drug free society.  There is no such thing. In the meantime, we have gutted the U.S. Constitution of our Founding Fathers in terms of civil liberties, privacy, and property rights.  We have allowed the increased use of deadly SWAT team raids, killing countless innocent bystanders. AIDS and other diseases are rampant in prisons across the nation because of inmates who violently sexually assault one another. Where is the compassion in subjecting non-violent individuals to behavior like that, simply because they are involved with drugs in some way?

To top it all off, in the post 9/11 world, the U.S. can’t afford to keep the War on Drugs going any longer.  Illegal drug sales fund international terrorism and provide rogue nations and terrorist groups with countless dollars to build their weapons programs and cause havoc throughout the international community.

The War on Drugs is not compassionate or conservative. It is morally bankrupt, coercive, corrupt, and unconstitutional. That’s right: Nowhere in the U.S. Constitution did the Founders give the government authority to wage war against the consumption of an arbitrary list of substances by the American public. There is no excuse that can justify the needless lives lost and destroyed through this draconian public policy. Alcohol prohibition was tried and proved to be a miserable failure. It’s time once and for all to bring an end to America’s failed experiment with drug prohibition as well.

Conservatives are supposed to stand for the Constitution, liberty, and limited government interference in individual lives. The War on Drugs is incompatible with a free society, and the fact that Ron Paul is the only conservative candidate running for the White House in 2008 to recognize that is troubling to say the least.

December 6, 2007

Jesse Starrick [send him mail] holds a B.A. in Political Science from the Honors College at Rutgers University – Newark.

Copyright © 2007 LewRockwell.com

http://www.reuters.com/article/domesticNews/idUSN0453686820071205

By Matthew Bigg

ATLANTA (Reuters) - Black Americans are 10 times more likely to be imprisoned for illegal drug offenses than whites, even though both groups use and sell drugs at the same rate, according to a study released on Tuesday.

Almost all large counties in the United States showed sharp disparities along racial lines in the sentencing of drug offenders, the study by the Washington-based Justice Policy Institute showed.

There were 1.5 million drug arrests out of 19.5 million drug users in 2002, it said. About 175,000 people were incarcerated for a drug offense, of which half were black, even though blacks account for 13 percent of the U.S. population, it said.

The study looked at data from 198 U.S. counties with the biggest population. Its findings were similar to others on the subject, but it is the first to look at relative incarceration rates at a local level.

"What you keep seeing is this towering drug admission rate for African Americans and a very small rate for whites. In many cases, the admission rate for whites is smaller than the (percentage of whites in the) whole population," said Jason Ziedenberg, the institute's executive director.

The reasons for the disparity include federal mandatory minimum jail terms for drug crimes, which he said hit blacks harder.

For instance, the mandatory federal sentence is the same for possession of 5 grams (0.2 ounces) of crack, more associated with blacks, as 500 grams (18 ounces) of cocaine, which is more often used by whites.

Local police also tend to devote more resources to policing illegal drugs in open-air drug markets in inner cities with more blacks than in suburban communities or college campuses, Ziedenberg said, citing other research.

Research also shows that probation officers are sometimes more lenient with white offenders, blaming their problems on factors such as a broken home, than with black offenders, who were more likely to be described as having a failure of moral character, he said.

Ziedenberg advocated more investment in drug treatment and applauded individual U.S. counties that decided to make drug enforcement a lower priority than policing violent crime.

Reform of drug laws and increases in funding for drug treatment are difficult to achieve because politicians are unwilling to be seen as soft on crime, according to Ethan Nadelmann, executive director of the Drug Policy Alliance.

"The public is by and large supportive of (some drug) reform, but legislatures have been hesitant to move forward. ... The law enforcement industry is politically very powerful and has a lot of sway over legislators," Nadelmann said.

http://stopthedrugwar.org/chronicle_blog/2007/dec/05/poll_hard_drug_legalization_little_use

Zogby Poll Suggests Prohibition Doesn't Reduce Use

Washington, DC -- Marking the 74th anniversary of the repeal of national Alcohol Prohibition, StoptheDrugWar.org today released polling results suggesting that drug prohibition's main supporting argument may be simply wrong. Drug policy reformers point to a wide range of demonstrated social harms created by the drug laws -- crime and violence, spread of infectious diseases, official corruption, easy funding for terrorist groups, to name a few -- while prohibitionists argue that use and addiction would explode if drugs were legalized. But is the prohibitionist assumption well-founded?

Zogby polling data released today asked 1,028 likely voters, "If hard drugs such as heroin or cocaine were legalized, would you be likely to use them?" Ninety-ninety percent of respondents answered, "No." Only 0.6 percent said "Yes." The remaining 0.4 percent weren't sure.

The results are similar to usage rates occurring under today's "drug war," as measured by the federal government's National Survey on Drug Use and Health (formerly the National Household Survey). The 2006 NSDUH found 0.3 percent of the population had used heroin in the past month and 2.4 percent had used cocaine. Even for cocaine, the numbers are compatible, because Zogby surveyed persons aged 18 years and up, while NSDUH begins with age 12; and because of the poll's statistical margin of error of 3.1 percentage points.

A comparison of drug use rates in countries with criminal penalties for drug use with the drug use rates of countries that have decriminalized personal use also suggests that policy may play only a secondary role in determining use rates. For example, in the Netherlands, where marijuana is sold openly in the famous "coffee shops," 12 percent of young adults age 15-24 reported using marijuana during 2005, as compared with 24 percent in neighboring France, where marijuana is an arrestable offense, according to data compiled by the European Monitoring Center for Drugs and Drug Addiction.In the United States, where police make nearly 800,000 marijuana arrests each year, young adults age 18-25 in the 2004-2005 survey year reported past-year marijuana use at the rate of 27.9 percent.

David Borden, StoptheDrugWar.org's executive director, commented when releasing the Zogby data:

    "Prohibition is sending hundreds of billions of dollars per year into the global criminal underground. That money fuels violence and disorder on the streets of our cities, while simultaneously helping to finance international terrorist organizations. Meanwhile, inflation-adjusted cocaine prices are a fifth of what they were 30 years ago, and any kid who wants to join the Mafia can sign up to deal it in his school. Addicts are harmed by the prohibition policy worst of all. It's time to stop shooting ourselves in the feet, and to control and regulate drugs through legalization."

The full Zogby poll results are available online at: http://stopthedrugwar.org/legalization

StoptheDrugWar.org (still known to many of our readers as DRCNet, the Drug Reform Coordination Network), is an international organization working for an end to drug prohibition worldwide and for reform of drug policy and the criminal justice system in the US. Visit http://stopthedrugwar.org/chronicle for the latest issue of our weekly, in-depth newsletter, Drug War Chronicle.

http://www.washingtonpost.com/wp-dyn/content/article/2007/11/20/AR2007112001777.html

Post-traumatic stress disorder had destroyed Donna Kilgore's life. Then experimental therapy with MDMA, a psychedelic drug better known as ecstasy, showed her a way out. Was it a fluke -- or the future?

By Tom Shroder
Washington Post Staff Writer
Sunday, November 25, 2007

THE BED IS TILTING!

Or the couch, or whatever. A futon. Slanted.

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She hadn't noticed it before, but now she can't stop noticing. Like the princess and the pea.

By objective measure, the tilt is negligible, a fraction of an inch, but she can't be fooled by appearances, not with the sleep mask on. In her inner darkness, the slight tilt magnifies, and suddenly she feels as if she might slide off, and that idea makes her giggle.

"I feel really, really weird," she says. "Crooked!"

Donna Kilgore laughs, a high-pitched sound that contains both thrill and anxiety. That she feels anything at all, anything other than the weighty, oppressive numbness that has filled her for 11 years, is enough in itself to make her giddy.

But there is something more at work inside her, something growing from the little white capsule she swallowed just minutes ago. She's subject No. 1 in a historic experiment, the first U.S. government-sanctioned research in two decades into the potential of psychedelic drugs to treat psychiatric disorders. This 2004 session in the office of a Charleston, S.C., psychiatrist is being recorded on audiocassettes, which Donna will later hand to a journalist.

The tape reveals her reaction as she listens to the gentle piano music playing in her headphones. Behind her eyelids, movies begin to unreel. She tries to say what she sees: Cars careening down the wrong side of the road. Vivid images of her oldest daughter, then all three of her children. She's overcome with an all-consuming love, a love she thought she'd lost forever.
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"Now I feel all warm and fuzzy," she announces. "I'm not nervous anymore."

"What level of distress do you feel right now?" a deeply mellow voice beside her asks.

Donna answers with a giggle. "I don't think I got the placebo," she says.

FOURTEEN YEARS AGO, Donna Kilgore was raped.

When the stranger at the door asked if her husband were home, she hesitated. Not long, but long enough. That was her mistake.

"That was it," Donna, 39 now, is saying. "He pushed in. I backed up and picked up a poker from the fireplace. I was screaming. He says, 'I've got a gun. If you cooperate, I won't kill you.' He unzipped his jacket and reached in. I thought, this is it. This is how I'm going to die. My life didn't flash before my eyes. I wasn't thinking about my daughter. Just that one cold, hard fact. I checked out. I could feel it, like hot molasses pouring all over my body. I went completely numb."
   
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She dropped the poker.

Afterward, she stayed strong. She wasn't going to make the classic victim's mistake of blaming herself for provoking the attack. She had no doubts about that. She'd screamed and screamed until the police came through the door. (They later reported that her attacker jumped up, clutching for his pants, saying, "She said I could!")

And, bottom line, she'd survived. She'd be fine, she told herself. She was wrong.

"It was what it must feel like to have no soul," she says. She quit all her hobbies. A passion for tennis died. Devastating nightmares woke her in the dark, her heart racing and palms slick. She dreamed of explosions, tornadoes, bears eating people.

"Psychologists will tell you to go to your happy place," she says. "Well, my happy place had bears in it."

Five years passed. Whatever went wrong, or right, in her life, it felt like it was happening to someone else. She found a wonderful, loving man -- she could still recognize those qualities, even though she couldn't respond to them fully -- and remarried. She had more kids. But even her family felt alien. It was "almost like going overseas and being an exchange student, living with someone else's family . . . I didn't like being close to people, and my children didn't understand that. Mommy was always busy." She was often irritable, and felt an unaccountable anger, which sometimes morphed for no obvious reason into a heavy-breathing, sweat-streaming rage. Almost worse, she couldn't feel the love she knew surrounded her. "I was afraid it was gone -- when you look at your child and say, 'I would die for that child in a heartbeat,' I didn't feel it -- and I was afraid I would never get it back."
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As she says this, she never breaks eye contact. Talking about her trauma and her treatment is a decision she's made, she says. "It's important." But it is also, obviously, hard, and she looks a little pale as she explains what it was like for those five years: "I would put my finger on my arm, and it would be like touching a dead body."

Incredibly, she didn't see a connection to the rape. Then, one evening, she was sitting on her couch watching a disaster show on TV -- she calls her interest in the genre "an addiction"-- when her apartment door opened. Something about the angle of it seemed odd. As she looked at the door, the room began to swirl. "It was kind of like a whirlwind, make-you-dizzy moment, and I saw the whole thing, that man pushing through the door, the warm molasses pouring down, my body going numb. I call it, 'when I left my body.'"

Now she understood: She had left her body -- and never come back.

The panic attacks began at work one Friday. She felt butterflies in her stomach, then couldn't breathe. "I thought: 'Oh my God, I'm dying. I'm having a heart attack.'"

It passed, but she was shaken, especially because she'd also been having fainting spells and migraine headaches. She went to a neurologist "sure they were going to find a brain tumor."

The doctor was getting ready to order an MRI scan when Donna just blurted it out: "Things don't feel real to me."
   
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The doctor turned. "Oh? There's a word for that," she remembers him saying. The word is dissociation, which happened to be a prime symptom of post-traumatic stress disorder, or PTSD.

PTSD is usually triggered by combat, rape, childhood abuse, a serious accident or natural disaster -- any situation in which someone believes death is imminent, or in which a significant threat of serious injury is accompanied by an intense sense of helplessness or horror. Not all or even most trauma victims develop PTSD, but enough do so that nearly 24 million Americans, or 8 percent of the population, have suffered from it at some point in their lifetime. It is estimated that in any given year, more than 5 million Americans have active PTSD -- a costly problem in humanitarian and economic terms. Drug and alcohol abuse are all-too-frequent consequences of PTSD, as is loss of productivity and the need for expensive, long-lasting medical treatment.

The ever-lengthening Iraq war will count among its other costs a legacy of thousands of veterans in need of psychiatric treatment. The government estimates that already more than 50,000 soldiers -- about 4 percent of those who have been deployed to Iraq and Afghanistan -- have been treated for symptoms of PTSD. Many more might actually have it: Military studies put the number at 12 to 20 percent of those returning from Iraq and 6 to 11 percent of those returning from Afghanistan. And the news gets worse.
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"Vets with PTSD are particularly costly to the [Veterans Affairs] system," says Linda Bilmes, a lecturer in public policy at Harvard's Kennedy School of Government. "They constitute 8 percent of the claims, but 20 percent of the payments." Bilmes, who has studied the ongoing costs of the wars, estimates that treating Iraq vets with PTSD over the next 50 years will cost taxpayers $100 billion. This is based on findings that one-third of vets with PTSD will remain unemployable, and all suffering with PTSD will have a much higher than normal likelihood of needing treatment for physical ailments. And that's just the direct costs to the budget. "Assuming that the war continues, though with lower deployments, through 2017," she says, and assuming the rate of PTSD isn't being underreported, the cost of lost economic productivity to the U.S. economy will be in excess of $65 billion.

Whatever the cause, the symptoms of PTSD are fairly consistent, and Donna's -- which rated severe on a standard diagnostic test -- were typical. Her prognosis was not great. Some antidepressants can diminish symptoms, and various forms of psychotherapy can, long term, sometimes untangle the psychological knot at the root of the problem. But the nature of PTSD makes therapy problematic. The very symptoms -- acute anxiety, heightened fear, diminished trust and inability to revisit the trauma -- are a direct roadblock to healing. At least one-third of people with PTSD never fully recover.

On that day of Donna's first diagnosis, the doctor sent her up to the seventh floor, the psych floor, to begin years of therapy and medication, none of which helped much, Donna says.

And then she found Michael Mithoefer and became the first to take one of his little white capsules.

THE CAPSULES RESIDE IN A SAFE, armed with an alarm and bolted to the floor of Mithoefer's office, a 1950s-vintage cottage on the road between downtown Charleston and Sullivans Island. It's been tastefully remodeled to create a softly lit, high-ceilinged sanctuary in the back, scattered with art and furnished with, among other things, the ever-so-slightly inclined futon where Donna got crooked.

The elaborate security is occasioned by what is inside the capsules: MDMA, a synthetic compound that is a chemical cousin to both mescaline and methamphetamine. Unabbreviated, MDMA is a real mouthful -- 3,4-methylenedioxymethamphetamine -- but it is far better known by its street name, ecstasy, millions of doses of which are synthesized in criminal labs from the oil of the sassafras plant. At one point, Mithoefer recounts, agents of the Drug Enforcement Administration, there to inspect the security arrangements, inquired about the therapist who rents the office adjoining the safe room.

"I guess they were concerned she might drill through the wall into the safe and steal the MDMA," Mithoefer says. "Though there's such a small amount in there, and it's so readily available on the street in such large quantities, I don't see how that would be worth the effort, even if she were so inclined."

Mithoefer became a psychiatrist in 1991, after a decade as an emergency room doctor -- he had found himself less interested in the bodily traumas his patients suffered than the psychological traumas that so often preceded their appearance in the emergency room. He's got that mellow, empathic vibe that they just can't teach at therapy school. He always seems moments away from a sympathetic chuckle, an understanding murmur or a sage observation. A fit 61, with a brown ponytail and relaxed dress code, Mithoefer has become the accidental point man of a movement to revive medical research into psychedelic drugs. His Food and Drug Administration-approved PTSD study that began with Donna Kilgore in April 2004 is now nearly completed, with 18 of 21 subjects having undergone the double-blind sessions. Two Iraq veterans with war-related PTSD, the study's first, are cleared to begin. Close behind are similar studies in Switzerland and Israel. At Harvard's McLean Hospital, researchers are set to evaluate MDMA therapy as a way to alleviate acute anxiety in terminal cancer patients. In Vancouver, Canada, the effectiveness of an ongoing program to treat drug addiction with another potent psychedelic drug, ibogaine, is under scrutiny. There is a proposal, based on case histories, to study the ability of LSD to defuse crippling cluster headaches.

All of these studies are directly or indirectly funded by a surprisingly robust organization whose roots stretch back 40 years to the psychedelic movement of the 1960s. Before Harvard lecturer Timothy Leary started channeling aliens and urging college kids to turn on and drop out, an intense cadre of doctors and researchers had come to believe that psychedelic drugs would revolutionize psychiatry, providing those with a wide spectrum of psychological problems -- or even just ordinary life difficulties -- the ability to, basically, heal themselves.

But Leary's bizarre career, which morphed from doing research on psychedelics to cheerleading their widespread abuse, obscured whatever medical potential the drugs may have had. Instead, authorities focused on the risks, and often exaggerated them. Richard Nixon famously called Leary "the most dangerous man in America." After a slow start, regulators and legislators cracked down hard. Millions of dollars in enforcement efforts were unable to end abuse of psychedelic drugs, but they effectively stamped out sanctioned research into their healing potential.

A small group of psychedelic researchers and therapists willing to break the law continued their work clandestinely. A much larger group did not flout the law, but waited in the wings and is now emerging. Experience had convinced these therapists that psychedelics, along with significant risks, had potential for even more significant benefits.

This may have been especially true of MDMA.

Mithoefer states the case in an article he wrote for a book of scholarly essays, Psychedelic Medicine: Social, Clinical and Legal Perspectives:"The reported results [of early therapeutic use] include decreased fear and anxiety, increased openness, trust and interpersonal closeness, improved therapeutic alliance, enhanced recall of past events with an accompanying ability to examine them with new insight, calm objectivity and compassionate self-acceptance."

In short, a therapist's dream. Or is it a hallucination?

THE PROMISE OF A BLOCKBUSTER TREATMENT, one that doesn't just address symptoms but defuses underlying causes, is a particularly seductive vision right now. A report issued last month by the National Academy of Sciences' Institute of Medicine emphasizes the uncertain effectiveness of current PTSD treatments, and the urgent need of returning soldiers who will suffer from it.

To a non-scientist, the very preliminary results of Mithoefer's study would suggest that MDMA might be just what the doctors ordered. Of the subjects who have been through both the MDMA-assisted therapy and the three-month post-experiment follow-up tests, Mithoefer reports, every one showed dramatic improvement.

But scientists are a cautious lot. "It's potentially nice to hear those things," says Scott Lilienfeld, an associate professor of psychology at Emory University. But until results are statistically analyzed and peer-reviewed for publication, "you can't really judge them. The plural of anecdote is not data." Especially with a drug that has considerable risk, Lilienfeld cautions, it pays to be skeptical.

A.C. Parrott, a psychologist at Swansea University in Britain who has devoted a large part of his career to studying the dangers of MDMA, is far more than skeptical. "MDMA is a very powerful, neurochemically messy and potentially damaging drug," he says. The government "should never have given it a license for these trials. Certainly I would not give it a license for any further trials."

But one of the nation's premier PTSD researchers, Roger K. Pitman, a professor of psychiatry at Harvard Medical School, disagrees. Morphine is a powerful, potentially damaging drug, Pitman says, "and we use it to treat the pain of cancer patients. Sound medical reasons should trump."

Current treatment for PTSD is "partial at best," he says. "There's a lot of room for improvement, and we need to be looking for novel treatments."

Though Pitman calls the MDMA study "a fringe hypothesis" -- "I've never heard anybody talk about it at any PTSD meeting I've ever attended in 25 years" -- he also observes that, based solely on a description of the preliminary results, "this seems worth further study. A lot of new ideas meet with rejection and skepticism, and we need to be careful not to be prejudiced against something just because it seems wacky. If it has a 5 percent chance, or even a 1 percent chance, of being effective in treatment of PTSD, it's worth pursuing."
   
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AS THE SESSION TAPE ROLLS TOWARD THE FIRST HOUR, the giggles have passed. Donna Kilgore is still on the crooked couch, but she sounds very level. She's talking about her husband. Her voice is clear, calm, but you can hear something in it, something rising in the throat like water from a newly tapped spring.

"I just have a deep feeling of gratitude for all the love and understanding he's shown. I know it's been tough on him, not understanding what I've been going through and not knowing how to help. But if it wasn't for him, I don't think I'd be here."

The study protocol requires that a hospital crash cart and a trauma doctor be present during all therapy sessions, in case the drug precipitates a medical emergency. They are waiting a room away, a reminder that this is a test of a potent experimental drug, though you'd never know that from the calm, sober tenor of the conversation. It's really more of a monologue: Michael Mithoefer and his wife, Annie, a nurse and co-therapist, mostly listen, only occasionally murmuring supportively. This is their treatment plan: Construct a reassuring, protective environment and "let the drug do its work."

"He used to spend a lot of time laughing and cutting up," Donna continues about her husband, "but things have gotten so serious. I love him with all my heart, but there just hasn't been that warm fuzzy feeling, how you get excited every time you see him. It's put a damper on it. I don't fully enjoy anything. I don't enjoy my kids. I don't enjoy my dog.
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"It's frustrating, just going through the motions day after day after day. I don't get any joy out of it."

She stops talking, and you can hear the faint strain of music coming from her headphones. She takes a deep breath. The blood pressure cuff, on a five-minute timer, starts to inflate.

"It sucks to just exist, and not live," Donna announces.

FIRST SYNTHESIZED IN 1912 -- A BYPRODUCT IN THE MANUFACTURE OF A DRUG TO SUPPRESS BLEEDING -- MDMA was little known until a former Dow Chemical researcher named Alexander Shulgin tried it himself in 1977. Shulgin had made his reputation, and made Dow millions, by inventing the first biodegradable pesticide. After that success, he was able to work on whatever he chose. He chose psychedelic drugs, based on a transforming experience he had with mescaline in the late 1950s. "I understood that our entire universe is contained in the mind and the spirit," he wrote. "We may choose not to find access to it, we may even deny its existence, but it is indeed there inside us, and there are chemicals that can catalyze its availability."

Shulgin made it his business to find those chemicals. In a New York Times profile in 2005, when Shulgin was 79, he estimated that he'd synthesized 200 psychoactive compounds and tested them on himself. Their effects ranged from paralyzing him with fear to granting him ecstatic visions. With MDMA, he was convinced that he'd found something special.

"I feel absolutely clean inside, and there is nothing but pure euphoria," he wrote in his field journal. "The cleanliness, clarity, and marvelous feeling of solid inner strength continued . . . through the next day. I am overcome by the profundity of the experience."

It's not well understood why MDMA, or any psychedelic drug, can produce extraordinary experiences. But in MDMA's case, the crude explanation seems to involve a drug-forced rush of serotonin in the brain. Serotonin assists in the transmission of nerve impulses and plays a role in regulating a wide range of sensations and impulses, from mood, emotion, sleep and appetite to sensation, pleasure and sexuality. One recent study pointed out physiological similarities between a brain under the influence of MDMA and the post-orgasmic state, also known for producing emotional closeness and euphoria.

Whatever the cause, Shulgin saw in the overwhelming positive feelings the drug engendered huge potential as an aid in the psychotherapeutic process. "I made samples of it for a good therapist friend of mine, Leo Zeff, which brought him out of retirement and into the enthusiastic task of making it available internationally with his psychotherapy friends," Shulgin recalls in an e-mail. "Its popularity spread in part by his enthusiasm, but in part by the fact that its ability to open the doors of communication made it widely popular as a social drug."

BY MULTIPLE ACCOUNTS, MDMA EMERGED AS A STREET DRUG IN 1984 at a new and instantly hot Dallas nightclub called Starck. Sold at $12 a hit, MDMA -- which Zeff's crowd had nicknamed Adam, for its presumed potential to return man to innocent bliss -- became ecstasy. Part of the drug's appeal was that it made dancing feel great, and staying up all night easy. But there was more. Here's an account of first-time ecstasy use from that period, recalled in the Austin Chronicle in 2000:

"The street lights got brighter, I could see the stars, car lights, even the shadows in this alley were, you know, more so. And I felt this tingle that began in my fingers and spread all over my body, coming in waves, just this indescribable feeling of aliveness. It was as if the nerves in my skin had been dormant all these years and were just now waking up and stretching. Just like that. And after this initial rush of pleasure came an overwhelming -- and I mean over-[expletive]-whelming-- feeling of total and complete positivity. Any and all fears I had harbored about doing my first drug were waylaid instantly. It was pure bliss, but it didn't knock me off my feet, or feel scary in any way.

"My girlfriend . . . and I . . . lay in the wet grass and watched the stars and cuddled. And we talked. We talked for hours. We talked about everything. Everything. It was probably the best, most open and honest conversation I've ever had with anyone in my entire life."

Word-of-mouth reviews such as that fueled an explosion of recreational use. From 1984 to 2001, the graph line for the number of first-time users of MDMA in the National Survey of Drug Use and Health quickly shot up, reaching a peak of nearly 2 million new users in 2001 alone. Concern about the drug, spurred by a spike in emergency room visits from rave bars and MDMA-related deaths, went up right along with it. Ecstasy use has since tapered off, though it is still substantial. The 2005 survey estimated that 11.5 million Americans had used ecstasy, and 615,000 had tried it for the first time that year. The average age skewed young. In 2001, 5.2 percent of eighth-graders and 11.7 percent of high school seniors had tried ecstasy (both numbers have been roughly cut in half in the most recent, 2006 survey).

When Zeff began his mission to spread the MDMA gospel in therapeutic circles, the drug was perfectly legal. But federal drug enforcement officials, who had taken half a decade to ban LSD, weren't about to delay on ecstasy. Within months of the rave boom in Dallas, officials announced they intended to list MDMA as Schedule I, the category reserved for dangerous drugs with high potential for abuse and no accepted medical use.

Rick Doblin was waiting for them.

LIKE A LOT OF OTHER PEOPLE, Doblin had discovered psychedelic drugs in college in the early '70s. By his own description a somewhat awkward, searching kid, he tried LSD in 1971 at New College of Florida, then a small, experimental liberal arts school in Sarasota. Very liberal and very experimental. "There was this tradition of all-night dance parties, until sunrise, under the palm trees, using psychedelics," Doblin says. It was bacchanalian, yes, but Doblin found something else in the experience, something "therapeutic and spiritual."

"I was like, man, this is the kind of energy, the kind of psychic stuff" that could lead him to the personal growth he had been yearning for. Ironically, says Doblin, "this was right as research into therapeutic uses was pretty much being shut down."

Doblin's world was legally circumscribed in another way as well. He was a draft resister. "What could I possibly do with my life, because I couldn't be a licensed anything, doctor, teacher a professional of some sort. All that was closed to me because I was a criminal."

As long as he was already an outlaw, Doblin reasoned, be might as well be one of those who disregarded drug criminalization and worked underground as a self-trained psychedelic therapist. When he encountered MDMA in 1982, he became convinced that he'd found the perfect therapeutic tool, one that had an LSD-like power to hurdle psychic roadblocks but lacked the frightening disorientation. Plus, it was still legal, and by then, so was Doblin -- President Jimmy Carter had pardoned draft resisters in 1977. Now Doblin had a vision: He would return to the mainstream and bring psychedelic therapy with him.

When, in 1985, prohibition of MDMA came, as everyone knew it would, Doblin had already prepared his case with a coalition of like-minded pro bono lawyers, researchers and therapists. He even won a round -- an administrative law judge ruled that MDMA met the standards for having a legitimate medical application and being safe enough for medical use. But the DEA rejected that recommendation and MDMA remained banned.

Doblin, decided he couldn't win in the courts and switched his crusade to the lab. He would focus on fostering the science that would prove the benefits of psychedelic therapy outweighed the risks. In 1986, he founded a nonprofit organization -- the Multidisciplinary Association for Psychedelic Studies -- to raise money for the research. (Knowing he would need to navigate through the obstacle course of federal bureaucracy, he entered Harvard's Kennedy School of Government and, in 2001, received a PhD in public policy.) On the elaborate MAPS home page -- alongside a psychedelic research library, the organization's financial statements, elaborate news updates and notices of psychedelic art for sale -- is a splash box featuring the MAPS "Rites of Passage Project." It's an extended pitch for the idea that "within responsible limits" parents can sometimes find great benefit in doing psychedelic drugs with their adolescent children, and includes an archive of testimonials with taglines such as "Mother-Son Peyote Ritual . . . a beautiful rite of passage a mother shared with her teenaged son, strengthening his family connection, his sense of self, and his bond with nature."

Doblin is frank about his passionate desire to defuse the drug war, which he believes is counterproductive and an assault on personal liberties. He doesn't think the government should be able to tell Americans what to put in their bodies, and he has even volunteered in interviews that he sometimes finds it useful to consider important personal and strategic issues with psychedelic assistance. He acknowledges that his outspokenness caused a schism in the original coalition that fought against relegating MDMA to Schedule I -- many of his colleagues wanted to stress their support for the criminalization of any nonprescription use. He has seen it jeopardize one of his most prized accomplishments -- MAPS funding of the Harvard MDMA-cancer study almost killed it. Doblin had to withdraw MAPS as a sponsor and persuade a donor to give the money directly to Harvard instead. He must realize he is handing his critics a potent argument, i.e.: Don't be fooled by the careful science and limited goals of the current studies; the real goal is unrestricted use of psychedelic drugs.

So, why does he do it? "Sometimes, it's just a relief to say, 'This is what I believe,'" Doblin says.

His honesty has apparently been no impediment to soliciting cash from fellow believers, which, fortunately for MAPS, include some entrepreneurs with a high regard for the psychedelic experience -- and a distaste for government drug policies -- who struck it rich in the tech boom. Last year, MAPS donations topped $1 million.

MAPS continues to fund Mithoefer's study, which is estimated to cost $900,000 through completion. And Doblin will raise money to support the much more expensive next step -- Phase III trials, which involve multiple sites and multiple therapists who will treat hundreds of people suffering from PTSD. If it proves safe and effective, MDMA would be certified as a prescription drug. That all could take five years and $5 million, Doblin says. "But if it took twice that long and cost twice that much, it would be worth every penny."

Mithoefer speaks far more cautiously of his eventual goal. "If MDMA indeed proves an effective treatment for PTSD," not only should the drug require prescription, but it should be administered only in licensed clinics with specially trained therapists, "like methadone," he says. Regarding Doblin's controversial views, Mithoefer says: "I respect his openness. I think it's a good thing that there's nothing sneaky about Rick, but that's not what I'm oriented toward. I'm oriented toward doing medical research. There are real patients suffering with real problems, and I'm trying to learn through good science if there are some methods to help people heal."

MITHOEFER DOES NOT WANT TO TALK ABOUT HIS PERSONAL EXPERIENCE WITH MDMA, except to say that it occurred when the drug was legal. But it must have stuck with him. "I was working in the emergency department, looking for some deeper way to address people's problems," he recalls. "Stan Grof's work really got my attention."

Stanislav Grof, a Czech psychiatrist and one of the first to research therapeutic uses of LSD, believed that the West had lost touch with the healing potential of non-ordinary states of consciousness. When psychedelic drugs became illegal in the United States, Grof created an alternative called holotropic breathwork. The idea was that hyperventilation, combined with music and a ritualistic setting, could foster an altered consciousness, through which patients could be guided into insight and problem resolution. Mithoefer went to California to train with Grof, then began to use breathwork in his own practice. And though he says it is often effective, he wondered how much more could be accomplished using MDMA. In 2000, Mithoefer approached Doblin to ask if he knew of a country in which a study of MDMA-assisted therapy might be permitted.

"You can do it here," Doblin said. "And we'll help."

Doblin says his optimism was based on a change in leadership and culture in the federal bureaucracy. When he first founded MAPS, Doblin says, "the FDA was refusing to permit all the studies we proposed," even one attempting to use MDMA therapy to ease the fears of a dying cancer patient who had found solace using the drug before it was banned. "The FDA said, 'No, we have to protect him from brain damage,'" Doblin says.

Then in 1992, after six years of refusals, the FDA approved a MAPS-funded human safety study. Safety studies are required before any drug can move on to Phase II -- studies of a specific medical application. In MDMA's case, this was particularly important because many believed the drug to be so toxic. Even talking about the possibility of therapeutic benefits would only make more people want to try it, some believed, and that would inevitably lead to more emergency room visits. And deaths.

More than 200 fatalities involving ecstasy use in the United States were reported to the Substance Abuse and Mental Health Services Administration from 1994 to 2001. Many of these deaths were related to traffic accidents and the use of other drugs and alcohol or other incidental causes. Of deaths directly related to ecstasy, most were caused by heatstroke. MDMA exerts a stress on the body similar to strenuous exercise and increases core body temperature, so dancing all night in a hot, crowded bar can quickly go from fun to deadly. More rarely, some ravers, paranoid about hyperthermia, have reportedly consumed so much water, many gallons, that the water itself became toxic and killed them.

But, even in the context of uncontrolled doses and settings, deaths from MDMA are relatively infrequent events, considering the estimated tens of millions of doses taken.

Perhaps of even greater concern was the possibility that MDMA could cause permanent brain damage. Though research is ongoing and hotly debated, it's clear that test animals injected with high doses experienced lasting deformation of serotonin receptors in the brain.

There were worrisome human studies as well: In some, long-term recreational users of ecstasy performed more poorly on tests for short-term memory and some other cognitive functions than control groups, though the meaning of these results is complicated by the fact that most long-term ecstasy users also use other dangerous drugs.

The new safety study was not testing the dangers of MDMA under the conditions of illegal use. Eighteen people were given dosages similar to those that would be used in psychotherapy sessions, and the settings were comparable to the calm of a psychiatrist's office. The gist of the findings: MDMA given under those circumstances produced no acute harm or evidence of brain impairment. These results were bolstered by a Swiss study in which people who had never before taken MDMA were given brain scans before and after being given a single therapeutic-range dose of the drug. Comparison of the before and after scans showed no damage.

Given those results, Doblin figured the time was right for persuading regulators to approve Mithoefer's proposal, a placebo-controlled, double-blind study (meaning that neither doctor nor patient would be told who got the real drug). The safety study, and others done elsewhere, had made the case: Many valuable medicines have been developed from far more problematic drugs.

Doblin and the Mithoefers spent 18 months developing an elaborate protocol for the study: Research subjects would be limited to people who'd struggled with the disorder for years, and whom conventional treatments hadn't helped. The cases would be relatively severe, as scored on the standard diagnostic test, and subjects would be required to undergo multiple non-drug therapy sessions with the Mithoefers before and after the two MDMA sessions to prepare them for the experience and to help them process it afterward. The protocol dealt with such details as what kind of touching would be permitted (supportive, non-sexual), and what kind music would be played on earphones (soothing).

Submitted to the FDA in October 2001, it was approved a month later.

Then, in September 2002, the institutional review board engaged to guarantee the study's ethics -- de rigueur for human medical research -- abruptly withdrew its support. A study published in Science magazine found that relatively small doses of MDMA had created severe damage to the dopamine system in the brains of squirrel monkeys and orangutans. Dopamine damage could put human users at risk of developing Parkinson's disease, among other problems. In the case of the primate test subjects, the Science article said, the drug was so toxic that two of 10 animals died, and two more were in such bad shape that the researchers didn't give them a planned third injection.

After 2 1/2 years of work, the PTSD study appeared to be doomed.

A year later, Science printed a retraction: The vials containing the drugs that so damaged the monkeys' brains had been mislabeled. It wasn't MDMA after all, but methamphetamine. A new review board quickly signed on to support Mithoefer's study, but the irony of the wasted year wasn't lost on him: The misidentified drug that had been deemed too toxic to evaluate for medical use, the drug that was far more toxic than MDMA, was already a prescription drug.

Meanwhile, in the four years the MDMA study lingered between concept and reality, Donna Kilgore had been driven to the brink. She took "every anti-depressant you can name," tried a dozen therapists and an almost equal number of therapeutic approaches. But nothing made that numbness, panic and rage recede.

"I was getting to the point," she recalls, "where it was either go sit on a mountaintop or go dive off a cliff."

That's when a therapist told her about the Mithoefers' experiment. She applied, and became patient No. 1.

DONNA SPENDS A LOT OF HER TIME ON THE CROOKED COUCH holding the Mithoefers' hands, one on each side. She needs that reassurance now, recalling the rape.

"I was backed into a corner, nowhere to go, desperate. I kept telling him I wouldn't tell anybody," she says.

Can she feel that desperation now?

"A little bit, yeah."

Minutes pass. On the tape, you can hear the blood pressure cuff whir to life as the amplified beat of her heart thumps faintly in the background.

Finally she speaks, her voice rising with conviction.

"I feel protected. I do. I feel completely protected. I don't feel like I'm hanging out there anymore . . . It feels good to be loved. It feels good to be protected."

Minutes pass. She is lost in a vision, she will say later. She can see herself standing on a ridge, high above a valley shrouded in mist. Down in the valley, she knows, is a battlefield, containing all kinds of terrors. Her terrors. She knows they are there, but can't see their shape through the fog. Now the fog is lifting. Now she can begin to see.

"You're right," she says, as if in response to an assertion that hasn't been made. "I am angry. I'm angry at myself. It changed from being afraid to being mad at myself, that I allowed it to happen . . .

"And not just that," she says. There's a sudden, involuntary intake of breath. "I think that a lot of this baggage I'm carrying around is really stuff that I put in there myself. I stacked the luggage. Either in disappointment in myself or self-blame. Don't get me wrong. Under no circumstances do I think that I deserved it or I asked for it or that I did something to bring that on. I don't feel that way at all . . . It's like you take your base line [which is] fear, and you throw some self-doubt on top of that, and then you throw some desperation on top of that, and, before you know it, you got a seven-layer burrito going there. I mean I can feel every one of them. I don't know how to express it, but I can feel them . . . just one right on top of the other, and maybe I've done that for so long, that when the rape happened, that was maybe the straw that broke the camel's back, and my mind said, 'Okay, that's enough, you're cut off, no more.' There's no more room on the pile."

The Mithoefers murmur sympathetic words as Donna continues unburdening herself.

"It's not just about the rape. It's not just about any one thing. It's so many different things . . . All I can remember feeling, as far as I can remember, is fear. Heart-stopping, gut-dropping fear . . . I've kept all this inside for so long, and it feels so heavy . . . these emotions -- it's like I've been trained to be this way as long as I can remember -- to be seen and not heard. Just from that point on, I've tried to make myself as small and inconspicuous as possible. And then the rape happened, and you're headline news . . . I was ashamed."

The study protocol calls for the therapists to periodically ask the subjects to rate their level of distress on a scale of zero to 10.

"Zero," Donna says quickly. Another pause. "No, that's not entirely true. That's a lie. I would say about a two. It's a disturbing revelation, I guess you could say."

Once again, she pauses.

"I feel calmer, a whole lot calmer," she says. "Kind of putting it all together, rather than just throwing it all in a box."

"OH, MAN, I'M IMPRESSED," SAYS MARK WAGNER, a clinical psychologist on faculty at the Medical University of South Carolina in Charleston, an expert in psychological testing and an independent evaluator conducting the before and after PTSD assessments in Mithoefer's study. "I didn't know much about the clinical use of MDMA before this," Wagner says, "But I've seen each and every one of these patients, and, just as a clinical psychologist, it is impressive to see the degree of treatment response these folks have had. There are a couple of areas in medicine, like hip replacement, where one day you are bedridden, and the next you're out playing tennis. Or with Lasik surgery, you're blind, and then you can see. Nothing in psychology is like that. But this was dramatic."

Lilienfeld, the Emory psychologist, is less enthusiastic. "These subjects knew if they got the drug or the placebo," he says. "Particularly when you have a very dramatic and powerful intervention, people may change but not in a longstanding way."

Wagner points out that two subjects who got the placebo were convinced they had gotten MDMA, and others who did get it weren't sure. The people who wrongly believed they'd gotten the drug initially showed improvement, but quickly relapsed. "The chance that a placebo effect would last for three months is very slight," Wagner says. "And for it to last for a year or more, which anecdotally we believe might be the case here, would be extremely remote."

But if MDMA does work, the question remains, why? "Patients in our study had a fear of the fear," Wagner says. "Something about the MDMA made it possible for them to approach the feared thought, the feared 'place' in their mind -- and when they got there, it wasn't as terrible as they thought. A lot of these people, the light bulb went off, they had the insight, but there's still a lot of work to do. They've had this for years, it's shaped their lives, and now they have to rebuild them."

In Mithoefer's Psychedelic Medicine article, he theorizes that the breakthroughs came from having the psychic calm -- the feeling Donna had of being protected -- that allowed subjects to meaningfully reexperience and reassess the events that traumatized them, and at the same time be able to feel a powerful new connection to positive aspects of their lives. In Donna's case it was the love of her husband and children. Another patient told Mithoefer: "I had never before felt what I felt today in terms of loving connection. I'm not sure I can reach it again without MDMA, but I'm not without hope that it's possible. Maybe it's like having an aerial map, so now I know there's a trail."

For some subjects, the most significant part of the experience seemed to be a physical release of mental anguish. In Mithoefer's article, he says one subject exclaimed: "I can relax! Forty-three years of fear and not being able to feel my body. Now I can feel my body without pain."

Another subject, a 50-year-old woman named Elizabeth, had one of the more dramatic physical releases. "I thought it was supposed to be talk therapy, that I was supposed to talk about things, but it doesn't have to be," she says. "The drug itself will do the work."

Her trauma centered on a stepfather who viciously abused her and her brother from an early age. She describes him as "a truck driver, ignorant, uneducated, Southern, moonshine-drinking, swearing, wife-beating idiot. He thought kids were there for his entertainment, amusement and personal use."

From an early age, Elizabeth was stuck in a grim survival mode. "Doesn't matter what you do to me, you will never touch me," is how she described it. "It was a feeling, all self-defense, all self-protection, nobody gets in."

Her whole life evolved, pathologically, from that premise. Running away as an adolescent from the horrors at home, she was raped, twice, by men who picked her up as she hitchhiked. With no real concept of love and nurture, she got involved in a series of physically and emotionally abusive relationships. When something triggered memories of her abuse, she froze in a nearly catatonic state, caught between fight and flight, unable to do either.

During her MDMA session, Elizabeth says, she remembered that after her mother divorced her stepfather, she'd confided to Elizabeth that he had been the best lover she'd ever had.

As she talked about how that made her feel, Elizabeth recalls, Mithoefer "was pushing me verbally. I was mad, and he was pushing me, provoking me to feel it. I just kept getting madder and madder, hitting the bed. Then the drug just took me and slammed me down. I was sitting one second, then down on my back in the next. I became very rigid, the tension was so powerful. I remember lying on the bed where I slammed down, looking at Dr. Mithoefer . . . like I'm mad at him for putting me through this, and this wave of energy just slammed through me, and it was just a release of a tremendous amount of this negative energy. It was powerful, and it was explosive. I felt like I'd been through something significant . . . My mother traded my childhood for sex!"

In the weeks following the therapy sessions, Elizabeth says, she would be standing in the kitchen, or just sitting in a chair at work, and without warning that powerful release would move through her body. Afterward, she says, "I felt at ease, a level of ease I was not familiar with, just being comfortable within myself, within my body."

That feeling of ease has given her a new relationship with her life, she says. Difficulties continue, but "I'm not having as much problem with the puzzle. I'm able to just keep slugging away. I don't feel so much like going to bed and sucking my thumb."

The problems don't disappear, Mithoefer says, they just become something that can be managed.

"All subjects have told us they found MDMA helpful," Mithoefer says in his article. "Some have felt the effect . . . was dramatic and even lifesaving: however, others have reported disappointment that MDMA was not a "magic bullet" to remove all their symptoms, or have said it would have been helpful to have one or a few additional sessions."

Parrott, the MDMA critic from Britain, worries that in some cases MDMA magnifies negative feelings instead of positive ones, and can bring up difficult memories that may be overwhelming. It's problematic, he says, that the outcome of therapy sessions can be so dependent on the skill of the therapist.

Mithoefer acknowledges that this is an issue and says that's precisely why he believes that, if MDMA is ever prescribed, it should be administered only in licensed clinics by specially trained therapists.

Still a problem, says Parrott. "Those patients who had good experiences on the drug would often want further-on MDMA sessions (just like many novice recreational users)," he writes in an e-mail. "This scenario is very worrying for many obvious reasons: reducing efficacy but increasingly adverse effects following repeated usage; drug seeking elsewhere when it stopped being forthcoming from the clinic etc; regular use leading to a variety of psycho-biological problems."

Wagner, who questioned all of Mithoefer's subjects in detail about their post-therapy attitudes, thinks Parrott is way off mark. "I didn't see a single individual who thought: 'Oh, yeah, this is great fun. I'm going to try to go out and use this for recreational use.' All of them took this very seriously and therapeutically. They saw it as hard, but important, work."

Amy, a woman in her 40s, is a case in point. She remembers being psychologically and physically abused by her father "from birth," culminating one winter when he locked her in the basement for three weeks. She had a reaction to MDMA very different from Donna's instant giggles. When the drug started to take effect, she says, "It just hit me, and it wasn't pleasant. I felt like I was going to throw up. So I said, Okay, when's this happy, lovey feeling going to happen? I went to lie down on the couch and waited to go higher, but the drug took me down instead. [Mithoefer] was taking notes. I felt like he was drawing circles around me, but he showed me his notes, and they were just notes. That's when I saw that my internal world and external world didn't match up, and I connected with that. I saw myself as a baby wrapped in a white blanket, my family members standing there, and I realized, It wasn't my fault . . . I was flooded with feelings of peace and safety. 'It wasn't my fault. I didn't do anything,' I kept saying. 'I was a little girl. I was a baby.'

"After the first session, I felt exhausted, like I had a really bad hangover. But everything continued to unfold. I started to make connections. Like going into the grocery store, I used to feel very alienated. I couldn't connect with the other shoppers. But after the first session, I realized I could look at the people, and I wasn't afraid, like they were going to hurt me. I made the connection between the way I was always sizing up my environment, the alienation and the numbness that I felt, and the abuse.

"It felt weird at first, but kind of nice, that I could look at someone, and they would look back, and we'd smile at each other."

But like several other of the test subjects, Amy also confronted difficult new terrain. "Sometimes to go forward you have to go backwards," she says. "I knew that, but it wasn't comfortable to go there, back into the basement, into the abuse, into the beatings. I was apprehensive. I had already started feeling more grounded, but I'd functioned so long on autopilot that feeling things was difficult."

Difficult, but also better. "So many things happened," she says. "Before, I never wore a seat belt. I would look at it but not wear it. It was self-sabotage. But after therapy, without even thinking about it, I just automatically started putting it on."

FOR A YEAR AFTER HER TWO MDMA SESSIONS, Donna Kilgore says now, she was symptom-free.

"To me, the biggest breakthrough -- it meant the world to me to be able to look at the fear, to look at the shame. I didn't know I was ashamed. It was like I'd been wearing the scarlet letter. It was so heavy. When I got out of that session, I felt a hundred pounds lighter.

"Before, I knew the path was through the battlefield, but I just could not get through it. [But during the MDMA therapy] I knew I could walk through it, and I wasn't afraid. The drug gave me the ability not to fear fear." Otherwise, she says, "I would have not been able to do it."

Donna's sense that she'd had a breakthrough was supported when she retook the evaluation test on which she'd rated as an extreme case just weeks earlier. Her score had declined dramatically -- Mithoefer says that he can't give an exact number before publication of results -- but if she had been taking the test for the first time, she would not have been considered to have PTSD at all.

It's now been more than three years since her MDMA sessions. Donna is "still extremely grateful for the experience," she says. But problems are starting to crop up again.

"I've had a lot of stressors recently," she says. Her husband got laid off from a good job; they had to move; she had a difficult job at a dental practice for children.

Donna was doing paperwork in the office. "It wasn't in the best part of town," she says, "and I started to have catastrophic thinking again." It was the resurgence of the paralyzing, unreasonable fears characteristic of PTSD that she'd had before the MDMA sessions. "I just started being convinced that someone was going to come in with a gun and start shooting. And then I just couldn't listen to the children screaming in the next room . . ."

She says she had to quit the job. She begins to cry.

"I know I can work through it," she says, her voice breaking a little. "I know what I'm fighting now, and I can fight it."

Does she think it would help if she could have another MDMA therapy session?

"Yes," she says quickly. "But I can't. It's illegal."

http://www.rollingstone.com/news/story/17438347/how_america_lost_the_war_on_drugs

After Thirty-Five Years and $500 Billion, Drugs Are as Cheap and Plentiful as Ever: An Anatomy of a Failure.

Ben Wallace-Wells Posted Nov 27, 2007 12:56 PM

1. AFTER PABLO

On the day of his death, December 2nd, 1993, the Colombian billionaire drug kingpin Pablo Escobar was on the run and living in a small, tiled-roof house in a middle-class neighborhood of Medellín, close to the soccer stadium. He died, theatrically, ­ridiculously, gunned down by a Colombian police manhunt squad while he tried to flee across the barrio's rooftops, a fat, bearded man who had kicked off his flip-flops to try to outrun the bullets. The first thing the American drug agents who arrived on the scene wanted to do was to make sure that the corpse was actually Escobar's. The second thing was to check his house.

The last time Escobar had hastily fled one of his residences - la Catedral, the luxurious private prison he built for himself to avoid extradition to the United States - he had left behind bizarre, enchanting ­detritus, the raw stuff of what would ­become his own myth: the photos of ­himself dressed up as a Capone-era gangster with a Tommy gun, the odd collection of novels ranging from Graham Greene to the Austrian modernist Stefan Zweig. Agents from the Drug Enforcement Administration, arriving after the kingpin had fled, found neat shelves lined with loose-leaf binders, carefully organized by content. They were, says John Coleman, then the DEA's assistant administrator for operations, "filled with DEA reports" - internal documents that laid out, in extraordinary detail, the agency's repeated attempts to capture Escobar.

"He had shelves and shelves and shelves of these things," Coleman tells me. "It was stunning. A lot of the informants we had, he'd figured out who they were. All the agents we had chasing him - who we trusted in the Colombian police - it was right there. He knew so much more about what we were doing than we knew about what he was doing."

Coleman and other agents began to work deductively, backward. "We had always wondered why his guys, when we caught them, would always go to trial and risk lots of jail time, even when they would have saved themselves a lot of time if they'd just plead guilty," he says. "What we realized when we saw those binders was that they were doing a job. Their job was to stay on trial and have their lawyers use discovery to get all the information on DEA operations they could. Then they'd send copies back to Medellín, and Escobar would put it all together and figure out who we had tracking him."

The loose-leaf binders crammed in Escobar's office on the ground floor gave Coleman and his agents a sense of triumph: The whole mysterious drug trade had an organization, a structure and a brain, and they'd just removed it. In the thrill of the moment, clinking champagne glasses with officials from the Colombian police and taking congratulatory calls from Washington, the agents in Medellín believed the War on Drugs could finally be won. "We had an endgame," Coleman says. "We were literally making the greatest plans."

At the headquarters of the Office of National Drug Control Policy in Washington, staffers tacked up a poster with photographs of sixteen of its most wanted men, cartel leaders from across the Andes. Solemnly, ceremoniously, a staffer took a red magic marker and drew an X over Escobar's portrait. "We felt like it was one down, fifteen to go," recalls John Carnevale, the longtime budget director of the drug-control ­office. "There was this feeling that if we got all sixteen, it's not like the whole thing would be over, but that was a big part of how we would go about winning the War on Drugs."

Man by man, sixteen red X's eventually went up over the faces of the cartel leaders: KILLED. EXTRADITED. KILLED. José Santacruz Londoño, a leading drug trafficker, was gunned down by Colombian police in a shootout. The Rodríguez Orejuela brothers, the heads of the Cali cartel, were extradited after they got greedy and tried to keep running their organization from prison. Some U.S. drug warriors believed that the busts were largely public-relations events, a showy way for the Colombian government to look tough on the drug trade, but most were less cynical. The crack epidemic was over. Drug-related murders were in decline. Winning the War on Drugs didn't seem such a quixotic and open-ended mission, like the War on Poverty, but rather something tangible, a fat guy with a big organization and binders full of internal DEA reports, sixteen faces on a poster, a piñata you could reach out and smack. Richard Cañas, a veteran DEA official who headed counternarcotics efforts on the National Security Council under both George H.W. Bush and Bill Clinton, can still recall the euphoria of those days. "We were moving," he says, "from success to success."

This is the story of how that momentary success turned into one of the most sustained and costly defeats the United States has ever suffered. It is the story of how the most powerful country on Earth, sensing a piñata, swung to hit it and missed.

2. THE MAKING OF A TRAGEDY

For Cañas and other drug warriors, the death of Escobar had the feel of a real pivot, the end of one kind of battle against drugs and the beginning of another. The war itself had begun during the Nixon administration, when the White House began to get reports that a generation of soldiers was about to come back from Vietnam stoned, with habits weaned on the cheap marijuana and heroin of Southeast Asia and hothoused in the twitchy-fingered freakout of a jungle guerrilla war. For those in Washington, the problem of drugs was still so strange and new in the early Seventies that Nixon officials grappled with ideas that, by the standards of the later debate among politicians, were unthinkably radical: They appointed a panel that recommended the decriminalization of casual marijuana use and even considered buying up the world's entire supply of opium to prevent it from being converted into heroin. But Nixon was a law-and-order politician, an operator who understood very well the panic many Americans felt about the cities, the hippies and crime. Calling narcotics "public enemy number one in the United States," he used the issue to escalate the culture war that pitted Middle Americans against the radicals and the hippies, strengthening penalties for drug dealers and devoting federal funds to bolster prosecutions. In 1973, Nixon gave the job of policing these get-tough laws to the newly formed Drug Enforcement Administration.

By the mid-1980s, as crack leeched out from New York, Miami and Los Angeles into the American interior, the devastations inflicted by the drug were becoming more vivid and frightening. The Reagan White House seemed to capture the current of the moment: Nancy Reagan's plaintive urging to "just say no," and her husband's decision to hand police and prosecutors even greater powers to lock up street dealers, and to devote more resources to stop cocaine's production at the source, in the Andes. In 1986, trying to cope with crack's corrosive effects, Congress adopted mandatory-minimum laws, which hit inner-city crack users with penalties as severe as those levied on Wall Street brokers possessing 100 times more powder cocaine. Over the next two decades, hundreds of thousands of Americans would be locked up for drug offenses.

The War on Drugs became an actual war during the first Bush administration, when the bombastic conservative intellectual Bill Bennett was appointed drug czar. "Two words sum up my entire approach," Bennett declared, "consequences and confrontation." Bush and Bennett doubled annual spending on the drug war to $12 billion, devoting much of the money to expensive weaponry: fighter jets to take on the Colombian trafficking cartels, Navy submarines to chase cocaine-smuggling boats in the Caribbean. If narcotics were the enemy, America would vanquish its foe with torpedoes and F-16s - and throw an entire generation of drug users in jail.

Though many on the left suspected that things had gone seriously awry, drug policy under Reagan and Bush was largely conducted in a fog of ignorance. The kinds of long-term studies that policy-makers needed - those that would show what measures would actually reduce drug use and dampen its consequences - did not yet exist. When it came to research, there was "absolutely nothing" that examined "how each program was or wasn't working," says Peter Reuter, a drug scholar who founded the Drug Policy Research Center at the RAND Corp.

But after Escobar was killed in 1993 - and after U.S. drug agents began systematically busting up the Colombian cartels - doubt was replaced with hard data. Thanks to new research, U.S. policy-makers knew with increasing certainty what would work and what wouldn't. The tragedy of the War on Drugs is that this knowledge hasn't been heeded. We continue to treat marijuana as a major threat to public health, even though we know it isn't. We continue to lock up generations of teenage drug dealers, even though we know imprisonment does little to reduce the amount of drugs sold on the street. And we continue to spend billions to fight drugs abroad, even though we know that military efforts are an ineffective way to cut the supply of narcotics in America or raise the price.

All told, the United States has spent an estimated $500 billion to fight drugs - with very little to show for it. Cocaine is now as cheap as it was when Escobar died and more heavily used. Methamphetamine, barely a presence in 1993, is now used by 1.5 million Americans and may be more addictive than crack. We have nearly 500,000 people behind bars for drug crimes - a twelvefold increase since 1980 - with no discernible effect on the drug traffic. Virtually the only success the government can claim is the decline in the number of Americans who smoke marijuana - and even on that count, it is not clear that federal prevention programs are responsible. In the course of fighting this war, we have allowed our military to become pawns in a civil war in Colombia and our drug agents to be used by the cartels for their own ends. Those we are paying to wage the drug war have been accused of ­human-rights abuses in Peru, Bolivia and Colombia. In Mexico, we are now ­repeating many of the same mistakes we have made in the Andes.

"What we learned was that in drug work, nothing ever stands still," says Coleman, the former DEA official and current president of Drug Watch International, a law-and-order advocacy group. For every move the drug warriors made, the traffickers adapted. "The other guys were learning just as we were learning," Coleman says. "We had this hubris."

 
3. BRAINIACS AND COLD WARRIORS

"At the beginning of the Clinton administration," Cañas tells me, "the War on Drugs was like the War on Terror is now." It was, he means, an orienting fight, the next in a sequence of abstract, generational struggles that the country launched itself into after finding no one willing to actually square up and face it on a battlefield. After the Cold War, in the flush and optimism of victory, it felt to drug warriors and the American public that abstractions could be beaten. "It was really a pivot point," recalls Rand Beers, who served on the National Security Council for four different presidents. "We started to look carefully at our drug policies and ask if everything we were doing really made sense." The man Clinton appointed to manage this new era was Lee Brown.

Brown had been a cop for almost thirty years when Clinton tapped him to be the nation's drug czar in 1993. He had started out working narcotics in San Jose, California, just as the Sixties began to swell, and ended up leading the New York Police Department when the city was the symbolic center of the crack epidemic, with kids being killed by stray bullets that barreled through locked doors. A big, shy man in his fifties, Brown had made his reputation with a simple insight: Cops can't do much without the trust of people in their communities, who are needed to turn in offenders and serve as witnesses at trial. Being a good cop meant understanding the everyday act of police work not as chasing crooks but as meeting people and making allies.

"When I worked as an undercover narcotics officer, I was living the life of an addict so I could make buys and make busts of the dealers," Brown tells me. "When you're in that position, you see very quickly that you can't arrest your way out of this. You see the cycle over and over again of people using drugs, getting into trouble, going to prison, getting out and getting into drugs again. At some point I stepped back and asked myself, 'What impact is all of this having on the drug problem? There has to be a better way.' "

In the aftermath of the Rodney King beating, this philosophy - known as community policing - had made Brown a national phenomenon. The Clinton administration asked him to take the drug-czar post, and though Brown was skeptical, he agreed on the condition that the White House make it a Cabinet-level position. Brown stacked his small office with liberals who had spent the long Democratic exile doing drug-policy work for Congress and swearing they would improve things when they retook power. "There were basic assumptions that Republicans had been making for fifteen years that had never been challenged," says Carol Bergman, a congressional staffer who became Brown's legislative liaison. "The way Lee Brown looked at it, the drug war was focused on locking kids up for increasing amounts of time, and there wasn't enough emphasis on treatment. He really wanted to take a different tactic."

Brown's staff became intrigued by a new study on drug policy from the RAND Corp., the Strangelove-esque think tank that during the Cold War had employed mathematicians to crank out analyses for the Pentagon. Like Lockheed Martin, the jet manufacturer that had turned to managing welfare reform after the Cold War ended, RAND was scouting for other government projects that might need its brains. It found the drug war. The think tank assigned Susan Everingham, a young expert in mathematical modeling, to help run the group's signature project: dividing up the federal government's annual drug budget of $13 billion into its component parts and deciding what worked and what didn't when it came to fighting cocaine.

Everingham and her team sorted the drug war into two categories. There were supply-side programs, like the radar and ships in the Caribbean and the efforts to arrest traffickers in Colombia and Mexico, which were designed to make it more expensive for traffickers to bring their product to market. There were also demand-side programs, like drug treatment, which were designed to reduce the market for drugs in the United States. To evaluate the cost-effectiveness of each approach, the mathematicians set up a series of formulas to calculate precisely how much additional money would have to be spent on supply programs and demand programs to reduce cocaine consumption by one percent nationwide.

"If you had asked me at the outset," Everingham says, "my guess would have been that the best use of taxpayer money was in the source countries in South America" - that it would be possible to stop cocaine before it reached the U.S. But what the study found surprised her. Overseas military efforts were the least effective way to decrease drug use, and imprisoning addicts was prohibitively expensive. The only cost-effective way to put a dent in the market, it turned out, was drug treatment. "It's not a magic bullet," says Reuter, the RAND scholar who helped supervise the study, "but it works." The study ultimately ushered RAND, this vaguely creepy Cold War relic, into a position as the permanent, pragmatic left wing of American drug policy, the most consistent force for innovating and reinventing our national conception of the War on Drugs.

When Everingham's team looked more closely at drug treatment, they found that thirteen percent of hardcore cocaine users who receive help substantially reduced their use or kicked the habit completely. They also found that a larger and larger portion of illegal drugs in the U.S. were being used by a comparatively small group of hardcore addicts. There was, the study concluded, a fundamental imbalance: The crack epidemic was basically a domestic problem, but we had been fighting it more aggressively overseas. "What we began to realize," says Jonathan Caulkins, a professor at Carnegie Mellon University who studied drug policy for RAND, "was that even if you only get a percentage of this small group of heavy drug users to abstain forever, it's still a really great deal."

Thirteen years later, the study remains the gold standard on drug policy. "It's still the consensus recommendation supplied by the scholarship," says Reuter. "Yet as well as it's stood up, it's never really been tried."

To Brown, RAND's conclusions seemed exactly right. "I saw how little we were doing to help addicts, and I thought, 'This is crazy,' " he recalls. " 'This is how we should be breaking the cycle of addiction and crime, and we're just doing nothing.' "

The federal budget that Brown's office submitted in 1994 remains a kind of fetish object for certain liberals in the field, the moment when their own ideas came close to making it into law. The budget sought to cut overseas interdiction, beef up community policing, funnel low-level drug criminals into treatment programs instead of prison, and devote $355 million to treating hardcore addicts, the drug users responsible for much of the illegal-drug market and most of the crime associated with it. White House political handlers, wary of appearing soft on crime, were skeptical of even this limited commitment, but Brown persuaded the president to offer his support, and the plan stayed.

Still, the politics of the issue were difficult. Convincing Congress to dramatically alter the direction of America's drug war required a brilliant sales job. "And Lee Brown," says Bergman, his former legislative liaison, "was not an effective salesman." With a kind of loving earnestness, the drug czar arranged tours of treatment centers for congressmen to show them the kinds of programs whose funding his bill would increase. Few legislators came. Most politicians were skeptical about such a radical departure from the mainstream consensus on crime. Congress rewrote the budget, slashing the $355 million for treatment programs by more than eighty percent. "There were too many of us who had a strong law-and-order focus," says Sen. Chuck Grassley, a Republican who ­opposed the reform bill and serves as co-chair of the Senate's drug-policy caucus.

For some veteran drug warriors, Brown's tenure as drug czar still lingers as the last moment when federal drug policy really made sense. "Lee Brown came the closest of anyone to really getting it," says Carnevale, the longtime budget director of the drug-control office. "But the bottom line was, the drug issue and Lee Brown were largely ignored by the Clinton administration." When Brown tried to repeat his treatment-centered initiative in 1995, it was poorly timed: Newt Gingrich and the Republicans had seized control of the House after portraying Clinton as soft on crime. The authority to oversee the War on Drugs passed from Rep. John Conyers, the Detroit liberal, to a retired wrestling coach from Illinois who was tired of drugs in the schools ? a rising Republican star named Dennis Hastert. Reeling from the defeat at the polls, Clinton decided to give up on drug reform and get tough on crime. "The feeling was that the drug czar's office was one of the weak areas when it came to the administration's efforts to confront crime," recalls Leon Panetta, then Clinton's chief of staff.

4. THE YOUNG GUNS

The administration was not doing much better in its efforts to stop the flow of drugs at the source. Before Clinton had even taken office, Cañas - who headed drug policy at the National Security Council - had been summoned to brief the new president's choice for national security adviser, Anthony Lake, on the nation's narcotics policy in Latin America. "I figured, what the hell, I'm going back to DEA anyway, I'll tell him what I really think," Cañas recalls.

The Bush administration, he told Lake, had been sending the military after the wrong target. In the 1970s, drugs were run up to the United States through the Caribbean by a bunch of "swashbuckling entrepreneurs" with small planes - "guys who wouldn't have looked out of place at a Jimmy Buffett concert." In 1989, in the nationwide panic over crack, Defense Secretary Dick Cheney had managed to secure a budget of $450 million to chase these Caribbean smugglers. (Years later, when a longtime drug official asked Defense Secretary Donald Rumsfeld why Cheney had pushed the program, Rumsfeld grinned and said, "Cheney thought he was running for president.") The U.S. military loved the new mission, because it gave them a reason to ask for more equipment in the wake of the Cold War. And the Bush White House loved the idea of sending the military after the drug traffickers for its symbolism and swagger and the way it proved that the administration was taking drugs seriously.

The problem, Cañas told Lake, was that the cocaine traffic had professionalized and was now moving its product through Mexico. With Caribbean smugglers out of the game, the military program no longer made sense. The new national security adviser grinned at Cañas, pleased. "That's what we think as well," Lake said. "How would you like to stay on and help make that happen?"

Taking a new approach, the Clinton administration shifted most military assets out of the Caribbean and into the Andes, where the coca leaf was being grown and processed. "Our idea was, Stop messing around in the transit countries and go to the source," Cañas tells me. The administration spent millions of extra dollars to equip police in Bolivia and Colombia to bust the crop's growers and processors. The cops were not polite - Human Rights Watch condemned the murders of?Bolivian farmers, blaming "the heavy hand of U.S. drug enforcement" - but they were ­effective, and by 1996, coca production in Bolivia had begun a dramatic decline.

After Escobar fell, the American drug agents who had been chasing him did not expect the cocaine industry to dry up overnight - they had girded for the fallout from the drug lord's death. What they had not expected was the ways in which the unintended consequences of his downfall would permanently change the drug traffic. "What ended up happening - and maybe we should have predicted this would happen - was that the whole structure shattered into these smaller groups," says Coleman, the veteran DEA agent. "You suddenly had all these new guys controlling a small aspect of the traffic."

Among them was a hired gun known as Don Berna, who had served as a bodyguard for Escobar. Double-crossed by his boss, Berna broke with the Medellín cartel and struck out on his own. For him, the disruption caused by the new front in America's drug war presented a business opportunity. But with the DEA's shift from the Caribbean into Bolivia and Colombia, Berna and other new traffickers had a production problem. So some of the "microcartels," as they became known, decided to move their operations someplace where they could control it: They opened negotiations with the FARC, a down-at-the-heels rebel army based in the jungles of Colombia. In return for cash, the FARC agreed to put coca production under its protection and keep the Colombian army away from the coca crop.

Berna and the younger kingpins also had a transportation problem: Mexican traffickers, who had been paid a set fee by the cartels to smuggle product across the U.S. border, wanted a larger piece of the business. The Mexican upstarts had a certain economic logic on their side. A kilo of cocaine produced in Colombia is worth about $2,500. In Mexico, a kilo gets $5,000. But smuggle that kilo across the border and the price goes up to $17,500. "What the Mexican groups started saying was, 'Why are we working for these guys? Why don't we just buy it from the Colombians directly and keep the profits ourselves?' " says Tony Ayala, a retired DEA agent and former Mexico country attache.

The remaining leaders of the weakened Cali cartel, DEA agents say, traveled up to Guadalajara for a series of meetings with Mexican traffickers. By 1996, the Colombians had decided to hand over more control of the cocaine trade to the Mexicans. The Cali cartel would now ship cocaine to Guadalajara, sell the drugs to the Mexican groups and then be done with it. "This wasn't just happenstance," says Jerome McArdle, then a DEA assistant agent for special operations. "This was the Colombians saying they were willing to reduce their profits in exchange for reducing their risk and exposure, and handing it over to the Mexicans. The whole nature of the supply chain changed."

Around the same time, DEA agents found themselves picking up Mexican distributors, rather than Colombians, on the streets of New York. Immigration and customs officials on the border were meanwhile overwhelmed by the sheer number of tractor-trailers - many of them loaded with drugs - suddenly pouring across the Mexican border as a consequence of NAFTA, which had been enacted in 1994. "A thousand trucks coming across in a four-hour ­period," says Steve Robertson, a DEA special agent assigned to southern ­Texas at the time. "There's no way we're going to catch everything."

Power followed the money, and Mexican traffickers soon had a style, and reach, that had previously belonged only to the Colombians. In the border town of Ciudad Juárez, the cocaine trafficker Amado Carrillo Fuentes developed a new kind of smuggling operation. "He brought in middle-class people for the first time - lawyers, accountants - and he developed a transportation division, an acquisitions division, even a human-resources operation, just like a modern corporation," says Tony Payan, a political scientist at the University of Texas-El Paso who has studied the drug trade on the border. Before long, Carrillo Fuentes had a fleet of Boeing 727s, which he used to fly cocaine, up to fifteen tons at a time, up from Colombia to Mexico. The newspapers called him El Señor de los Cielos, the Lord of the Skies.

The Mexican cartels were also getting more imaginative. "Think of it like a business, which is how these guys thought of it," says Guy Hargreaves, a top DEA agent during the 1990s. "Why pay for the widgets when you can make the widgets yourselves?" Since the climate and geography of Mexico aren't right for making cocaine, the cartels did the logical thing: They introduced a new product. As Hargreaves recalls, the Mexicans slipped the new drug into their cocaine shipments in Southern California and told coke dealers, "Here, try some of this stuff - it's a similar effect."

The product the Mexican cartels came up with, the new widget they could make themselves, was methamphetamine. The man who mastered the market was a midlevel cocaine trafficker, then in his late twenties, named Jesús Amezcua. In 1994, when U.S. Customs officials at the Dallas airport seized an airplane filled with barrels of ephedrine, a chemical precursor for meth, and traced it back to Amezcua, the startling new shift in the drug traffic became clear to a handful of insiders. "Cartels were no longer production organizations, whose business is wrapped up in a single drug," says Tony Ayala, the senior DEA agent in Mexico at the time. "They became trafficking organizations - and they will smuggle whatever they can make the most profit from."

5. THE LOBBYISTS & THE MAD PROFESSOR

It is only in retrospect that these moments - the barrels of ephedrine seized in Dallas, the quiet suggestion that meth had worked its way into the cocaine supply chain - take on a looming character, the historic weight of a change made manifest. Up until methamphetamine, the War on Drugs had targeted three enemies. First there were the hippie drugs - marijuana, LSD - that posed little threat to the general public. Then there was heroin, a horrible drug but one that was largely concentrated in New York City. And, finally, there was crack. What meth proved was that even if the DEA could wipe out every last millionaire cocaine goon in Colombia, burn every coca field in Bolivia and Peru, and build an impenetrable wall along the entire length of the Mexican border - even then, we wouldn't have won the War on Drugs, because there would still be methamphetamine, and after that, something else.

Gene Haislip, who served for years as one of the DEA's top-ranking administrators, believes there was a moment when meth could have been shut down, long before it spiraled into a nationwide epidemic. Haislip, who spent nearly two decades leading a small group at the agency dedicated to chemical control, is his own kind of legend; he is still known around the DEA as the man who beat quaaludes, perhaps the only drug that the U.S. has ever been able to declare total victory over. He did it with gumshoe methodicalness: by identifying every country in the world that produced the drug's active ingredient, a prescription medication called methaqualone, and convincing them to tighten regulations. Haislip believes he was present the moment when the United States lost the war on methamphetamine, way back in 1986, when meth was still a crude biker drug confined to a few valleys in Northern California - a decade before the Mexican drug lords turned it into the most problematic drug in America. "The thing is, methamphetamine should never have gotten to that point," Haislip says. And it never would have, he believes, if it hadn't been for the lobbyists.

Haislip was known around the DEA as precise-minded and verbal. His impulse, in combatting meth, was the same one that had pushed the drug warriors after Escobar: the quixotic faith that if you could just stop the stuff at the source, you could get rid of all the social problems at once. Assembling a coalition of legislators, Haislip convinced them that the small, growing population of speed freaks in Northern California was enough of a concern that Congress should pass a law to regulate the drug's precursor chemicals, ephedrine and pseudoephedrine, legal drugs that were used in cold medicine and produced in fewer than a dozen factories in the world. "We were starting to get reports of hijacking of ephedrine, armed robbery of ephedrine, things that had never happened before," Haislip tells me. "You could see we were on the verge of something if we didn't get a handle on it."

All that was left was to convince the Reagan administration. One day in late 1986, Haislip went to meet with top officials in the Indian Treaty Room, a vast, imposing space in the Eisenhower Executive Office Building: arches, tiled floors, the kind of room designed to house history being made. Haislip noticed several men in suits sitting quietly in the back of the room. They were lobbyists from the pharmaceutical industry, but Haislip didn't pay them much attention. "I wasn't concerned with them," he recalls.

When Haislip launched into his presentation, an official from the Commerce Department cut him off. "Look, you're way ahead of us," the official said. "We don't have anything to suggest or add." Haislip left the meeting thinking he had won: The bill he proposed was submitted to Congress, requiring companies to keep records on the import and sale of ephedrine and pseudoephedrine.

But what Haislip didn't know was that the men in suits had already gone to work to rig the bill in their favor. "Quite frankly," Allan Rexinger, one of the lobbyists present at the meeting later told reporters, "we appealed to a higher authority." The pharmaceutical industry needed pseudoephedrine to make profitable cold medications. The result, to Haislip's dismay, was a new law that monitored sales of ephedrine and pseudoephedrine in bulk powder but created an exemption for selling the chemicals in tablet form - a loophole that protected the pharmaceutical industry's profits.

The law, drug agents say, sparked two changes in the market for illegal meth. First, the supply of ephedrine simply moved overseas: The Mexican cartels, quick to recognize an emerging market, evaded the restrictions by importing powder from China, India and Europe and then smuggling it across the border to the biker groups that had traditionally distributed the drug. "We actually had meetings where we planned for a turf war between the Mexicans and the Hells Angels over methamphetamine," says retired DEA agent Mike Heald, who headed the San Francisco meth task force, "but it turned out they realized they'd make more money by working together." Second, responding to a dramatic uptick in demand from the illegal market, chemical-supply companies began moving huge amounts of ephedrine and pseudoephedrine out to the West Coast in the form of pills, which were then converted into meth. Rather than stemming the tide of meth before it started, the Reagan administration had unwittingly helped accelerate a new epidemic: Between 1992 and 1994, the number of meth addicts entering rehab facilities doubled, and the drug's purity on the street rose by twenty-seven percent.

Haislip resolved to have another go at Congress, but the issue ended up in a dispiriting cycle. The resistance, he says bitterly, "was always coming from the same lobbying group." In 1993, when he persuaded lawmakers to regulate the sale of ephedrine in tablet form, the pharmaceutical industry won an exception for pseudoephedrine. Drug agents began to intercept shipments of pseudoephedrine pills in barrels. Three years later, when lawmakers finally regulated tablets of pseudoephedrine, they created an exception for pills sold in blister packs. "Congress thought there was no way that meth freaks would buy this stuff and pop the pills out of blister packs, one by one," says Heald. "But we're not dealing with normal people - we're dealing with meth freaks. They'll stay up all night picking their toes."

By the time Haislip retired, in 1997, the methamphetamine problem was really two problems. There were the mom-and-pop cooks, who were punching pills out of blister packs and making small batches of drugs for themselves. Then there were the industrial-scale Mexican cartels, which were responsible for eighty percent of the meth in the United States. It took until 2005 for Congress to finally regulate over-the-counter blister packs, which caused the number of labs to plummet. But once again, the Mexican groups were a step ahead of the law. In October 2006, police in Guadalajara arrested an American chemist named Frederick Wells, who had moved to Mexico after losing his job at Idaho State University. An academic troublemaker who drove around campus with signs on the back of his pickup truck raging at the college administration, Wells had allegedly used his university lab to investigate new ways that Mexican traffickers could use completely legal reagents to engineer meth precursors from scratch. "Very complicated numerical modeling," says his academic colleague Jeff Rosentreter. By the time Wells was arrested, the State Department had only just succeeded at pressuring Mexico to restrict the flow of pseudoephedrine, even though Wells had apparently been hard at work for years creating alternatives to that chemical. The lobbying by the pharmaceutical industry, Haislip says, "cost us eight or nine years."

For some in the drug war, it was a lesson that even the most promising efforts to restrict the supply of drugs at the source - those that rely on legal methods to regulate legally produced drugs - remained nearly impossible, outflanked by both drug traffickers and industry lobbyists. The tragedy of the fight against methamphetamine is that it repeated the ways in which the government tried to fight the cocaine problem, and failed - racing from source to source, trying to eliminate a coca field or an ephedrine manufacturer and then racing to the next one. "We used to call it the Pillsbury Doughboy - stick your finger in one part of the problem, and the Doughboy's stomach just pops out somewhere else," says Rand Beers. "The lesson of U.S. drug policy is that this world runs on unintended consequences. No matter how noble your intentions, there's a good chance that in solving one problem, you'll screw something else up."

6. THE GENERAL & THE ADMAN

Within the Clinton White House, the reform effort spearheaded by Lee Brown had created a political dilemma. Republicans, having taken control of Congress in 1994, were attacking the administration for being soft on drugs, and the White House decided that it was time to look tougher. "A lot of people didn't think Brown was a strong leader," Panetta tells me. As senior figures within the administration cast about for a replacement, they started by thinking about who would be the opposite of Brown. "We wanted to get someone who was much stronger, much tougher, and could come across that way symbolically," Panetta says.

During the planning for a possible invasion of Haiti, Panetta and others had discovered a rising star at the Pentagon, a charismatic, bullying four-star general named Barry McCaffrey, who had annoyed many in the Pentagon's establishment. In 1996, halfway into his State of the Union address, Clinton looked up at McCaffrey, a lean, stern-seeming military man in the balcony, and informed the nation that the general would be his next drug czar. "To succeed, he needs a force far larger than he has ever commanded before," Clinton said. "He needs all of us. Every one of us has a role to play on this team." McCaffrey, the bars on his epaulets shimmering, saluted. It was one of the president's biggest applause lines of the night.

For the drug warriors in McCaffrey's office, "the General" was everything the languid, considered, academic Lee Brown had not been. "It was clear from the outset that here was a guy who would take advantage of the bully pulpit and who, unlike Brown, would probably be able to get things done," says Bergman, Brown's former liaison. "One thing that surprised us all was how thoughtful he was - he wasn't a knee-jerk, law-enforcement guy. He understood there needed to be money for treatment. He prided himself on being very sensitive to the racial issues, and he was sensitive to the impact of sentencing laws on African-American men." McCaffrey imported his own staff from the Southern Command - mostly men, all military. They lent the White House's drug operation - previously a slow place - the kinetic energy of a forward operating base. "We went to a twenty-four-hour clock, so we'd schedule meetings for 1500," one longtime staffer recalls. "His people sat down with senior staff and told us what size paper the General wanted his memos on, this kind of report would have green tabs, this would have blue tabs."

The General's genius was for publicity. "He was great at getting visibility," Carnevale says. McCaffrey held grandstanding events everywhere from Mexico to Maine, telling reporters that the decades-long narrative of impending doom around the drug war was out of date - and that if Congress would really dedicate itself to the mission, the country had a winnable fight on its hands. Drug-use numbers were edging downward; even cocaine seemed to be declining in popularity. "We are in an optimistic situation," McCaffrey declared.

For the first time ever, McCaffrey had the drug czar's office develop a strategy for an endgame to the drug war, a plan for finishing the whole thing. The federal government needed to reduce the amount of money it was spending on law enforcement and interdiction. But McCaffrey believed this was only possible once it could guarantee that drug use would continue to decline. "The data suggested very strongly that those who never tried any drugs before they were eighteen were very likely to remain abstinent for their whole lives, but that those who even smoked marijuana when they were teenagers had much worse outcomes," says McCaffrey's deputy Don Vereen. So the General decided to focus the government's attention on keeping kids from trying pot.

The "gateway theory," as it became known, had a natural appeal. Because most people who used hard drugs had also smoked marijuana, and because kids often tried marijuana several years before they started trying harder drugs, it seemed that keeping them off pot might prevent them from ever getting to cocaine and heroin. The only trouble is, the theory is wrong. When McCaffrey's office commissioned the Institute of Medicine to study the idea, researchers concluded that marijuana "does not appear to be a gateway drug." RAND, after examining a decade of data, also found that the gateway theory is "not the best explanation" of the link between marijuana use and hard drugs. But McCaffrey continued to devote more and more of the government's resources to going after kids. "We have already clearly committed ourselves," he declared, "to a number-one focus on youth."

"That decision," Bergman says, "was where you could see McCaffrey begin to lose credibility."

In 1996, less than a year into his term, the new drug czar met Jim Burke, a smooth-talking, silver-haired executive who chaired the Partnership for a Drug-Free America - the advertising organization best known for the slogan "This is your brain on drugs." "Burke personally was very hard to resist," one of his former colleagues tells me. "I've seen him sell many conservative members of Congress and also liberals like Mario Cuomo."

Burke told McCaffrey a simple story. In the late 1980s, he said, the major television networks had voluntarily given airtime to the Partnership to run anti-drug ads aimed at teenagers. The number of teenagers who used drugs - especially marijuana - declined during that period. But in the early 1990s, Burke said, the rise of cable TV cut into the profits of the networks, which became stingier with the time they dedicated to anti-drug advertising. The result, the adman told the General, was that the number of teenagers who used drugs was climbing sharply - to the outrage of Dennis Hastert and other conservative members of Congress. As a clincher, Burke handed McCaffrey a graph that showed the declining amount of airtime dedicated to anti-drug advertising on one axis and the declining perception among teenagers of the risks associated with drugs on the other. "I'm ninety-nine percent sure," one staffer at the Partnership tells me, "that it was that conversation that sold McCaffrey."

The General mobilized his office, lobbying Congress to allocate enough money to put anti-drug advertising on the air whenever teenagers watched television. His staff was skeptical. For all of McCaffrey's conviction and charisma, he didn't have much in the way of facts. "That was all we had - no data, just this one chart - and we had to go and sell Congress," Carnevale recalls. But Congress proved to be a pushover. Conservatives, who held a majority, were thrilled that soft-on-pot liberals in the Clinton administration finally wanted to do something about the drug problem. "At some point, you have to draw a line and say that some things are right and some things are wrong," says Sen. Grassley, explaining his support of the measure. "And using any drugs is just flat-out wrong." To the Partnership's delight, Congress allocated $1 billion to buy network time for anti-drug spots aimed at teenagers.

The General was also starting to make friends beyond the Clinton administration. The drug czar had found a natural ally in Hastert, who had become the GOP's de facto leader on drug policy. The former wrestling coach struck few as charismatic - his joyless and drudging style, his form like settled gelatin - but his experiences in high schools had left him with the feeling that the drug issue, in the words of his longtime aide Bobby Charles, "had become extremely poignant." Hastert wasn't quite Lee Brown; he believed that the prime focus of the drug war should be to increase funding for military operations in Colombia. But he and his staff had grown frustrated with the exclusively punitive character of drug policy and wanted the Republicans to take a more compassionate stance. His staff had studied the RAND reports and largely agreed with their conclusions. "We felt if you didn't get at the nub of the problem, which was prevention and treatment, you weren't going to do any good," says John Bridgeland, a congressional aide who helped coordinate Republican drug policy. Hastert eventually won $450 million to be used, in part, to expand a faith-based program discovered by Bridgeland: Developed by a former evangelical minister, it brought together preachers, parents and drug counselors to fight the problem of "apathy" through "parent training" and "messages from the pulpit."

But with McCaffrey's emphasis on kids came another, almost fanatical focus: going after citizens who used pot for medical purposes. If he was fighting marijuana, the General was going to fight it everywhere, in all its forms. He threatened to have doctors who prescribed pot brought up on federal charges, and dismissed the science behind medical marijuana as a "Cheech and Chong show." In 1997, voters in Oregon introduced an initiative to legalize medical marijuana in the state. "I'll never forget the senior-staff meeting the morning after the Oregon initiative was announced," Bergman says. "McCaffrey was furious. It was like this personal affront to him. He couldn't believe they'd gotten away with it. He wanted to have this research done on the groups behind it and completely trash them in the press." As the General traveled to the initiative states, stumping against medical marijuana, his aides sneered that the initiatives were "all being mostly bankrolled by one man, George Soros," the billionaire investor who favored decriminalizing drugs.

Even for those who shared McCaffrey's philosophy, the theatrics seemed strange: There he was, on evening newscasts, effectively insisting that grandmothers dying of cancer were corrupting America's youth. His office pushed arguments that, at best, stretched the available research: Marijuana is a gateway drug that leads inexorably to the abuse of harder drugs; marijuana is thirty times more potent now than it was a generation ago. "It didn't track with the conclusions our researchers came to," says Bergman. "It felt like he was trying to manipulate the data."

McCaffrey had taken the drug war in a new direction, one that had little obvious connection with preventing drug abuse. For the first time, the full force of the federal government was being brought to bear on patients dying from terminal diseases. Even the General's allies in Congress were appalled. "I can't tell you how many times I went to the Hill with him and sat in on closed-doors meetings," Bergman recalls. "Members said to him, 'What in the world are you doing? We have real drug problems in the country with meth and cocaine. What the hell are you doing with medical marijuana? We get no calls from our constituents about that. Nobody cares about that.' McCaffrey was just mystified by their response, because he truly believed marijuana was a gateway drug. He truly believed in what he was doing."

7. THE HARVARD MAN

For the cops on the front lines of the War on Drugs, the federal government's fixation with marijuana was deeply perplexing. As they saw it, the problem wasn't pot but the drug-related violence that accompanied cocaine and other hard drugs. After the crack epidemic in the late 1980s, police commissioners around the country, like Lee Brown in Houston, began adding more officers and developing computer mapping to target neighborhoods where crime was on the rise. The crime rate dropped. But by the mid-1990s, police in some cities were beginning to realize there was a certain level that they couldn't get crime below. Mass jailings weren't doing the trick: Only fifteen percent of those convicted of federal drug crimes were actual traffickers; the rest were nothing but street-level dealers and mules, who could always be replaced.

Police in Boston, concerned about violence between youth drug gangs, turned for assistance to a group of academics. Among them was a Harvard criminologist named David Kennedy. Working together, the academics and members of the department's anti-gang unit came up with what Kennedy calls a "quirky" strategy and convinced senior police commanders to give it a try. The result, which began in 1995, was the Boston Gun Project, a collaborative effort among ministers and community leaders and the police to try to break the link between the drug trade and violent crime. First, the project tracked a particular drug-dealing gang, mapping out its membership and operations in detail. Then, in an effort called Operation Ceasefire, the dealers were called into a meeting with preachers and parents and social-service providers, and offered a deal: Stop the violence, or the police will crack down with a vengeance. "We know the seventeen guys you run with," the gangbangers were told. "If anyone in your group shoots somebody, we'll arrest every last one of you." The project also extended drug treatment and other assistance to anyone who wanted it.

The effort worked: The rates of homicide and violence among young men in Boston dropped by two-thirds. Drug dealing didn't stop - "people continued what they were doing," Kennedy concedes, "but they put their guns down."

As Kennedy reflected on the success of the Boston project, which ran for five years, he wondered if he had discovered a deeper truth about drug-related violence. If the murders weren't a necessary component of the drug trade - if it was possible to separate the two - perhaps cities could find a way to reduce the violence, even if they could do nothing about the drugs.

In 2001, Kennedy got a call from the mayor of San Francisco that gave him a chance to examine his theories in a new setting. The city had experienced a recent spike in its murder rate, much of it caused by an ongoing feud between two drug-dealing gangs - Big Block and West Mob - that had resulted in dozens of murders over the years. Could Kennedy, the mayor asked, help police figure out how to stop the killings?

Kennedy flew out to San Francisco and met with police. But as he researched the history of the violence, it seemed to confirm his findings in Boston. Though both Big Block and West Mob were involved in dealing drugs, the shootings were not really drug-related - the two groups occupied different territories and were not battling over turf. "The feud had started over who would perform next at a neighborhood rap event," says Kennedy, now a professor at John Jay College of Criminal Justice. "They had been killing each other ever since."

Such evidence suggested that drug enforcement needed to focus more narrowly on those responsible for the violence. "Seventy percent of the violence in these hot neighborhoods comes back to drugs," Kennedy says. "But one of the profound myths is that these homicides are about the drug trade. The violence is driven by these crews - but they're not killing each other over business." The real spark igniting the murders, he realized, was peer pressure, a kind of primordial male goad that drove young gang members to kill each other even in instances when they weren't sure they wanted to.

Given that police departments had already locked up every drug dealer in sight and were still having problems with violence, Kennedy thought a new approach was worth a try. "There's a difference between saying, 'I'm watching this, and you should stop,' and putting someone in federal lockup," he says. "The violence is not about the drug business - but that's a very hard thing for people to understand."

But in the early days of the Bush administration, police departments were in no hurry to experiment with an approach that focused on drug-related murders and mostly ignored users who weren't committing violence. Kennedy's efforts proved to be yet another missed opportunity in the War on Drugs - an experience that made clear how difficult it is for science to influence the nation's drug policy.

"If ten years ago the medical community had figured out a way to reduce the deaths from breast cancer by two-thirds, every cancer clinic in the country would have been using those techniques a year later," Kennedy says. "But when it comes to drugs and violence, there's been nothing like that."

8. HELICOPTERS AND COCA

Instead of pursuing the Boston Gun Project and other innovative approaches to fighting drug violence, the federal government decided to escalate its military response in Colombia. For the past decade and a half, cooperation from officials in Bogotá had been halfhearted, sporadic and deeply corrupt. But by 1999, the country, it seemed, was on the verge of collapsing into civil war. The drug money that had flowed into Colombia had found its way into the hands of the rebel militia - the FARC - which had been laying siege to the Colombian government. The Clinton foreign-policy team, having spent the previous few years dealing with the consequences of failed states in Somalia and the Balkans, was deeply concerned about the possibility of a failed narco­state in America's own back yard.

One afternoon in June 1999, a dozen senior Clinton officials filed into the National Security Council's situation room, summoned by Sandy Berger, the president's national security adviser. Even though Bogotá had ceded control of vast swaths of the country to the left-wing rebels, they were told, recent peace talks had collapsed. "The FARC had basically always been jungle campesinos - they were a pretty austere bunch," says Brian Sheridan, who was in charge of the Pentagon's counternarcotics effort at the time and attended the meeting. "All of a sudden, they were leveling these attacks that had gotten more and more audacious." When FARC rebels had emerged from the jungle for a round of peace talks the previous fall, they had brandished brand-new AK-47s and Dragunovs, as if on military parade. One U.S. official observed at the time that the weaponry was "far beyond" what the Colombian army had - in a pitched battle, the Clinton administration worried, the ­Colombian government could plausibly collapse.

The White House advisers weren't the only officials in Washington concerned about Colombia. Earlier that day, two men who attended the briefing - Rand Beers of the State Department and Charlie Wilhelm of the Defense Department - had gotten a call from the Republican caucus on the Hill. Dennis Hastert, who had been elevated to Speaker of the House six months earlier, wanted to see them right away. "It was kind of unusual," Beers recalls - but when Hastert called, you came.

When Beers and Wilhelm arrived, Rep. Porter Goss, then the chairman of the House Intelligence Committee, handed them a piece of paper. It was a copy of a supplemental spending authorization that the Republicans planned to offer immediately. Crafted by Bobby Charles, Hastert's longtime aide, the bill would have more than doubled military aid to Colombia to take on the rebels and narcotraffickers -to a staggering $1.2 billion a year. But it was the politics of the situation that worried Beers as much as the money. "It occurred to me that if the administration was going to do anything on Colombia, it better do it soon," he says now, "or the Republicans would once again outflank what they perceived as the I-never-inhaled Clinton administration." Beers told the Republicans he would take a look, and then hurried to Berger's meeting.

Throughout much of the Clinton administration, the hope had been that the United States would be able to reduce its military aid to the Andes as the cocaine epidemic waned. Now, as Berger's group heard from intelligence agents, that hope seemed to be fading. Narcotraffickers were paying off the FARC so they could grow coca in the jungles of Colombia. The FARC were then turning around and using the money to buy weapons to stage attacks on the Colombian government.

Berger decided to act. Rather than oppose the Republican plan, he agreed to negotiate on an assistance package to bail out the Colombian government. The result was Plan Colombia - nearly $1.6 billion to escalate the War on Drugs in the Andes. The new program would arm the military and police in their fight against the FARC, launch an ambitious effort to spray herbicide on coca crops from the air and provide economic assistance to poor farmers in rural villages. The initial aid, officials decided, would be heavily concentrated in Putumayo, a rebel-run province in the jungle.

No one is sure what convinced President Clinton to approve such an ambitious escalation in the War on Drugs. But some observers at the time speculated that the critical factor was a conversation with Sen. Christopher Dodd, the Connecticut Democrat, whose state is home to the helicopter manufacturer Sikorsky Aircraft. In early 2000, Clinton unveiled Plan Colombia - and Sikorksy promptly received an order for eighteen of its Blackhawk helicopters at a cost of $15 million each. "Much has been made of the notion that this was Dodd looking to sell Blackhawks to Colombia," Beers tells me. He pauses before adding, "I am not in a position to tell you it didn't happen."

Plan Colombia would be the Clinton administration's primary and most ­costly contribution to the War on Drugs, the major counternarcotics program it bequeathed to the Bush administration. But as with so many other aspects of American drug policy, the plan had an unintended consequence: As it evolved, the emphasis on supplying arms to the Colombian government ended up having less to do with drugs and more to do with helping Bogotá fight its enemies. Colombia used the military aid to target the left-wing FARC - even though many believed that right-wing paramilitaries, who were allies of the government, were more directly involved in narcotrafficking. "It wasn't really first and foremost a counternarcotics program at all," says a senior Pentagon official involved in the creation of Plan Colombia. "It was mostly a political stabilization program."

9. THE TEMPLE OF HOPE

In July of 1999, Gov. George W. Bush of Texas traveled to Cincinnati to visit Hope Temple, a former crack house that had been turned into a church. It was an almost unbearably hot day. Bush was on a tour through the Midwest during which he was testing out his philosophy of compassionate conservatism, trying to see if its rhetoric and principles could sustain a winning presidential run. "The American dream is vivid," Bush told audiences, "but too many feel, 'This dream is not meant for me.' " John Bridgeland, the congres­sional aide who had helped steer federal funding to Hope Temple, says Bush was "overwhelmed" by his visit to the church that day, and stayed the whole afternoon. That evening, Bush spoke about the fervent ­religiosity of the place and the rough joys of the addict's redemptions. "These," he said, "are the armies of compassion."

This was a strange moment in the politics of the drug war: Just as the Clinton administration was toughening its rhetoric, influential Republicans were going all soft and gentle. John DiIulio, a political scientist from the University of Pennsylvania who would become a key Bush adviser, was disgusted by the "perverse consequences" of harsh sentencing laws that had put millions of young Americans in prison, disbelieved the "sweeping scientific claims" made about the dangers of medical marijuana and wanted to expand "meaningful drug-treatment opportunities in urban areas." DiIulio and his contemporaries were troubled, too, by the racial imbalances of the War on Drugs: Blacks, who comprised only fourteen percent of drug users, made up seventy-four percent of those in prison for drug possession. It was not as if the Republican Party had suddenly taken up a position on the far left of the drug war. But it did seem, for a moment during the 2000 campaign, as if some moderation were possible.

Three months later, when the Bush campaign released its drug policy, even the most experienced drug warriors were impressed. The platform balanced spending between demand- and ­supply-side programs, stressed treatment and doubled the number of community anti-drug coalitions. When Bush won the White House and DiIulio became the director of the Office of Faith-Based Programs, they raided the team of compassionate conservatives surrounding Hastert: Bridgeland became director of the White House Domestic Policy Council, and Charles became assistant secretary of state for narcotics control. The new administration, DiIulio believed, would take the lead in "reforming drug-related sentencing policies that ­research had shown were having perverse consequences."

"If you look back at that campaign document, it really is pretty impressive," says Carnevale, who ended up heading the drug office's transition team for the Bush administration. "Which is kind of remarkable, given what happened next. They've appointed a drug czar who ran like hell from a very sensible policy."

It took Bush nearly a year to pick his drug czar, and almost no one felt encouraged by his choice: John Walters, a laconic Midwesterner who had served as Bill Bennett's chief of staff during the administration of George H.W. Bush. "We all knew who Walters was," one longtime drug warrior tells me, "but he wasn't what you would call an inspiring figure, even to conservatives." When Walters submitted his first National Drug Control Strategy to Bush in February 2002, it became clear that the administration's focus had narrowed: Walters was devoted to