Almost 18 months after Bashar al-Assad fled into exile, such frantic improvisation is unsurprising. It’s also necessary. For if, by its end, his Baathist regime had transformed the country into a virtual narco-state, whose products surfaced in ports from Rotterdam and Genoa, the Syrian drug trade is alive and kicking. Indeed, one of the civil war’s most enduring legacies is that Assad’s former country has now become a major transit and drug hub, not just in Europe but across Asia and Africa too, encompassing narcotics as varied as crystal meth and liquid cocaine.

Yet it’s Captagon that truly keeps Syria’s drug empire afloat. Offering a blend of euphoria and detachment, the stimulant is popular among young Gulf club-goers and overstretched medical students seeking an edge in their exams. Over time, it’s become one of the country’s most lucrative exports. As he visits London for the first time today, President Ahmed al-Sharaa will doubtless parade a new Syria, one primed for investment and revived Western contact. The truth, though, is that Syria has become a legal black hole, a place where drugs can disappear, before reappearing elsewhere with little law enforcement scrutiny. That matters: not only for Syria and its own fragile future, but also for the region, Europe and the wider world.

Before the revolution, drugs weren’t really part of Syria’s story. There was cannabis, of course, grown in pockets around Baalbek, Homs and Latakia, and peddled by small-time gangsters and Hezbollah. But overall, Syria wasn’t known as a drug-exporting state, while dealers themselves were dealt with harshly. I remember living in a Damascus suburb and seeing funerals for local dealers who’d been killed in shootouts with police. Then, young men would smoke cigarettes like chimneys (they still do), and might have the odd drink, but it was rare to hear of drug-taking. There was a special stigma attached to its use. Captagon, for its part, was virtually unheard of. Syria did not present itself, to its neighbours, to Europe, or to its own citizens, as a country whose most lucrative export was narcotics.

Then came the war, and it turned Bashar al-Assad into a narco boss with a country attached. Captagon’s appeal isn’t hard to grasp. Over the past decade, parts of the Middle East — particularly the Gulf — have experienced a gradual loosening of social and religious restrictions. Among a young, affluent population with disposable income, ample free time, and a growing appetite for entertainment, the inexpensive stimulant has found a ready market. Easy to manufacture, easy to package, easy to move, it requires no fields, seasons or harvests.

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All a would-be kingpin needs are chemical precursors —  usually a mixture of amphetamines, caffeine and various fillers — alongside machinery and protection. As Assad was crushed by sanctions and the demands of an insatiable war machine, Captagon production proved to be an invaluable financial lifeline. By this stage, the regime boasted a growing ecosystem of militias and businessmen who propped up what remained of the hollowed-out state. Only trouble was, they all needed paying, and Captagon was the answer. And since the regime was now involved, they could manufacture most of those chemicals themselves, or else import them under official cover, attracting little scrutiny about their intended use. Importers like Eyad Lahham and former MPs like Amer Tayseer Kheiti were in on the racket, as was Assad’s brother Maher, who added drug running to his list of dubious accolades. Reports suggest that the Assads legally imported chemicals from India before producing Captagon from a disused potato-chip factory in the Damascus suburb of Douma.

At first, the Assad regime denied any connection to the drug. Its appearance was instead blamed on ISIS, with the “jihadi drug” supposedly used by fighters to remain calm in battle. On 1 July 2020, Italian police seized 14 tons of Captagon in Salerno, a port south of Naples, and initially seemed inclined to believe the shipment was indeed intended to fund ISIS. The Italians also explored links between the Islamists and the Neapolitan Camorra. No Camorra-ISIS connection was ever substantiated. What is known, though, is that one of Europe’s biggest drug traffickers, with Camorra ties, was arrested by Hayat Tahrir al-Sham — al-Sharaa’s former outfit — while attempting to cross into regime-held territory in 2022.

Assad-linked networks were, by then, the drug’s main manufacturers and exporters. Maher al-Assad is again a case in point: his notorious Fourth Armored Division got so rich of Captagon that it reportedly maintained an $80 million cash reserve at a time when the average Syrian was surviving on just $2 a day. Maher and his associates meanwhile flaunted their wealth — supercars, watches, funds parked safely abroad — embodying the stark inequality that Assad’s narco-economy had created. All the while, this bonanza offered opportunities for ordinary Syrians. A young soldier might supplement his poor salary; a Bedouin school kid, instead of going to school, could smuggle Captagon and earn $1,000 a day.

The profits, then, were simply too hard to ignore. But so too is the social impact it’s wrought. Some weeks ago, while visiting friends in the war-scarred city of Raqqa — the former de facto capital of ISIS — my host warned me not to leave belongings in the car. Anything left behind, he said, would likely be stolen and sold to finance an addict’s drug habit. A UN employee from the city, speaking on condition of anonymity, describes the situation as an epidemic. Things are exacerbated, he adds, by the Syrian Democratic Forces (SDF), a group of mostly Kurdish fighters, whose personnel turn a blind eye to trafficking — and allegedly take a cut of the action.

In this, al-Sharaa is surely an improvement. His new government celebrated the end of the trade, partly for propaganda reasons but also sincerely. For Muslims in general, and Islamists in particular, drugs aren’t just criminal but impious. Mere weeks after his victory, in the grand setting of the Umayyad Mosque in Damascus no less, al-Sharaa announced the end of “the largest Captagon factory in the world” to a rapt audience.

All that was ultimately dismantled, however, was the regime-era infrastructure; a decentralized “cottage” industry of smaller players remain. Logistics is on their side. From there, consignments are moved towards Jordan using smuggling tactics that sound like folklore until you meet the men tasked with stopping them, with everything from livestock to drones used to hide the drugs. The real key, though, is to secure the networks through which you can move your goods — and those criminal networks didn’t go away when Assad fell.

The point, here, is that Syria’s narco-state didn’t disappear. Rather, it decentralized, its remnants scattering and grouping in enclaves where government control was weakest. Many former regime producers, as analyst Charles Lister has noted, fled to join the area controlled by Sheikh Hikmat al-Hijri, the de facto ruler and spiritual head of the Druze community in Suwayda. From 2018, the Assad regime allowed the province, not far from the Jordanian border, a degree of self-rule and a free hand in Captagon. For Hijri, handing over power to Damascus would effectively cut off the trade that funded both his militias and the autonomy they implied. Following his split from Damascus last year, and the creation of an independent enclave closely aligned to Israel, Hijri has emerged leader of what one expert calls a “narco-statelet” — one far closer to cartel-run corners of Mexico than any imagined Druze utopia.

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The Damascus authorities are hardly blind to this reality. But the fact remains that anti-drug campaigns are overstretched, under-resourced and often improvisational. Yet again, this can partly be explained by the 2024 revolution. Many experienced law-enforcement officers fled after Assad’s fall. In some areas, policing has since fallen to young local men, often without much training. Responsibility for counter-narcotics rests largely with the Interior Ministry and a security apparatus still being built, all while confronting more immediate threats. The result is a nationwide game of whack-a-mole, with raids, seizures, shootouts and occasional successes — followed by the reappearance of dealers elsewhere.

Meanwhile, officials I speak to describe increasingly sophisticated smuggling methods, from hidden tunnels to the sea route via Latakia. Scarcity has driven up prices; tighter restrictions have paradoxically made Captagon more lucrative. The trade adapts because, once more, its incentives are structural. According to the World Bank, extreme poverty still affects one in four Syrians, and with basic services like electricity eye-wateringly expensive, drugs remain a tempting option. That’s clear enough online. In forums I follow, there’s a lively trade between punters and traders, discussing prices, routes and volumes with the casual tone of men selling spare parts. Sometimes an odd request for a gun or cocaine is thrown in with a picture, and the trader asks for the buyer to DM him. Users sometimes upload images to show they’ve picked up their stashes, their dealer responding with a jaunty thumbs-up emoji.

What becomes evident from these conversations is that Captagon’s reach extends far beyond the Levant or even Europe, and now encompasses far-off East Africa and the Ivory Coast. One network, operating laboratory facilities in Turkey, shared wholesale prices that illustrate this reach. A million pills were apparently sold for around $150,000, with smaller batches priced in neat increments.

And if the Syrian trade was made by Captagon, there are ominous signs that diversification is the order of the day. That Turkish network doesn’t only deal in Captagon, but also heroin, Tramadol, Ritalin, Modafinil, Lyrica, hashish and crystal meth. Of course, not every claim made online is necessarily true. But that matters less than what these claims reveal: traffickers now think globally, because the market itself is global.

Given all this, how can the authorities respond? Beyond ad hoc raids — officials recently seized a major shipment of liquid cocaine from the port at Latakia — one senior Syrian official I speak to is skeptical. Dismantling an industry built over a decade and a half, he suggests, would take two or three years of sustained effort. What with its global spread, even that estimate may be optimistic. To be fair, there are now signs of cross-border cooperation, like when the Jordanian airforce recently bombed Captagon supply lines in Suwayda. More than that, though, the Syrians themselves need help: both technical support and investment.

After all, places like Suwayda rely on Captagon because of political or militia power — but also because of poverty. And if Syria and the international community aren’t careful, this small pill may yet prove more destabilizing than anything the region has seen, like a modern Pied Piper, luring its youth with the promise of oblivion. Add the networks expanding across Europe and we may soon find Captagon on the streets of Britain. Whatever al-Sharaa might claim, Syria’s civil war isn’t over yet.

Another shrine has appeared in North London. On Tuesday lunchtime, Adam Henry, aged 15, was cornered down a side street off Westbourne Road, Islington, not far from Highbury Fields, and stabbed. Someone called 911. Paramedics arrived, and office workers on their lunch breaks saw them trying to save Henry’s life. He was rushed to hospital, where he died.

Within a day, the customary shrine had appeared. At the foot of a low brick wall have been laid flowers, drinks and biscuits, less than a minute’s walk from Henry’s old secondary school, St Mary Magdalene Academy, which he attended until partway through Year 8. His yearbook entry said he enjoyed skateboarding and reading the Bible. It has been reported that, after leaving St Mary Magdalene, Adam was a pupil of the Bridge Satellite School, which specializes in teaching children with autism. Laying flowers on Tuesday evening, Henry’s family told Metro that he was “quiet and respectful… very funny. Just a nice boy.”

The police have opened a murder investigation. As yet it is not known why Henry, nicknamed “AZ”, was stabbed to death one lunchtime in one of London’s wealthiest boroughs, minutes away from £8-a-pint gastropubs, a Bang & Olufsen showroom and the townhouse that was once Tony Blair’s. Like much of London’s Zone 2, Islington is an area where incredible wealth luxuriates a few doors away from poverty and strife. Beside the lawyers, celebrities and investment bankers live the boys and young men embroiled in violent street gangs.

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One might assume that the violence breaks out when one drug-selling gang encroaches on the turf of another, but the truth is more prosaic: stabbings can be precipitated by social media posts and petty personal beefs. If you are spotted talking to the wrong person, or you repost the wrong video, you can become a target. There are only a small number of street gang members, but thousands of children are one misstep away from becoming a target.

And when acts of thuggery take place, they reverberate through the neighborhood. Islington’s new youth safety strategy, which was published in November, found that even among young people in the borough unknown to police and child services, being robbed, and knowing someone who had been stabbed, was commonplace.

The result is an atmosphere of worry and fear. “We have to stay behind [at school] until 4:20pm [when] it’s dark,” said one child, “so when I leave and have to go home, I just shit myself.”

Another said: “As soon as you step out of your front door, you just have to be vigilant; you know you can’t go to certain areas, and you don’t go out when it’s dark,” said another. “You always see young people all ballied up [i.e., wearing balaclavas]. You never know what they are going to do.”

These teenagers are rightly worried, yet they have at least been fortunate enough not to be drawn into the street gangs vortex. The more vulnerable they are — and often this involves having ADHD, autism and other mental health problems — the more likely needy children are to be sucked in, and the more likely they will be abused, brutalized or killed.

“Gangs are just another form of social extremism,” one expert told me. (Because he works with vulnerable children at risk of violence, he asked not to be named.) “These kids are lost boys, and the gangs are found-families. If you’re vulnerable, and looking to belong, you’re more likely to become exploited by these groups.”

And what does it mean to end up in those groups? You might be coerced into missing school in order to go phone snatching on e-scooters; you might be strong-armed into selling crack and heroin on a “county line” from a drug user’s council house in Colchester or Norwich for weeks on end; or you might be required to carry out acts of brutal violence on people you have never met before.

There has always been some quantity of criminality in society, but its expression and scale are in flux. Thirty years ago, in London there were a small number of large street gangs run by seasoned adult criminals. But this order has fractured, and today there are a myriad of smaller gangs, sometimes headed by kids. In Islington, the most prominent street gang are the “Cally Boyz”, who are based around the Caledonian Road, a couple of minute’s walk from where Henry died.

The Cally Boyz made the headlines in July this year when five members were jailed for stabbing to death two people, including a 15-year-old, while on a “rampage” in an Islington council estate in 2023. The gang members wrongly believed that their victims were part of a rival gang who had dared to film a music video on their turf. Mistaken identity, unfortunately, is another recurrent feature of gang violence.

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In such a climate, Henry’s death does not come out of the blue, but nor is it run-of-the-mill. Two teenagers were killed in Islington in 2024; one was killed in 2023; in 2022, one 15-year-old was killed by another 15-year-old in Highbury Fields. Compared to boroughs such as Croydon and Hackney, Islington is not a hotspot for youth killings. In 2021, 30 teenagers were killed in London, the highest since the Second World War, but only two of these killings occurred in Islington. The violence is not always teen-on-teen; in March, three teenage girls were charged with killing a 75-year-old man in Seven Sisters Road. Still, the borough is less well known for its street gangs than for the original moped robbery gangs of a decade ago, and for the aging Adams crime family. Its leader, Terry Adams, was described by the judge who jailed him for money laundering in 2007 as “one of the country’s most feared and revered organized criminals”.

Henry’s death comes at a time when the number of teenagers being killed each year on the capital’s streets is falling: that peak of 30, four years ago, fell to 12 in 2024. But behind the fluctuating death tolls, the damage is incessant. “There is harm that’s not deadly, but it can be life-destroying,” the youth expert, talking about how young people get sucked into a 24-hour existence of brutal violence and relentless crime. “These children, they are not going to have good lives. They may not die, but they’re not really living.”

By the time a teenager has been stabbed, he has probably already been badly let down in some way, be it by his family or the state. Adam was killed the day before the Government launched its new youth safety strategy, which is being framed by Labour as an attempt to right the wrongs of the previous Tory government’s regime of austerity. With youth clubs closed, goes this account, teenagers ended up on the streets; as a result, the closures were blamed by multiple government reports for fueling youth violence.

But blaming the Tories for London’s youth murder problem is just “politicking”, says the youth expert. He says Labour could have done more themselves, and that those advising London’s Mayor Sadiq Khan on the causes of youth violence “don’t know what’s happening on the ground… they are not well-informed people”.

He adds the solution does not solely lie with more youth clubs, or the use of tired enforcement tactics such as stop and search, but in changing the school system so children with the kind of problems that can lead to involvement in gangs and violence can be helped earlier. He suggests that too many children with special educational needs are ignored or discarded from schools at an early age, so their problems go unaddressed, worsen and they become more susceptible to joining gangs.

By the same token, any school-age intervention will take years to make an impact on rates of youth violence, and politically, it is far trickier, and more expensive, to a headline-friendly quick fix. There seems little even a beefed-up police force, or a more efficient justice system, could do to stop these attacks. So far, attempted interventions have had little effect on this kind of deep-rooted youth crime. For the time being, the worried teenagers of Islington have little option other than to remain fearful.

Social media gently mocked Dowd when her column first appeared: silly Boomer, she didn’t dose it right — couldn’t handle the ride. Momentum for legalization was gathering back then, driven by the anti-antidrug Left, the free-market Right, and lobbyists and entrepreneurs who could just hear the cha-ching sounding from the next big vice industry. Twenty-three states plus the District of Columbia would follow in Colorado’s footsteps in the decade that followed.

The picture of weed shared by many older Americans, drawn from their own college years, helped ease the path of legalization. Weed, the mellow drug. The Cheech-and-Chong drug. The Grateful-Dead-road-trip drug. The munchies drug. The drug that, if anything, makes you overly cautious behind the wheel. Dowd thought of marijuana along similar lines — that is, until she tried the legalized stuff for herself and nearly lost her ever-loving mind. 

Since then, weed potency has only intensified, with some concentrates reaching near-pure levels of THC, the plant’s primary psychoactive compound. Only now are policymakers and opinion elites reckoning with what Big Weed has wrought: “turning a drug that used to be 5% THC, and made people pass out for a few hours and eat Cheetos, into one that triggers psycho killers,” as Kevin Sabet, a former drug adviser in successive Democratic and GOP administrations, tells me.

Sabet admits that such talk can make him sound like Reefer Madness, the classic anti-weed propaganda film from 1936. “But if you look at almost every single mass shooting in this country, there are many common denominators, and one of them is a substance. And it’s not alcohol, and it’s not meth, and it’s not fentanyl. So you can guess what it is. It’s marijuana.”  

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Take Robert Westman, the 23-year-old who murdered two children and wounded 30 people in a gun rampage at a Minnesota Catholic school in August. In his diaries, Westman, who both used weed and worked at a dispensary, blamed the drug for his violent tendencies. “Gender and weed fucked up my head,” he wrote. “I wish I never tried experimenting with either. Don’t let your kids smoke weed or change gender until they are, like, 17.” 

A 2025 study, published in the East Asian Archives of Psychiatry, found a definite and growing link between US mass-shooting perpetrators and the use, possession, and distribution of cannabis. Moreover, the researchers found that younger mass killers are more likely to be involved with marijuana. They concluded that the drug is particularly harmful to “subgroups of individuals” prone to such violent eruptions.

Even if they don’t go full Columbine, young people who regularly use today’s high-potency varieties are at elevated risk for psychosis, per a 2019 study published in Lancet Psychiatry. King’s College London, home to the lead author, sums up the grim finding: “In cities where high-potency cannabis is widely available, such as London and Amsterdam, . . . a significant proportion of new cases of psychosis are associated with daily cannabis use.”

Things have gotten so bad that The Guardian, which once pooh-poohed concerns about weed, now regularly runs warnings about its adverse effects on health (it doubles the risk of heart death, to mention just one recent finding). Most recently, the paper took readers inside a pioneering London clinic specially dedicated to addressing cannabis psychosis. It’s a crisis that goes far beyond a typical “bad trip,” shattering minds and leading many users to take their own lives.

“We are dealing with a fundamentally different drug,” says Sabet, “that has been genetically modified and bred by a powerful industry that we are now sanctioning and encouraging, and allowing to contribute to inaugurations.. . . The fact that we are allowing this, to me, that’s immoral.” Despite bipartisan opposition from a pro-weed lobby led by the likes of John Boehner, the former Republican House speaker, Sabet’s calls for limits have begun to break through.

Most notably, Sabet has led the campaign urging President Trump not to remove marijuana from Schedule I, the most serious category in the federal government’s scheme for classifying drugs. As he wrote in a widely read UnHerd essay, reclassification wouldn’t mean federal legalization. But it would grant the drug a false federal “imprimatur of being safer,” thus allowing Big Weed to enjoy tax deductions from which they are currently barred. 

So far, Sabet’s campaign seems to have stayed Trump’s hand, even as the president has floated the idea of Medicaid coverage of marijuana products as a stress and pain balm for seniors. “This [reclassification] isn’t a priority for the president,” Sabet tells me. “But on the other hand, there are some lobbyists and maybe friends of his son-in-law and others in the business” who would benefit from rescheduling and its associated tax deductions, meaning Sabet’s work is far from over.

Kevin Sabet came to the drug problem from an unusual personal angle. Born in the Midwest to a Bahai family that left Iran before the 1979 Islamic Revolution, he remembers a childhood in which he didn’t know anyone who so much as drank. (The Bahai religion, which is persecuted by Iran’s ruling Islamists, preaches the unity of all faiths — and total abstinence). When he moved to Orange County as a teenager, his perspective was radically different from that of his peers. And what he saw of addiction encouraged him to fight it. 

As an undergrad at the University of California, Berkeley, in the mid-’90s, he says, “I saw the influence of the [drug] culture. I saw marijuana shops before that was even a thing.” Then the rave culture arrived, giving rise to what he describes as a “mini-epidemic” associated with the hallucinogen ecstasy, also known as MDMA. As a student, he’d go to clubs and hand out postcards showing scans of drug-addled brains on one side, and a call-for-help number on the other.

His activism won him some attention in the press — and then a phone call from Barry McCaffrey, the retired US Army general then serving as President Bill Clinton’s drug czar. “I thought the call was fake,” Sabet recalls. But it wasn’t. Gen. McCaffrey was offering him a job as a speechwriter. Sabet accepted and moved to Washington before heading to Oxford to earn a master’s degree in social policy.

After 9/11, many of Sabet’s friends went off to Afghanistan in defense of the homeland, and he felt guilty writing papers at “Oxford, of all places, a comfortable place.” As it happens, the White House called again — this time, the George W. Bush administration with an offer to hire him as a senior speech writer on drug policy. “ ‘We want you to serve your country,’ ” he remembers the caller saying. “ ‘We know you’re not a Republican, but we also know you’re not a Democrat, and that’s fine with us.’ ” (His politics, as far as I can tell, are: whatever will stop this scourge.)

Yet another White House stint came during the Obama administration, which tapped him as senior drug-policy adviser (by then he’d finished his master’s and a doctorate at Oxford). It was around that time, the 2010s, that marijuana legalization went from a pothead’s dream to a serious business and political enterprise. Weed, the legalizers said, is harmless. Sabet disagreed, and he published a book, Reefer Sanity, to push back against the complacent mythology.

The book, in turn, led to his founding of a restrictionist advocacy group, Smart Approaches to Marijuana, or SAM, today the most visible drug-policy organization in Washington (a telling indicator of the growing concern about Big Weed).

But why the focus on marijuana? Why not the likes of fentanyl or heroin? Marijuana, Sabet answers, “is the most dangerous drug in my mind because it’s the most misunderstood.” There was a time when one could “experiment” with pot as part of the transition to adult responsibility and success. “The marijuana of today is doing the opposite,” he says, potentially derailing a person for life. “It’s causing violence, it’s causing erratic people to lose any sense of reality.”

And it’s addictive, a truth that Americans are still reluctant to accept. Sabet recalls speaking to a large group about the addiction angle, only for a member of the audience to tell him during the Q&A portion: “I use it every day, Kevin, and I’m qualified to tell you it’s not addictive.” 

The numbers say otherwise. As the Associated Press reported on Tuesday, regular use of marijuana has now outpaced drinking, with 18 million Americans reporting daily use, up from fewer than 1 million in the 1990s. In tandem, there has been an explosion in diagnoses of cannabis-use disorder — an insatiable craving for the drug that leaves people incapable of fulfilling ordinary responsibilities; 1 in 3 pot users suffers from it, with symptoms classified from mild to severe.

But aren’t alcohol and tobacco just as destructive? Why not call for a new Prohibition and extend it to cigarettes for good measure? 

“The reason I would say that Prohibition wasn’t sustainable as a policy in America is because alcohol has been so ingrained in Western civilization, since before the time of the Old Testament.” Then, too, alcohol is associated with human sociality, and for most people, the substance and its effects leave the body after 24 hours. Not so with weed, which lingers for much longer and at a cellular level. Sabet thus dismisses the argument that we shouldn’t restrict marijuana until alcohol is under control: “That’s like saying my headlights are broken, and just to be consistent, I’m going to break my tail lights, too.”

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As for smoking: “Ninety percent of the people who built the Brooklyn Bridge were smokers. They were smoking at the time they built the Brooklyn Bridge. They could function. Maybe it even made them concentrate better,” Sabet says. The cigarette — unlike tobacco itself — “is a relatively new invention.” 

Lung-cancer deaths before the 1920s were almost unheard of. Only with the rise of a cigarette industry did the smoking crisis appear. And that, he says, is also what’s happening with legalized, industrial weed, a product hawked by growers chasing ever higher THC yields — mental health be damned. Moreover, as cigarette smoking rates decline, Big Tobacco is looking to enter the weed market, Sabet says.

So what to do now, beyond restriction (a cause that’s already lost in half of US states)? At the root of the drug crisis, Sabet thinks, is a “moral and spiritual breakdown.” Drugs, he suggests, offer too-easy answers to the search for meaning; or else they palliate the pain associated with modern life. Even so, Western societies can erect guardrails, for example by hindering the spread of weed advertising to ever-younger audiences. 

As for those already trapped, Sabet sees a role for behavioral incentive systems, such as programs that offer cash rewards for addicts who don’t use — or ones in which they face a choice between doing time or going to rehab. 

“I’m calling for a new effort on drugs,” he says, aware of the odium attached to the War on Drugs. “I don’t love the war analogy because wars have defined ends, or they should. And this will never stop. We will never stop having to stop drug use among young generations. . . . I embrace aiming for a drug-free society, even if it’s not possible. We’ve never had a violence-free society, but that doesn’t mean that we don’t want to aim for that.” 

Two days earlier, then-president Felipe Calderón announced the deployment of 6,500 soldiers and federal police in an offensive called Operation Michoacán. The following January, an additional 3,300 troops would carry out Operation Tijuana. It gradually became a national mobilization with the bulk of the Mexican army along with marines and paramilitary federal police taking on narcos. Soon after, President George W. Bush held talks with Calderón. By 2008, Washington was bankrolling the new Mérida Initiative, a pan-American campaign to take on drug traffickers.

“New pages of glory will be written. I instruct you to persevere until glory is achieved,” Calderón told soldiers in February 2007. “We will give no truce or quarter to the enemies of Mexico.” These were stark martial terms. In another event, Calderón addressed troops wearing an army jacket and cap in a base on Michoacán, unusual attire for a Mexican president.

Over 18 years later, the Mexican army is still on the streets fighting cartels, which have diversified from drugs to a portfolio of rackets including extortion, human smuggling and oil theft. During this time, Mexico has suffered about half a million total homicides (Mexico’s statistics institute counts 486,000 between 2007 and 2024). Cartels and the security forces fighting them, which have also committed massacres, could be responsible for almost two thirds of that number. Cartel sicarios — hitmen — not only wield Kalashnikovs and 50 cals (mostly from the United States), but build home-made fighting vehicles, or “monsters”, armored drones and improvised landmines. Self-defense militias, or auto defensas, have risen up as a third force, though they can often just be narcos in disguise. With 130,000 people disappeared, and mass graves in cow fields and ranches, mothers join brigades to search for their lost children, while citizens march vainly for peace.

Meanwhile, foreign mercenaries are increasingly involved on the side of the cartels. They have come from various countries, including the United States, but Colombian veterans are especially sought after, with their combat experience and with specialist snipers and drone operators.

And then there’s Trump. He has designated various cartels as foreign terrorist organizations, and US special forces are currently training Mexican soldiers. He has also threatened US attacks on cartel targets in Mexico, and US forces have blown up boats allegedly carrying drugs in the Caribbean and Pacific.

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While this bloody mess in Mexico has claimed more victims than some traditional wars, there is still disagreement over how we should understand this conflict, or even name it. This isn’t just an academic debate. Recognizing an armed conflict has legal implications for the Mexican government. It’s also bad publicity.

When the International Institute for Strategic Studies in London classified Mexico as the second deadliest armed conflict in the world in 2017, Mexico’s foreign office issued an irate response. “The report irresponsibly points to the existence of an “(non-international) armed conflict” in Mexico,” it said. “This is incorrect.”

But beyond what is politically convenient for Mexico, there are other factors making the Mexican labyrinth tricky to frame. Much of the country appears largely peaceful despite the bloodshed, and even when cartels control territory it’s as a shadow power rather than a full takeover. And as there are comparable problems of organized crime and militarized law enforcement across Latin America, should we also talk about armed conflicts in Brazil, Honduras and now Ecuador?

So how can we understand this period of violence, which I now think is best referred to as the Mexican Cartel Wars? We need to look at when it really began, who the sides involved are, and, to offer some hope, when it may finally end.

I join some other writers in describing the Mexican Cartel Wars as a form of hybrid armed conflict, somewhere between crime and war. This crime war is far less lethal than international conflicts like the Second World War, and nor does it reach the threshold of traditional civil wars, like the Spanish, US or Salvadoran, in terms of intensity or politics. There aren’t two sides with clear leaders and ideologies fighting for dominance of the central state. Yet there is endemic organized violence, which claims thousands of lives per year. As such, it could be compared to periods of violence elsewhere, which, though brutal, did not descend into full-scale civil wars. These include the Colombian conflict, the civil conflict in the Philippines, the Chinese warlord era, the Haitian crisis and, albeit on a smaller scale, the Troubles in Northern Ireland.

The Mexican Cartel Wars involve a plethora of criminal kingpins, death squads and self-defense militias, as well as police, soldiers and marines. All these are entwined with the cartels and fight among themselves. Violence shifts around the country in a series of distinct but interconnected conflicts, with operatives, money and techniques (from beheading to drones) flowing between them.

The Geneva Conventions haven’t caught up with the language and laws for this type of hybrid conflict. I wouldn’t argue that the Mexican government has to treat sicarios like prisoners of war, but it still has to figure out a strategy for peace.

Cartels are at the heart of this conflict, yet they are complex and evolving organisms. Essentially, they are hierarchical networks of paramilitary organized crime. Profits from drugs and a range of rackets drive the violence. Cartels include the biggest mobs, Jalisco and Sinaloa, and powerful regional players, like the Gulf and Northeast cartels, as well as more local but still brutal outfits like the Guerreros Unidos, which we could call cartelitos.

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When Calderón launched his offensive in 2006, he was reacting to rising cartel violence, especially in his home state of Michoacán. But fighting between drug traffickers and the involvement of the Mexican army in anti-drug operations go back decades. The first US Customs probe into Mexican opium traffickers was in 1916. The Mexican government mobilized soldiers against poppy growers in Sinaloa in the Forties, and then more seriously in the Seventies in what it called Operation Condor (which was also the name of a CIA op against Leftists across Latin America).

Colombian traffickers were dubbed the Medellín Cartel from about 1980, and the Guadalajara Cartel reached its zenith in 1985 (though, as the academic Carlos Pérez Ricart writes, people didn’t refer to it as that until later). The Tijuana Cartel pioneered narco terror in the Nineties, and army defectors in the Zetas seriously upped the game with paramilitary hit squads in the 2000s, leading to Calderón’s offensive.

Yet the sheer quantity of Mexican troops on the streets, and the severity of cartel violence, reached new heights under Calderón. We could see the period from the Nineties to 2006 as a proto-phase of cartel battles: with the real Mexican Cartel Wars unleashed after the military offensive.

Another detail is that after Calderón kicked off the crackdown, murders in Mexico actually dipped, before going up sharply in 2008 and then exploding in 2010. It’s unfair to blame Calderón entirely for the cartel wars, but he did throw oil onto the fire, as cartels escalated their brutal battle tactics and Mexican soldiers carried out murders themselves. From 2010 onward, Mexico suffered the massacres and mass graves that have characterized the conflict.

A tricky but central question is how many murders are actually related to cartels, as opposed to just bar fights or “passion” killings. The truth is we can’t know for sure: about 90% of homicides are never solved. Yet there are clues.

Calderón created a unit with members of the army, police and Mexico’s intelligence agency (CISEN) to estimate how many deaths were cartel-related. Alejandro Hope, who was then at CISEN, described to me how they looked for signs of cartel activity, from beheadings to the use of grenades and AK-47s. They also included killings confirmed by soldiers.

The count varies by year, but in both 2010 and 2011 cartel-related violence represented close to 60% of all homicides. If you extrapolate that over all homicides since 2006, it would be about 300,000 deaths. That is a colossal figure. Over these last two decades, Mexico has been a genuine bloodbath.

Is there a way to end the Mexican Cartel Wars? One challenge is that it’s not like a regular war where governments or political factions come to the table and hammer out a peace deal. We have also learned that taking out kingpins, like El Chapo and El Mayo, doesn’t stop it. Cartels are many-headed hydra, and when you cut off a head, several more vicious ones grow in its place.

Some have called to send the army back to the barracks. This doesn’t finish the fight either, as cartels keep on battling amongst themselves. Presidents have pulled troops out of various cities only to send them back when violence explodes.

But no conflict goes on forever. About 2010, I heard a CISEN officer make the prediction it would be a 30-year war. There is no exact science to that, but it rings true to me: a full generation of killing before things calm down. Or until the murders go back to the level of 2006, with 10,000 homicides or fewer in a year.

There needs to be a combination of factors to reach this. More effective law enforcement in Mexico is crucial, however that is achieved. Trump’s idea of bombing cartels is certainly a deterrent, though it could put prices up, which encourages others to get in the business. And Trump hasn’t addressed US drug demand; perhaps in the future this will finally go down. Changing demographics in Mexico may be key too: as the birth rate falls, there will be fewer youths to recruit as sicarios. Increased living standards could also reduce the temptation of becoming a cartel killer.

There are other worries though. Back in 1998, Charles Bowden wrote Juárez: The Laboratory of Our Future, illustrating the violence on the US-Mexico border. In retrospect, the title was prescient about the bloodshed that awaited Mexico in the 21st century. But has Mexico over the last two decades itself been a laboratory for a new style of warfare? And if that is the case, could this type of hybrid armed conflict find new environments to nestle in? With organized crime moving easily over borders, economic stagnation and the power of many states eroding, I fear it will.

“We’re growing enough for 4,000 prescriptions a month,” says James Leavesley, CEO of Dalgety, the firm that built and owns the facility. “So far we’ve invested £12 million. But we plan to expand to meet the needs of 22,000 patients.” To get this tour, I’ve had to sign a non-disclosure agreement, which means the only thing I can say about the location is that it’s somewhere in the Midlands. Security, supplied by ex-soldiers, is tight. Should a criminal gang try to steal the crop, an armed police response is only a phone call away.

Licensed by both the Home Office and the Medicines and Healthcare Regulatory Agency (MHRA), Dalgety is one of four firms that run legal cannabis farms in Britain, and represents the most respectable end of the country’s burgeoning medicinal cannabis market. Jane Sawyers, a former Staffordshire chief constable, is a non-executive director, and until she became a minister last year, so too was the former Labour Home Secretary Jacqui Smith.

When regulations on medicinal cannabis were first eased seven years ago — following a campaign by parents desperate for an effective treatment for epilepsy in their children — this is roughly what was envisaged: a robust and regulated operation, providing rigorously tested products to people with specific clinical needs.

This, however, is not what most of Britain’s £300 million medicinal cannabis industry actually looks like. Nor is it why figures like Snoop Dogg are so keen to invest. What has emerged, rather, is an online bazaar — below the radar, but perfectly legal — in which British patients can obtain imports of ultra-high strength cannabis from American and Canadian companies whose brand names emphasize their non-medical purpose. “Fuck Around and Find Out” and “Haymaker Haze” are just two among many, the latter fronted by the ex-boxer and convicted rapist Mike Tyson. Most are not supplied in any recognizable medicinal form, such as capsules, but as cannabis flowers to be vaped or smoked.

The fact that non-medical cannabis remains illegal in Britain has not stopped doctors from prescribing these brands, marketed as lifestyle products in jurisdictions where marijuana is legal, for medicinal purposes at private clinics. Meanwhile, the Government is only starting to wake up to the risks, particularly when it comes to cannabis-related psychosis. Just last Thursday, its Advisory Council on the Misuse of Drugs announced plans to investigate whether legalization has had its “intended impact” — and to identify any “unintended consequences”.

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Certainly, evidence implying this isn’t hard to find. “This cannot be real,” writes a contributor to a Reddit forum on medicinal cannabis. “I just got my first order. I can’t believe I’m holding weed legally.” Strains UK, a dedicated cannabis review website, also lauds high-THC brands being prescribed by doctors. One example, known as “Gorilla Glue”, is apparently famous for “putting users into an amazing daze!” Another is “Lemon Cherry Gelato”, whose users find that “every hit will make you grin like a fool”.

How did we get to this point? Cannabis, after all, is still a Class B substance under the Misuse of Drugs Act, which means those caught selling or importing large quantities illicitly face hefty jail terms. In theory, possession is illegal too, though this is rarely enforced.

Yet there are also legal ways to secure cannabis. By the middle of the last decade, a handful of pharmaceutical products derived from the plant had been licensed. One example is Sativex, a mouth spray used to treat nerve damage caused by multiple sclerosis. That was shadowed by a broader campaign to legalize cannabis for medicinal use, led by MPs such as Labour’s Paul Flynn. In 2016, the All-Party Parliamentary Group for Drug Policy Reform issued a report saying the medicinal use of cannabis should be permitted, with the document co-authored by an NHS neurologist called Mike Barnes.

Spooked by the publicity given to childhood epilepsy, the then-Home Secretary Sajid Javid oversaw the legalization of medicinal cannabis in November 2018. This meant that cannabis could be privately prescribed by doctors registered as consultant specialists with the General Medical Council (GMC). According to Professor Trevor Jones, a former government adviser who developed drugs to treat epilepsy and HIV as head of research at the Wellcome Trust, regulation was supposed to be “extremely strict”. Advertising the drug is unlawful, and prescriptions are supposed to be based on “purely therapeutic considerations”.

However, the rules do not specify what type of specialists are permitted to prescribe cannabis. The GMC says that “any doctor on the specialist register in any specialty” is permitted to do so, with perhaps 140 working across the country. Nor is there any restriction on the conditions for which cannabis can be administered. Classed as a “special category” drug under the Human Medicines Act, it can be privately prescribed for any patient whom a doctor considers has an “unmet clinical need”. This includes conditions for which it is banned in the NHS, such as pain relief, depression or anxiety, because of a lack of evidence.

“Many patients use the clinics simply to get marijuana and not be arrested,” Jones says, “and that’s not good medical practice.” All the while, prescriptions have soared. In 2020, private clinics and pharmacies dispensed just 4,000 prescriptions. Yet though new NHS prescriptions are rare — the Care Quality Commission (CQC) stated there were fewer than five across the country in 2022-3 — in the year to March 2024 the number of private prescriptions increased by 130%, to 346,000, following a jump of 119% the year before. In 2024, legal imports of the drug also more than doubled. Industry sources says there are roughly 75,000 patients nationwide.

There are now 43 cannabis clinics in the UK, including Mamedica, the outfit with which Snoop Dogg has announced his £4.5 million investment, and which alone claims some 7,500 patients. Mike Barnes, co-author of that 2016 parliamentary report, is doing well too: his consultancy firm Maple Tree has advised more than 300 private cannabis clinics, pharmacies and distributors.

Taken together, this gaggle of private clinics provide cannabis prescriptions for over 70 conditions, including not only anxiety, depression and chronic pain, but also more surprising ailments such as psoriasis. Most operate entirely online: patient and doctor will never meet face to face, but rather conduct a short video interview following a written survey. The clinics are supposed to be regulated by the CQC, but so far, it has inspected just 17 out of 43. The cost for an initial consultation is usually about £100, but after that, there is bigger money to be made, with some patients paying more than £2,000 a month for cannabis.

The consequences, says Professor Sir Robin Murray, one of the world’s pre-eminent experts on the links between cannabis and psychosis, can be disastrous for mental health. To explain what he means, he describes one of his patients at Britain’s only cannabis psychosis clinic at the Maudsley Hospital in London. His patient was a young man who had totally lost the ability to distinguish between his psychotic delusions and reality. With treatment, Murray’s patient improved — until he was prescribed medical cannabis from a private clinic. Far stronger than the illegal drugs he had smoked previously, Murray’s patient slipped back into psychosis. More than a year on, he’s still sectioned under the Mental Health Act.

There are no reliable statistics on how many medicinal cannabis patients have become psychotic. But there is good international evidence that frequent intake of high-strength cannabis increases the risk — and here the situation is especially worrying. For if the dried leaf marijuana found in Britain 40 years ago was just 3% THC, which Murray likens to a weak draft lager, private clinics now regularly prescribe cannabis 10 times as strong. Once again, that’s arguably a function of lax regulation. Remarkably, the law sets no limit on a prescription’s potency, while The Lancet has found that smoking high-THC cannabis daily increases the risk of psychosis by at least 400%.

Cannabis clinics say they will not prescribe the drug for anyone with a history of psychosis. But many who do develop psychosis after taking cannabis will never have experienced it before, with one new study finding that individuals with no history of mental health issues, and who “self-medicate” with cannabis, are actually more likely to develop problems later.

Given the potential risks, the way many clinics and suppliers market their services is a further area of concern — especially given the supposed advertising ban. On top of its investment from Snoop Dog, for instance, Mamedica operates in partnership with Cookies, a hugely popular American recreational brand founded by the rapper known as Berner, whose hits include an album called Hempire. Cookies brands available in Britain via Mamedica include the 31% THC “Hawaiian Rain”, which Strains UK says provides “an enjoyable head high and a relaxing body stone”.

Despite the advertising ban, meanwhile, Mamedica trumpeted its Cookies partnership on social media, calling it an “iconic brand”, and in June issued a promotional video presented by the comedian Dom Joly. It shows him trying unsuccessfully to buy cannabis using euphemisms such as “hippy broccoli” and “stuff”. The video never mentions the drug’s real name, but its meaning is clear. It closes with a voiceover saying: “Talk to the experts if you’re considering alternative healthcare. Mamedica — for safe, legal care you can trust.”

Then there’s Mike Tyson, whose strains, marketed under the brand name “Tyson 2.0”, and including the 28% THC Haymaker Haze, are grown in North Macedonia and distributed in Britain by PHCann International. Last year, its CEO Sasho Stefanoski said that partnering with the former boxer meant “we can lead the charge in pushing industry boundaries”.

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I asked Andrew Tyler, Mamedica’s CEO, if he thought the line between using cannabis for recreational and medicinal purposes was becoming blurred, and about the risks of high THC strains. He said Mamedica ensured patients went through a “rigorous eligibility process”, with their safety the “overriding consideration”, and “where there is any personal or family history of psychosis, we do not prescribe”. Perhaps. But as even Ralph MacMurray, the man behind Medbud.wiki says, “you can’t really separate recreational and medical use”.

Of course, medicinal cannabis still retains plenty of supporters, including many seemingly conscious of the risks. One is Graham Woodward, a former psychiatric nurse who now heads the Releaf cannabis clinic. Beyond refusing to prescribe cannabis with THC of more than 25%, Releaf is also unusual in gathering data on the drug’s effects. The firm is currently working with researchers on a clinical trial for people with long Covid.

Mike Barnes, too, says he is against using strains stronger than 25% THC, and railed last year against the growth of the “pseudo-recreational market” under a medical guise. On the other hand, he is a Mamedica shareholder, whose strongest available strain comes in at 34%. He also insists that Murray overstates the risk of psychosis, arguing that with careful prescription the dangers are “minimal” — a claim that prompts Murray to suggest Barnes visit some of his patients.

Despite the new Advisory Council review, meanwhile, much of officialdom seems blind to the risks. Last year, for instance, the CQC called for a multi-agency inquiry into whether the law was working as intended. It was ignored. Jones and others recently lobbied the Home Office and the MHRA, which is supposed to grant permission for every cannabis import. He has heard nothing back, and when I asked the same departments for comment, I got no response. Jones also wrote to the GMC asking them to investigate the role of the “specialist doctors”, but was rebuffed. “The GMC,” he was told, “is not an inspectorate, and we do not proactively monitor compliance with our professional standards.”

All the while, the bonanza continues. Barnes says he thinks 2-3% of the population could “potentially benefit” from taking medicinal cannabis — altogether including about two million people. Dalgety’s James Leavesley is not quite as bullish, but points out that 1.8 million people already take illegal cannabis for medical reasons. If even half that number switched to legal prescriptions, he says, “the market would be huge”. Given the apparent risks, however, not everyone will be lighting up.

One reason for this is that the dimensions of ourselves that are churned up while under the influence of psychedelics are ones that we often have difficulty squaring with the persons endowed with moral agency that we ordinarily take ourselves to be. It is normal to recoil from some of what we find within ourselves, to seek to disavow it once the trip is over. But the fact that we are able to find hidden dimensions of ourselves that seem to have a life of their own, whether we like what we find or not, while under the influence of certain substances, is itself of interest, or should be, to anyone who wants to understand what it is to live in this world, with a human mind and a sense of wonder.

It raises the question: how is it that we perceive reality the way we do? And what does it say about our perception of reality that it can be so fundamentally altered through an intentional alteration of our internal chemistry? Do psychedelics warp our perception of reality, drawing us further than in our ordinary lucid state from the actual way things are? Or do they rather reveal something to us about the way things are that we ordinarily cannot perceive? It seems that to answer in favor of the view that psychedelics push us further from apprehension of the world as it is presupposes that our mind is, in its default state, naturally and adequately constituted so as to know reality itself. But philosophy has spent the last few millennia coming up with some pretty good reasons why we should be skeptical of the idea that the mind is so constituted.

Something therefore seems a bit off, a bit fishy, when philosophers, along with the surrounding culture, shy away from psychedelics, whether taking them or studying their effects, on the grounds that they distance you from reality. Philosophy is born of the realization that we already are, or seem to be, at some distance from reality even in our default mode of consciousness. Why not, then, explore all the modes of consciousness available to us, considering what each of them might have to tell us about the relationship between mind and world? That is exactly what I did while researching my new book, On Drugs: Psychedelics, Philosophy, and the Nature of Reality.

Not so long ago, I was in a city in the Netherlands for three nights. I had been invited to give a public lecture, and I decided to stay on over the weekend to conduct some research for my book. In that time, I took psychedelics twice.

The evening of the second psilocybin trip, having taken more than before, and far more than is recommended, would turn out to be one of the most intense and transformative experiences of my life. Though I bump up against the limits of language when I try to convey what it was like.

My hotel room had a cheap-looking poster of Marilyn Monroe framed on the wall. One of the first signs that the psilocybin was taking effect arrived when I was walking towards the bathroom, and I saw her there and paused in front of her image and stared at her in absolute wonder. “Do I know Marilyn Monroe?” I asked myself. I never met her, but she has been with me my whole life, just as she has probably been with everyone reading this piece. She is at least as familiar to me as, say, any of my first cousins. And yet, I reflect, I have never so much as greeted her. How strange! So, there in that hotel room, I greeted Marilyn Monroe, and it was heartfelt, and I was certain that whatever just transpired counted as a meaningful interpersonal exchange.

But this was just the beginning, as the particular quality of that encounter with Marilyn would be felt 10 times more strongly when I returned to the bed and pulled up old clips on YouTube of Cass Elliott, more commonly known as Mama Cass. For some inscrutable reason, earlier in that day I had had an earworm from The Mamas and the Papas’ 1967 song “Creeque Alley” going through my head, in particular the line that runs: “And no one’s gettin’ fat except Mama Cass.” This had come to me in my completely unaltered mental state, a reminder that the mind and memory are a marvel, too, without psychedelics. I don’t know what it was doing there. I’m not particularly a fan of Sixties folkpop. But there it was, in my head, and so I pulled it up on the computer, and I ended up spending the next few hours watching clips of Mama Cass on the talk show circuit, all the while feeling not only that I knew her, and had always known her, but that I had always loved her.

To say it like this sounds ridiculous, but the feeling was entirely sincere. Something about Mama Cass seemed to tell the whole story of my own existence. I suddenly recalled a black-and-white picture of my parents, from the summer of 1972. My mother is pregnant with me, and she is unusually heavy. Then I recalled a distant memory from early childhood when that photo was being shown around to guests at our home. I knew I was in it, though still unborn, and I knew I was the reason why my mother had gained so much weight. Then I recalled that someone, I don’t know who, said, when looking at the photo, that my mother looked like Mama Cass. Resemblance, now, seemed to collapse into identity, or rather the distinction between them no longer mattered. Mama Cass suddenly appeared to me as “Mama” in the fullest sense: the fount of my being and the origin of my world.

I am not going to attempt to defend this conviction, which felt so strong at the time. That it is indefensible, that it is ridiculous, is precisely what I am attempting to convey. Why did such thoughts come to me so intensely and unbidden? The mind, it seemed to me as I reviewed the experience on the following day, is just so much more wondrous, so much stranger, than my professional colleagues ordinarily take it to be! We philosophers are typically concerned to understand how a human mind can entertain such propositions as “There is a pain in my foot” or how it can perceive a red dot on a screen. These are fascinating problems, too, but surely we might also gain from considering how the mind can become convinced that a long-dead pop star has become identical with one’s own mother or with something like “cosmic motherhood”.

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I think at least a part of the reason we tend to stick with the pain in the foot or the dot on the screen is that, in order to talk about the stranger divagations of the mind, we generally have to acknowledge that we have experienced them, and that is an acknowledgment that typically entails a measure of shame. Part of my motivation in writing what I have written here is to push beyond that shame, to write about conscious experience in a way that truly faces up to the weirdness of the world.

Was my encounter with Mama Cass so ridiculous in the end? Was I completely out of line in my conviction that I loved her? In the Symposium Plato has Socrates describe the ideal ascension of this emotion, from its lowest to its highest expressions. Early in life, we experience love mixed with sexual desire for the beauty of a particular other person’s body, and then we move from there to love of all beautiful bodies. But if we progress as we might hope to do, towards wisdom, then as we age we will also gradually come to love all beautiful minds, and in turn all beautiful institutions and endeavors, then all beautiful knowledge, and in the end, as wise old philosophers, our love will be focused upon nothing but Love itself.

The truth is that most of us vacillate throughout our lives between the various positions on this imagined hierarchy. But whether we think of the ascension as a one-way journey or not, the key philosophical idea in it is that there is a real entity, Love, that exists independently of any of its instances as we know them from experience. This is what we generally refer to as a “universal”, and the question whether such a thing exists or not — not just loveable creatures and things, but Love itself; not just instances of justice, but Justice itself, and so on — will divide the schools of the philosophers, with their running “footnotes to Plato”, as Alfred North Whitehead described the history of Western philosophy, for millennia to come.

I am certainly not going to make any progress towards solving the problem of universals in my book, nor even stake out a position on either of the familiar sides of the debate. But I will remark, first, that psychedelic experience can itself deliver a strong argument in favor of the realist camp in the debate. Under the influence of psilocybin, I seemed not to love Mama Cass, for example, in her particularity, but rather to love her because this love is a point of entry, so to speak, to the experience of Love itself. When I listen to music while on psilocybin, I love the particular song, but I also feel, much more strongly, that the song is my point of entry to Music, with a capital “M”, to the thing itself that exists eternally behind and before all the songs that have ever been sung.

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We all have this feeling from time to time, to some extent. It’s the feeling, in fact, that music and poetry excel above all at conjuring in us: the feeling that there is another dimension that these works of art are coming from. Ordinarily, in a sober and lucid mind, this feeling mostly gets expressed in the form of longing. Songs we love have a particular power to make us feel as though there is a world that we know, somehow, but from which we are cut off. Songs seem to emanate from that world but generally do not seem fully to open that world up to us. Yet under the influence of psilocybin, one of my most vivid thoughts goes something like this: “So that other world is real after all, and it is now open to me! I wasn’t only imagining it!”

Do I still think that other world is real, now, when my brain chemistry is back to its default setting? The answer is complicated, but I believe philosophy can help us face up to the challenge somewhat.

The trouble is that Western philosophy has long valorized the sober, lucid mind above the drugged, drunk, or dreaming one. For at least the past two millennia, Western philosophy has defined itself in contrast to other related endeavors, such as mysticism, theology, poetry, and myth, even as nonspecialists often run these endeavors together. The key difference between philosophy and mysticism in particular, and indeed a key point of pride among the philosophers, is that unlike the mystics — who often rely on techniques to bring themselves into altered states of consciousness, which might include drugs, but also include meditative practices, or attention to one’s own dreams, or the hallucinations induced by descending into the dark depths of a cave — we philosophers are expected to rely entirely on the cognitive faculties available to us in our lucid, waking, and sober state. Our aim is to produce natural-language propositions that can be shared with other philosophers, discussed, argued about, and nitpicked.

Philosophy is almost always held to be concerned, by definition, with meanings and arguments, not with what lies beyond these. But there has also always been a dissenting camp, which says that philosophy should occupy itself with whatever human beings experience, whether easily rendered into propositional form or not. It may be that it is ultimately for the good of philosophy if some of its practitioners willingly run the risk of being seen as having gone off the deep end.

***

This is an excerpt from On Drugs: Psychedelics, Philosophy, and the Nature of Reality. Copyright (c) 2025 by Justin Smith-Ruiu. Used with permission of the publisher, Liveright Publishing Corporation, division of W. W. Norton & Company, Inc. All rights reserved.

Cases like Spejcher’s illustrate the stakes involved in the federal reclassification of marijuana. If President Trump follows through with such a move, the drug would remain illegal on the federal level, but would receive an imprimatur of being safer and face fewer restrictions, with significant commercial and social implications.  

Yet voices across public discourse persist in asking: why should anyone care if President Trump does just that? 

Celebrities like Mike Tyson and Joe Rogan and hedge-fund bosses like Andrew Lahde tell us that marijuana is no big deal. Numerous states have already legalized it for medical and recreational usage, and they claim to be regulating it well. If we are to believe the advocates, marijuana is a miracle cure for PTSD, anxiety, depression, and bipolar disorder — not to mention an unbeatable salve for the pain suffered by cancer patients.

So what sense does it make for this drug to sit in the same federal category as PCP and heroin? Isn’t marijuana’s placement in Schedule I, the most serious category, merely a relic of discredited thinking from the bad old days of the War on Drugs? It isn’t. To understand why it isn’t, and why a Trump move to reclassify weed would risk unmitigated harm to American health and safety, it’s first important to clear up some common misunderstandings around how and why drugs end up classified as they do.  

Under the Controlled Substances Act of 1971, a five-part schedule was established for classification of potentially dangerous drugs. This schedule is emphatically not an index either of a drug’s “hardness” or a kind of unofficial charging and sentencing guide for prosecutors and judges. Placement is earned specifically through consideration of a drug’s accepted medical use and its abuse risk. Drugs with no accepted medical use and a high risk of abuse get placed in Schedule I.  

That’s the commonality between marijuana and heroin; under federal law, the relevant agencies necessarily view them that way.  

Neither has an accepted medical use, though both drugs have approved medicines derived from them that remain in lower schedules (the medicine dronabinol, for example, is synthesized THC, the active ingredient in marijuana, and is in Schedule III). Both have high risks of abuse. The argument that one is a “hard” drug and the other is not  — which is debatable, especially given today’s ultra-high-potency weed — simply doesn’t come into play.  

Nor does the criminal-justice question. Keeping marijuana in Schedule I isn’t, as critics have it, a carceral strategy; conversely, moving it into Schedule III isn’t a de-carceral one. Under a move to Schedule III, the drug would remain federally illegal, still subject to the enforcement power of the Drug Enforcement Administration and the Department of Justice. No low-level offender would see his sentence commuted. This is sort of beside the point anyway, since most low-level marijuana users never receive a sentence for anything. 

But how can it be, another objection runs, that the drug has no medical use? Most US states currently allow doctors to recommend it. 

That, again, is technically correct. But the decisions those states made to allow doctors (and in some cases, “designated caregivers”) to recommend marijuana to treat pain and other issues were political decisions, not medical or scientific ones. Voters stated a preference; that has no effect on how federal agencies are required by current law to view the question. The facts of just how those recommendations get handed out drive home that political aspect. In 2022, Pennsylvania saw some 132,000 medical-marijuana certifications, a third of the state’s total for that year, issued by only 17 doctors.

Those decisions, taken in the aggregate, don’t constitute an accepted medical use. Or at least, they didn’t until October 2022. That was the month the Biden administration directed its Department of Health and Human Services to look into a possible reclassification of the drug.  

Again, history is important here. Before the Biden process, the federal government had used an eight-factor test to determine how to schedule various drugs. Those factors focus on what the current and historical patterns of its abuse look like, as well as what that means for individual users, what risk it presents to public health, how likely it is to cause dependence (either physical or psychological), the state of the science around the drug and its pharmacology, and whether it’s a chemical precursor or “analogue” of another controlled substance.  

By these metrics, marijuana is precisely where it belongs in Schedule I. The best science shows that it isn’t an effective medical treatment. One of the most frequent conditions it’s used to treat is chronic pain. But the 2017 study cited to prove its efficacy there has seen dozens of subsequent meta-analyses and reviews fail to support its conclusions; a 2022 study of a decade’s worth of surgical records from a Cleveland hospital even found that using marijuana actually increases pain after surgery. 

The data also demonstrate that marijuana poses a significant risk of dependency: addiction rates are around 30% of all users and rising. Addiction in this case means exactly what it does for other substances: inability to quit, a need for ever more of the drug to achieve the same effect, and even withdrawal symptoms. Given the recent avalanche of data cataloging marijuana’s harms specifically to cardiac and mental health — like a June British Medical Journal review  connecting it to a two-fold risk of cardiovascular death or the massive Danish study from 2023 suggesting that as much as 30% of schizophrenia cases among men between 21 and 30 were linked to cannabis-use disorder — its wider public-health risks are glaringly clear.  

The Biden administration supplanted the eight factors with a new system seemingly designed to push the drug into a less restrictive schedule. The Biden recommendation — likely a political compromise between the status quo and full legalization, timed just before Joe Biden’s re-election bid — also incorporated the shaky argument that because so many states have made political decisions to allow medical marijuana, that constitutes an accepted medical use.

An incisive article in JAMA Neurology, by the Harvard addiction scientist Bertha Madras, took a hard look at the process and found disturbing evidence of politicization. This included the fact that a high-ranking Biden DOJ official, Acting Assistant Attorney General Peter Hyun, argued that “cannabis has not been proven in scientific studies to be a safe and effective treatment for any disease or condition” — six months before the rescheduling directive appeared. Yet the science Hyun cites certainly had not changed in the interim.  

The federal government has long held the position Hyun laid out. Under the Obama administration, Jay Inslee and Gina Raimondo — then the governors of Washington and Rhode Island, respectively — petitioned the federal government to reclassify marijuana. The administration’s response made clear that federal drug schedules reflect what the science says, not “danger” or “severity.” Obama’s then-DEA chief, Chuck Rosenberg, announcing the denial of the petition, used language Hyun would later echo: “This decision isn’t based on danger. This decision is based on whether marijuana, as determined by the FDA, is a safe and effective medicine . . . and it’s not.”

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But let’s assume, for the sake of argument, that Trump reverses years of federal precedent to follow the logic of the rescheduling argument. What happens then? 

The truth: no one knows.  

It’s clear that the marijuana industry believes that rescheduling will be an enormous benefit to its shareholders. In one sense, that’s likely correct. Businesses selling substances in Schedule I face severe commercial restrictions under the tax code. A provision of the tax code prevents any such business from taking normal deductions at tax time on expenses like advertising. Lifting those restrictions seems sure to provide an enormous boost to revenues and reach for businesses selling marijuana products.

The impact on society is a different matter. The available evidence suggests that this will be a significant negative for society, especially given the research around how the young start using the drug: data published in June by researchers from the University of Southern California and Rutgers University show that exposure to marijuana social-media content plays a huge role in teens initiating use.  

But there are other externalities in play.  

If marijuana moves into Schedule III, it will be the only substance there without Food and Drug Administration approval. Will that play out in a similar way to the case of opium-poppy straw (i.e., the entirety of the plant, as it exists prior to the processes that turn it into heroin or opium)? Poppy straw is listed in Schedule II, but it also lacks an FDA approval — and it’s regularly seized by drug and border authorities, with a massive shipment grabbed up just in May. Though weed entrepreneurs clearly expect smooth sailing after a reclassification, they may well be in for a rough ride.

Then there’s the fact that substances listed in Schedule III face additional regulatory and enforcement power: Not only from the DEA and DOJ, but also from the FDA. There are strict rules around what sellers of Schedule III substances can and can’t say in advertisements. They’re forbidden from advertising off-label uses — and since marijuana lacks an FDA approval, all therapeutic uses are off-label. It’s easy to imagine another operator in the Schedule III space filing a lawsuit demanding precisely that kind of enforcement. 

In other words, rescheduling opens the door to regulatory chaos, even as it seems certain to add commercial firepower to an industry whose products, on the evidence, are extraordinarily harmful. How this combination will produce the benefits promised by proponents of rescheduling also remains unclear. 

The federal government shouldn’t signal to the American people that a drug that lacks medical or scientific imprimatur somehow possesses such approval. Others disagree — and vocally. They have a lot of money riding on it. But we should be crystal clear about what their preferred policy would  actually mean for American society — nothing good. 

In the early hours of 15 August 2007, six young Italian men got into their cars after celebrating an 18th birthday at Da Bruno, a pizza restaurant in the city of Duisburg in western Germany. 

Out of the dark, masked gunmen sprayed their vehicles with 70 bullets, then shot each victim in the head, including the youngest, Fracensco Giorgi, aged 16. In the pocket of the dead birthday boy, Tommaso Venturi, police found a half-burnt image of Saint Michael.

Italian investigators brought in by the German authorities knew what the scorched picture indicated. An image of the saint is partially burnt during initiation rituals into the ‘Ndrangheta, a powerful, 10,000 strong, mafia network founded in the southwest Italian region of Calabria 160 years ago. During this gangster baptism, which marks a rebirth and a lifelong pledge of loyalty, initiates are told:  

“Before the family, parents, sisters, brothers, comes the interest and honor of the society.
 From now on, the society will be your family.” 

The shooting, it transpired, was the result of a simmering 16-year feud between two powerful clans from San Luca, a hilltop commune in Calabria and birthplace of the ‘Ndrangheta. What perplexed the public and the authorities was why this ultra-violent gangland scene had played out, of all places, in Germany. 

Amid the public outrage and a flurry of police anti-mafia activity, what the authorities failed to realize was the extent to which the ‘Ndrangheta had been able to embed itself in the country. Germany wasn’t just a place of refuge for mafia misfits — it was a hub of activity, and Duisburg was a bloody red flag. 

Today, almost two decades after the Duisburg shooting, the ‘Ndrangheta has grown to become one of the largest criminal conglomerates on the planet, with a presence in more than 80 countries across Europe, North America, West Africa and Australia. Described by Interpol as “one of the most extensive and powerful criminal organizations in the world,” the ‘Ndrangheta are involved in a range of criminal activities, including drug trafficking, money laundering, extortion and corruption. But it is Germany which hosts the world’s largest outpost of the Calabrian mob, after their homeland in Italy. 

But it’s the way the mafia has done this that is such a pisstake. The ‘Ndrangheta’s expansion into Germany has largely come on the back of a large portion of parmesan cheese and charm. A network of mafia-run Italian restaurants, from pizzerias and trattorias to gelato shops and cafés, has become the backbone not just for labor rackets and extortion, but in helping to flood Europe with cocaine, even as mobsters use the profits to infiltrate society and establish power in the business world. 

How this has been allowed to happen in one of the world’s most stable and efficient democracies is the subject of a book by Zora Hauser, a criminologist specializing in the mafia from the University of Cambridge. Hauser says this mafia creep has been “made easy” by the German authorities, whose failure to root out the Calabrian mafia in their midst has created a ticking time bomb for law, order, and even democracy, in Germany. 

But why did the authorities fail so blatantly to understand what was happening? Why has the presence of the mafia in the country been overlooked and downplayed for such a long time? These are questions worth asking, because Germany is not alone in facing the rising threat of gangland infiltration. Across Europe’s biggest democracies, after all, organized crime groups are slowly gathering power. 

***

When the first Italian guest workers started arriving in Germany in the Fifties, like many immigrants they were initially distrusted. By the Seventies and Eighties, though, this animosity had dwindled, with an influx of Turks a new diversion. Meanwhile, Germans discovered Italy as a holiday destination with tasty food and good weather, and the number of Italian restaurants and gelato stores in Germany boomed. The Italians went, says Hauser, “from being ‘knifers’ and ‘mafiosi’ to representing good and well-integrated foreigners”.

But as more Italians moved to join family and seek careers in Germany, along came members of the Italian mafia, most notably the Calabrians, who built up businesses and became involved in street drug dealing, theft and extortion. The ‘Ndrangheta’s franchise-like structure — whereby clans set up outposts abroad after gaining approval from a central committee of senior mafiosi in Calabria — made it easy for its mafiosi to venture out of their homeland. Crucially, by the Nineties, compared with the more notorious Cosa Nostra from Sicily and the Camorra from Naples, the Calabrian mafia was far better placed to quickly and efficiently expand their criminal networks abroad. At this time, both in Sicily and the US, the Cosa Nostra was busy fighting an all-out war with the Italian state and the FBI, from which it would not recover; the Camorra was too chaotic and feud-prone to expand so prolifically.   

As luck would have it, the ‘Ndrangheta’s expansion abroad dovetailed with the rise of the international cocaine trade. 

In 2017, after the end of Colombia’s civil war, South American cocaine traffickers decided they needed a fresh market for their product. Mexican cartels had monopolized and saturated the US market, so they turned their full attention to pumping the drug into Europe, where organized crime groups were only too pleased to help out. In a typically bold move, one of the first things the ‘Ndrangheta did to boost imports of the drug from South America was to help build a new port, at Gioia Tauro in Calabria. Plus, their growing presence in countries in northern Europe, near the continent’s busiest shipping ports in Antwerp, Rotterdam and Hamburg, left them perfectly placed to take advantage when the steady stream of cocaine coming across the Atlantic turned into a deluge. 

Since then, Europe has overtaken the US as the world’s largest cocaine market, boosting the coffers — and the power — of crime networks including the ‘Ndrangheta, Albanians, Serbs, Moroccan-Dutch, and Irish. Milking the profits from smuggling a drug that costs $2,000 a kilo in Colombia and at least $40,000 a kilo as soon as it lands in Europe, these gangs deal in multiple tons of the stuff. Annual seizures of the drug at Europe’s borders grew from 60 tons in 2014 to 320 tons in 2022. The profits are mind-boggling. 

Europe’s cocaine blizzard has created a rise in addiction, gangland violence and corruption. In Germany, where estimates put the number of ‘Ndrangheta clan members at between 1,000 and 3,000, the country’s excellent strategic position has enabled the mafia to turn it into a logistical drug smuggling hub, using the profits to infiltrate the country by stealth, infecting it from the inside out. 

***

Diners at the Leonardo Da Vinci restaurant in Wesseling, a small city outside Cologne, could never have known, but behind its unassuming facade of red awnings, pot plants and and terrace dining, lurked a money laundering and cocaine smuggling hub run by the ‘Ndrangheta. As customers ate their carbonaras, cocaine-loaded cars were being driven into Da Vinci’s car park, stored upstairs before an onward travel to Milan. 

These mob-run Italian restaurants, gelato stores and cafés have always been a crucial part of the ‘Ndrangheta’s strategy in Europe. And it is in Germany where this tactic looms largest. This is not the odd restaurant. In some parts of Germany, it’s tricky to buy a pizza without accidentally helping to fund the next shipment of cocaine. A clan based in Erfurt, a city in the central state of Thuringia, has established a near-monopoly of the city’s Italian eateries. Police linked the mafia there to 23 Italian restaurants, cafés, and gelato stores — in a city the size of Luton. 

Behind the pizza ovens and spaghetti bolognese in scores of eateries in Germany, the charm of Italian hospitality is being cynically used by the mafia as a cover to launder money, smuggle cocaine, engage in racketeering and get close to those in power. 

“It’s hard to believe the mafia infiltrates democratic life through the corner pizzeria — but that’s exactly the point: hiding in plain sight,” Hauser tells UnHerd. “The goal is full integration. Winning over the community, reaching into politics.”  

Often, it’s presumed that businesses run by criminal gangs are shells with few customers. But in Germany, they can be the most popular joints in town. A restaurant in the central state of Hesse, whose owner had been involved in drug trafficking, extortion and murder, was the center of public life. It hosted evenings run by the local newspaper, small concerts and events for the elderly. Luigi, the long-standing clan boss behind the restaurant, applied jointly with the local mayor for EU subsidies to restore an old building in the town center. 

The underworld seamlessly mixes with the upperworld. “While the [criminal] business still relies on intimidation, coercion, or, more generally, the constant flow of illicit gains,” says Hauser, “to the outside, it presents a friendly façade, exemplified by good food for honest prices, a warm welcome, and a taste of the Italian ‘dolce vita’ that so fascinates German society.” 

Behind the smiles, though, comes the threat. Hauser spoke to a German businessman who ditched plans to open an ice cream shop in his local town after a ‘Ndrangheta messenger told him there was no space for two gelato stores in the neighborhood, adding that they knew where his children went to school.  

When Hauser traveled to neighborhoods infiltrated by the mafia, and talked to locals about the gangsters arrested in their midst, many thought that she and the police must be mistaken. The mafia had gained so much trust that neighbors and customers refused to believe what they read in the news. Why? Because they had a romantic, nostalgic, movie-inspired view of the mafia. A neighbor of one clan boss, who ran a local pizzeria and was arrested by police special forces, told Hauser that if he really had anything to do with the mafia, then why had the police not intervened earlier? 

Perhaps because the local authorities had also been sucked in.  

‘Ndrangheta mobsters in Germany have been quick to befriend people in positions of power. Politicians and civil servants are deliberately wooed to increase gangster’s social capital, their influence and to help — wittingly or not — shield them from the law. Right from the start, people in positions of authority have had their heads turned by some of these relationships. When police in the late Nineties intercepted the phone of a ‘Ndrangheta member, who owned a restaurant in Stuttgart, they were surprised to find that he was in direct contact with a man he called “my minister”. This turned out to be Günther Oettinger, the leader of the Christian Democratic Union in Baden-Württemberg. Instead of investigating further, the authorities warned Oettinger about the phone surveillance. A public inquiry into the scandal found the politician had not committed any crime, but concluded he might have been “unwillingly and unknowingly used by organized criminals” to further their business. 

A former mayor of Erfurt told Hauser that though he had heard that Luca, a local restaurant owner, had links with the Duisburg massacre and was a member of the mafia, they became friends. He held his re-election party in Luca’s restaurant. “We decided to do Bella Italia,” he told Hauser. “Italian music, federal ministers came and spoke, I was there. We did this as our election rally celebration, and they could profit as well, there were so many people, they were queuing!” 

When a special commando unit entered one of the Erfurt clan’s restaurants as part of a murder-related investigation, the police bumped into their direct superior, the State Minister for Home Affairs, having a meeting over pizza with the Governor of Thuringia. The search was halted. An investigation by journalists found there was no mention of the incident in official records. 

In another restaurant round the corner, phone surveillance caught a district judge telling a mafioso restaurant owner suspected of drug trafficking that his restaurant was under surveillance — before giving him the name of a good lawyer. “This is what differentiates mafias from other criminal networks and explains their unique resilience over centuries,” Hauser tells UnHerd. “It is hard to overstate the importance of the link between the mafia and people in power, because it ultimately guarantees them protection.”

***

It’s a mistake to measure the threat of gangsterism just by the amount of blood spilled. While the Calabrian mafia used to operate with a gun behind its back, after the heat from Duisburg the clan in Germany decided to keep their pistols in their pockets. 

When in 2013 a ‘Ndrangheta boss heard that two of his men had got into an argument and pulled out their guns in Melsungen, a spa town in central Germany, he was furious. A police phone intercept recorded his reaction: ‘What is this circus? Getting out a weapon on the street?!.. I am telling you now and I will not tell you again! Melsungen must be like a church!’

A deliberate policy to put profits before murder, to make it easier to blend in with the legitimate world, was adopted. Avoiding the kind of brazen violence that has necessitated state crackdowns on organized crime networks across Europe, has been crucial to the Calabrians’ expansion abroad and their success in the cocaine trade.

Nicola Gratteri, a mafia prosecutor,  said in 2023 that the ‘Ndrangheta in Germany is now “more interested in cash than blood… the mafia is here to buy cocaine and reinvest the money to buy hotels, restaurants, and pizzerias.” 

This is far from saying Europe’s major cocaine traffickers have become impotent. Quite the contrary. According to Europol’s latest organized crime threat assessment, published in May this year, drug trafficking “has a high potential to destabilize EU society, given its association with… corruption, and infiltration in the legal economy.”  The report found that 80% of organized crime networks in Europe also ran companies in the legal economy. 

Slowly, then, organized crime is infecting Germany’s institutions and economy. Police officers and officials are increasingly being investigated for corruption and having links to organized crime. In an ongoing trial which started in May this year, a court has heard how the chief public prosecutor involved in one of Europe’s biggest ever cocaine seizures at Hamburg’s port is alleged to have been on the payroll of the same network of traffickers he was supposed to be investigating. 

***

Why have the German authorities been so blindsided by the Italian mafia — who, after all, have something of a reputation? 

For a long time, Germany’s authorities seemed to consider gangsterism to be something that affects poorer, less stable nations around the world, like Albania or Colombia. The ‘Ndrangheta was allowed to operate “virtually undisturbed,” says Hauser, owing to a mix of incompetence and complacency. She suggests this lack of know-how has resulted in weak organized crime laws; an anti-money laundering framework so bad it has failed to reach EU standards; and a perversely high bar for prosecutors to prove a suspect is a member of a criminal organization. 

“The rise of the ‘Ndrangheta is symptomatic of how vulnerable Germany is to organized crime more generally,” Hauser explains. “Calabrian mafiosi are by no means the only crime groups active in Germany, nor is this presence a new phenomenon. The notable aspect is how long it is taking for Germany to wake up to reality.”

Law enforcement across Europe has been stepping up operations against the ‘Ndrangheta. In 2023, for instance, Operation Eureka revealed how clans in Germany teamed up with Albanian and Latin America crime groups to smuggle 25 tonnes of cocaine in under three years. But German authorities themselves have so far failed to convict any ‘Ndrangheta members in Thuringia, a state in which the ‘Ndrangheta has thrived. 

In fact, they have been suspiciously bad at this. 

During Operation FIDO in the 2000s, the German federal police successfully planted an undercover detective within the Erfurt mafia organization to target eight key clan members. But in 2002 the investigation was suddenly halted without arrests or explanation — a decision that is now the subject of an inquiry by the state parliament. 

Then, in 2019, at a secret meeting in Rome, Italian mafia investigators gave Thuringian state police a list of 70 suspected members and associates of the Erfurt organization, including a list of restaurants and companies they were linked to. Yet bizarrely, no further action was taken. “German authorities… have never acted upon the evidence that they have collected over the years, to the point that a parliamentary inquiry is now investigating a possible case of negligence,” writes Hauser.

This nefarious mix of collusion and negligence fuels mafias the world over. If the money is flowing and the authorities are doing nothing, it’s in no one’s interest to kick up a fuss. And the more mafias integrate, the less suspicious they appear. 

***

Organized crime conglomerates such as the ‘Ndrangheta loom large over the future. At a time when the drug trade continues unabated, and nations are becoming less collaborative and institutions are hemorrhaging trust, crime groups are stepping in to further expand their networks and use the cover of legitimacy to gain more power. How powerful they actually are is a mystery, because the less you look the less you find.

When police from Europe, the US and Australia accessed hundreds of thousands of messages sent between 2019 and 2022 – sent on encrypted mobile phone systems used by gangsters to arrange everything from cocaine deals to executions – what surprised them most was how much they had underestimated the capabilities of organized crime. 

Amid a sea of mundane gangster chat, a treasure trove of intelligence revealed that the scale of the cocaine business, from the UK and the Netherlands to Switzerland and Sweden, was far bigger than they had estimated. But, crucially, the hacks revealed how international crime networks were far more interconnected and collaborative than law enforcement officials had ever imagined. In Europe’s biggest democracies, in countries seen as being “too civilised” for organized crime to become a big threat, gangs are laundering billions in cash, corrupting senior officials, becoming major youth employers, and are shooting witnesses during trials. 

In Spain, the country’s chief economic crimes investigator was arrested after he was linked to a secret stash of €20 million and a gang that smuggled 13 tons of cocaine into the country. In Antwerp, there is so much cocaine being seized the authorities cannot incinerate it fast enough, so it’s being stolen back by the traffickers. Across the border in the Netherlands, which some of its police have called a “narco-state”, the impact of organized crime is being highlighted by frequent incidents of violence, including the execution of a journalist and a lawyer during a gang trial.

In France, a report last year by senators warned the country was becoming “submerged” by drug trafficking and the corollary of exacerbated violence. In Switzerland, drug money is having a growing influence on the legitimate economy, from money laundering to protecting mafias such as the ‘Ndrangheta. In Sweden, where wars over cocaine profits have sparked record gun murders and bombings, crime networks have resorted to recruiting and radicalizing hundreds of teenagers to carry out a spate of gangland killings.

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Closer to home, meanwhile, the UK has become a continental hub for Europe’s cocaine industry and a target for investment by the ‘Ndrangheta and other crime groups. Cocaine money has empowered a new generation of British gangsters, enabling them to disguise themselves as entrepreneurs. Amid this blizzard of profit, every hour inner-city children are being recruited to swap school lessons for a career selling crack and heroin in trap houses in rural and seaside towns and cities across the country. Meanwhile, an endless series of Albanian gang-run cannabis farms staffed by slave labor in suburban homes and abandoned churches, police stations and banks pump out cheap cannabis so the profits can be used to import cocaine.    

Like several other organized crime networks, the Calabrians are on the up, according to those charged with fighting them. “Ndrangheta operations are now extensive across Europe,” Samuel Heath, communications director at Interpol, tells UnHerd. “Over the past few years, we have seen a significant increase in the scope and reach of ‘Ndrangheta: they’re operating in more than 40 countries and continuing to grow.”

If you want to see what the future of gangsterism looks like in a Europe which chooses to face the other way, look at Italy. There, even though mafia-related homicide is very low, the mafia is reaping the rewards of decades of entrenchment, and its grip on society is tightening. Every month, a city council is disbanded, which is the state’s measure of last-resort when there is evidence that the mafia has such a high level of influence over institutions that the whole municipality is deemed to be under its control. Between 1991 and 2020 there have been 351 such dissolutions in Italy, together affecting more than five million people. Calabria saw the most of any region in Italy, with 123 dissolutions. This is control without the need for gunfire or garrotting.

“Virtually no big infrastructure project, political campaign, natural emergency, from earthquakes to Covid subsidies, international event, sporting occasion, including the whole management of the San Siro football stadium in Milan, moves forward in Italy without the mafia trying to get a cut,” says Hauser. ”If no action is taken, this is where we end up.” 

How the Italian mafia, fueled by the cocaine trade, has used pizza restaurants as a way to expand its influence in one of the world’s most robust democracies is just part of a wider story about the relentless spread of worldwide organized crime. It’s also a warning. 

The intermittent noise of gangsterism — a bloody street execution or an innocent caught in crossfire — naturally hits the headlines. Yet all the while, its more clandestine activities continue to rot societies from the inside, degrading the public’s right to hold power to account. 

In hard times, their illegal wealth acts as a vortex of temptation to recruit the young to work on the criminal shopfloor, and to flip business owners, police and politicians. Furthermore, falling trust in mainstream political parties and institutions, complacency and rising extremism has opened the back door to criminal groups who want to get closer to power. Gangsters are useful to corrupt insiders because they can carry out deniable crimes at arms length on behalf of politicians or businesses. In return, they get impunity and favors. Together, the billions of dollars generated by organized crime and corruption each year acts as a vampiric-like leech on societies, widening inequality, making it harder for democracies to help citizens and make life better. Looking the other way is not an option.    

The essay was published well before the Manson Family murders, before the Rolling Stones’ Altamont Speedway concert debacle, the Kent State shootings, the deaths of Jimi Hendrix, Janis Joplin, and Jim Morrison — before any of the infamous totems of the death of the Sixties. Yet the picture Didion paints of an already decaying counter-culture is bleak: rather than discovering the kind of fluid, boundary-less utopia imagined in the new culture of psychedelic drugs, thousands of young people had squandered their minds and lives chasing a pseudo-enlightenment sold to them by gurus and cult figures — the most famous of course being Timothy Leary, who had traveled across the country inviting every American to “Turn on, tune in, and drop out”. Instead of precipitating a glorious era of mass enlightenment, LSD ended up creating a burned-out, drug-addled generation of lost children.

Considering Didion’s prophetic picture of that burned-out acid generation, it seems entirely possible that our own society stands on the edge of something similar, even if its own destructive ideals of utopian design have been institutional and technological, where the Sixties dream was countercultural. Beset by internet addiction, climate anxiety, depression, overwork, ADHD, and a general tendency towards distraction and retreat from the world, ours is a culture of burnout and exhaustion which looks like nothing so much as a recapitulation of the Sixties fallout, only with the internet as our new mind-altering drug of choice. Yet these eerie similarities are no accident.

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From the release of formerly clandestine information, in the Seventies, we know that LSD was introduced into America by concerted governmental programs in the early Fifties as part of Cold War MK-ULTRA operations, in an attempt to develop new forms of brainwashing and mind control. For years, the United States government experimented with psychedelic drugs on people in asylums, prisons, and clinics. The journalist Tom O’Neill, in his rather persuasive book CHAOS: Charles Manson, the C.I.A., and the Secret History of the Sixties (2019), has even gone so far as to suggest that Charles Manson himself may have been the product of deep-state testing, during his time in prison. Whether or not this is true, the fact remains that the drug which unleashed massive anti-societal, anti-institutional energies onto an unsuspecting American public was the product of a state experiment, an attempt to discover a new technology of power.

As the Sixties dream collapsed, these mass collective visions were channeled into more explicit cults, and into narrower, individualist ideas of therapeutic soothing. The Seventies saw the proliferation of guru-centered religious cults such as the Rajneesh Movement and Jim Jones’ People’s Temple — the latter infamous for its congregational mass suicide in 1978 in Guyana. The decade was also dominated by what came to be known as the New Age, a vague bricolage of spiritualist practices including Americanized popularizations of Zen and yoga; neo-pagan groups like Wiccans and the Church of Satan; even expanding middle-class interest in Freudian and Jungian psychotherapy. The emerging popular images of “spirituality” at the time — healing crystals, meditation retreats, soothing muzak — were all part of this new climate, stemming from the collapse of the commune movement, an emergent global recession, and increasing fragmentation into individualist anomie. This was the “Me Decade” which the great socialist critic Christopher Lasch detailed acutely in his 1979 book, The Culture of Narcissism.

For Lasch, the new therapeutic language of the Seventies had combined with the slow constriction of family life, an addictive obsession with professional sports, ingeniously distractive media, and a collapse in popular faith in institutions, to create an isolated and narcissistic culture losing all sense of shared vision or communal life. For all its potential value, the increasing middle-class obsession with therapy was ultimately only teaching people to further obsess over themselves: people were growing more and more concerned with tracking and transforming their own feelings and thought patterns, instead of turning outwards to the world, or confronting the need for real public, political transformation. The ever-unattainable ideal of “mental health” had effectively replaced the Christian doctrine of the salvation of the soul. In place of religion, or even those utopian visions of mass psychedelic enlightenment and countercultural communalism, the West now had a myriad of individual spiritual projects — all increasingly packaged, marketed, and thoroughly commodified.

Around the same time, Silicon Valley had begun to form. With the Advanced Research Projects Agency Network (ARPANET), California university researchers funded by the US Department of Defense had created a new mass packet-switched network, functionally connected by 1969. This ARPANET formed the foundation for what would later be the Internet. Given the name “Silicon Valley” by Dan Hoefler in 1971, that section of the San Francisco Bay Area played host to the world’s largest concentration of hardware and software developers, start-ups, and inventors of new computer technologies. With the introduction of the IBM Personal Computer in 1981, and the establishment of the official Silicon Valley Bank in 1983, the place became the epicenter of the coming digital revolution.

Silicon Valley had its own emergent culture, too — one which, as it turned out, had much to do with that death of the Sixties counterculture, and all those lost dreams of a boundaryless utopia. In an influential 1995 paper, University of Westminster media scholars Richard Barbrook and Andy Cameron gave this loose ethos a name: “The Californian Ideology.” This “bizarre fusion of the cultural bohemianism of San Francisco with the hi-tech industries of Silicon Valley… promiscuously combin[ing] the free-wheeling spirit of the hippies and the entrepreneurial zeal of the yuppies”, made up the set of liberatory ideals which had formed the ideological basis for these new networks, from its earliest days to 1990, when the British researcher Tim Berners-Lee from CERN had built the first web browser, along with the software behind the creation of the World Wide Web.

According to Barbrook and Cameron, the creators and theorists of the Internet had come to see an unlimited, untamed cyberspace as a chance to finally achieve the old utopian dream, following the collapse of the New Left movement and the burnout of the Californian counterculture. What the Sixties had failed to bring about at the level of consciousness might now be done through technology. But Barbrook and Cameron noticed something disturbing going on, namely a strong rightward drift, into fantasies of “perfect” markets and totally sovereign individuals, freed by the ultimate “democracy” of the internet from any societal responsibility. They reported that the new hi-tech and media industries were becoming rhetorically very important for the New Right, since “both capitalists and well-paid workers fear[ed] that the open acknowledgment of public funding of their companies would justify tax rises to pay for desperately needed spending on health care, environmental protection, housing, public transport and education.” They also wrote, despairingly, about how many people in this new “virtual class” had been “seduced by the libertarian rhetoric and technological enthusiasm of the New Right. Working for hi-tech and media companies, they would like to believe that the electronic marketplace can somehow solve America’s pressing social and economic problems without any sacrifices on their part.”

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Of course, this is a paradigm we’ve seen repeat itself many times over in the past decades. It’s fairly well accepted at this point that the 2024 US presidential election was at least partially clenched for Trump by the support of tech titans like Elon Musk, Jeff Bezos, Mark Zuckerberg, and Peter Thiel, whose Orwellian corporation Palantir has already benefited immensely from working with the new government. Democratic socialists in America have argued for years that the sway tech companies can purchase in the government only further facilitates the transfer of federal money away from new infrastructure, or welfare for a struggling population, and into the coffers of these already exorbitantly overvalued and over-subsidized monopolies.

The parallels on the historical scale are also obvious if we look at the beginnings (and the end result) of the Californian Ideology. First introduced as a technology of control, with large-scale military investiture, psychedelic drugs and the counterculture which emerged from them took an entire generation from mass public defiance of conformism, and celebration of spiritual transcendence, into mass psychological crash-out, followed by a descent into narcissism and myopia. Via those inventors and businessmen of Silicon Valley who successfully globalized the Californian Ideology, a similar project was envisioned, only now at the institutional and technological level. It was no longer merely counter-cultural: it was the underlying impetus for the new technological regime itself. And it, too, had decades of concerted investment by the US military to thank for its sudden widespread effect.

Which brings us to the present moment, and what it shares with the death of that older utopian ideal. All pretensions towards the “democratizing” power of Web 2.0 social media died with the Arab Spring 15 years ago; since then these sites have only increased our political polarization and intra-group hatred. We’ve even begun to develop our own cult leaders and cultish language: consider accelerationists following the example of Nick Land, or new anti-democratic “philosophers” like Curtis Yarvin, along with an Internet filling up with doom-laden terms like “the longhouse” or “the cathedral” and, of course, “taking the red pill”. Transhumanism, Applied Rationalism, and Effective Altruism have established themselves in actual institutional centers, in affiliation with many companies in Silicon Valley today — yet all have shown the tell-tale signs of cult-like activity, from sexual grooming scandals to tales of obscene behavior to murky influence on the rich and powerful.

Then there’s the simple fact of mass emotional collapse, as overstimulation from internet addiction and portable devices only worsens. In 2010, the philosopher Byung-Chul Han characterized the primary disease of our time as “neuronal”, manifesting in pathologies like ADHD, depression, and burnout. In his remarkable book, The Burnout Society, Han traces the transformation of Western society from a “disciplinary” paradigm to an “achievement” paradigm. From a society based on coercion and force from above, we’ve shifted to a society in which each person becomes self-exploiting, suffering not from any threat of direct oppression from the Other, but from “an excess of positivity”. Consider all our brief media obsessions over fads like “quieting quitting”, “ghosting”, or the “Great Resignation”. In a world of entrepreneurs, personal brands, and internet avatars, the ruling feeling of the day is the constant threat of an immense narcissistic crash-out, an exhaustion which comes from having to aggressively and constantly be one’s own authentic self — and then to sell it. We’ve never been more stimulated, more overwhelmed by information, or more productive in our work. The result is a deepening sense of total existential exhaustion, not at all dissimilar to the post-Sixties burnout.

It’s impossible to know where any of this is really heading. Yet if we follow some of these analogues — keeping in mind that it’s hardly a perfect one-to-one map, only a sense of the way our massive societal upheavals tend to produce mass exhaustion — we may glimpse some of what’s in store for us. Consider the increasing evidence for the “Dead Internet” theory, the suspicion that maybe even a majority of the internet is, at this point, only dead bots interacting with other dead bots. We’re looking at a pandemic of tiredness, overstimulation, and overwork, and even that is accompanied by a loss of any last vestige of meaning or reality in the digital networks we’ve used to distract ourselves. In the next decade, we’ll likely see a rise in even more obvious cults and spurious new spiritual movements; huge increases in young people “tuning in, and dropping out” from mass communications technologies; the increased transition from mild “digital detoxes” to outright rejection of digital existence; and a rise in the establishment of primitivist communes.

The benefits of this new paradigm could be remarkable: a return to pragmatic grassroots socialist politics; an increase in DIY planting and repair-work; more communal living, perhaps cross-generationally; the return of something like a true counter-culture, or an artistic avant-garde; new, classically humanistic educational institutions, away from our ineffectual universities; even a larger return to sincere interest in the great world religions. If history is any guide, and we really are in for a massive post-utopian burnout at a level never seen before, then these are the very kinds of alternatives and experiments which we’ll have to embrace. Unless we want to live in a world where the destruction wrought by pseudo-utopian projects is simply replayed at the mass technological level, then we’ll be forced to find ways of connecting to each other which don’t rely solely on digital technology or existing institutions. We may indeed be in an escalating mess of mass emotional collapse — a crisis of exhaustion. Yet as Winston Churchill is supposed to have said (in a way which still rings quite true): “Never let a good crisis go to waste.”

We watched people come and go. Black and white, but mainly black. The estate was largely Afro-Caribbean, which is a problem when you’re perpetually accused of only stopping black people. A few of the pub-goers were known cannabis dealers. They saw our marked car and either sucked their teeth or pointed their fingers at us like pretend guns. “There you go,” said Stuart, nodding at a tall black man wearing a tracksuit. The man was leaving the beer garden, wreathed in sickly white smoke. “That’s my man.”

The thief-taker got out of the car and began reciting the catechism known to all police officers: “I can smell weed on you, mate. I’m gonna search you. Now, have you got anything in your pockets you shouldn’t have, anything sharp?” Then he continued with a heavily-abbreviated version of the information required under Section 1 of the Police and Criminal Evidence Act 1984. The search led to the discovery of several wraps of crack and a quantity of cash. The man in the tracksuit was a dealer who the thief-taker had been keeping a beady eye on. And, yes, the scent of weed was the key to the door.

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I later tried the same trick myself. Stopping a suspect who smelled of weed, I searched him and found a car key. The suspect, who didn’t have a driving license, had “borrowed it”. Inside the car? A dozen freshly stolen leather jackets from a local motorcycle shop. I was no thief-taker, but then again the guy with the stolen jackets wasn’t exactly Moriarty, either.

The tactic is hardly a secret. London’s police are sanguine about cannabis use unless you’re — to put it bluntly — taking the piss. During my stint as a uniformed officer I was fairly liberal in my application of the law, but found it was a useful tool for catching bad guys. And, for some reason, petty criminals love weed. Sadly, such earthy truths offend the sensibilities of those in power. Which is presumably why Sadiq Khan’s recent review of drugs use in the capital recommends decriminalizing small quantities of cannabis for personal use. The review, which pompously treats London as an independent state rather than the UK’s capital city, was (of course) headed by an impeccably liberal lawyer and close friend of Tony Blair, Charlie Falconer. Falconer said officers use such tactics “disproportionately against black men”, and that the enforcing of drugs laws is an “incredible friction point between the police and black communities”.

The politics behind this review are typical of London’s mayor: performative, headline-grabbing, problematic for policing and designed to garner support from Labour’s base, especially younger voters. Unlike his predecessors, Khan’s support for the Met has been equivocal, despite policing being one of his only significant Mayoral powers (the other is transport).

Khan is the third London mayor since the role was created. I have been an officer under all three London mayors, of whom Khan has been the most unhelpful to policing. Ken Livingstone, despite his reputation as a Left-winger, understood the importance of robustly policing a capital city. Boris Johnson had the good sense to subcontract policing to his more capable deputies and, eventually, to get rid of the lackluster police chief Sir Ian Blair. What of Sir Sadiq? His opportunism is shameless yet instructive. How so? Delve into the small print and you’ll see how, practically, his proposals are unworkable. The Mayor said: “The report makes a compelling, evidence-based case for the decriminalization of possession of small quantities of natural cannabis, which the Government should consider.”

This is where the proposal falls apart, or perhaps the mask slips. Small quantities of natural cannabis? Patrol officers would be required to become mobile pharmacologists. All arrests for drug possession are usually “on suspicion of”, because, at the moment they seize the drug, officers can’t evidentially prove precisely what it is. Another difficulty is that, compared to other drugs, cannabis covers a wide spectrum, from brain-rotting psychoactive skunk to the sort of mellow, artisan weed smoked by surfer dudes on Cornish beaches. How, in the rain, at 2am, is a police officer meant to know the difference? This betrays the report’s likelier purpose: the police officer isn’t meant to stop and search in the first place. Just leave the kids alone! Perhaps I’m a natural cynic. Or perhaps I’m simply a keen student of Sadiq Khan’s approach to Ulez “evidence-gathering”, whereby his strident claims about air pollution and congestion were found wanting. Either way, this looks more like an attack on stop and search as a tactic.

What we should pay attention to is the direction of travel. Stop and search is a totemic issue for progressives, and always has been. Is it always fairly applied? No. Is it necessary? Yes. Is Sadiq Khan prepared to tackle the reasons why stop and search is so contested, or simply pander to his political base? I would, were I able, lock Sir Sadiq in a room and make him watch the third season of David Simon’s TV epic The Wire. Written by progressive creatives for a largely progressive audience, The Wire is nonetheless the best drama ever produced on urban policing. The episode titled “Amsterdam” concerns the consequences of an experiment in decriminalizing drugs in order to ease community tension and treat addiction as a health issue. The experiment goes badly wrong when gangs realize parts of Baltimore have essentially turned into a free-fire zone, a place where they can ply their trade unhindered by local officers.

As ever, though, British politicians trail their American counterparts by five to 10 years. American cities have experimented with varying degrees of drugs liberalization in cities such as Portland and Los Angeles, with predictably dystopian results. The criminal ecosystem, the real one as opposed to the one described by academics, thrives on weakness of any kind. A city weakening its stop-and-search policies for small amounts of drugs, as the Americans discovered, has a cumulative (if not intended) effect as users and dealers drag with them their associated social problems. Portland was transformed from an artsy, bohemian city into an open-air drug market and refugee camp for the addicted homeless. Los Angeles and San Francisco, with their lax prosecutors and defanged police, became lawless paradises for shoplifters and robbers.

Even San Francisco, America’s most liberal city, has had enough. Its Democrats have rediscovered the benefits of robust policing, prosecution and sentencing. The lax policing was an inheritance from the academic revulsion at the “Zero Tolerance” policies of the early Nineties, whereby law enforcement targeted minor offenses. The approach was viewed by criminologists as oppressive and ineffective, a verdict that ignored the “lived experience”, usually so respected by academics, of people living in communities blighted by criminality and antisocial behavior.

This light-touch style of policing is finally going back out of fashion. Naturally, the academics concerned have yet to admit they were wrong — just that their pet policies “haven’t been implemented properly”. Predictably, the milquetoast British College of Policing also reviles Zero Tolerance law enforcement.

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Alternatively, closer to home, Sadiq could simply Google Brian Paddick, the real-life police commander who posited legalizing cannabis in the interests of “community relations”. This isn’t to unnecessarily disparage Brian, who in my experience was a fundamentally decent man. Serving in Brixton in the early Eighties, he became evangelical about reforming stop and search. The results of his experiment in what I’ll call “Total Tolerance” are disputed, but like the Mayor’s review, it was about much more than implementing drugs laws. It was, again, about a direction of travel, part of the ouroboros of a debate between “robust” versus “soft” policing. The answers are, of course, situational, complex and uncomfortable. This reality is too often lost on policymakers.

My experience suggests that drugs laws are like speed limits. If you set the motorway limit at 70mph, invariably the police (although not money-grubbing cameras) will usually turn a blind eye until you hit 90-ish. Why? Resources. Discretion. Common sense. It’s the same with minor drugs offenses. Politicians like Sadiq Khan don’t really like stop and search. They don’t trust the police, either. Why doesn’t Khan simply say so? Or would that involve opening fresh cans of worms about police funding, training, recruitment and leadership? Including, of course, the Mayor’s. He is, after all, the de facto Police and Crime Commissioner for Greater London.

The wheel goes round and round… and where will it stop? We all know, actually, but that never deters progressives like Khan from trying another spin. In the meantime, the Mayor has his headline for the day. The quangocrats of his drugs review board will have been paid their stipends. The slow, inexorable creep of progressive policymaking continues, only ever heading toward one destination: failure.

Meanwhile, for operational police officers, the mood music is clear. It’s also clear to the activists seeking to undermine or even defund the police. All parties know that stop and search is something frowned upon by the powers-that-be. Should something go wrong, an officer is unlikely to be defended by those at the top. All this means that thief-takers like Stuart are no longer welcome in London’s police. Parts of London already resemble cannabis-stinking favelas. Perhaps, until Sadiq Khan notes the lessons from Portland and elsewhere, that’s where the city’s future lies.

The move would eliminate more than 20,000 jobs: case workers, public-health researchers, Narcan distributors, Medicaid rehab staff — the very professionals and programs, in other words, that serve the victims of American Carnage. It is among the gravest betrayals of Trumpian America in a second Trump term that undeniably favors Reagan-style austerity over popular domestic policy.

Since Oxycontin emerged on the market in 1996, more Americans have died from accidental opioid overdoses than were killed in the Vietnam War, the Korean War, and the Second World War combined. The bloodshed of the opioid epidemic is the worst conflict in America this century; and its architects — the Sackler family — still live in luxury and wealth.

For decades, the crisis only got worse, prescription meds giving way to fentanyl-laced pills; the Covid pandemic isolating people from their support systems; hundreds dying every day. Yet recent successes were undeniable. This year, overdose deaths plummeted by nearly 30,000, the first such drop since the Nineties. This progress owed to a combination of expanding Medicaid rehab, making the anti-overdose drug Narcan free and ubiquitous in rural counties, and establishing data systems to track where spikes were happening in real time. In other words, thanks precisely to the programs now on the chopping block.

Yet, even as Team Trump destroys the tracking programs that rendered the crisis visible, American literature has served up the first great opioid novel, The Emperor of Gladness. The 36-year-old author, Ocean Vuong, grew up in the ruins of the crisis in Connecticut, where Oxycontin was created, lending him the firsthand experiences that form his tender Bildungsroman. It follows his fictional stand-in, Hai, rescued from suicide by an older Lithuanian woman who makes him her carer.

The book is infused with the grim, perpetual reality of post-industrial America — the words “pills” and “war” recur in every chapter. Hai describes the bloodshed around him as his adolescence unfolds: “It did not have a name, this slaughter, and yet your loved ones were being slowly erased, even teachers and lunch ladies overdosing overnight, then cremated without ceremony, their faces soon existing only in your mind.”

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When I went to his book launch in New York, Vuong moved himself to tears three times. He gets a lot of flak for being too emotional, and his earnestness can be exhausting (watch him on Oprah). But it reveals something profound: he believes his success is born from the fluke that he is still alive. He is “no better than the friends I’ve lost, just lucky that when I tried the pills, they made me feel like I was drowning; and that I didn’t like that.” In this part of the country, lucky means he was addicted to cocaine, instead of the Oxy and “fent-dope” his friends took.

That sense of arbitrary survival, just brutal luck, is threaded through the novel. Hai tries rehab, relapses, remembers the boy he loved who died from wanting “too much of one feeling.” He witnesses his first overdose at age 12, and thinks as he watches a woman saved by Narcan at work: “Her mouth was open like a Scream mask.” One of Hai’s coworkers at the local fast-food chain thinks the world is run by lizards that are “feeding off our negative energy.” She’s crazy, Hai thinks, but kind of right.

It’s a reptilian twist on a capitalist reality: Vuong watched his friends die from fentanyl and OxyContin that billionaires had bribed doctors to prescribe. 

The pain exhaled throughout Vuong’s book stores enormous political capital that Trump once tapped into. In 2016, he campaigned on a platform of expanding access to Narcan, cutting opioid prescriptions by a third, and securing “billions” for opioid treatment. Then, in 2024, he started to mine support from an even more politically rewarding angle: revenge, by promising to shut the borders through which chemicals for fentanyl come into America and threatening the death penalty against dealers. Vuong, who worked picking tobacco and at the fast-food chain Boston Market, wasn’t “surprised” by Trump’s win either time. The “slaughter” around him wasn’t being talked about by the Democrats, and Trump swooped in.

When they started to market OxyContin, Purdue Pharma’s sales reps targeted communities with high cancer rates, which were mostly white, working-class, and rural. They told doctors that OxyContin was “non-addictive,” encouraged high dosages, and launched “pain-management seminars” with steak dinners and bonuses. By 2012, opioid use in those areas was 50% higher than in similar economic regions, and overdose deaths were twice as common. Communities hooked on prescriptions have since turned to fentanyl bought from dealers.

In 2016 and 2020, the counties that had been hit hardest by Purdue’s marketing became some of Trump’s most loyal voting blocs. A 2023 study by economists Carolina Arteaga and Victoria Barone traced a direct line from Purdue’s targeting to the ballot box: people who lost their families to pills also lost faith in the status quo, and when conservative media paid more attention to their pain than liberal media did, they chose their side. The opioid crisis radicalized people in favor of Trump.

He blamed border enforcement, whilst spinning his own Justice Department’s choice to go easy on the Sacklers as a big win. Since then, CNN’s coverage has helped his case, with the network interviewing cartel members who move fentanyl across the border. But these have a powerful point when addressing Trump: “the problem is the consumers are in the US. If there weren’t consumers, we would stop.”

Yet the second term has seen Trump attacking anti-opioid policy and abandoning even the pretext of addressing the deeper social crises that drive addiction. His attorney general, Pam Bondi, claimed a few weeks ago: “Since your last 100 days, we’ve seized 22 million fentanyl pills, 3,400 kilos … which saved — are you ready? — 258 million lives.” The number is suspect, but it doesn’t matter, her onlookers cheered.

The bigger point is that fentanyl is not a thing you “win” against by merely seizing it. The crisis will be stopped by addressing why people want to use it in the first place. Funding housing, health care, and treatment. Asking why Americans, alone among wealthy nations, keep dying by the tens of thousands. In 2023, there were still more than 125 million opioid prescriptions written. I tested it myself. I found an online health site, and 20 minutes later, with nothing but a call and some claim to vague back pain, I was offered a way to get a prescription for Oxycodone. America is still manufacturing this crisis; still pretending it’s a foreign invasion, not a domestic product.

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A boy I went to elementary school with in California, with whom I’d exchanged love notes with under the table, was prescribed Oxy after a high school football injury. He died in 2020 of an accidental overdose, at age 18, alone in his car. His funeral was held on Zoom, and his mother wept into a screen. He’s not a statistic, but he is one of a generation; a vanished cohort that Vuong writes about with unblinking clarity. And the systems that were just beginning to try to save kids like him are now being dismantled by Trump.

Vuong does not pretend that addicts will always choose redemption, but he offers something stranger: mercy. “How strange,” Hai thinks, “to feel something so close to mercy… and stranger still that it should be found here of all places, at the end of a road of ruined houses by a toxic river.” We’re back at that river again. A brief drop in death and a flicker of institutional compassion, but now, a sudden turn back to cruelty and abandonment. The real question isn’t whether Trump’s budget cuts will let more people die, but whether he’ll get away with saying this is about safety, instead of feeding the fantasy of revenge. The opioid epidemic is not a mystery. We know how to fight it and what works: research, Narcan, Medicaid and funding.

This crisis has always been about pain, who gets to treat it, who gets punished for it, and whether America is willing to recognize that the people who are suffering most are still worth saving. ​Now, we need to learn Vuong’s lesson that it is “something close to mercy” that saves lives. The sharp reduction in deaths proved it. The question is whether we’ll be smart enough to hold on to the gains.

Scotland’s current gang war can feel like a Netflix series, from the mob dynasties and the firebombing to the villains-in-hiding nicknamed “Miami”. The current bout of feuding apparently concerns the theft of a cocaine shipment worth hundreds of thousands of pounds. Yet amid the social media threats and the Costa-del-Dubai exiles, the country’s gangsterism is actually a lot like Hay Drive itself — a strangely retro throwback, to a time before mass migration and when gangsterism was strictly local. It all speaks to the relative isolation of Britain’s Celtic fringe, and offers a useful reminder that not all our problems can be blamed on foreigners.

Much like the country itself, English organized crime is increasingly cosmopolitan. Dominated by multinational gangs, it’s a teeming bazaar, chaotic and transient. Loyalties change and business models adapt, all to the buzz of 24/7 TikTok commentary and grime crews. Criminal intelligence analysts find tracking this stuff like nailing jelly to the wall. By comparison, the Scottish underworld has a vibe reminiscent of a Berkshire high street circa 1995: dependable and dominated by big names. The Daniels and Lyons, two of the long-standing crime families involved in the current feud, might as well be Debenhams and The Gap. To paraphrase another retro classic, it’s a case of two tribes go to war.

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I’ve had a taste of crime north of the border. Serving as a London detective, I was sworn in as a constable at Glasgow Sheriff’s Court. It felt curiously like being in an old Western, swearing an oath like a deputy and signing a register. Working on a corruption investigation, I was given local police powers; English cops have no jurisdiction in Scotland (except for specific offenses, usually around terrorism). As a London copper, Glasgow felt reassuringly familiar, and not just because it’s my favorite Scottish city. Prior to the 2013 amalgamation of Scottish forces into Police Scotland, the city’s police were part of the Strathclyde force, known as the “Scottish Met”.

In my experience, Met officers enjoyed a good working relationship with their Glasgow counterparts. And, like the Met, surrounding forces saw Strathclyde as overly dominant. They were happy to see it taken down a peg or two. Many Glasgow coppers lamented its passing, as police are wont to do whenever change occurs.

Even so, criticism of the new force is about more than nostalgia. Politics often trumps operational effectiveness, with performance-obsessed restructuring sucking up organizational bandwidth better spent on crimefighting. Relations with a deeply political SNP administration have occasionally been strained too — and that was before the investigation into Nicola Sturgeon. Some officers have also felt the SNP are more focused on independence than bread-and-butter issues like education, health, or indeed crime. Did this mean the police took their eye off organized crime? This is the immediate context in which Scottish gangsterism should be viewed: that of distracted ministers and a mismanaged police force.

Even so, Scottish mobsterism is about something deeper than bureaucracy. The country only hosts 5.5 million people, or about 8% of the UK population. And, despite its regional differences, it’s 95% white, something England hasn’t been since the Eighties. The occasionally overegged issue of religious sectarianism aside, that makes Scotland practically a monoculture, certainly compared to Birmingham or London. More to the point, these demographics also make the working class communities of Glasgow and Edinburgh less transient, more cohesive, and more able to resist the encroaching globalization of Somalis or Kurds.

Nor is this simply a Scottish phenomenon. Right across the Celtic fringe, the old ways survive, offering real life folk-horror, with houses burning instead of wicker men. I’m thinking, for instance, of Liverpool, forever an outpost of the Irish Republic. Liverpool boasts the UK’s primary seaport linking the UK to the coca fields of South America. As such, it’s coveted by criminals. Yet law enforcement legend has it that even the brutal Albanian mafia are wary of the city: local Scouse gangs are too well-organized and violent. As for Belfast? Northern Irish gangs overlap with psychotic paramilitaries. They’re armed with assault rifles, and deeply embedded in their communities, strutting like central-casting bad guys in an action movie. The long-suffering, politically hamstrung and underfunded PSNI can only operate a strategy of appeasement and semi-containment.

Contrast all this with London’s traditional crime families. These days, they’re good for little more than straight-to-streaming movies, ghost-written memoirs and the occasional nonagenarian funeral. Terry Adams, the former scourge of Clerkenwell, now spends more time with his art collection. “Dodgy” Dave Courtney shot himself. Other old-school “faces” keep their heads down.

And not only that. For apart from remaining mostly untouched by globalization’s international criminal diaspora, Scottish criminals also employ an MO The Krays and Charlie Richardson would recognize.

This old-school works on familiarity. On personalities. On an understanding of the other side’s way of doing business, be it drugs or protection rackets or smuggling. Not so much movie talk of “codes” or “honor” — but more of knowing what to expect from whom. The threats, acts of violence and feuding all follow a time-honored pattern. Furthermore, the criminals enjoy significant ties to the “respectable” non-criminal world. Compared to, say, London? It’s an anachronism. The south’s multicultural postcode gangs, middle-market cocaine dealers and county lines retailers operate in a relative state of freewheeling anarcho-capitalism.

Then there’s corruption. Organized crime of the sort blighting Glasgow and Edinburgh can’t exist without palms being greased. I’m not suggesting Scotland is uniquely prone to graft. It is, however, vulnerable for the reasons I’ve described: a close-knit monoculture, ruled by cliquish elites. This is why I’d suggest political institutions and law enforcement north of the border are disposed to a specific type of compromise. For instance, Glasgow’s Labour-dominated political machine, prior to the ascension of the SNP, was no stranger to scandal.

As for the police, it’s in a similar vein to the corruption that dogged the Met until the early 2000s, some of it involving working-class detectives and the criminals they grew up with. Some years ago, a Scottish detective told me about an investigation into drug money. It ended mysteriously, when the trail meandered too close to establishment figures. In more recent times, Police Scotland’s Organized Crime and Counter Terrorism Unit was recently compromised by corrupt detectives leaking intelligence. That flavor of corruption is less common in London nowadays, replaced by something equally damaging but perhaps more fragmented: corruption stemming from poorly-vetted, hastily-selected cops, led by inexperienced and out-of-touch managers.

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What, then, is the answer? As the violence escalates across Scotland’s two largest cities, the SNP-led administration has promised urgent action. A 100-strong task force is on the case, backed up by The National Crime Agency (NCA). As for the gangs themselves, the old ways are both a strength and a weakness. Yes, they’re deep-rooted, tough to infiltrate, operating a code of omertà. On the other hand, their identities are largely a matter of record. When your organized crime group has its own Wikipedia page? Yes, you’re lighting up the police radar. The authorities, therefore, know precisely who their targets are. The rest is a question of time, resources, political will and luck. Police officers specializing in proactive operations know all four are as rare as gold dust. And make no mistake: the Scottish Parliament will throw the kitchen sink at the gangs who so blatantly challenge their authority, even if the SNP has to grit its teeth and get support from south of the border.

Nor is needing help from Westminster very surprising. The “pointy end” of fighting organized crime can sometimes feel more like counterinsurgency than beat policing. The mantra “Clear, Hold, Build” sounds like something you might attempt in Basra or Helmand. And it’s something our establishment prefers to deny, not least as it undermines their cozy image of British policing. In this case, anyway, Police Scotland can’t handle the gang crisis alone: 100 officers is a trifling number for an operation of this scale. The NCA, and possibly the Security Service, will need to provide technical know-how and assets (like MI5 did with the Adams Family). At the less glamorous end of the business, meanwhile, local police will have to work doubly hard to develop intelligence by winning trust on the streets. This, as Scottish politicians are about to discover, illustrates the consequences of neglecting neighborhood policing, which has suffered swingeing cuts from Taunton to Aberdeen.

A three-ring circus of law enforcement will therefore be pitching up in Scotland, with its attendant politics, agendas and egos. Can its thoroughly modern methods, reliant on theoretical models, proportionality, human rights and technology, defeat such a tried-and-tested enemy? In Glasgow and Edinburgh, the Wicker Man burns. Let’s hope the officers sent to extinguish it have more luck than Edward Woodward.

Ketamine is one of the more interesting drugs out there. It can make you feel relaxed, wobbly, trippy or, at a high dose, can send you down the K-hole, a state of intense detachment. Once the preserve of a few “psychonauts” in the Seventies, now the dissociative, hallucinogenic tranquilizer seems to be everywhere. It’s cheap, easy to get hold of and crosses social and class boundaries — wastewater analysis released last week found its use had increased by 85% in the past year. And while its popularity has been on the rise since the turn of the century, its unique high is especially embraced today by those aged between 16 and 24. Eclipsing MDMA, almost as popular as cocaine; Generation Z are now three times more likely to use ketamine than they were a decade ago.

Inevitably, the authorities, fired up by the mainstream media, have caught on. Citing the drug’s rising prevalence, its ability to ruin people’s bladders and its use in spiking, the Government wants to curtail its use by bumping it up from a Class B to a Class A drug, on a par with crack and heroin. Yet as history shows, moral panics about illicit substances often only tell half of their story. Drugs are never taken in isolation; they are taken for a reason. A drug’s rise or fall in popularity says something about the people taking them, but also the world they live in.

Ketamine was first developed back in the Sixties when it was tested on prison inmates who claimed it made them feel like “they had no arms or legs, or that they were dead”. Approved for medical use in the Seventies, the US army used it as a battlefield anesthetic during the Vietnam War. Closer to home, vets started using it to tranquilize horses (and camels) before surgery. Meanwhile, in the wake of the counterculture revolution, the psychonauts were experimenting, enjoying how it opened new doors of perception.

One such adventurer, the American, John C. Lilly, who was given funding by NASA to teach dolphins to speak, routinely injected ketamine while in a flotation tank. It led him to believe earth was being controlled by aliens, who one day stole his penis. As he wrote: “That evening I took 150 milligrams of ketamine, and suddenly the Earth Coincidence Control Office removed my penis and handed it to me. I screamed in terror. My wife Toni came running in from the bedroom, and she said, ‘It’s still attached.’ So I shouted at the ceiling, ‘Who’s in charge up there? A bunch of crazy kids?’”

The kids of today clearly see something in this drug too. “I’ve tried weed, coke, shrooms, LSD, MDMA, and ketamine — obviously,” says 23-year-old Lucas*, a musician from London. “But I find coke really boring. Ketamine is the most fun. It actually makes me feel different, not just in my body but in how I think.” And this is very much part of its appeal.

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The drug first popped up in the UK as “techno smack” and “brown acid” on the UK’s “crusty” free party scene in Bath and Bristol. It was a much cheaper, more squalid alternative to ecstasy or LSD. One former party goer said it wasn’t just the techno crusties taking it back then, it was also “oddball” farmers’ sons. “They had access to it as it was a horse tranquilizer. They would descend into incoherency and then basically sit in the corner in their K-hole for a few hours.” Then, via the gay clubbing scene, a classic route into the mainstream, it was adopted as a post-ecstasy, post-club, chill-out drug. Some dealers mixed it with cocaine and sold it as CK1. By the late 2000s, it had become one of the preferred drugs of UK university students, because it was cheap and cerebral. It still, though, had a scuzzy reputation compared to ecstasy and cocaine. Its users were usually the ones who ended up on all fours at the wedding disco.

Then, before you knew it, ketamine was all over the summer music festival scene; an Instagram account called Ketflix and Pills had 1.3 million followers; and models were walking down runways wearing tops that read “Ketamine Chic” — a fashion trend characterized by “an embrace of disheveled aesthetics”.

Amy, a bar worker who is now 23, got into ketamine when she was 19. “We would go out, drink a lot, then head to an afters where we would completely dissociate from the slugs. We were all just completely out of it for hours.” Alex, 21, takes it at his friend’s mom’s house. “I once got really worried that my legs didn’t belong to me and that they were someone else’s legs. I think we were just watching Star Wars at the time.”

Surprisingly, for a drug that can make you forget whether your legs are your own legs, it is seen as one of the more manageable highs. In small doses, it’s shorter lasting than ecstasy, and less intensive than LSD and magic mushrooms. It’s a little like getting tipsy. This means it can be treated as an everyday sort of drug — easy to take a line at lunch breaks or in the loos at school. Alternatively, you can go deep into the K-hole. Luke has been taking ketamine since his late teens. “People really enjoy that completely otherworldly thing,” he says. “I guess a bit like an acid ego death, it completely transports you out of your reality in a way that coke, MD, even shrooms don’t.” There’s no hangover, nor a depressive comedown. And it’s around half the price of cocaine. Why bother socializing when you can dissociate together.

But Generation Z’s fondness for ketamine goes deeper than this.

“From what I’ve seen, young people’s ketamine use is largely a response to an overwhelming sense that the world isn’t going in the right direction, and this tends to lead to wanting to detach from reality, or at least taking a holiday from it,” says Chloe Combi, an author and consultant specializing in Gen Z. These youngsters were already suffering from unusual levels of anxiety and stress, dosing themselves with benzos such as Xanax. But then the pandemic hit.

“For a group of people turning 18 during lockdown who should have been out clubbing, ketamine was a way of experiencing the trippiness of drugs whilst being alone,” says Abigail, a 23-year-old fashion assistant from Reading. “Like you can go to another realm and back from your own bed basically. That would have been the appeal. A lot of ketamine addiction seems to have started during lockdown.”

Part of this is about feelings of dissatisfaction that are haunting Generation Z, Abigail says. “There’s a song by Steve Lacy [a 26 year old American musician] where he sings: ‘Baby, you got something in your nose/Sniffin’ that K, did you fill the hole?’” she says. “This idea of using ketamine to fill a hole, I get it. There’s a sense of emptiness in our generation, a disillusionment shaped by years spent behind screens, lockdown isolation, phone addiction, and constant online comparison.

“It’s no coincidence that ketamine and social media addictions have risen simultaneously. Our attention spans have shortened, and the hobbies we used to spend time on — reading, sports — now have to be carved out from endless screen time in the midst of a boredom epidemic. There’s a constant guilt around being online 24/7, yet it feels impossible to stop, and ketamine is a way out of that dilemma.”

But ketamine is far from a consequence-free cure-all for Gen Z ennui.

In 2014, back when ketamine was first emerging, I interviewed the friends and family of Nancy Lee from Brighton. She had died earlier that year, aged 23, after several years of heavy ketamine use which had started at the age of 16. It was a tragic story. Her group of friends had started using the drug when it was available at 12 grams for $90. It was her dad who told me that it was the perfect drug for a depressed teenager.

By the age of 21, due to the effects of heavy ketamine use on her bladder and appetite, Nancy was hospitalized, weighing just over five stone and suffering from incontinence and a weak heart due to malnutrition. Her bladder barely functioned. “I was quite depressed,” Nancy wrote after coming out of the hospital in 2011. “K takes your mind to a different world so you forget the bad stuff. But in the end, ketamine becomes the bad stuff.” Unlike the tragic death of Leah Betts from ecstasy, which triggered a moral panic and national outcry, Nancy’s death barely registered in the media.

Ten years on, though, and the heavy ketamine use of Nancy and her friends has become less of a rarity, with doctors seeing a rise in young people with shrunken bladders trashed by chronic ketamine use. Meanwhile, the damage to the urinary tract caused by intensive ketamine use can cause debilitating abdominal pain known as “K-cramps,” which can, in turn, lead to users taking more ketamine to deal with the pain.

Lucy*, now a 24-year-old teacher who does not use drugs, became addicted to ketamine during university. She ended up snorting 12 grams every week and suffered terrible K cramps. She thinks she had an “addiction to dissociation, fueled by guilt and self-loathing”. Every time she took the drug, she would feel that guilt and shame, and the only way to escape those feelings was to take it again, to completely dissociate from reality. And because the effects are so short-lived, this became a self-perpetuating cycle of self-abuse. In the end, Lucy was faced with a stark choice: ketamine or her dream job as a teacher. But addiction of any kind is hard to kick.

The appeal of ketamine is complicated by the fact that public figures such as Elon Musk openly admit to using it to treat low mood. And its “nitty” reputation has been cleansed — or disguised — by a burgeoning wellness industry which cites it as a useful treatment for depression, among other things. Ketamine therapy has become big business in the US where its popularity matches the trajectory of the “psychedelic renaissance” of magic mushrooms, LSD and DMT in medicine. That’s all very well if you are medicating under controlled conditions. It’s quite different if you’re buying it on the streets.

What we do know about addiction — whether it’s to heroin, alcohol or ketamine — is that those most likely to suffer the most are those who are most vulnerable: the hopeless, the depressed and the traumatized. Young people with undiagnosed mental health issues are well-known to self-medicate and we know that the lockdown generation, more so than any other in history, is suffering from a blizzard of anxieties.

And while the vast majority of Britain’s estimated 172,000 16-24 year olds who admitted to taking ketamine in the past year only use the drug infrequently, in low doses and with little problem, its rise in popularity has come with consequences. The database for drug treatment (NDTMS) shows that the number of under-18s receiving treatment for a ketamine problem increased from 500 to 1,200 between 2020 to 2025, a similar number for cocaine and ecstasy, but far less than for cannabis (12,500).

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There has, too, been a rise in deaths. Everyone heard about Matthew Perry’s death through drowning after taking the drug. And only this month, the drag star, The Vivienne, died from a cardiac arrest caused by its effects. Unpublished figures seen by UnHerd show there were 49 deaths linked to ketamine registered in England and Wales in 2023, a three-fold increase in the past decade. Meanwhile, analysis of 19 ketamine deaths in the northwest of England, carried out by the Public Health Institute at Liverpool John Moores University, found that most often ketamine was a contributing factor in deaths rather than people dying from direct toxicity. Three drowned in the bath at home, having taken ketamine beforehand. One person died in a canal: entering it intentionally after taking ketamine.

Last week, Fiona Measham, an expert in drug harm reduction at Liverpool University, visited a new ketamine clinic in St Helens in Merseyside, where a third of the patients receiving treatment were under 18. “These are kids who have been taking it frequently enough for several years to already have serious health problems. They were mostly from a working-class background around St Helens. Nearly one in 10 of them are referred on to have their bladder removed and a permanent urine bag.”

What, then, are we to make of the government’s push to increase the punishment for those caught in possession of or dealing ketamine? Professor Harry Sumnall, an expert in substance misuse at Liverpool John Moores University, is part of the Advisory Council on the Misuse of Drugs, which will advise the Home Office on whether to make ketamine a Class A drug. He says we cannot afford to get it wrong again.

“Ketamine was made a Class B drug in 2014,” he told me. “This provided the ideal opportunity to ensure that sufficient attention was paid to prevention, harm reduction, and treatment activities. Unfortunately, this didn’t happen, and this has led to many of the concerns that we have with ketamine today.”

Given the drug’s increasing prevalence, it’s unlikely the Government’s “message” will scare young people off. As Abigail says, “well, loads of people my age do cocaine, and that’s Class A, it’s not stopped them.” If anything, as life gets ever bleaker for Gen Z with extortionate rent, dwindling opportunity and a mistrusted political class, they’ll be taking more drugs.

As more young people increasingly seek escape from their earthbound reality, the Government is heading down its usual boneheaded path to prohibition to solve a complicated problem they don’t understand. And we know from experience that this simply doesn’t work. If politicians were really sincere about helping the teenagers who are worst affected, they might think of more effective ways to address their feelings of despair, because sometimes, the drugs do work.

*Names have been changed.

Treasure Trove opened a year ago in Harrisburg, Pennsylvania, as a satellite store of their toy and second-hand goods shop in nearby Newberrytown. But this second location, within spitting distance of the Pennsylvania State Capitol, has evolved into something like a mission for the chronically homeless that also sells Funko Pops figurines. The owners, a pleasantly nerdy couple named Jason Crocenzi and Jennifer Draisey-Crocenzi, say it was impossible to operate a standard retail business in a downtown where hundreds of deprived homeless people wander the streets and often outnumber regular pedestrians.

In July, the Crocenzis were featured in a feel-good story for the local newspaper about turning their business into “a hub for helping the homeless”. One of Treasure Trove’s employees is Daniel, a gravel-voiced 75-year-old veteran who had been sleeping in a tent since 2011 until the Crocenzis were kind enough to let him live in the store building.

The problem is that the homeless don’t always love them back. Less than a month after the article appeared in The Burg, someone named Toby walked into the store and angrily demanded $3,000 for a new e-bike. He’s a bespectacled 26-year-old homeless person already infamous among some local merchants and residents because, for years, he’s been aggressively demanding no-strings-attached financial assistance. The Crocenzis offered Toby free clothes, beverages and leads on affordable housing, but wouldn’t hand over thousands in cash to him.

Jennifer’s account of what happened next is harrowing: “He then threatened to sue me, then kill himself, and then charged at my huge husband, ripping part of his beard off, hitting him with a mop, throwing his phone, and breaking inventory. He ripped Jason’s shirt, kicked and hit him, and refused to let him go for several minutes as we kept yelling: ‘Let him go, stop this!’

“Jason was on the ground, unable to breathe, until the police arrived and immediately pulled him off. It’s not many who would even try to attack a 600-pound store owner who does nothing but give free items to the homeless all day long.”

The Crocenzis pressed charges, and Toby eventually pleaded guilty to assault but was not in police custody for long. Meanwhile, Toby told a completely different story about the encounter. According to an account on a neighborhood Facebook group, he was the blameless one being discriminated against. “They started yelling, cussing, and harassing me,” he wrote. “If anyone supports this business, they are not human.” The moderators sided with Toby and banned the Crocenzis from the group. When Jason Crocenzi protested, he said he was told they didn’t want to infringe on a homeless person’s First Amendment rights.

Today, Toby continues to use the group to beg for PayPal or Venmo donations and bullies people individually through direct messages. Everyone in this liberal-leaning city seems too uncomfortable to put an end to it; anyway, what can truly be done?

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It’s not an uncommon story: nearly every American city now has a version of Toby. Often, it’s a handful of individuals — mentally ill or drug-addled chronically homeless people — who terrorize entire blocks, neighborhoods, or public transit for weeks, sometimes years.

In San Francisco, one such repeat offender is Lacey, a woman who, since 2020, has chased people and their children around city parks while screaming bloody murder. In Austin, Texas, a homeless man named Rami Zawaideh smashes city property with a sledgehammer and cuts down trees with a chainsaw and machete while shrieking all through the night. Due to a confrontation with Daniel Penny in a New York subway car, the entire nation is aware of the sad story of Jordan Neely, a homeless person with 42 prior arrests — including three subway assaults. Neely remained on New York City’s “Top 50 List” of homeless people in need of assistance and treatment from 2019 until he was killed in 2023.

In Harrisburg, a small city in south-central Pennsylvania, the problem isn’t just Toby. There’s another unhoused man who — for seven years — has created havoc wherever he goes in a stretch of downtown. “He just comes in, and he’s ranting and raving, torturing customers, yelling in their face for money, doing drugs,” said Angel Fox, the owner of a local laundromat. “It was so sad to see that he’s not just tortured the other small businesses on the street but the community. In a four-block radius, one person is terrorizing the community, and nothing is being done.

“Why is he still on the streets? Is law enforcement… waiting for him to hurt someone or someone’s kid, or do we have to be traumatized because we have to self-defend ourselves?” Fox continued.

The local police say they’re doing what they can under the system as it exists — they’ve arrested this particular perpetrator nine times in 2024 and 45 times since 2017, but the charges aren’t violent enough to warrant longer-term jail. There’s little in the way of other recourse. The Harrisburg State Hospital, which once took care of thousands of mentally ill patients for a century and a half, was shut down in the early 2000s and sat decrepit and abandoned until it finally burned to the ground late last year.

The fiery destruction of the state hospital is an appropriate metaphor of America’s under-institutionalization problem. Since John F. Kennedy signed the Community Mental Health Act of 1963, most of the country’s mental hospitals were closed over the second half of the 20th century. And it was a bipartisan project: liberal reformers catalyzed by exposes of abuses found common ground with fiscal conservatives who opposed the costliness of the asylum system. Without these institutions, the tens of thousands once housed in them are instead cycled in and out of jail, emergency rooms, and living on the streets. The shelters that offer to put a temporary roof over them run on government funding, grants, and donations and are all voluntary. No one is forced to get treatment or stay in a shelter, and so many of the homeless inevitably pick up where they left off after they leave jail, for better or worse.

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What we get instead, in a time of ever-increasing economic inequality and hyper-individualism, is the rise of the anti-institution — large informal homeless encampments that have become a standard feature of the American city. Harrisburg’s own ragged tent city grows in a forested acre on the south edge of town, a no-man’s-land patch of wilderness between the Pennsylvania Department of Transportation building, a trainyard, and the Susquehanna River. It’s a series of tents, lean-tos, and makeshift camps walled in with found objects, surrounded by litter and discarded items.

This isn’t the first iteration of Tent City. The previous version, under the Mulberry Street Bridge, was cleared out in 2023 after police said the area was full of trash, rats leaping out of garbage, and “a spike in violent crime, drug usage, overdoses, sex workers, rapes, stabbings, and shootings”. Without institutionalization and a short-term housing plan beyond the shelters, the homeless simply recreated the bridge encampment in a new location.

It isn’t safe to live there. Two men were stabbed in the camp in 2024, and dangerous blazes break out as people try to stay warm by building haphazard campfires. On 16 January, after a man named Alfred Colon burned to death in a tent there, his family said they hadn’t had contact with him in four years, and didn’t even know he was homeless. Drug overdoses are also common, hence the emergency doses of Narcan at Treasure Trove. According to Daniel, the former homeless employee at Treasure Trove, a portion of tent city’s residents are addicted to $5 fentanyl pills, often called “blues”.

The dysfunction of the tent cities inevitably spills out into the downtown area which, like many cities, is already suffering from a post-Covid malaise. A lack of foot traffic in a struggling local economy reliant on state government jobs that have stayed remote, boarded-up businesses, and the chronically homeless population have given much of downtown Harrisburg a tragic post-apocalyptic quality.

The political vacuum creates a doom-loop effect: businesses are often wary of investing in neighborhoods like these, and when they don’t, residents lack access to essential services, including groceries and healthy food options. Commercial and property values drop, reducing funding for public schools and other municipal services. Middle-class people in these neighborhoods tend to move out, exacerbating the concentration and clustering of disadvantage. Without policy changes, cities like these threaten to produce more homeless people and quietly slide into oblivion.

The lack of a legitimate response to this issue, or liberals’ defense of the status quo, may help explain some of the urban working class’s revolt in November’s election of Donald Trump. The media scratched their heads and tried to puzzle out why working-class people, especially those of color in cities, turned towards MAGA.

At least some of that anger was directed at the Democrats for prioritizing the chronically homeless and illegal immigrants for free housing and services. Liberal cities continue a delusional Housing First policy that’s next to impossible to succeed over the next decade when there’s hardly any affordable housing for the non-college-educated working class, much less the destitute. In 2024, the Biden-Harris administration awarded $3.16 billion to over 7,000 homeless-related projects, including $2 million to Harrisburg. That amounts to about $7,500 per homeless person included in the city’s Continuum of Care. Meanwhile, those who hide their homelessness or who scrape by working multiple jobs receive little help.

Those who object to these priorities or the anarchic state of encampments are considered bigots. Thanks to progressives’ culture of weaponized “empathy”, there’s little expectation of accountability or pro-social behavior from the homeless because it’s considered inherently cruel to a class of people to be pitied as symbolic victims of capitalism and contemporary society. But treating the homeless like they’re Peter Pan’s Lost Boys helps no one, especially not the mentally ill or drug-addicted people themselves, who are often victims of crimes at the hands of each other in tent cities.

Thankfully, the tide may be slowly turning towards involuntary treatments. California and New York have recently adopted and expanded involuntary treatment policies and so have Canadian provinces such as British Columbia and Alberta. Trump has said that he will work with states to ban urban camping and push people into treatment for drug addiction and mental health, but it’s unclear whether his administration will invest in the kind of resources needed. Thus far in his second term, he’s appeared to be much more interested in wrecking existing institutions than creating new ones.

But without serious reform, we will just see more tragedies such as Daniel Penny’s vigilante confrontation with Jordan Neely in a New York subway or the attack on Jason Crocenzi in Harrisburg. More tragedies by inertia.

It blew my head off. But not in the way I thought it might. There were no hallucinations, there was no Day-Glo assortment of colors. It was something much more profound. Basically, it was paradise, and it was paradise all the more so for being so adjacent to everyday reality.

The first time I did LSD I was in a family house — a house I’d been to thousands of times before. But suddenly, everything about the place was imbued with new layers of meaning. Touching the chairs that my grandparents and great-grandparents had sat in, I discovered a new understanding of these figures who had always been somewhat remote to me.

My thoughts were still recognizably my own, but rather than having, say, three or four at once, I now seemed to have 11 — each occupying its own dimension, as if in some kind of stereo effect. I would be thinking about different phases of my childhood and the music I was listening to and the room I was in and the dynamics I had with each person around me. At the same time, I felt a calm self-assurance. Having spent my twenties (in retrospect) in the grip of different anxieties, I could now, with the aid of the LSD, see myself far more fully, far more richly. I could see that there were worlds and worlds inside myself — as there are for everyone.

Inevitably, I suppose, that started a journey. The lab-created psychedelics such as LSD and MDMA showed the immense resources latent within a person, and the drop of acid, like a scientist putting a bit of fluid onto a slide, illuminated what was already there. The plant medicines, such as ayahuasca, were where it really got trippy, since these were entirely natural compounds. They seemed to be part of an intelligence that existed throughout the natural world. If I took kambo — a frog venom — I found myself seeing the world like a frog; if peyote, like a cactus. Each one seemed to have their own personality, to have a message directed at a particular psychological tangle in my own life.

Towards the peak of my psychedelic exuberance, in 2017, I realized that I was only a small part of a bigger movement, “a breath, sweeping through the cognoscenti”, as I wrote at the time. So many people I was coming across in this space — perfectly sane, balanced people — had psychedelic experiences that changed their lives. And, for a while, it felt like a dizzying scavenger hunt.

After my LSD experience I began to hear about ayahuasca — which, at the time, still seemed like an urban legend. Soon, I would find myself at a beach cafe near a group actually preparing for an ayahuasca ceremony, complete with Amazonian shamans in full regalia. And then when I was exchanging Facebook friendships with these ayahuascans, I discovered that the one friend we had in common was the most interesting guy I knew in college who turned out to be running a group, based in New York, for taking an African plant, iboga. Inevitably, not long after, iboga would blow my head off.

“All these people I meet all seem to be on the same page — with a united outlook, which is very different from how any of us were raised,” I wrote, trying to understand what was going on. “We believe in self-work, a kind of unremitting self-awareness and self-improvement. We are people of faith, which isn’t religious. It’s more that we believe everything anybody has ever said.” We were part of what became known as the “psychedelic renaissance” — a wave of young people, largely millennials, discovering that psychedelics had been seriously misrepresented in the aftermath of the Sixties culture wars and enthusiastically embracing them as a means for self-knowledge and self-growth.

Within the psychedelic community there were a few widespread, entrenched beliefs. One was that, throughout history, psychedelics had been a core part of the spiritual life of many societies. That is, the use of psychedelics was the norm, and our abstinent society was the exception. This was certainly true in indigenous societies all over the world. The classics professor Carl Ruck had very convincingly argued that the Eleusinian Mysteries in Ancient Greece partook of psychedelic ergot, a fungus that is also in LSD, while a few years ago Brian Muraresku was at least intriguing in claiming that early Christian rites, the Eucharist included, involved psychedelics. In the Fifties, the banker R. Gordon Wasson had been startled to come across a thriving mushroom sect in Mexico, and I experienced a mature, coherent religion in Gabon that centered on plant medicines.

Another belief was that the culture wars had basically gone the wrong way. After its lab discovery in 1943, LSD had been practiced in clinical settings throughout the Fifties and had been the therapeutic wonder drug of the era (you can see some of the videos of its use on YouTube). The belief was that the genie had escaped the bottle a bit too fast — above all, through the showmanship of Timothy Leary — and that resulted in a severe backlash. In 1970, the Nixon Administration gave LSD a Schedule I status, right alongside heroin, and then for good measure threw in plant medicines like peyote and ibogaine. Baby Boomers spoke wistfully of their LSD trips — a surprisingly large number of Americans claim to have dropped acid at one point or another in their lives — but, basically, the War on Drugs had stamped out both the clinical use of psychedelics as well as a great deal of psychonautic exploration. The belief in the millennial community was that this had vastly set the culture back. So much of the great art of the Sixties, the music above all, had been psychedelically inflected: the Beatles, for instance, dropped acid innumerable times during that period, with Paul McCartney saying “it started to find its way into everything we did, really”. Stories abounded that the Prague Spring had been a psychedelic event, that Kennedy had been turned on to LSD in 1963 and that it had driven his pursuit of peace in the Cold War, and that Silicon Valley was largely created on the back of psychedelic experiences.

I had a similar experience. Even early in my journey, the psychedelics helped me immensely. Writing had always seemed like a massive anxiety attack — it took me months to agonize over a play. But after trying LSD, I found it came easily, I sounded like myself, and writing became a pleasure. I haven’t had writers’ block since (although the anxiety never entirely goes away). My fear had been that psychedelics would cause me to “drop out”, to become some kind of a hippie, but, actually, they gave me a new relationship to work — I could understand much better that a job needn’t be all of my identity. Meanwhile, there were no deleterious effects from the psychedelics. To this day, I’ve never had a bad experience with any one of them.

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The most influential book to make the case for the mainstreaming of psychedelics was Michael Pollan’s How To Change Your Mind (2018). Pollan told the story of the clinical use of psychedelics in the mid-20th century, and the “restart”, which was a series of studies starting in the 2000s by Johns Hopkins University that found that psychedelics could produce mystical experiences, reduce anxiety in terminally ill cancer patients, all with next-to-no-negative impacts. What seemed to have disappeared completely was the bad science of the War on Drugs — for instance, the myth that MDMA created a dopamine deficiency, which was based on a bottle mix-up during a study. Enough people were doing psychedelics, both in clinical settings and on their own, without going crazy or suffering flashbacks. So many of the arguments against the psychedelics just didn’t hold up. And then the clinical benefits did seem very real and were borne out in study after study.

I suppose the peak of my psychedelic journey occurred when I was stone-cold sober. I was working on a documentary about ibogaine — a derivative of iboga — and accompanied a heroin addict from San Francisco to a clinic in Mexico. The place was called “Clear Sky” because, apparently, an addict right after his treatment looked up outside and said “oh a clear sky” — it was the first thought, really, that he had had of the outside world after years of being in the grip of his addiction. My experience was very similar. I had seen how the addict I was accompanying was living — unable to sit through a meal without going to the bathroom to smoke heroin off tinfoil, driving to the airport with a car that would shut down completely if it ever came to a complete stop. And then I saw him a few days later, after the ibogaine trip. He had cut his hair for the first time in a decade. His voice had a different timbre and his eyes had a different light. He had no cravings for heroin at all — it was, in the language of the clinic, an interruption that could allow him to reset his life.

One of the medical practitioners I met during the making of the documentary, a former ER doctor, described the first time he saw an ibogaine treatment as “a miracle”. I felt the same way. There weren’t very good numbers on how well the ibogaine cure had worked but the clinic estimated that the recovery rate was about 40% after a year compared to around 5% in the mainstream recovery industry. If there weren’t good numbers to go by, I was at least somewhat persuaded by what I read in the clinic guestbook. “Take this moment, breathe the air, hug the staff, feel the tears coursing down your cheek. You have waited so long for this.” “I woke up from treatment if reborn, alive with senses I hadn’t felt in years,” wrote another. A third simply wrote: “Ibogaine saved my life.”

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The psychedelic renaissance has since lost some of its momentum. There were a number of decriminalization initiatives in different states, and a number of companies attempting to put psychedelics through clinical trials. A ketamine spray for the treatment of depression was approved by the FDA in 2019 and ketamine treatments have become widespread among therapists. Psilocybin (magic mushrooms) continues to perform well in clinical trials, above all in alleviating depression. Microdosing has become widespread, most famously in Silicon Valley. But California’s governor vetoed a decriminalization bill and, more significantly, the FDA asked the company Lykos Therapeutics to redo their phase 3 trial for MDMA. Lykos’ offense had more to do with the fact that one of the therapists had had a sexual relationship with a patient six months after that phase of the study concluded — but it was enough for The New York Times to more or less declare the drug renaissance dead: “How Psychedelic Research Got High On Its Own Supply,” one recent article was titled. But even avowed practitioners have had to recognize setbacks. “The media pendulum is swinging,” Pollan said in an interview. “The wind has definitely gone out of its sails,” said researcher Rick Strassman.

Psychedelics disappeared from my life as well — and, as it happens, really around the time that the psychedelic renaissance was cresting. I can almost remember the moment when I knew that I wouldn’t have much to do with psychedelics again. It was during the pandemic, and it felt like a tide was going out. I had never had a directly negative experience with a psychedelic, but there were some adverse effects. Through my epiphanic period, I had probably developed a false optimism which turned out to be unsustainable. I had also come across some of the darker sides of the psychedelic renaissance — self-appointed “gurus” and “shamans” who allowed their transcendent psychedelic experiences to inflate their own egos and then enjoyed manipulative control over people who participated in their ceremonies. Looking back — and I think about this every day — it is very hard for me to say whether psychedelics have made my life better or worse.

But if I had a choice I would do it all again the same way. The psychedelics represented a journey into the unknown and the more complicated aspects of the self. They showed me that there was far more to the world than I ever would have suspected. And that seemed to be more or less the same place that the culture-at-large had got to. The sense with the Sixties was that it had been too much too soon — that society wasn’t able to handle the insights of psychedelics. We may have already started to feel the same way about the “psychedelic renaissance”, that psychedelics are so powerful that they can’t be casually disseminated on a mass scale.

That is not necessarily an indictment of psychedelics. They really are, as Aldous Huxley put it, “the doors of perception”. If psychedelics are too much for us (and they often are), that may say more about our own limitations than it does about the psychedelics themselves.

Especially given the extreme youth of both boys, and the fact that both ended up dead after being hired to commit murder by an infamous drug dealer, himself in jail, local journalists were quick to characterise the deaths as a tragic novelty. All the same, the newness of these recent killings shouldn’t be overstated. More than a century ago, after all, stories of teenagers butchering each other were front-page stories here almost daily. And then, as now, reporters wondered what caused so much chaos at such a tender age. In 1916, for instance, Le Petit Provençal newspaper characterised the Ace of Clubs gang as a “bunch of young brats” and speculated that they were driven to violence by copying what they read in the newspaper.

These days, members of the DZ Mafia or the Yoda Gang, the two main groups that paint Marseille red, can access their entertainment at a swipe. Yet from their ruthless violence to their international spread, sepia-tinged groups like the Ace of Clubs have nonetheless bequeathed much to their modern successors. More than that, they became inspirations and the names of the gangsters of old are still familiar to the current generation, who like their predecessors often use criminality as a way to climb a social ladder that is otherwise denied to them.

And, perhaps most of all, the continued resilience of criminality in this city by the sea speaks to the utter inability to smash the scourge of poverty — one that ensures there’s always a willing supply of desperate young men willing to kill, or die, for the chance at a better tomorrow.

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Inside Marseille's drug wars

By Cole Stangler

Organised crime in Marseille has a long history. Things began at the end of the 19th century, when the city acted as the gateway to France’s colonial empire. In need of cheap labour, the port attracted immigrants from southern Italy and Corsica. The first criminal gangs quickly appeared, when pimps operating in the so-called Reserved Quarter, then one of the largest red light districts in Europe, chose to join forces. Their first ringleader was a former Corsican sailor named François Albertini. Nicknamed François the Madman, he led the Gang of 21, running prostitutes in the Reserved Quarter and getting into fights with other clans.

These disputes soon turned deadly. In 1907, in an echo of today’s killings, Albertini ordered a 16-year-old pimp to murder several rivals. André Anfriani, the teenage assassin, shot three people before being arrested, tried and guillotined. By 1911, Albertini had been detained too, and sentenced to spend life in a penal colony in French Guyana. In the end, the Madman escaped and disappeared, but nonetheless succeeded in planting the seeds of Marseille’s later crime scene. The routes the Gang of 21 used to evade justice — Spain, Portugal and Morocco, or else straight to the US — would soon be employed to transfer prostitutes to brothels in Africa and South America. Over the decades to come, drugs would flow the same way.

The Twenties and Thirties were a golden age of Marseille gangsterism. Corsican clans took over the business created by Albertini, promptly diversifying their trade. Paul Bonaventure Carbone, a tattooed former sailor who took inspiration from Al Capone, became the local godfather. With his partner François Spirito, Carbone gradually gave up prostitution for more profitable businesses: nightclubs; casinos; smuggling. They also opened laboratories to refine heroin, which proved so effective that Marseille became the dope capital of the world after the Second World War.

At the same time, Carbone and Spirito became local stars, entertaining visiting journalists and sponsoring showbiz celebrities. Music hall shows and films were made about them, cheap flicks with names like Justin de Marseille. Collaborationists during the Second World War, the pair were replaced after liberation by the Guerini brothers, who were close to the local Socialist Party and took over the local nightlife. That’s even as they smuggled drugs and cigarettes into Europe from Turkey and Morocco.

From the Sixties, the growing consumption of drugs such as heroin led to the famous French Connection. The world’s premier network of drug trafficking, it was controlled by Le Milieu, a Marseille-Corsican syndicate with the Guerinis among its leaders. After their demise in the mid-Seventies — Antoine Guerini was murdered in retaliation for killing an ex-cop-turned-mobster — figures such as Gaëtan Zampa and Francis Vanverberghe took the reins. With a surname like that, the latter was unsurprisingly known as Francis the Belgian. Gradually, they gave up drugs for safer and more lucrative ventures, including robbing armoured vans and using casinos to launder money. Given the French Connection was at various times exploited by both the CIA and France’s own intelligence service, with the spooks selling drugs to fund off-the-books operations, a change of focus was probably wise.

The gentrification of the Marseille-Corsican mob left a vacuum for others to fill. Since the late-Eighties, in fact, the port’s thriving cannabis and cocaine trade has been run by what has been described as La Mafia des Cités (“The Suburbs Mafia”), originally manned by families from cannabis-growing countries such as Morocco. For his part, the pusher who hired those two doomed teenagers is believed to be a member of the DZ Mafia, one of two Cité gangs now fighting over Marseille’s drug trade. The name hints at its origins. DZ stands for Algeria — a nod to the country’s name on licence plates — and indeed many of the group’s founders come from this former French colony with strong historic ties to Marseille.

The second part of that name is important too: by adopting the “mafia” moniker, the gangsters are emphasising their credentials both as an international criminal outfit. To prove their point, they even ran a video on social media claiming they had no involvement in the recent killings, hoping to retain a degree of respectability in the districts they control. And if that hints at one similarity with the past — where Carbone burnished his reputation via music hall ballads, the DZ Mafia uses Facebook — contemporary Marseille gangsters borrow from history in other ways.

That’s clear, for instance, in terms of the way they showcase nationality. When the Corsicans were running the place, family ties were essential to the gang’s survival. Clan members were often from the same village, also a common tactic with the Cosa Nostra in Sicily. It’s a similar story today: quite aside from the reference to the DZ Mafia’s homeland across the Mediterranean, the gang is partly run from Algeria.

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No less important, gang warfare in Marseille has often been waged along ethnic lines. In the Twenties, for example, black soldiers who remained in the city after the First World War took over parts of the Reserved Quarter, resulting in a deadly conflict with their Corsican rivals. A similar conflict took place in the Nineties, when members of a North African group from the city’s suburbs decided to take over the slot machines, bars and discos controlled by Corsican gangs around Aix-en-Provence. The conflict ended in 2006, when Farid Berrahma, the son of an Algerian miner, was shot nine times at a brasserie outside Marseille. In a strange way, in fact, Marseille seems to have returned to the chaos epitomised by the Ace of Clubs. Just like in the 1910s, the city lacks any single dominant crime lord. Jacques Imbert, Marseille’s last traditional godfather, died in 2019.

More fundamentally, the socioeconomic conditions that allowed those early gangs to thrive remain. Then, as now, large areas of the city are desperately poor — even if the criminals these days have swapped crumbling 18th century tenements for the concrete hell of modern housing blocks.

You can spot echoes of the past elsewhere too. In the Belle Époque, the press sensationalised the gangsters, leading to a situation where they tried to one-up each other in daring and brutality. And where newspapers once fretted about how “cinematographic methods” inspired the Ace of Clubs, their modern successors use social media in a like-minded way, advertising their crimes on Telegram.

Not, to be clear, that everything has remained the same. The wild industrialisation of the early 20th century brought an influx of firearms into Marseille, but François the Madman would surely be amazed at the availability of Kalashnikovs on the dark web. More than that, how criminality actually happens has shifted too. Quite aside from the fall in prostitution, and the rise in drug dealing, how cannabis and cocaine are sold has changed. Until the Nineties, dealers came downtown to sell in the clubs or bars they controlled. These days, punters drive to one of nearly 130 spots, spread across the underpasses and rubbish dumps of Marseille’s northern suburbs. That rendered the competition for territory even more fierce — and bloody.

The year 2023 marked a record for drug-related gang murders. A full 52 people died, most of them youngsters, after a police crackdown led to 2,000 arrests and depleted more established gangs like the DZ Mafia. But crime abhors a vacuum, and the fight to regain control of the most lucrative selling spots now rages more wildly than ever. Things have become so bad that some in Marseille are even starting to romanticise the older generation of mobsters, imagining them boasting a “code of honour” that today’s ruffians lack. That’s leavened by sentimental movies, notably Borsalino (1970) and La Scoumoune (1972), which depict old Marseille as a picaresque film set.

In truth, though, nostalgia is unwise. For over a century, Marseille has suffered beatings, shooting, stabbings. Those early prostitutes, run by men like François the Madman, were treated little better than slaves. And no matter how many thugs the authorities round up, the city’s persistent poverty means there are always people happy to take their place. Especially after a misjudged focus on developing its port to welcome oil shipments — a mistake that wrecked Marseille’s economy after the Yom Kippur War — this has become, to quote one local journalist, “a working class city with bourgeois ghettos”. It hardly helps that though the links between politicians and crime are rather less explicit than during the glory days of the Milieu, graft persists.

After Anfriani’s arrest, back at the dawn of the last century, the French government voted to reform the country’s law and order. New Mobile Brigades were established, with les flics offered a radical new technology — police cars. Nicolas Bessone, the current prosecutor in Marseille, is leading calls for similar shock treatment today. “We badly need new legislation,” he lately proclaimed, arguing that special jails for drug traffickers were sorely needed too.

Perhaps. But challenges remain. Quite aside from Marseille’s underlying socioeconomic conditions, globalisation means modern gangs now have access to faster cars, deadlier guns — and a network abroad that allows them to evade justice. There’s also a lingering distrust of the police in the areas controlled by the gangs, meaning even honest citizens are reluctant to help. That’s hardly unfair: since January, an internal investigation has been examining alleged corruption among local anti-narcotics cops.

Yet these vast hurdles aside, Bessone seems confident that victory is ultimately possible. Asked about whether the war against the dealers could be won, he was defiant: “Absolutely.” He would say that. As those two dead kids so graphically suggest, the fight against Marseille’s gangs is far from done.

In the best of cases, harm reduction is hard to define. It has, like most radicalisms, a front-facing and a covert side, and any given spokesperson upbraided for its defects can always resort to the no true Scotsman strategy, blaming its excesses on a fringe that is less fringey than one might be led to believe. The least objectionable of the harm reductionists cling to the addiction-as-disease model that has become commonplace despite the absence of any testable etiology, any efficacious cures, or even a good definition of what addiction is. They advocate for needle exchanges, Naloxone distribution, and the provision of basic services for the drug addicted. This is now the norm across America: all but a few states have these programmes in place, and even states with stringent drug laws are locking up far fewer people for possession than they used to.

The most extreme harm reductionists (I draw on here the unintentionally hilarious document “Harm Reduction Calls to Action from Young People who Use Drugs on the Streets of Vancouver and Lisbon”) claim that “drugs themselves can be forms of harm reduction and treatment”, and envision a novel social model in which drug abusing youth are provided with free housing, safe consumption sites, and “peer-led compassion clubs that sell pharmaceutical grade cannabis, heroin, cocaine”, free from “paternalistic and judgmental attitudes in encounters with caregivers and providers”. Attitudes of this kind are particularly prevalent among activists and academics, whose phobia of judgement has created a paradoxical, shifting model of the addict or, in their jargon, the PWUD (person who uses drugs): they must not be subject to censure, because theirs is a medical condition; at the same time, they ought not be pathologised, because they are free subjects engaged in self-care; if their behaviour is problematic, which not everyone can agree on, then the solution is to offer them more and better services and resources until they decide to quit on their own.

If harm reduction has a gospel, a foundational myth, it is surely Glenn Greenwald’s 2009 white paper for the Cato Foundation, “Drug Decriminalization in Portugal: Lessons for Creating Fair and Successful Drug Policies”. Greenwald’s work was intended to examine the effects of a 2000 law decriminalising acquisition, possession, and use of personal quantities of all psychoactive drugs. The author’s partiality was evident from the very first page — his claim that “there is no real debate about whether drugs should once again be criminalised” is rather disconfirmed by the fact that criminal penalties for possession had been reinstituted a year before his findings were published — and he systematically attributes causation to correlation to suggest a number of benefits, from reduced HIV transmission to a decrease in drug use and drug-related deaths.

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Greenwald’s conclusions were parroted more or less uncritically by The Economist, Time, and Scientific American, and became a model for a shift away from a punitive approach to addiction and toward a public health one in numerous states and municipalities. The most famous adopter was Oregon, where Measure 110 decriminalised possession of most psychoactive drugs until it was amended earlier this year following a rise in violent crime, the largest spike in overdose deaths in the nation, and a proliferation of open-air drug markets. Though its problems were more severe or more evident than elsewhere in the country, Oregon was less of an outlier than its critics may admit: over the past decade, imprisonment and drug enforcement have declined across America, at the same time, overdose deaths have risen steadily, from just over 20,000 in 2002 to 107,000 in 2022. Bad as they are, the numbers hardly exhaust the associated social ills. In Philadelphia, where I live, the drug-ravaged area of Kensington has 10 times as many shootings per square mile as the rest of the city; Kensington Avenue, its former main street, is a virtual dead zone.

There are lessons here. One, of course, is to look close at the data or the absence thereof. Greenwald’s report examined a narrow range of years: 2001 to 2007. Since Portugal didn’t track the prevalence of drug use prior to decriminalisation, Greenwald had little idea where usage stood in the period prior to 2001, and many of the positive tendencies he saw in that brief interval have reversed in the intervening years. Another is to seek context: HIV rates, for example, fell across the developed world irrespective of drug policy.

But most importantly, and most obviously, one should ask whether there is any reason to believe outcomes in one country can be extrapolated elsewhere. Portugal and the United States are a particularly odd comparison to anyone who knows the two countries at all. The first is tiny and peaceful, relatively poor and relatively old, well-behaved, orderly, cohesive. The second is the land of the vaping congressman, the Gathering of the Juggalos, Diddy’s Freak-Offs, Jeffrey Epstein, the Doritos Crunchy Crust Pizza, young earth creationists, and the emotional support peacock.

If I overdo myself a bit with these examples — though they don’t scratch the surface of America’s weirdness — it’s to say that restraint isn’t exactly my people’s jam. And yet it remains a virtual heresy to suggest that our gargantuan hunger for intoxicants might point to an ethical failing on our part, or even a problem with drugs themselves. As to the latter, with great certainty, and with no proof at all, Maia Szalavitz of The New York Times tells us that “most addiction results from attempts to self-medicate isolation, social disconnection, psychiatric disorders, trauma and severe economic distress”. The greatest predictor for addiction is, of course, the easy availability of drugs. I would broadly assume that some of the problems Szalavitz cites are more pressing in Chad or Iraq than in the United States; but in these countries, and many like them, drugs are scarce, few can afford them, and the penalties are severe. Studies of rats, which seem to display similar addiction dynamics to humans, show a significant minority of them are vulnerable to addiction (around 15-20% in the case of cocaine) — perhaps Szalavitz and the rest of the trauma inflation crowd think scientists are just really good at finding rats plagued with anomie?

If we shouldn’t generalise among countries, we should be wary of doing so among drugs, too. Users, police, counsellors, and drug dealers will all tell you fentanyl has been destructive on an unprecedented scale. Two milligrams — less than a pinch of salt — can be deadly, and because it’s cheap, hard to detect, and easy to transport, it’s now found in everything: fake prescription pills, cocaine, ecstasy. Fentanyl is shorter-acting than heroin, which it has nearly pushed out of the market, so users who might once have held a job or cared for their families now spend half their days chasing the next high. The xylazine and benzodiazepines people take with fentanyl, either unwittingly or to stretch out its effects, knock them out so fast that more and more are using methamphetamine and crack to stay awake, making the term “opioid crisis” a rank simplification.

A recent spate of articles has celebrated a drop in the rate of overdose deaths in America for the first time since 2018 (that year was an anomaly, and apart from it, rates have risen steadily since the Nineties). Many speculated on which political interventions have finally bent the curve. None that I’ve seen has stated the obvious: that the supply of hard drug users is not infinitely elastic, and that in the past decade, 700,000 of them have died. Moreover, this is an underestimate: the Center for Disease Control tracks overdose mortality, but not deaths from drug-related sepsis, cirrhosis, suicide, or violence. Drugs follow the pattern of epidemics: they strike at vulnerable populations, some of whom die and some of whom recover, and they confer a measure of immunity in their wake. In the Eighties, crack devastated many black communities, to the point that “crackhead” became one of the worst terms of abuse; now young whites are nine times as likely to try crack as young blacks (this is perhaps the place to say a word in praise of the efficacy of stigma, which despite its bad reputation among harm reductionists is the primary enforcer of behavioural norms). The same pattern has already begun to play out with fentanyl and meth, and cocaine will probably follow in short order.

When the numbers go down, the dead will be forgotten. Whoever happens to be in power will claim victory over problems they did nothing to solve, and we will attribute to the policy in vogue at the time the abatement of an affliction many have pontificated about, and few have bothered to try to understand. Then eventually, a new drug will appear, or an old one will come back into fashion, and we will start the cycle again.

Now compare the experience of Linda van Zandt. In 2016, on the day of her aunt’s assisted suicide in California, an Uber arrived bearing thousands of dollars worth of lethal medication. That included 100 capsules which had to be crushed, dissolved and swallowed within the hour. Wearing latex gloves and wielding toothpicks, the family frantically scraped the white powder from the capsules, combining it with a sugar syrup to make a bitter sludge so “vile” that van Zandt broke down in tears. Afterwards, she sat at her kitchen table wondering: “Who wrote this law?”

That, to be clear, isn’t everyone’s experience — but then nor is the romanticised picture presented by assisted-suicide advocates. The vision of people like Pratchett “is not the clinical reality”, says Mark Taubert, palliative care consultant and professor of medicine at Cardiff University. Claud Regnard, a retired consultant, points out that only two studies have compared “quality of death” by assisted suicide and by nature taking its course. Both studies, one in Oregon, one in the Netherlands, concluded that they were as good, or bad, as each other.

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Assisted suicide relies on lethal drugs. But how reliable are the medications themselves? An article in a leading medical law journal remarks: “The pervasive belief that these, or any, noxious drugs are guaranteed to provide for a peaceful and painless death must be dispelled; modern medicine cannot yet achieve this.” On every point — the supply chain, the means of administration, the risk of complications — the reality is far from straightforward. But that reality is about to hit Britain as the Leadbeater Bill on assisted dying is being debated by MPs on 29 November.

Take Mehdi Alavi’s Dream Pharma — which operated out of the Elgone Driving Academy in Acton. In 2011, this one-man firm was suddenly placed under the spotlight of an international human rights story, as it emerged that it was supplying Arizona’s death penalty system with deadly chemicals.

Why did Arizona have to rely on a man at a driving school in Acton? Welcome to the strange world of lethal drugs, a shadow world largely unmonitored by health authorities, where supply chains can suddenly disappear, where new experimental mixtures come and go, and where best practice remains decidedly unclear.

When it comes to the physical stuff doctors depend on, assisted suicide and the death penalty are entwined. In the early 2010s, European companies launched tough new restrictions on the export of certain drugs to the US because the drugs were being used for capital punishment. That explains the emergence of individual suppliers such as Mehdi Alavi. But these small-scale alternatives were soon banned by American courts too. US pharma companies also stopped making the drugs used in assisted suicide — possibly because there are few other medical uses for them.

The shortage caused problems for penitentiaries and assisted-suicide clinics alike. One chemical, until then a popular choice in assisted-suicide states, practically disappeared from the market. Assisted-suicide doctors’ groups scoured America looking for the drug, but to no avail. Next they turned to another chemical which was supplied by a company called Valeant. The company was plagued by scandal and investigated for price gouging; the price of the drug rose from around $400 to almost $3,000 per lethal dose between 2010 and 2016.

In the end, American assisted-suicide doctors had to come up with their own solutions. But the blend of toxic substances caused “severe pain” , so physicians tried out other combinations, tweaking the formula half-a-dozen times. Across the globe, meanwhile, there are countless variations: more than 30 chemicals are used in the different forms of oral or intravenous assisted suicide.

As with death penalty procedures, then, there is no gold standard, but rather a great variety of options, none of which has established itself as the most appropriate. According to an article in The Lancet, complication rates with assisted suicide may be even more frequent than those with the death penalty.

How serious are those complications? The data is extremely patchy, but some have attempted statistical estimates. With oral methods, a third of assisted suicides take between 90 minutes and 30 hours. Up to 9% have trouble swallowing the dose; up to 10% vomit it up; up to 2% re-emerge from their coma. There are also horror stories, such as the Dutch woman with Alzheimer’s who recovered consciousness and was held down by her daughter and husband while a doctor finally euthanised her.

Then there are the unknowns. Baroness Finlay, a palliative care specialist, told the parliamentary committee on assisted suicide last year that during executions by lethal injection, “four-fifths probably regained a degree of consciousness”. Finlay said that though there is an obvious need for more research on consciousness in euthanasia and assisted suicide, nobody has ever done a proper study.

Not everyone is so sceptical. As Silvan Luley of Dignitas has claimed: “There has been not one case that did not work, in the sense of the person not reaching the goal in a dignified way.” Dr Lonny Shavelson, of Bay Area End of Life Options, has made similar claims. “These,” he says, “are lovely deaths.”

But every claim and counterclaim should be qualified by the fundamental point: the evidence base is inadequate. No drug regulatory authority anywhere has approved any drugs for use in assisted suicide. The 2019 protocol from the Canadian Association of MAiD Assessors and Providers acknowledged that there had been “little to no research” on their recommended combinations, and “no peer-reviewed literature to guide best practice”.

In the British context, meanwhile, supporters of assisted suicide seem conscious of the need for more research. Dignity in Dying told me in a statement that assisted-suicide drugs “are under constant review amongst clinicians and that best practice is constantly developing”, and that the UK procedure would depend on “engagement with healthcare bodies and regulators”, drawing on other jurisdictions “where they are confident that the drugs used are safe, effective and provide dying people with a dignified death”.

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Which drugs might a future UK assisted suicide programme adopt? The Leadbeater Bill mentions none specifically, simply stating that the “Secretary of State must, by regulations, specify one or more drugs or other substances”. Leadbeater has not given any view on the subject; her chief of staff Lance Price tells me that it would be a matter for NICE and other regulators. NICE didn’t respond to a request for comment. For their part, UK doctors themselves seem unaware of the challenges. As a 2016 report by the British Medical Association found, some physicians were “surprised” to learn that assisted suicide could come with complications.

Dr Regnard, who is not against assisted dying per se, told me that the introduction of such unevidenced drug combinations would be completely unprecedented. “I think it puts us back 100 years to when there was no regulation, basically people could do pretty well what they wanted.”

In the end, the assisted suicide debate will hinge less on these questions, though, and more on the familiar trade-offs between personal autonomy and threats to the vulnerable. Yet that shadow world of lethal drugs suggests a broader point: that taking life is, at the very least, an awkward fit with healthcare — and that when these cocktails are introduced into a medical system, the system itself inevitably changes. You can call Kim Leadbeater’s proposal brave or reckless. But it would surely be the biggest experiment ever conducted on the NHS.

You can call Samaritans for free on 116 123, email them at jo@samaritans.org, or visit www.samaritans.org to find your nearest branch.

This scene takes place just after midday on a Monday — nothing unusual. Commuters and taxis pass by, indifferent to the events surrounding them. This is life in Europe’s drug death capital. Yet, for the city’s marginalised substance users, a new hope has been promised in the form of Scotland’s first sanctioned drug consumption room (SDCR). Scheduled to open last week, safety checks on the building have led to delays. The stunted opening seems in keeping with Scotland’s troubled approach to its drug crisis — the worst in Europe and second only to America, globally. 

The road to the UK’s first official SDCR has been long and winding. The first facility of its kind was run illegally by activist Peter Krykant out of a van in the city centre. In perhaps the most significant example of direct action in the history of drug campaigning in the UK, Krykant’s activism was instrumental in mainstreaming debate around Scottish drug reform, influencing the eventual approval of the UK’s first sanctioned drug consumption room in Glasgow. 

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Running parallel to Kyrkant’s campaign was Glasgow’s Heroin Assisted Treatment (HAT) programme, launched in 2019, which aimed to provide chronic heroin users with a pharmaceutical-grade substitute (diamorphine) under medical supervision. This harm reduction approach sought to reduce overdose deaths, minimise the harms associated with street heroin, and improve the quality of life for participants who had not responded to other treatments. 

Despite the initial hope, various reports on its effectiveness present a mixed picture. Participants saw improved health, reduced criminal activity, and access to additional services. However, enrolment was low with only 20 participants while also being expensive at an estimated annual cost of £12,000–£15,000 per person. This led to criticism of its scalability and limited impact on Scotland’s broader drug crisis, especially given the underfunding of other drug treatment services, namely residential rehab. While certainly a significant development in the long arc of a crisis now spanning decades, the HAT programme’s overall impact was nothing to write home about. This is, of course, a running theme where government-backed harm reduction strategies are concerned. 

Legal heaven and earth have been moved to establish a safe drug consumption room in Glasgow. This was initially hindered by UK legislation that criminalises drug possession and use. However, after years of advocacy and pressure from public health experts and local officials, the Scottish government worked with then Lord Advocate Dorothy Bain, Scotland’s chief legal officer, to find a pathway. In 2023, Bain agreed not to prosecute users of the proposed facility, effectively decriminalising drug use within the site and allowing the pilot programme to proceed without changes to UK-wide drug laws. This move marked a significant step forward in harm reduction efforts amid Scotland’s ongoing drug crisis. But in truth, like many policies adopted in Scotland, it came about 10 years too late and is not part of any wider strategy to steady the ship.  

While the SDCR is expected to reduce overdoses, infections, and connect users to services, the deeper issues driving demand for drugs persist. People in deprived communities are 18 times more likely to die from drug-related causes, pointing to poverty as a root cause. The healthcare offer made to the poorest is always inferior, but this inequality is compounded for addicts who face additional stigma in healthcare settings, where addiction is too often seen as a moral failing rather than a health condition. Treatment options remain limited, and SDCRs, such as methadone programmes, will at best merely keep users stable until better solutions emerge. Be under no illusions that this action alone will make any significant impact on the overall crisis.

That’s why it’s odd that the Scottish government chose to expend so much political capital creating the legal headroom for this initiative, because even if it succeeds as hoped, its impact will be minimal. In truth, politically speaking, a legal standoff with London was the path of least resistance when you consider the true scale of the crisis and the action on social inequality required to turn it around. Creating a constitutional spectacle produces a sense that something radical is being done when in truth, the status-quo has simply been repackaged. 

Rather than take more politically risky action that may involve ruffling the feathers of middle-class voters, leaders with no coherent vision for a more comprehensive treatment landscape look instead to well-placed harm-reduction advocates who propose more of the same initiatives. The challenge facing the SDRC is immense. Even if it all goes well, its remit is limited and questions remain as to how exactly these short-term, pop-up initiatives will have any real impact on a nationwide epidemic.  

Consider the practicalities of actually getting people through the door of the facility when it opens. One challenge is geographical: expecting vulnerable addicts to travel into the city centre frequently is unrealistic. Advocates argue there are plenty of drug users within the city centre already who are eligible, but many dispute not only those figures but also the merits of a service set up to target a narrow cohort of serious addicts within a small urban area. Arguably, it’s the intravenous drug users in the city’s surrounding housing estates who are not only most vulnerable but who are also creating the greatest negative impacts in their communities. Wouldn’t they stand to benefit most, with their participation reaping greater social benefits? In any event, how will they be incentivised to make the trip? How likely is it that they will hold onto a bag of heroin and jump a bus into town before safely injecting?  

Even once enrolled, participants face numerous barriers. Many will fear being drawn onto the social work or criminal justice radars merely by identifying themselves or filling out paperwork. Distrust of authority is pathological among this marginalised community for obvious reasons. If they do present at the SCDR, who will greet them? Who will reassure them and gain their trust? Will drug workers with lived experience lead this important work, or will well-meaning but less streetwise staff who arouse suspicion in users pull the strings behind the scenes? Ultimately, will the same class dynamics that subtly underscore lopsided drug policy and debate in Scotland be needlessly replicated, or has serious work been undertaken to identify and correct for that problem? Then there’s the very basic harm-reduction paradox produced by the pilot’s central focus on intravenous drug use — will smoking heroin or cocaine be discouraged even though it’s often safer than injecting? 

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How Britain abandoned Scotland

By Tom McTague

The notion the SDCR will act as a portal to other services only sounds plausible if you know nothing of what’s actually out there in this baron treatment hellscape. What other services do we mean, exactly? Even people with no history of drug problems may wait months for the most basic mental health counselling. The complexities of lives ravaged by addiction, police involvement and homelessness often require specialist multi-faceted care, that is, quite simply, unavailable for most people. Addicts also face lengthy waits — up to a year — for rehab placements should they desire one, by which time the addiction may have deepened, or the desire to enter a residential setting may have waned. We don’t have an integrated system that pulls in the same direction as in Norway, where, for example, rehab facilities are integrated with some prisons. In Scotland, different organisational factions operate independently of one another, pushing their own agendas, pursuing their own interests, often based on selective assessments of a narrow evidence-base and a keen awareness of what’s “trending” with the hapless Government holding the purse-strings.

Staff turnover in the drug sector is also high due to burnout, demoralisation and short-term funding settlements while wider health services are overwhelmed. Unlike Germany or Switzerland — cited often by advocates as best practice that could be easily replicated — Scotland’s fragmented and underfunded services, operating well overcapacity in a more structurally unjust society, will hamper similar success, irrespective of noble intentions. 

I want it to succeed. If not simply for the minor morale boost it may generate at a time where even seasoned campaigners like me have grown apathetic or walked away from the fight to regroup. Despite critics being labelled regularly as cynical (admittedly with some justification), it’s decades of dire harm reduction outcomes in Scotland that fuel this scepticism. The problem is not harm reduction as a philosophy, it’s the fragmented and untimely manner in which Scotland implements these policies. We’re always playing catch up while dealing with the consequences of unforced errors like cutting safe benzodiazepine prescribing (which drove demand for deadly street Valium) or slashing funding to services that demonstrably save lives. This has been the way of things since the first methadone programme was introduced as a treatment in the Nineties and it remains the predominant treatment for heroin addiction despite showing up on around half of all drug death certificates since records began. 

Nearly 40 years later, with drug deaths now many times higher than in those early days, harm reduction remains the only real tool in Scotland’s drug policy box — a political choice and not one imposed by Westminster. The safe consumption room pilot must be viewed in this broader context. Rather than a clean break offering something new, it’s the latest iteration of the same idea we’ve seen before, yet for some reason, we are encouraged to expect different results. Rumours of staff walking out after inductions, a defensive management team unwilling to address tough questions, and the fact the SDCR was still advertising job vacancies as recently as mid-September (one month before it was due to open), suggest to this hardened cynic deeper issues behind the delay than the building safety checks cited. 

If the countless headline-grabbing initiatives we’ve seen throughout the past decade — as deaths have risen to intolerable levels — are anything to go by, this may mark yet another harm reduction gimmick struggling before it even begins. I hope I’m wrong, but it all reads like a familiar tale and one that tells the real story of Scotland’s drug crisis.

Berlin is my favourite city. I relocate there every summer now. It always bothered me that the groups I’d been in found popularity in Paris, but not Berlin. I don’t want to sound ungrateful, but it left me feeling like an anachronism. Paris is where you go for fashion, for very long walks, to read or write, to have affairs and to eat red meat. It’s architecturally ill-equipped to support nascent music scenes. A nascent music scene requires a populace long neglected by their government, living in a kind of post-industrial tabula rasa, a DIY-or-die kind of pressure. Detroit, Manchester, Sheffield, New York before they cleansed it. Even though it’s been several decades since the reunification that spurred the city’s techno explosion — an explosion now sanctified by Unesco no less — Berlin still has that unfinished energy.

It doesn’t have a curfew either. There’s no infantilising call of “bedtime” from on high. If a club stays open for days, you can sort of “move in” over the weekend. You can learn a lot about yourself if you try this for a few days. Especially if that club is a throbbing, homosexual techno dungeon. Ironically, this governmental act of faith in the good behaviour of its populace came about not long after the fall of the Third Reich. Before the erection of the wall, a tit-for-tat extension of opening times had ensued between the western segment of the city and the Soviet.

In the west, last orders had been 9pm; in the east, 10pm. The moment the west upped the ante, the east responded in kind, until a hotelier named Heinz Zellermayer grew sick of the stand-off. Over a bottle of whiskey, he’s said to have told the commandant of the western sector that “mayhem only comes when the bartender has to say ‘closing time’”. He insisted that zero curfew wouldn’t just be good for business, but would also make for a fine demonstration of liberal values.

The Western powers voted 2–1 in favour of never-ending nightlife: France and America for, Britain against, claiming it would render the city “too rowdy”. I wonder how that same freedom might pan out here in London? For the most part, ours is a culture of post-pub living-room cocaine binges. We are one-room adventurers. Maybe that’s for the best? We lack the inherent love of “order” that underpins the German psyche. Where drink and drugs are concerned, we sprint. We cannot be trusted with a marathon.

The stakes are high in Berlin if you’re looking for a good time. It’s death or glory. You might stumble into transcendent communion with a group of strangers in a warehouse somewhere; you might just as easily stumble into a plague of self-doubt and misdirected recriminations. If you want to play, you also have to accept getting played — by the music and by the heroically cynical door policies.

At a good club everyone is the front person, and no one is the front person. Right at the moment you feel like you’re at the centre of the universe, you suddenly disappear. Through this barely human machine music, social atomisation is inverted, or repurposed, made good somehow. In Berlin, clubs aren’t just places you go to get out of your box — they’re like extra-moral zones where nature’s lack of design is put on trial. It’s fun, but it can also be kind of like graft. Taken too seriously, does pleasure become work? Nowhere is this question more pertinent than at Berghain.

To an extent, Berghain paints its self-portrait in the misery of its rejects, its mythos carved in a never-ending succession of random refusals. The door policy — much like the music played within — is an ode to ephemerality. It is EasyJet-set-proof. You never know when or if you’re ever going to set foot in the place again. The club, an isolating concrete monolith, looms over a stretch of wasteland shrouded in an aura of regal indifference. Its only code of conduct: hard glamour.

I’ve seen people turned away from Berghain who looked like they were born there, head to toe in tattoos, leather and Balenciaga, people who had just queued for three hours. Certitude is passé. The sovereignty of the club precludes all solidarity. It’s easier to think of the place as a kind of tyrannical decades-long immersive art experiment than a night spot. Once beyond the gauntlet, you’re met with a sense of “anything goes” that exists nowhere else on earth. You are met with perfectly tuned German chaos.

The door staff all but extinguished my “youth” on a Sunday afternoon at the tail end of the summer of 2022. A fifth rejection in a row all but broke my heart. It’d been 10 years since my one and only visit. All I’d wanted was for them to turn me into a techno androgyne again: an android allergic to anxiety, a machine that can process nothing save raw enthusiasm. I had it on good authority that my music was being played inside and had gone down well with a few of the residents there. My geisha-gimp alter ego was welcome; I was excluded.

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But then, a year and half later, my band was booked to play the club’s 19th birthday party. This booking became the end point of my imagination: the title fight on the horizon. After this gig, I could retire or die or start writing pompous essays full-time. The gig meant closing the loop and paying my dues. Since my only visit, I would forever try to find my way back to a Berghain state of mind while up on stage. But things weren’t nearly filthy enough in the world of London indie.

I wanted to pay my dues, but of course, I also wanted vengeance. They had cast me aside with barely a shrug time and time again. They’d briefly pitted me against my dear friend Rob, whose resemblance to a demonic Phillip Schofield I blamed entirely for the mass rejection. They had taken a part of my dignity, and sent me back to London pregnant with shadow and self-doubt. I loved them; I had no choice but to love them. But now, it was their turn to love me. Sprawled semi-spread eagle across a monitor, wearing nothing save a half a tub of Vaseline, with one hand wrapped around a microphone, the other searching my own cavity, I think I won that love. I emptied myself entirely.

One great thing about getting asked to play Berghain is that you can bring a posse. They normally don’t let you in if you show up with a posse. They want you to show up alone. To be alone together. By showing up alone you can more readily disappear. Disappear into yourself. Which is where the first skirmish of their war on banality has to take place. That being said, on this occasion, I got to bring my laddish big bro, whom, by his own admission, “ain’t ever getting let into that fucking place”.

He couldn’t contain his excitement on the main floor later that night. He kept singing sped-up Cat Stevens lyrics over the world’s most elegant techno, much to the chagrin of the hot-pant-clad muscle Marys adjacent. When we got home to England, he summed the place up perfectly: “I miss it like a person, Lias, that club. My heart aches for it. We don’t want safety. We want salvation.”

Pushers have been a persistent problem in Görlitzer Park, or Görli for short, a hotspot for immigrants without clear residency or work permits to hustle in the narco-economy. Attempts to bring the park under control have included zero-tolerance patrols, and even marking designated areas for dealers to stand in with pink spray paint. But now Germany’s trying something completely different. A long-awaited to partially legalise cannabis comes into force on Monday, much to the delight of the nation’s kiffer (stoners).

“I was waiting for years for this to happen,” says Anna, 29, from Augsburg, Bavaria. “I don’t smoke as much as I used to anymore, but I always felt like a criminal [even though] I was only smoking weed. Also, most dealers are shady and you engage with a lot of shady people. No need to do that anymore, when there are clubs or the possibility to grow it myself. I feel like [the police] should go and use their time on real criminals and not some stoners.”

It’s as sober and reasonable a case for drug liberalisation as one could imagine. But you can find the same plea from young people across Europe, and yet legislators have proved resistant to change. So, how did it come that the continent’s largest economy is officially going 420-friendly, and what could it mean for the rest of us?

Cannabis and its derivatives were not completely unknown in Germany: “To escape from unbearable pressure you need hashish,” wrote Friedrich Nietzsche, the original stoner philosopher. But much like in the rest of Europe, it was largely a non-issue until the Sixties. Although the Nazis considered narcotics a Jewish scourge, they didn’t treat addicts too harshly if they were of the right bloodline, and unlike cocaine, morphine or speed, weed was too exotic to even worry about.

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After the Second World War, Germany was divided into East and West by the occupying powers, and then even more starkly segregated by the Berlin Wall. In capitalist West Germany, marijuana, LSD and other illicit inebriants were adopted as part of the counterculture revolution of the Sixties: one group of militant students called themselves the Central Council of Roaming Hash Rebels. Meanwhile, communist East Germany was largely insulated from narcomania. The average East German wasn’t exactly flush with cash, so escaped the notice of international drug cartels. The few who managed to acquire drugs enjoyed connections with diplomats and other elites permitted to travel abroad. In East German propaganda, narcotics were presented as a malady of the doped-out West, ironically adopting the same Reefer Madness-style anti-drug hysteria that prevailed in America from the Thirties to the Fifties. The supposedly Left-wing hippies were frowned upon. As one headline put it: “Hashers don’t read Das Kapital.”

Still, by the early Eighties, customs officers were complaining to the Stasi that hashish from the Middle East was being hidden inside pistachios. And it was in the euphoria of the reunited Germany in the early Nineties that 14-year-old Steffen Geyer toked his first doobie at a party. A few years later, on the way to complete his mandatory military service, police stopped him at a train station with 4.9 grams of hashish, which cost him three weeks’ jail time. “This was my moment of awakening, the first time I felt the injustice of the political system around cannabis,” says Geyer, now the director of Berlin’s Hemp Museum and, since 2003, the chief organiser of the annual Hemp Parade. “We start with speeches and music onstage, and then there’s a march across the city, we come back to the stage and there’s another four hours of political speeches and music… We try to show cannabis in all its varieties, but most of the people visiting are stoners.”

A thriving cannabis culture, then. According to Geyer, the attitude towards the drug in modern Germany is “a little bit like the attitude towards sex in the United States”. Officially, it is a slightly taboo topic, ignored by serious politicians, but 8.8% of the population partake on a yearly basis, including a quarter of 18 to 25-year-olds. There have been popular stoner comedies such as Lammbock and Lommbock, while rap videos such as “Was Hast Du Gedacht” (“What Did You Think”) by Gzuz boast enough guns, ganja and gyrating derrieres to make 50 Cent look like the Fresh Prince. And so, over the years, there’s been a cultural shift: whereas a decade ago only 30% of Germans supported legalisation, by 2022 there were more for than against.

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That very year, the pro-business FDP party campaigned on a legalisation platform in the federal election, eventually agreeing to form a government with the Greens and Social Democrats. The “traffic light” coalition, named after the colours of the three parties, initially proposed a system of licensed shops to protect children, similar to the age restrictions on alcohol, and quality control to prevent toxic contaminants (there was a scare that weed was being laced with heroin to get smokers hooked, but no evidence to back it up). The plan was opposed by conservative politicians in Bavaria, who feared it would spawn Amsterdam-style drug tourism, as well as doctors and police unions. But there was a greater snag — the EU.

“Unlike Uruguay or Canada, where although they violate the UN drug conventions there isn’t really any sanction, there have been consultations between the German government and the European Commission — and it became very clear that, if they would have a full commercial supply chain, there would be problems,” explained Tom Blickman of the Amsterdam-based Transnational Institute. And so, to maintain neighbourly relations, the bill was watered-down. The new rules approved by the German parliament on February 23 only allow possession of a maximum of 25 grams at a time in public, with 50 grams and three plants permitted at home. Three months later, non-profit cannabis clubs will be allowed to distribute the herb between their members.

There are still details to be ironed out, such as a proposed amnesty for 16,000 cannabis offenders (when reforms took place in Thailand in 2022, thousands of prisoners were released the very same day — some even got their growing equipment back). But Geyer believes this is just the beginning. “It’s only a first step — it’s not legalisation they promised two years ago, and it’s far away from legalisation as I would like to see it,” he says. The drug is “still illegal in Germany, so we only have a little bit more breathing room. First of all, we have to campaign to enact the law as fast as possible. And then afterwards, there will be a lot of discussion and arguing about the cannabis social clubs, because they’re too harshly restricted right now. And we need to establish them in a way that they are able to solve at least a little bit of the cannabis black market problem.”

The fact that there’s no US-style dispensaries on the horizon means joining a cannabis club, which mandate a minimum amount of consumption each month, is still a hassle for those less committed “cannasseurs”, who’ll keep Görli’s immigrant entrepreneurs in business for quite some time. Meanwhile, reformers are closely following developments in the hopes they will reverberate across the continent. “We see Germany as quite a sensible, if not boring, safe country, and them saying ‘we’re going to change our laws’, I think that sends a message to the rest of Europe that this isn’t a big scary issue,” says Paul North, director of the Volteface drug policy think tank. He adds that if Germany eventually adopted an American-style dispensary model this would greatly embolden cannabis campaigners, whereas its slow-and-steady approach leaves lawmakers more cautious. “What Germany does is really important, and it will send a clear signal as to what to expect and see what the light line in the sand is for the rest of Europe to follow.”

For someone like Steffen Geyer, there is only one direction of travel: full normalisation of cannabis. “There will be huge differences in the enforcement of this law between huge cities in the north, and the south of Germany,” says Geyer. “Usually, it’s more liberal in the north than in the south, so if you live in a small town in Bavaria, you will have a lot of contact with the police just to check if you have less than 25 grams with you. But I live in Berlin, and Berlin right now is quite a liberal city and it will be an even more liberal city within a couple of months, when people don’t have to hide their cannabis anymore. It will become more normal, less freaky. It’s a little bit like when the gays were liberated, and that’s a really good thing.”

It’s a quixotic vision for the future. The question remains whether it’s a future Europe really wants. Malta, Czechia, Luxembourg, and the Netherlands are also experimenting with reform, but current EU policies restrict how far they can go. And any fundamental change to drug laws at a continent-wide level would represent something of a revolution: contrary to popular belief, until recently weed was not actually legal in Amsterdam’s famous coffeeshops — merely tolerated. France, Sweden and Hungary, for example, remain firmly prohibitionist, and will likely oppose wholesale reform for the foreseeable future. The rise of the populist Right across Europe has also stoked fears that European drug policy could completely change tack, becoming more authoritarian and conservative. While the “war on drugs” that dominated the second-half of the 20th century might be over, the campaign for the kind of liberation Geyer envisages is far from settled.

Not one week later, and we can breathe easy again: it was all just propaganda. He’s flogging smokeless stoves, shrewdly positioning himself as the George Foreman of a less lung-cancer-inducing inhalation technology. I genuinely thought for a moment there that he was sick of the fog. I’m kind of sick of the fog myself by now. What never ceases to amaze me is how sexy some artists manage to make smoking the herb seem. It’s not.

A friend of mine — a middle-aged mum — once claimed that skunk was worse than heroin. I thought this comment laughable at the time, having been around a lot of heroin abuse. I’ve dabbled myself, but I was always a bit of a tourist, truth be told. Too much time spent watching Countdown for my liking. Too much vomit. Too much possibility of sudden death. What’s a little green by comparison? When someone you love endures a bout of skunk psychosis, you soon find out.

Heroin has a tendency to make the user manically self-involved. Not everyone, might I add, lest I offend anyone. With drugs it’s always different strokes for different folks. Some people, it’s for the best they’re on the smack. They might have been terrible alcoholics otherwise. Or have untethered themselves from reality entirely blazing the chronic. But you can’t get away with smoking brown casually, hence why, even among fairly committed caners, the line is often drawn at heroin. That’s when the phone calls go around to family members. Talk of possible interventions.

Whereas weed is just there. No one bats an eyelid. Intimations of Sixties optimism, of low-grade, no-risk consciousness expansion. That today’s genetically engineered varieties are up to 100 times stronger than those smoked by our Boomer forebears has only recently begun factoring into the equation. This has given the stuff a Trojan Horse-like incisiveness where fucking up young people’s minds is concerned. Never mind that it might leave you three times more prone to have a psychotic episode, or that 25% of Priory cases of paranoid psychosis — a schizophrenia-like illness and depression — were caused by weed or spice use. According to a 2014 Lancet psychiatric report, adolescent weed smokers were at particular risk: 60% less likely to graduate from high school, and seven times more likely to attempt suicide.

Curiously, although cannabis-related hospitalisations have more than doubled since 2013, use of the stuff has been steadily plummeting. Especially among youngsters, who seem to be wising up to the grim realities. In 1995, 30% of 16-24-year-olds were users, today that figure is something closer to 16%. The connotations of pot use are shifting in tandem with the nature of the drug itself then. The Romanticism and consequent naiveté of the previous era are indeed beginning to fade into something darker, sadder, more claustrophobic.

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Had this vibe shift occurred before I’d arrived in London aged 18 to study art at the prestigious Slade School, I wonder if life might have panned out differently? I might not have squandered the opportunity tooting skunk and masturbating in my halls of residence. All the graft I put in winning my place there as a diligent, pre-skunk teenager back in Cookstown where I grew up went swiftly down the drain. Pornography and pot. Somehow these things became my priority. Life since has basically been a contingency plan rooted in the unforced errors of those wasted years. That the stuff is a gateway drug goes without saying. If you smoke enough skunk, eventually cocaine becomes a bare necessity, a kind of social defibrillator. It might turn you into a prick, but at least you’re out and about again.

Smoking weed is like rolling the dice with the rest of your day psychologically. The stronger the smoke, the higher the stakes. These days, if I’m blazing, I tend to pepper a single skin roll-up with a few crumbs of hashish in the evening. These are odds I can handle. All the same, I often find myself marooned, dumbfounded. My partner can tell almost instantly I’ve had a toke too many. The dry-lipped silence. The absence of common sense. It pluralises perception, as opposed to embellishing it like more intense psycho-actives.

Thoughts cross-pollinate incessantly, pile up and provide you with a new and thrilling vantage point… or… they cascade down into the nether world leaving you speechless with profound doubt, little more than a symptom of your selfhood. There’s no telling which way the wind’s about to blow. This randomising factor can be incredibly useful where creativity is concerned. If you’re working in music — the purest of all art forms — especially. For example: you’ve spent several years making an album. Towards the end of this process, you’re inevitably bored shitless with everything you’re working on. You have to make it new for yourself again in order to summon up the will to push it over the finish line. Simple, just listen to it on drugs.

It isn’t just weed that young people are turning away from, but narcotics across the board. Also: religion, working part-time jobs and having a girlfriend/boyfriend. All things that help you not to feel isolated and lonely. Things might have panned out differently had I not spent the end of my formative years pickled in skunk. But then at least I hadn’t been subjected to social media from day dot in combination with the stuff. That people are watching you and attempting to interfere with you from afar is no longer the stuff of weed-induced paranoia, but hard fact. And if young people have substituted weed for the internet, they might well be replicating the former’s effects.

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Drugs have ravaged my community. Where they haven’t completely alienated people from themselves and the wider world, they have enfeebled without mercy. As we hobble towards and out beyond the 40 mark, we’re all just picking up the tab. We made a few half-decent tunes though. Admittedly, my social group aren’t exactly a great demographic from which to extract generalisations. Over-sensitive song and dance men, entertainers, fools… we only made it through adolescence on account of a handful of records, records disproportionately made by arch-hedonists who frequently dropped dead at 27.

These artefacts were our rallying call, our entry point into something larger than ourselves. They gave our lives something resembling purpose. Generation Z, the world’s first digital natives, don’t seem to be taking the bait where this overweight mythology is concerned. It’s hard to imagine another Winehouse in this day and age. Maybe not. The inevitably meditative kind of boredom we had to play around in growing up is off the menu, probably forever. It’s not been eradicated, but inverted and intensified horribly, a kind of mind-death by convenience, by over stimulation is taking its place.

The old gods are fading, along with their shitty behaviour, replaced by a Warholian micro-portioning out of fame itself. Today, everyone has a public soul. Fame, de-centralised, has lost its transcendent capacity. The druggy role models of yore, deflated. Even if it means there’s no longer any albums worth smoking an ounce to as Snoop Dogg would have it, nobody wants to come off a whopping anachronism. I dare say the future might be a little kinder, a little safer, a lot softer on the liver. But if it’s tuneless, what’s the point?

I was here for the Product Earth Expo: the “UK’s no.1 legal cannabis, CBD, and nootropic experience”. The three-day event, co-organised by a former marketing lead at Facebook and a Harvard-educated medical data executive, is an outdoor festival of business and pleasure, with live music taking place alongside panel discussions on the various questions and goings-on in British cannabis. There are glassblowers, stalls for CBD businesses, tools for rolling, growing and baking weed, as well as medical and activist groups such as David Nutt’s Drug Science, Hemptank and the UK cannabis patients’ group.

Being an event centred around cannabis, it’s little surprise that funny smells were detectable throughout the grounds. No police were in sight. As with Hyde Park’s annual “4/20” gathering, last month’s Notting Hill Carnival and near-enough every music festival, the Expo’s look-the-other-way approach allows for a brief and flailing glimpse at our muddied present of drug policy.

Britain’s approach to cannabis can be described as contradictory — and in many ways backward. North America has largely legalised the drug, and Germany is following suit. But in Britain, some police forces will still raid large-scale dealers, even while medical cannabis patients are cultivating their own plants and small-scale growers are semi-officially tolerated in some counties. One scheme with a stall at the Expo was Cancard, an unapproved ID card scheme that lists users as medical cannabis patients and is backed by some police officers. If stopped, users can show their Cancard to excuse their use on medical grounds.

In reality, though, little has officially changed since 2018, when medical cannabis was first approved. Since then, senior Tory figures including William Hague have come out in favour of reform, while new cannabis companies entered the market and the City wetted its lips with anticipation. Britain swiftly became one of the world’s largest export-producers of medical and scientific cannabis. But, last year, regulators launched a crackdown on substandard and over-marketed items — and now the Expo’s founders are concerned about the CBD market’s possible collapse.

Medical cannabis was first approved in California off the back of stories of how it could relieve the symptoms of Aids patients. And this playbook has been followed in the UK. In 2018, a child whose epilepsy was treated with medical cannabis had his prescription seized at Heathrow Airport, prompting a relapse. Cameras and press were ready waiting. The resulting campaign, “End Our Pain”, was funded by commercial interests and led by Steve Moore, a former insider in the Cameron government, who later started the drug reform advocacy organisation VolteFace with funding from Paul Birch, the founder of Bebo. One of the other co-founders was Alastair Moore (no relation), who also co-founded a cannabis consulting firm called Hanway Associates.

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Two years later, the British Medical Journal documented a dense range of interconnections between pressure and patient groups and industry funders in the nascent cannabis market. New initiatives have since emerged: as well as founding VolteFace (with which he is no longer involved) Steve Moore would go on to set up the industry-funded Centre for Medical Cannabis and the Association for Cannabinoid Industry. Elsewhere, the All-Party Parliamentary Group (APPG) for CBD is managed by Tenacious Labs, a CBD firm, while the newly-elected Secretariat of the APPG for Medical Cannabis is jointly held by VolteFace and the industry-funded Medical Cannabis Clinicians Society.

It is an instinctively suspicious series of intersections between government and business lobbying. But Neil Woods, an ex-police officer and activist for drug policy reform, has questioned the significance of such connections. “Big business is of course interested in the emerging opportunities of a legal cannabis market for adult use,” he says. “But so what?” And Steve Moore himself has previously argued that a “public-private partnership” will always underlie a coalition for change. But for all the money involved, the market is still fraught with problems: many firms are loss-making, and rising interest rates are cutting the relative attraction of risky and future-looking businesses. Westminster isn’t playing ball, either, with home secretary Suella Braverman reportedly considering upgrading cannabis to Class A status.

Despite Braverman’s concerns, the medical case for cannabis has made some important advances. Medical cannabis was Nice-approved in 2018 for three conditions: severe treatment-resistant epilepsy, muscle spasticity, and chemotherapy-related nausea. Each of these conditions is prescribed as a last resort using a patented formulation, even when first-line treatments involve punishing side effects. But few prescriptions have ever been made on the NHS. Instead, a large private sector using registered cannabis clinicians has emerged, offering prescriptions to patients for a range of conditions where prior treatments have failed — including anxiety, depression and ADHD, for which evidence of cannabis’s efficacy is quite limited. For an “initial consultation” at clinics such as the Lyphe Group, Sapphire Medical Clinics and the London Cannabis Clinic, patients pay as much as £399. And many later complain that the expensive products from private prescribers are of inferior quality — often late, sometimes contaminated with mould.

Unsurprisingly, ideological arguments about the “right to get high” and bodily autonomy are rarely seen (at least explicitly) in the mainstream. All throughout the Product Earth Expo, the dominant way to present cannabis is medical — in line with broader medicalisation rhetoric that presents drug use as a public health problem and not a carceral one. And, perhaps inadvertently, allying with the medical system has exposed cannabis to greater scrutiny on its risks and benefits — as well as the demands of medical evidence. The last 10 years have produced more evidence in particular of cannabis’s link with psychosis, schizophrenia and a range of mental health problems. Indicatively, the Home Affairs Select Committee released a new report last week, which supports a “public health-based harm reduction” approach and calls for “greater provision” of medical cannabis on the NHS. Yet its authors “remain concerned” by cannabis harms and oppose full legalisation.

Walking the aisles of the Product Earth Expo, you get a two-sided picture. Users believe history is on their side. Much more than the old, the young are largely convinced of cannabis reform — though use of the drug has actually declined markedly among the young since the Nineties. Failing legal change, the growing normalcy of cannabis smoke forms part of a gradual and de facto erosion of anti-cannabis policy. Users will keep ignoring the law, until the law is so absent as to seem unworkable.

“Working in the sector it has been so frustrating to see the dialogue stagnate politically,” said Katya Kowalski, the Director of Operations at VolteFace, earlier this year. Indeed, among activists and campaigners, one hears many of the same arguments that have been made for decades, and which first caught flame in the Sixties: the motives of the original anti-hemp campaigners, the possible tax rewards, the relative safety of cannabis. Yet that final point is one on which the cannabis community seems to be losing ground. Making the case that “Cannabis Is Safer Than Alcohol”, as Bebo founder Paul Birch attempted in 2015, is no longer feasible.

Instead, it is possible that once again re-converging on a sympathetic human story will shift the debate. And Britain is full of such poignant cases. Kyle Brown, 26, is from Winchester and lives with craniometaphyseal dysplasia, a rare genetic disorder that causes the muscles and bones around the head to grow abnormally. He approached me at the Expo and told his story. Brown expects he will not live past 60, and estimates he probably has around eight years of high-capacity living left. Brown consumes medical cannabis to manage the punishing side-effects of his licit prescriptions.

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Can psychedelics cure depression?

By Flo Read

But he still relies on the so-called “legacy market” of street sales because of the high expense of legal prescription. Understandably, he is concerned about the presence of adulterants such as MDMA and fentanyl in his cannabis — as well as the lack of transparency about what exactly he’s smoking, which could contain the high THC concentrations so associated with mental health problems.

Who is truly leading Britain’s evolving cannabis policy is therefore difficult to estimate. The influx of medics, commerce and Big Pharma (though the latter is not as present at the Expo) has so far disappointed with their Whitehall strategy. But the lobbyists still hope to win through a long game, and their proximity to lawmakers would allow them to shape whatever model Britain eventually adopts.

“If they are to legalise cannabis, it will be a fully corporate model,” says Greg de Hoedt, a Crohn’s patient who manages his symptoms with cannabis. He’s also the founder of UK Cannabis Social Clubs, an activist umbrella group for private members’ clubs around the country that grow their own cannabis, smoke together, and offer testing on potency. Social Clubs are part of Germany and Malta’s legalisation models and form a third-way between community and commerce. Social Clubs have been tolerated in Britain historically, says de Hoedt, but he has noted more crackdowns from police in the five years since medical approval compared to before.

The Expo’s attendees are likely unaware of all the lobbying and politicking of the last half-decade. They form the lobby’s shock troops, normalising use and forming the consumer base for the current medical market and a future commercial one. The strategy has a shadow side, though: the more cannabis is unofficially decriminalised, the less immediate the issue seems for a short-term and crisis-driven political system.

This week, Prof Nutt visited the UnHerd Club to discuss his latest research, the resistance he’s faced from the academic community and the transformative power of psychedelics. Below is an edited transcript of his conversation with Flo Read:

Florence Read: Instead of turning on parts of the brain, psychedelics can do something quite unusual, which is actually turn some parts off. Could you just explain a little bit more about that?

David Nutt: Obviously, Timothy Leary was wrong, these drugs don’t turn on the brain, they actually turn off the brain. Imaging work has shown that there’s a circuit in the brain called the “default mode network”, which controls how you think. Our research showed that network was being switched off.

You’ve probably heard of Aldous Huxley’s book The Doors of Perception. That book was written after a mescaline trip, but the phrase “the doors of perception” is taken from William Blake. And Blake said that: “If the doors of perception were cleansed every thing would appear to man as it is, Infinite. For man has closed himself up, till he sees all things thro’ narrow chinks of his cavern.” He was referring to people who aren’t artists, who see things in a very restricted way. Huxley used that quote, but he realised that what mescaline had done was open his mind, and then worked out that something must be closing his mind. What’s closing his mind? He said: the brain.

The brain is an instrument for focusing the mind. Psychedelics switch off the parts of the brain that control your mind. There was a group at Yale doing work in depression. They showed that the default mode network — the part of the brain that was turned off by psychedelics — is overactive in depression. If you scan the brains of depressed people, a greater amount of their brain is engaged in this internal, reflective, self-referential thinking. We thought: “Let’s see if we can turn it off in depressed people, and will they be non-depressed?” And lo and behold, they were.

We gave a single dose of psilocybin to people who had failed on other treatments. (They’d all failed on two antidepressants — somebody had failed on more than 10; they’d all failed on CBT.) They all got better. It’s the strongest effective treatment for resistant depression there’s ever been. Some of them are still well now, 10 years later. For the majority, the depression has crept back, and that tells us something else about the nature of how deeply embedded depressive thinking can be. But the fact that you could switch off the depression circuit, and lift people’s mood — that was a discovery.

FR: Among that cohort of treatment-resistant depressives, was there a common thread between them, in terms of their experience on the psilocybin? Or is it quite individualised?

DN: The content of a psychedelic trip is completely unpredictable. After that first trial, we set up a second trial, where we wanted to see if we could prolong the antidepressant effect of psilocybin by giving two trips, three weeks apart. And there was absolutely no relationship between the first trip and the second trip. Some people had a terrifying trip the first time, then a good one, and vice-versa.

What we try to do in therapy is get people to use the experience to deal with the thinking that is underpinning their depression. We asked them to try to engage with problems, to go back to issues in their childhood that might be relevant to their depression. Most of them don’t want to do that. One of the theories of depression — one of the theories about why your mind is so preoccupied in depression — is that you’re trying to resist re-engaging with those traumas. But we encouraged them to do that. It’s challenging, it’s difficult, they find it distressing — but they often get fundamental insights.

One of our patients on the first trial said: “I saw my father abusing me and I realised that was why I was depressed.” He realised: “I was blaming myself for the abuse. And in the trip, I was able to say to him, ‘That’s it.’” He got closure. He came out of the trip and he’s been well ever since. So people’s trips often focus on an individual trauma in their lives which they struggled to deal with. They have that in common.

FR: So given this level of success, why are these drugs not available for depressives in the UK?

DN: There are so many hurdles. Where to begin? The first is really weird. That initial study that we did was actually funded by the Medical Research Council. They put out a call for new treatments for depression and we got the grant. Getting the grant was the easiest bit. It took three iterations of the Ethics Committee to get permission to do this study. The ethics committee said: “It’s too dangerous; you can’t give depressed people psychedelics.” Why not? “Well, they might die.” That’s pretty unlikely — no one’s ever died on psilocybin before — but why do you think depressed people might die? “Well, they’re depressed.”

The third time we were going to this committee, I realised if we didn’t agree to do what they said, we would never get the study done. So in the end, they said: “You cannot do a controlled trial; you can do a safety study. Give 12 people it, see how they go. If none of them are dead in six months then you can come back and do a controlled trial.” So we said yes — in fact, the original trial was to see if people survived, which they all did. And the secondary outcome was whether their mood had changed. They could have got worse. They all got better.

So it took us a year to pass ethics. It took us another year to get hold of the medicine — the drug — because there’s only one place in the world that could make it. Then we had to get import licences and export licences. It took 30 months to get hold of the drug, and two more months to get permission from the Home Office to actually use it. That’s 32 months out of a 36-month grant — all because these drugs have been vilified for the last 50 years. The bureaucracy is so intense.

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FR: Is this a bureaucracy problem or is it a moral failing?

DN: It’s more than moral; it’s political. The reason psychedelics were banned in 1967 in the US and in 1970 in the UK was simply because psychedelics were allowing people to think differently about how they wanted to run international relations. The war in Vietnam was being protested. There’s this amazing photograph I have, of someone holding a placard that says: “Drop acid, not bombs.” They couldn’t ban the anti-war protests so they banned the drugs instead, thinking that would dissipate the protests. Of course it didn’t, and eventually, the protesters won.

The Vietnam War ended but by that time, the drugs had been banned. And one of the worst things about drug laws is that it’s almost impossible to remedy them. For example, in America, two-thirds of states have medicalised cannabis, and half of states have recreational cannabis, but it’s still illegal under the federal law. In fact, there’s only two countries in the world that have actually pulled cannabis out of the UN conventions, and that’s Canada and Uruguay. Every other country in the world, even America, still complies with the UN regulations, which still say that cannabis is an illegal drug. And no country has pulled psychedelics out of the UN conventions.

So everything we do, we do in the face of this enormous barrier. They’ve created this myth that these are very dangerous. Almost everything you’ve heard about psychedelics has actually been a deliberate misrepresentation to perpetuate this political decision that people shouldn’t use them.

FR: Would the power dynamic between a doctor and a patient change if this kind of drug became legalised?

DN: The medical profession isn’t really that progressive. And I can say that: I’m a doctor. I have become more and more disappointed by the inability of medicine — particularly in fields like psychiatry — to move with the times. I personally think that psychedelics will re-energise psychiatry. A lot of psychiatrists are very disillusioned. We haven’t had any real innovation in psychiatric medicine or psychiatric psychotherapy for 50 years.

FR: One thing under threat at the moment is the idea of holistic health — the idea that your mind and body have some sort of co-dependent relationship.

DN: We are quite top-down, paternalistic and autocratic in healthcare. There is very little scope to do anything that we’re not told to do from above — and, of course, that’s why I was sacked. Because even if you challenge — even if you just raise an intellectual question about the policy — they don’t like it.

It probably doesn’t come as a surprise to you that I’m quite a fan of Huxley. But my favourite book is not Brave New World or Doors of Perception. It’s actually Island, his last book. It is a roadmap to a society where you use psychology — you use dance, you use movement, you use exercise — and you use psychedelics to maximise quality of life. That’s what we should be doing. I was on the Good Read programme about six years ago, and Island was my Good Read. And two weeks later, I was in Parliament, at a group on drugs and drug addiction, and I was viciously attacked by a drug service provider for daring to talk on the radio about the use of illegal drugs to help people have a better life. That exemplifies our silos of thinking, which have become entrenched over decades. I don’t even think psychedelics could open their minds. 

FR: When people are having these transcendent experiences on psychedelics, are they finding something that we have all lost? Barely 3% of the country goes to church anymore; we’ve lost so much of our connection to the spiritual. Do you think they are recovering some of that?

DN: Yes, I have no doubt. Psychedelics increase connectedness — with the self, with other people and with nature. There’s a very interesting relationship between psychedelics and religion, because pretty much all religions emerged from groups of people using psychedelics. Hinduism came from a combination of mushrooms and Ephedra. South American beliefs came from ayahuasca and DMT and also from mushrooms. There’s a wonderful study going on in the States using psilocybin on priests who’ve lost their faith, and it’s working — it’s working for some faiths: I don’t think it’s quite as good for Islam as it is for Christianity — but there are priests coming out saying they have begun to find their faith again.

And of course, there was this remarkable experiment called the Marsh Chapel Experiment at Harvard in the Sixties. They took trainee priests on Good Friday — when they’re going to be in chapel praying and contemplating for the whole day — and they split them and gave 10 of them psilocybin in the same doses. And of the 10 given psilocybin, eight of them have this powerful mystical experience where they saw God.

So that does help make sense of the way in which religion or religious beliefs can be facilitated by changing the way your mind works. Of course, historically, people have done that in very different ways. In the old days, you used to starve yourself for days and nights, or kneel and pray for hours and hours, to get those kinds of mystical changes. And they would have been produced by alterations in biochemistry — due to stress — which are not necessarily very different from those that psychedelics produce. But psychedelics are just easier and probably more effective.

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FR: If these drugs did become widely available, how would we preserve this connection to spiritual well-being?

DN: There’s a really interesting experiment going on in the US now. Oregon has made magic mushrooms effectively a legal medicine. But more than that, they are authorising wellness centres, all around the state, to provide mushroom therapy, or mushrooms as part of wellbeing therapy. Now, that’s an amazing decision. It’s the first time anywhere in America that there’s kind of socialised medicine — using what it is now, and will be even when the therapy centres are open, an illegal drug. The purpose is to improve wellbeing in communities, and I think it’s going to work. 

FR: You’re a good advocate for psychedelics, but have you faced judgement from your academic peers? Do you find that you are in any way isolated in that community?

DN: About five years ago, I gave a talk to the Royal College of Psychiatrists and about psychedelics as the future of psychiatry. And after the talk, the room divided into three separate groups. There were about seven or eight men in the room older than me, who said: “Fantastic. I was there in the Sixties, we were using it. It was working fine. Thank goodness you’re bringing it back.” And the majority of the room were people from 35 to 60 who said: “This is rubbish. There’s no RCTs. They’re dangerous drugs.” And then there were about 50 trainees who said: “Fantastic — at last. Psychiatry has got something to offer me!” So credibility is very age-related.

Academically, I’ve been generally pleasantly surprised by the positivity. I think there are a lot of academics out there who realise that this is the way forward. They just don’t have the courage to stand up and do it because they don’t want to be vilified, they don’t want the Daily Mail writing about them. But they are on-side. There’s very little criticism within the scientific community about what we’re doing, because it’s good science. It’s published in the top journals. It’s very hard to argue with that.

FR: Let’s take some questions from the audience.

You spoke about shutting down the “default mode network” as a one-off event. Have you found that there’s a need to link therapy, psychotherapy, and a deep understanding of people’s trauma with the psychedelic experience, versus treating it like a neuroscientific event?

DN: What I find amazing is that both are true and that’s why it’s unusual. In fact, it’s kind of unique in psychiatry — to be able to do a brain imaging of someone who’s had a treatment, and see why it’s worked. What we see in people who’ve been depressed, who’ve had a psychedelic trip, is their brains are more flexible. And that accords extremely well with the cognitive experience of actually being able to think differently and not be locked into negative thought loops.

But I absolutely agree with you that the experience itself is what people want to talk about — and the value of that, in terms of helping them change their lives and move forward is, for the patient, absolutely central. Critics say: “Prove to me that what the patient thinks matters.” In fact, there are people who’ve said to me: “I’m not going to believe that psychedelics work until you give it to people under anesthetic, because it could all be placebo.” It’s surreal, because we don’t do any other kind of therapy under anaesthesia. People want to talk about why the experience is valuable to them. They want to get other people to engage with it. 

FR: Placebo is a concept that’s totally vilified in the mainstream scientific arena. Do you think that there’s room for a good placebo effect?

DN: Half of everything any doctor does to you is placebo. It’s you wanting to get better. If you don’t want to get better, you won’t get better. If you want to get better, you can get better, and psychedelics allow you to get better — whether that’s a placebo, or whether it’s a drug effect. I think it’s a drug effect, but proving it’s a drug effect is kind of pointless, and probably impossible, and I’m not going to bother.

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I was a government minister in the Department of Health in 2018, when we rescheduled THC for therapeutic use. And probably the most important thing was having a cause célèbre. There was Billy Caldwell, and a number of children with horrendous, untreatable epilepsy — suffering dozens of fits a day — who were treated by these medicines. And the compassionate power, forced on people in positions of power, was irresistible. That is actually what led to change. So applying that to psychedelics — who will be the cause célèbre?

DN: Australia decided in February that, from the first of July, psilocybin for treatment-resistant depression, and MDMA for treatment-resistant PTSD, will be approved medicines. And that was driven by an example: a woman who was actually a friend of the Prime Minister’s husband became severely depressed, begged for psychedelic therapy, couldn’t get it, and killed himself. And she made videos and she campaigned and she became the cause célèbre because of her dead husband.

We haven’t got that patient in Britain. But the sad thing is, we do have a lot of veterans who are medicating themselves. Some of them have been part of our studies. We’ve been working with them for eight years. They have been campaigning for this law change. And it’s not happening. These veterans are going to South America to get treatment — many of them can’t afford it; we’ve got senior members of the military arguing for this. But it’s falling on deaf ears. And I don’t know what the problem is. It may be because it’s not a child. The other thing about Billy Caldwell is that he was dying in St. Thomas’s, which is just across the river from politics. Parliamentarians could not avoid the fact that he could be dead within a few hours. So they had to do something. We don’t have quite the same immediacy.

I feel that cannabis has got stuck. It’s got stuck at this stage where unlicenced cannabis medicines are massively on the rise, but the NHS is not prescribing the licenced medicine. And it’s very hard to change. Even if tomorrow, the Home Office looked to reschedule psilocybin, we’ll end up in a similar place — where psilocybin therapy is only accessible privately because the NHS won’t endorse it. What’s your view on how we push past that?

DN: You’re quite right: for four and a half years cannabis has been a medicine, and there have been four prescriptions on the NHS. That’s almost as big of a scandal as having made it illegal in the first place in 1971. The NHS is not flexible and the mistake made was to insist that cannabis could only be prescribed by a specialist. And most specialists are old white men like me who spent their lives working on treatments which aren’t cannabis, and they don’t want to have to get out of their rut and learn about cannabis. The people that need to prescribe medical cannabis are the GPs and they’re not allowed to.

The other problem with the NHS is their budgets are controlled by pharmacists.You’d think pharmacists would be interested in pharmacology, but actually they’re not — they’re interested in money, and they’re really resistant to bringing in new treatments. So even with patients where it’s incontrovertible — the consultant says: “Medical cannabis has helped this person, please can we prescribe on the NHS” — the pharmacist says: “No because NICE hasn’t approved it.” And that’s why I left the NHS. That’s why now my work with ketamine is outside the NHS. Because it’s the only way we can actually use a psychedelic drug on patients. The same will be true with psilocybin or MDMA when they become available.

What we’re doing in the clinics that I’m working with — the awakened clinics here — is collecting data. At some point in the not-too-distant future, we will be able to go to the NHS and say: “100 patients with depression treated with ketamine therapy. Make NICE approve it.” We’re all campaigning to get NICE to accept that this real-world data for ketamine could be used — in the same way that real-world data for cannabis was collected.

I work at the Centre for Social Justice and we work with around 800 small grassroots charities, many of which are working in the addiction sector. And I have yet to meet a single one of those organisations that thinks legalisation is the answer. In fact, they actually think the opposite. We recently held a roundtable with a load of drug dealers, and we asked them what they thought about legalisation, and they said they were absolutely desperate for it, because it was going to significantly increase the number of people who will be buying drugs. And their response to that, they said, would be to undercut the legal drugs by making them cheaper, and then they can make them stronger or weaker, depending on what the clients want. And I wondered what you thought of that?

DN: Free markets are a problem, aren’t they? So my argument would be that we should decriminalise personal possession of all drugs. Criminalising people who use drugs is both immoral and ineffective. It would be economically sensible to have regulated markets for all drugs which are less harmful to the user than alcohol. Because reducing the use of alcohol would have a net beneficial effect on society. We’re beginning to see that now, in countries or states where medical cannabis has become legal: people are drinking less, and also using less opiates.

In our medical cannabis initiative — the Drug Science 2021 initiative, which you can access online — we had 3,500 people on medical cannabis, over 1000 of them for chronic pain. And they almost halve their use of opiates without even being asked to stop opiate painkillers. They’re just stopping because medical cannabis is better for pain.

In terms of treatment providers, the reason cannabis is a problem in Britain is because we tried to get rid of cannabis, in the same way that heroin is a problem in America because they tried to get rid of heroin. They tried to stop people using relatively mild forms of cannabis and what did the market do? The market just shifted to make stronger forms of cannabis. When we tried to clamp down on cannabis in prisons, what happened? We started making spice, and spice kills people; cannabis doesn’t. So our hostility to cannabis has driven the problem for cannabis. When we tried to stop the use of opium in 1910 by Chinese people in the East End of London, what happened? They stopped smoking opium; they started injecting morphine.

Almost every drug we’ve tried to control through prohibition has resulted in the use of stronger, more toxic alternatives, and lead to greater problems with addiction. I was in a huge conference in Orlando, speaking to 2,500 addiction service providers, last year. I started talking about using psychedelics to treat addiction and they were horrified. But it’s their business. The addiction business is a big business. A lot of people get their employment out of it, but they need addicts to keep the business going. And if we can get rid of addicts, they will be out of business, so they don’t want change either.

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When the default mode network is switched off, how does it come back? And if it comes back, how does it not cause the depression again?

DN: It comes back different, it comes back more flexible, it comes back less entrenched. Now why that is? We don’t know. One analogy is, if you keep thinking something, it’s like a cartwheel going along in a muddy field. It digs deeper and deeper and deeper. But then if you have a rainstorm or a flood, you can wash the ruts away and you can start again. But how that actually translates into neurochemical changes, or neurological changes in neurons, is still a mystery, and it is actually to my mind the big target at present. I would really like to understand how we get rid of it. Some people use the analogy of a snow field: once you’ve skied for a long time, you get stuck in a rut. Then the snow comes and you can see normally again. But eventually, for many people who’ve been chronically depressed, particularly from childhood, there’s a pressure to rut again. And what is that? I don’t know. And that’s one of the areas I’m really trying to get my head around intellectually, because then we might be able to design some experiments to test it.

FR: This comes back to this idea of neuroplasticity, which you have when you’re young and then you lose as you get older — do you think people have a fear of the general public becoming more neuroplastic?

DN: Yes and no. No one minds people with Alzheimer’s getting more neuroplastic. But young people thinking differently — that frightens society, or the establishment. But neuroplasticity — this is an ancient concept. Every time you do anything, you’ve grown a few synapses in your brain, you’ve consolidated some synapses, you’ve made them more efficient. Now, that process is very powerfully stimulated by psychedelics. It’s also stimulated by ketamine and MDMA. And from the insights you get during a trip, people often see things very differently, come up with new solutions to old problems. But they can consolidate those new solutions by neuroplasticity. 

The US Department of Defence has invested something like $27 million in trying to develop drugs which will produce plasticity, without being psychedelic, because they’re terrified of psychedelics. If you’re a vet in America, and you use an illegal drug to get better, you lose your pension, and you lose your access to healthcare. So rather than change the law, they’re trying to find drugs which will actually heal the brain through plasticity. I don’t know if that’s going to work. I think it might be useful. It might augment psychotherapy. But I think it’s going to be something you take every day. I don’t think you’re going to have a single dose of a neuroplastic agent and suddenly you’re going to wake up the next morning feeling un-depressed. But the research is going on, and we’ll find out.

What is monkey dust?

DN: Monkey dust is a new cathinone. Here’s a story. Just before the 2010 election, along comes mephedrone (“meow meow” or MCAT), a relatively weak cathinone that’s legal. It becomes very popular. But an election’s coming up, and Gordon Brown doesn’t want to be seen as soft on drugs. So mephedrone gets banned. And then, after a couple of years, we start to look at the data. And what we saw with mephedrone between 2008 and 2010 was as use went up, cocaine deaths fell, amphetamine deaths fell. Why? Because people were switching from an illegal, dangerous, harmful drug, to a legal, less harmful drug. So there were two or three deaths from mephedrone, and it reduced cocaine deaths by about 50%. It’s the biggest impact on cocaine death ever.

When mephedrone is illegal, and the dose and supply runs out, people switch back to cocaine because it’s a better drug. If everything’s illegal, why not use a better drug. Cocaine deaths have now gone up and up and they’ve now reached an all-time high. So for those two years, we saw that the drug market does have a lot of rationality. People want a drug that is fun but less harmful than the ones they’re using. So having banned mephedrone people said: “Mephedrone is pretty weedy. Why don’t we make a stronger mephedrone which we can sell in smaller amounts?” That’s monkey dust. Monkey dust is to mephedrone what fentanyl is to heroin. It’s just the product of having banned mephedrone.

Are there any studies on microdosing?

DN: Yes there are and we’ve done the best one. It’s very difficult to do because the problem with microdosing is: it’s illegal. And when we set up a microdosing study at Imperial, six years ago, we wanted to give a microdose — one microgram of LSD — to people twice a week for six weeks and see what happened. And the ethics committee said yes, but every single microdose had to be given in hospital, and they had to stay in hospital for 12 hours. We’ve never done the study because we couldn’t afford to do it.

So we did a citizen science study. We basically worked out a way of getting people to randomise their own microdoses, and that study was published last year. It shows that microdosing works — if you think you’re microdosing. So if you’re taking placebo, and you think it’s a microdose, it works. That’s the best study we have so far. It’s what you want it to be, in a way. So at present, we don’t know if microdosing works, but it doesn’t seem to harm you.

With antidepressants, you don’t know what it’s doing, but you feel better after it’s built up. With psilocybin, we can see the effect on the brain scan: it’s essentially an experience that changes the person. Are there any other drugs that are like that? 

DN: It’s like surgery. It’s like a cure. Are there any other drugs like that? I suppose with some anti-cancer drugs, you might get a relatively rapid cure. But not in terms of mental health. But the idea of a sudden cure is not novel in psychiatry. When I was on the Isle of Skye 30 years ago, there was a wonderful tale there about how they used to treat depression. They used to take depressed people to the blacksmith and put their head down on the anvil and the blacksmith would take out his massive hammer and bring it down right next to their head, but not hit them. And they would get better. That seems implausible, but it’s not completely implausible, because that is a massive stress.

Pavarotti suffered from depression. And he was talking about how he overcame his depression, and he was on a plane that crashed. He said: “That near-death experience lifted my depression.” And in fact quite a lot of people who have near-death experiences say not only that their depression goes, but that they feel more spiritual. Interestingly, the brain scans of people who have near-death experiences and those after psychedelics are very similar. So the final answer to your question is that it is a psychological experience, but fundamentally it’s a biological experience, changing your psyche, and that’s why it’s so powerful. Huxley was right: your brain controls your mind. If your brain gets it wrong, as it sometimes does, change your brain. Then your mind can be free.

Neither my wife nor I use Adderall with any regularity. A 60-count “break-in-case-of-emergency” supply might last the Bateman family ‘til death do us part. But the same cannot be said for millions of others who are reliant on the drug: since last August, the world has experienced a shortage of Adderall. This is probably tied to manufacturing and supply chain issues combined with rapidly increasing demand — though nobody knows for sure. It has had a particularly acute effect on the US. A high-income country of 330 million people is bound to have an outsized impact on world affairs. But the numbers related to Adderall beggar belief. America consumes 80% of the drug’s global supply. Back in 2013, there were 18 million Adderall prescriptions in circulation in the United States — a number that exploded to 41.4 million in 2021.

These statistics can be partly explained by another equally astonishing set, relating to the condition for which Adderall is prescribed. According to the US Centers for Disease Control and Prevention, 6.3% of US children aged 5-9 have ADHD, compared to 1.5% of UK children aged between 6-8. Some attribute that to differences in diagnostic principles. The criteria used in the US are considerably more detailed, allowing for diagnosis only if at least five symptoms are present, whereas the globally-accepted standard gives more leeway to the clinician, only stating that symptoms should be “sufficient in number” and cause “significant psychological, social, educational or occupational impairment”.

When I asked one therapist why this leads to a much higher number of ADHD diagnoses in the US — rather than the opposite — she pointed to the laws governing education. Here, the Individuals with Disabilities Education Act mandates that schools provide special education services and accommodations to students with ADHD, while in the UK, there’s no specific legislation for ADHD, and schools have more flexibility to support students with diverse learning needs without a formal diagnosis. American doctors know that parents and students need this diagnosis for paperwork purposes, so they, to borrow a line from Jean-Luc Picard, “make it so”.

In other words, an ADHD diagnosis opens a lot of doors in the US. If you know what to say, it’s not hard to get Adderall. And there are plenty of reasons to want Adderall. It significantly improves cognitive function, increases wakefulness, and enhances mood — temporarily turning poor learners into decent ones, and good ones into rock stars. Longer-lasting than other ADHD drugs like Ritalin, Adderall offers that intense “clear” feeling I mentioned, resulting in higher levels of focus, attention, and motivation.

These stimulants can improve, among other things, performance on various standardised tests that (at least for now) still have an outsized impact on admission to the most prestigious academic programmes. Unsurprisingly, there’s plenty of evidence that rich parents and their kids are working with willing doctors to secure easy access to Adderall, and other so-called “smart drugs”. A 2016 study found that 10.7% of high school students who had used Adderall in the past year had obtained it from a doctor. Meanwhile, 13.2% had obtained it from a friend or family member, indicating that these drugs circulate widely in certain academic and social circles — a fact many of us may know all too well.

I’ve watched a number of friends and relatives game the system to receive legal prescriptions for ADHD, visiting physicians and uttering the magic words needed to meet diagnostic criteria. Their motivations varied: one cousin likes to be “amped up” on stimulants at all hours of the day, while a friend from college uses it to improve his performance as an esports athlete. And I’m willing to admit that the drug has benefited me in small and very infrequent doses. But there are obvious ethical concerns here. Adderall, like Ozempic (for weight loss) or testosterone (for muscle building), gives some people an unfair advantage over others.

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The US Drug Enforcement Administration acted last month to rein in what some now consider a “Wild West” environment. Adderall prescriptions in the US rose 16% during the pandemic, with telehealth appointments a main driver. The DEA’s proposed rule would require at least one in-person visit to the physician prescribing controlled substances such as Adderall. But it faces stiff resistance from clinicians and users, who argue that remote consultations increased access to life-changing medications. People whose lives and identities are tied up in ADHD have been lamenting that their condition, defined by an inability to focus without Adderall, becomes doubly hellish when they’re required to actually go somewhere to get prescriptions filled; the complaint of one legal aid attorney, representative of thousands of others, was that the “nationwide adderall shortage means I skipped my doses this weekend and fucking fought for my life to do the dishes”.

And yet, the rate at which Adderall is prescribed in the US must mean that the majority of diagnosed cases of ADHD are not life-destroying, merely life-affecting. Moreover, even long-tenured experts on ADHD, including Remembering Ritalin author Lawrence Diller, have serious qualms about the “realness” of the “disease”. In his book, Diller reflects on the various young patients — “Generation Rx”, he calls them — with whom he worked during the Eighties and Nineties, probing the extent to which ADHD is a legitimate diagnosis or an oversimplified, harmful label that could be applied to anyone in certain conditions. “For patients, if ADHD truly exists, risking their health by taking a drug to treat the condition or disease makes a lot more sense… [but] if it doesn’t exist, then perhaps they’re just using it as a crutch… and setting themselves up to abuse it,” he writes. Adderall, like other stimulants, presents numerous dangers: side effects that run the gamut from high blood pressure, increased heart rate, panic attacks, psychosis, agitation and irritability. And of course, there’s the horrific feeling of crashing when one doesn’t have regular access to the stimulant.

Diller’s concerns are echoed by my neurologist acquaintance. ADHD, like most diseases of the mind, are “all in one’s head”: the symptoms are not verifiable by any methods beyond the claims of the patient. Physicians have a duty to take these claims seriously, but it’s difficult to gauge the roots of a symptom from the outside. Is lack of concentration, far from being a “disease”, merely a sign that someone is a poor student — a sad but unavoidable fact of life that one must confront in the ordinary course of existence? And if so, would liberally prescribing this now-scarce drug be the ethical thing to do? Or would that be unfair on those who use Adderall to get through the day, rather than excel?

These are loaded questions, but important ones. In response to the Adderall crisis, the media has pumped out nuts-and-bolts policy proposals. A recent New York Times column, for instance, argued for maintaining full telehealth physician availability and boosting Adderall production by shifting regulation and oversight from the DEA — which is primarily interested in drug interdiction — to the FDA — which is more concerned with drug safety and access. There is certainly much to recommend such arguments. The libertarian, “government is the problem” side of me favours wide latitude with regard to drug access, but that doesn’t acknowledge the core cultural questions fuelling all of this feverish pill-popping.

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It’s hardly surprising that increasing numbers of people are struggling to concentrate. We are bombarded with stimuli, which naturally leads to difficulty focusing and increased impulsivity in day-to-day life — symptoms of ADHD — and the subsequent prescription of Adderall. If assigned, a diagnosis can become a core plank in an individual’s sense of self; as Freddie deBoer has written for UnHerd, our very online culture encourages people to turn diagnoses into identities. Viewed this way, Adderall’s is a toxic, “ouroborotic” cycle of consumption — the culture fosters the behaviours that result in an ADHD diagnosis, Big Pharma sells you the medication needed to address it, and the various social media platforms that monetise your freely-provided content offer you space to earn attention by #ShoutingYourStigma.

Are you your disease — as a young influencer might proclaim on TikTok — and therefore entitled to Adderall access as some sort of fundamental human right? By extension, is someone who has the attention span of a feral cat that’s locked onto its prey not entitled to this “smart drug”? Or should everyone have access to Adderall, since it’s a tool that might encourage further human flourishing, before we’re forced to insert neural implants and merge with AI? Or should no one, since our “human essence” is sacred and must remain unsullied by chemical interventions?

These are the questions we will need to answer. But for now, all we can be sure of is that fewer people will get Adderall, particularly cheaper generic-brand Adderall, than want it. Those that do will probably be the richest — who may use it to get richer — rather than those who most need it. We can only hope that these dynamics will encourage us to reflect on whether wanting and needing, like our illness and our selves, are inextricably linked, or merely connected because “thinking makes it so”.

Antwerp harbour leads up the River Scheldt and into the heart of Europe, a port the size of 16,600 football fields, sucking in 240,000,000 tonnes of freight each year. From the giant aerial photograph spread out on the floor of the Port Authority Building, you can see the open sprawl of its spreading fingers and multiple roads. But it’s not just bananas, steel and new cars that are unloaded here. Antwerp is now Europe’s main artery for cocaine smugglers, and the attendant violence they bring with them.

The increase in violent crime is, according to the Antwerp Federal Police, impossible to ignore. Last year, they confiscated €20.7 million in cash and goods and started 94 investigations into drug-related violence. Intercepted cocaine in Rotterdam harbour, in the Netherlands, dropped from almost 73,000 kgs in the record year of 2021 to under 47,000. Meanwhile finds in Antwerp have increased to a peak of almost 110,000 kgs. Antwerp is now, say customs officers, “the top destination for criminals”, and established Dutch drug gangs are spilling over the Belgian border. Last autumn, four Dutch suspects were arrested for allegedly preparing a kidnapping attempt on the Belgian justice minister Vincent van Quickenborne, who went into hiding following a summer of grenade attacks linked to Dutch and Belgian criminal gangs. In Antwerp this January, 11-year-old Firdaous EJ, the niece of an alleged Belgian druglord, was shot dead in a drive-by attack on her home.

“It’s a narco-state lite,” says Teun Voeten, a photographer and the author of several books on the drug trade, who lives in Antwerp. He was first made aware of the problem of drug violence by the sound of hand grenades on his street in Deurne in 2018, an attack which damaged 16 cars and 10 houses. “The Amsterdammers were always the big bosses, but with the cracking of EncroChat and Sky ECC, some gang leaders have been arrested. Now the Antwerp families are going for themselves, and every change is marked with violence.” It is something Antwerp mayor Bart de Wever has warned about repeatedly: vergismoorden, collateral murders of civilians, which are rife in the Dutch criminal world. Now he says it is a “national crisis”. Last month, Belgian prime minister Alexander De Croo announced €17 million a year for a new harbour police force, more scanners, screening for 16,000 personnel in “sensitive” positions, and international efforts, including a deal with five shipping companies and the Dutch.

“Belgium has a problem because of its proximity to the Netherlands,” says Andrew Cunningham, drugs market and crime lead at the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). “Rotterdam was seizing big hauls of cocaine a few years ago, the Dutch really improved port security, then there’s this waterbed effect: the criminals move to Antwerp to bring in the cocaine. Antwerp is a huge, sprawling port and it’s very difficult to control.” Around five years ago, police and prosecutors feared crime was leaching from the Dutch underworld into Belgium. But when academics including Charlotte Colman, professor of criminology at the University of Ghent, investigated the matter, they didn’t find a displacement, but an expansion of both the drug market and the Belgian and Dutch criminal networks.

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Historically, when there was a Low Countries frontier at all, the Dutch-Belgian border was always leaky. The Fifties and Sixties saw a “bitter battle” for customs officers when Dutch gangs began smuggling butter southwards. The Dutch, who had commercialised margarine, weren’t bothered about what they spread — but the Belgians demanded butter, which cost twice as much. Stuffing it into the back of American trucks, armed butter smugglers traded it over the border until it was no longer profitable. Then came the illegal drugs. By 2015, a peninsula in the River Maas had become a top crossing point for drug smugglers. It was impossible to police, so Belgium gave it back to the Netherlands.

The criminals here speak the same language and exploit the free travel. “It’s a historical thing, that Belgium and the Netherlands work together, and they misuse the border,” says Prof Colman. “For example, in the case of synthetic drug production, you have the drug production facility in Belgium and then the dumping in the Netherlands… The border between Belgium and the Netherlands is a bottleneck for criminal justice, and an opportunity to be invisible and expand territory for the criminal organisation.” When one of her research team went into prisons to interview people convicted of producing or smuggling drugs, they said they saw Antwerp and Rotterdam “as one port” — all that mattered was which contacts they had on the inside. So when Rotterdam increased fines last year for people trespassing in the harbour to collect drugs hidden in shipping containers, the smugglers could easily shift to Antwerp. “The criminal organisations also take advantage of the difference in jurisdictions,” points out Joris van der Aa, crime reporter for the Gazet van Antwerpen.

Researchers believe most of the cocaine coming to Belgium goes to the Netherlands, and police hacks of “secure” messaging services — key to arresting suspects Ridouan Taghi and Saïd Razzouki in the ongoing Dutch Marengo gang trial — have revealed the inner workings of this relationship. “Initially with the Belgian-Dutch criminal networks, the [Dutch] were mostly involved in the higher level: logistics, the financial organisation,” says Prof Colman. “But today we notice that Belgians have gone up the chain, including controlling and organising the smuggling. They are not only working for Dutch people: Dutch people could be working for them as well. We see an expansion in the criminal networks, and we also see a kind of shift with people from Belgium picking up the lead role as well.”

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The cocaine trade is particularly streamlined, and the European market price of €50 a gram remains stable despite the amounts intercepted. Cunningham at the EMCDDA says: “When I ask law enforcement what they think the interception rate is, sometimes they say 10%, sometimes they say 25%.” Even if 40% were intercepted, it may still be worthwhile for criminals — like self-service tills in supermarkets, which accept a certain level of theft as “shrinkage” in exchange for lower staff costs. This is also a story, after all, about trade: a battle between the trade of the criminals supplying European demand for drugs, and “legitimate businesses” whose infrastructure networks they piggyback. When a company’s ships bring perishable goods to a new harbour like Vlissingen instead of Antwerp, says Van der Aa, the cocaine follows.

On the flip side, harbour companies and shipping businesses know that if — as Rotterdam mayor Ahmed Aboutaleb wants — they scan every fruit container, this costs time and money, making them less competitive. When I asked the five shipping firms that signed an accord with the Belgian and Dutch governments last month about this — Hapag-Lloyd in Germany, MSC in Switzerland, Seatrade Group Rotterdam, CMA-CGM in France and Maersk in Denmark — there was some reticence.

Menno van Gorcum, director of Seatrade Group Rotterdam, is glad of joint action. “It had reached a level where something had to be done, and fortunately there is sufficient political attention to this,” he says. “We just keep on doing what we have been doing.” Hapag-Lloyd stresses that it is a team game and agrees that nobody wants to be less competitive than other firms — or to tell the criminals how to get around the new measures. The puzzling thing, though, is why criminal gangs are now so openly violent, when this draws attention to their activities and forces politicians to invest more in policing. Voeten, whose book on the crystal meth trade is being translated into English later this year, believes it is down to cocky amateurism. “A good gangster is an ultra-capitalist,” he points out. “You use violence now and then, but the imminent threat of violence works better than violence itself.”

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While violent crime in general has decreased across Europe, in the context of drug-related criminality, it has remained stable or increased, according to the EMCDDA. Cunningham ascribes this to the rivalries between many groups “all vying for a slice of the lucrative cocaine market”. The increase in Belgium is undeniable since 2012, with the first known case related to a rip-off deal. Now experts see violent crime used as intimidation and punishment, but also a tactic, so that police will investigate a competitor. We also know more about “invisible” violence, including the construction of an underground prison equipped with a gruesome torture chamber in the Netherlands.

Elsewhere, the contrasting approach of the Belgian and Dutch governments is starker. While the Belgian prime minster and the mayor of Antwerp are talking about cracking down — including on drug users — the Dutch will start a trial of regulated cannabis growing in the south this October, and Germany plans to legalise and control the drug. “Let’s be realistic: it’s impossible to make a fortress of our ports,” says Van der Aa. “The federal police is short 150 detectives. Trying to stop the cocaine is cat and mouse play, but the criminals are still there. You have to stop them — and that is not happening in Belgium.”

While the combination of drugs and sex is nothing new, chemsex as an underground cultural phenomenon became popularised in conjunction with the mainstreaming of online dating apps and HIV antiretroviral drugs in the late Eighties and Nineties. “Stigma towards methamphetamine from those who did not use it kept us united as a group… we called ourselves ‘chemsex club’,” wrote David Stuart, an HIV activist who claims to be one of the first to use the word. “We were united less by commonalities or friendship, but more so by our shared preference for chems.”

Most of the current discourse around chemsex comes from the public-health sector, which tends to frame it in a paradigm of risk and harm reduction. But a field of academic study sometimes called critical chemsex studies has recently emerged that aims to centre the practice instead within the realms of pleasure, intimacy and identity. One seminal text in this growing field is Pleasure Consuming Drugs by the writer Kane Race, which tackles the question of how drugs have come to mediate sex in the gay discourse.

In the book’s final chapter, “Exceptional Sex”, Race opens with a personal experience: one night in Sydney, he was approached in a video lounge by a guy who was rolling hard on ecstasy. The swooning stranger was too impaired to carry through the sexual encounter, and eventually staggered out of the place as they parted ways. Kane remained haunted by the encounter, returning to it over the years as he attempted to untangle the ethico-political tensions between autonomy and care. “What is my duty to this stranger? How do I enact it?” Kane writes. “Why does this guy put himself in this situation? Why does he feel he has to knock himself out to be here?”

Last autumn, I co-moderated a discussion in New York City on chemsex where we attempted to answer these very questions. Titled “Appetite, Euphoria, and the Inevitability of Coming Down,” the event was hosted by The Infernal Grove, a study group that meets once a month to pursue “an unsystematic structural analysis of drug use, addiction, and recovery (not necessarily in that order)”. In addition to Infernal Grove founders Emily Vey Duke and Cooper Battersby, both professors at Syracuse University, my co-moderators included experimental filmmaker Devon Narine-Singh and multimedia artist Mikiki, whose chemsex-inspired video work was showing at the Whitney Museum that week in honour of World Aids Day.

That evening, about two dozen artists, filmmakers, writers, and other creative-types showed up to a darkened dance studio near Herald Square that doubled as our meeting room. Many more attended virtually through Zoom. A tall man with a blonde ponytail hopped on the piano in the corner, improvising a haunting welcome tune as we took our seats in a circle, smiling shyly as we introduced ourselves by way of unpacking our relationships to drugs. What was remarkable was the diversity of not just age, gender, and racial identities in the room, but the breadth of psychoactive experiences across the sober-using spectrum — from former heroin junkies to professionals who’ve never touched a drug, devout AA members to party-loving recreational ravers, underground psychedelic healers to sober-curious skaters.

This colourful cast of characters reminded me of Alcoholics Anonymous meetings I’ve attended in the past, where folks from all walks of life form unlikely alliances in pursuit of communal healing. In fact, Alcoholics Anonymous seems to be going through a contemporary rebrand; what David Foster Wallace described in Infinite Jest as a “goofy slapdash anarchic system of low-rent gatherings and corny slogans and saccharine grins and hideous coffee” is turning into a veritable hot scene. More sober-curious young people are showing up to meetings who aren’t hardcore alcoholics per se, perhaps sensing that AA can provide something increasingly rare these days: a sense of community, which is to say support without the strings of self-interest.

Yet, AA’s dogma of total drug abstinence does not appeal to everybody, and many are hungry for alternatives. New groups such as The Infernal Grove now cater to those seeking more sustainable relationships to substance use beyond the established orthodoxy of traditional sobriety paradigms. Despite the necessity of these alternative paths, I had been afraid that the chemsex discussion would be seen as problematic or triggering. Conversations about drugs usually play out as a moral drama of extremes: the anti-drug abstinence of AA vs the drug-positive enthusiasm of recreational settings. It is still so rare to enter a thought space where sobriety is discussed as more of a spectrum, where the ambiguous zones of druggie disinhibition can be untangled by people from all over the drug-sober continuum. It felt like the future.

“Honestly? This conversation is extremely triggering to me, but I’m also very excited to be here,” confessed someone who was in AA. Another person explained she had never touched a drug in her life, but was here because of an addict family member. The conversation turned to how recreational sex and drugs are not beyond the realm of care and attention; how even though drug practices often take place in a sub-intentional zone — “zoning out, getting distracted, losing yourself to something, cutting loose, getting carried away,” as Kane put it — they should not be exempt from insight and consideration.  Whenever we began to romanticise drugs too much, extolling the ways they can be used as quick escape routes from normative or oppressive societal demands, the sober people would chime in. “Sure, there is an element of surprise in drug use, but also, there isn’t,” one said quietly. “Maybe you imagine breaking through a barrier, but then you wake up hungover and nothing has changed.”

The conversation that night brought to light intersectional commonalities in the reasons why people of all stripes engage with chemsex — most commonly, it seems, to dissolve the culturally-conditioned sexual anxieties that can be so tricky to shake off while sober. Gay men and straight women alike spoke of letting go of body dysmorphia and shame while in the disinhibited state of chemically-enhanced euphoria, of exploring desires that the cultures of toxic masculinity and transmisogyny have impinged their abilities to see. “It is possible to look at the shadow without the shadow taking over,” said Mikiki, speaking on how the history that people carry often shapes their sexual inclinations. “Of course my desires are related to my trauma, but am I not allowed to explore that?”

Untangling the ways drugs can modulate pleasure, dampen the voices of our inner critics, and foster a kind of dark intimacy is still such a sensitive topic — and the movement to destigmatise chemsex is, in many ways, still in its infancy. As a woman, I am also not the traditional demographic that is typically “allowed” to even discuss this concept, let alone in these expansive terms. In fact, Stuart has accused folks who use this term but do not identify as gay men of cultural appropriation.

But like a growing number of academics in the field, I believe this framework should include a wider population — because as the discussion in New York suggested, many other social groups already engage in these practices for similar reasons as gay or bisexual men, yet are under-represented in current research. Adopting a broader and more intersectional lens to the study of drug use and sex could allow a deeper understanding of how the dense mesh of governing power structures both shape and curtail our desires. It could also help us to understand how this practice reflects the historical and social contexts from which they emerge — including the pharmaceuticalisation of sexuality, contemporary culture of endless self-enhancement, and crisis of intimacy under neoliberal individualism.

As the conversations around chemsex continue to evolve, perhaps our conceptions will also move beyond the current narrative of retreat and resilience. “I want a different conception of corporeal agency, where drugs don’t feature such an obvious and thrilling escape route,” Race wrote. “What would it take to engage more fully with the texture of these escapes? What possibilities of care, what new pleasures, what ethics, what multiplicities emerge?”

In a twist of fate, however, García Luna is now himself on trial in New York, accused of pocketing millions of dollars from those same kingpins after helping them traffic tons of cocaine to America. The trial, which began on 17 January in a federal court in Brooklyn and is expected to last eight weeks, breaks new ground in the drug war. Since Richard Nixon first declared a war on drugs in 1971, the US has taken down a vast array of Mexican traffickers — most famously Joaquín “El Chapo” Guzmán, who was convicted in the same Brooklyn courthouse in 2019. But never before has such a high-ranking Mexican official faced a US jury on drug charges.

Journalists and activists have for years pointed out that it is no use targeting the mobsters if you don’t go after their political protection. This case therefore marks a serious turning point for US law enforcement. But it also rings alarm bells. The level of corruption alleged by the witnesses goes beyond anything I’ve seen in my two decades covering Mexico’s drug war. At the very least, the trial is deeply embarrassing for Washington’s drug agents and politicians who schmoozed with García Luna. (There are photos of him with Hillary Clinton, Barack Obama and former Attorney General Eric Holder.) More seriously, the far-reaching allegations also suggest that, unless the United States can reduce the amount that Americans spend on illegal drugs — estimated at close to $150 billion a year in one study — this narco corruption may just carry on with catastrophic consequences.

What’s more, it is by no means guaranteed that the jury will convict García Luna. In his opening argument, defence lawyer César de Castro claimed the prosecution does not have hard evidence that his client led a double life as law enforcer and crime boss. “No money. No photos. No videos. No texts. No emails. No records,” De Castro said. “No credible, believable, plausible evidence Mr García Luna helped the cartels.”

Prosecutors are, however, using the testimony of so-called cooperating witnesses, including scarred and grizzly cartel operatives who could have made deals with prosecutors to take the stand. Some have confessed to killing multiple victims and were major traffickers. Before the trial started, the judge even had to rule that the defence could not ask them about potential acts of cannibalism — a practice that various gangsters have been found to engage in — because it might be “distracting”.

As the jury was selected, prosecutors rigorously made sure the candidates agreed they could believe such witnesses and convict someone on their evidence, even if it were not backed up by physical proof. If the jury were to find García Luna not guilty, it would be, as Mexican President Andrés Manuel López Obrador said on Tuesday, “a fiasco — the agencies and government of the United States would look very bad”. There is a lot at stake.

When I met García Luna back in 2005, when he was a rising star as the head of a federal investigative agency dubbed as Mexico’s FBI, he struck me as underwhelming, largely because he mumbled and stuttered. But he was convincing in his argument that Mexican law enforcement had to change to meet the new challenges. This was a time when gangland murders in Mexico were on the rise and Mexican traffickers had usurped Colombians as the biggest gangsters on the continent, smuggling the lion’s share of cocaine, heroin and crystal meth over the Rio Grande.

The following year, García Luna rose to a cabinet-level role under President Calderón, who ordered soldiers and police on a national offensive against the cartels. García Luna revolutionised the federal police, increasing it from a force of 6,000 to 37,000 officers. He also tried to salvage its image, financing a TV soap opera called El Equipo, in which good-looking cops went on daring operations. Moreover, Calderón crafted the Merida Initiative with Washington to increase cooperation in the fight. Under it, the United States provided Mexican law enforcement with billions of dollars in equipment and training, including Black Hawk helicopters and wiretap gear. García Luna also forged strong relationships with agents from across the US security apparatus.

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At first, this new war on cartels appeared to bear fruit. In 2007, Mexican marines made the world’s biggest ever cocaine bust, a seizure of 23 tons off the Pacific coast. Kingpins who had long evaded justice were shot dead. Detained cartel suspects were made to record confession videos, like that of Tyson, in which they detailed serial murders.

But then violence erupted, with relentless firefights, execution-style hits and massacres. I covered much of this bloodshed — a grim period spent discovering bullet-ridden corpses on the street and watching too many mothers screaming in grief. By the time President Calderón left office in 2012, Mexico was suffering from a humanitarian crisis of mass graves and disappearances that remain unsolved. For his part, García Luna left Mexico for Florida to set up a security consulting company and rent a luxury beach house.

Seeing García Luna in the first days of the trial, he cut a transformed figure, silver-haired and beaten down by prison, where he has been since his 2019 arrest. Yet he also looked calm and alert to all the technicalities of the trial, occasionally smirking and blowing kisses to his wife. The first government witness was Sergio Villarreal Barragán, a hulking enforcer known as El Grande, a former police officer who was recruited by the Sinaloa Cartel. The fact that Villarreal was in the police before the mob is not a freak occurrence, but revealing of Mexico’s history: the country’s cartels grew from their humble beginnings as peasant farmers with the help of corrupt networks in the security forces. The career path between gangsters and police officers was like a revolving door.

Villarreal described seeing his boss, the kingpin Arturo “The Beard” Beltrán Leyva, meet García Luna in a safe house in the south of Mexico City and hand over bribe payments in duffel bags and cardboard boxes — worth more than a million dollars a month — on behalf of the Sinaloa Cartel. In return, García Luna allowed the cartel’s cocaine to travel through Mexico, busted its rivals and passed on police intelligence. “Everything ran perfectly. It was the best investment they made,” he said. One time, the cartel used this intelligence to steal two tons of cocaine from rivals, Villarreal testified, and split the profits with García Luna himself.

Such testimony was expected in this trial. But what Villarreal then described was remarkable. The cartel, he explained, would make false cocaine bricks and swap them with police for real cocaine that had been seized. Another time, the mobsters dressed up as police, arrested a rival and then handed him over to the real officers. On one occasion, the cartel kidnapped García Luna and brought him before The Beard because he wasn’t answering the telephone.

Villarreal also explained how the cartel’s close relationship with corrupt police actually succeeded in reducing Mexico’s murder rate for a period in 2007, just when Calderon’s offensive seemed to be going well. But then, he said, the deals inside the cartels fell apart and the violence soared. One of the biggest battles was between Beltrán Leyva and his childhood friend “El Chapo”, which ended with Beltrá Leyva being gunned down by Mexican marines.

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In 2019, I covered a stretch of El Chapo’s trial, which was more enthusiastically embraced by the New York media. Everyone wanted to be in the courtroom and see such an infamous mobster and his beauty-queen wife in the gallery. US cable networks ran regular segments on the trial’s revelations, whether it was El Chapo running through a tunnel naked to escape marines or his former lover taking the stand and crying while his wife chuckled. García Luna’s trial, by contrast, has garnered far less attention. But in some ways, the revelations are more important in showing how corrupted Mexico’s institutions are and why the country is so violent.

The trial might act as a deterrent to make Mexican officials think twice before blatantly taking cartel bribes. Mexican President López Obrador certainly looks upbeat when he talks about it in his morning press conferences, saying it shows how corrupt the previous administration was. Yet the trial also symbolises something uncomfortable about modern-day Mexico. It is notable, for instance, that the trial is in New York not Mexico City. Mexican judges have convicted generals and state governors for working with drug gangs, but not an official as powerful as García Luna — or a former president. And as long as the country’s security forces find more sophisticated ways of taking bribes, such as using intermediaries, this looks unlikely to change. Perhaps even more depressing is the fact that since García Luna has gone, the cartels have shifted to more perilous synthetic drugs such as fentanyl, which are driving a far worse rate of overdoses in the United States.

Everything has changed since, and not necessarily for the better. In his testimony, El Grande also talked about the glitter of narco wealth; how his boss The Beard had a fleet of cars, including a Lamborghini, a Ferrari, and a Rolls Royce, and pets including a white tiger and black panther. Amid such opulence, achieving justice for the deaths on both sides of the border will be an extraordinary, if impossible, challenge. While the stories of El Grande, The Beard, and El Chapo may dominate the headlines, they are far removed from the bloody conflict that has consumed Mexico — and the decaying corpses still being dug up in mass graves.

Psychedelic trips have played a part in mystical traditions for millennia, but their revival comes at a time when our old religions are endangered. The march of Reason and Evidence has left a gaping void; we are surrounded by a bubbling sea of Unreality. Television, billboards and newspapers first threatened the dam between dreams and waking consciousness; Twitter, Netflix and the smartphone, always there and nudging away, have blasted it asunder.

In place of structural changes, or indeed religious ones, the system defaults to plaster solutions, offering mere jolts of aliveness. The “altered states economy”, now generating as much as $4 trillion worldwide, offers a range of techniques to tap into the Real, or at least muffle the Unreal. There’s alcohol and disposable vape pens, video gaming and high-intensity sports, breathwork, meditation apps — and now, the legal psychedelic drug, perhaps the most significant launchpad to sacred states yet.

Medical authorities in Oregon are set to roll out psychedelic therapy this year, while many cities and states in the US have, to various extents, decriminalised the drugs. Meanwhile, Mexico is tapping into the market for psychedelic experiences still illegal in the US: the Guardian reported yesterday on clinics set up just over the border that offer courses of the powerful psychedelic ibogaine as treatment for trauma.

The faith we once put in transcendent states has been swiftly industrialised. A scan of the current psychedelic market reveals a strange mix of Big Pharma and young start-ups, such as ATAI, a Peter Thiel-funded firm. Its founder, Christian Angermayer, has been accused of manoeuvring to dominate the psychedelic market through zealous patenting strategies. He envisions his trials as perpetuations of mystical traditions from Ancient Greece. More than 2,000 years later, though, “profane illumination” is now under the microscope, dissected, refashioned as a tool. Only when validated in scientific, psychiatric discourse is it taken seriously. The industrial boom has happened in tandem with an enormous amount of research, much of it funded (with likely biasing effects) by profit-driven entities.

Whereas psychedelic culture used to be defined by its naive subjectivism — you have to take it to know what it’s like, man! — a kind of naive objectivism has taken its place. On a scale of one-to-five, the Mystical Experience Questionnaire asks trial participants, how would you “sense that [your psychedelic] experience cannot be described adequately in words”?

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Our grasping search for the Real is heading for more disturbing developments still. As documented by the scholars Maxim Tvorun-Dunn and Tehseen Noorani, efforts are underway to render “psychedelic medicine” continuous with growing suites of “digital therapeutics”. Some firms plan to substitute post-trip in-person therapy for an app. Other companies intend to track and harvest data from clients’ voyages, via wearable devices that “personalise” and “facilitate” the “clinical experience”.

The ketamine market in the United States offers a terrifying glimpse at this future of runaway capital. In some so-called “McKetamine” clinics, users are shuttled through a pricey yet cost-minimised production line of “profane illuminations”, with little after-support — despite serious risks of addiction, psychosis, and permanent visual disturbances. One such company, Peak, thankfully shut down its operations amid a backlash to its flagrant promotional strategy, which included online consultations lasting two minutes and promises to “cure depression forever”.

Such absurdly utopian rhetoric abounds among the proponents of psychedelics, who include many powerful people in the tech world. Certain transhumanist thinkers in Silicon Valley have called for more research into drugs that produce permanent bliss states without side effects; theirs is an “abolitionist” ideology that seeks to eliminate all conscious suffering from the universe. Meanwhile Elon Musk, who hints strongly at a taste for psychedelics like the aforementioned DMT, has expressed hopes of “extend[ing] the light of consciousness to the stars”, in tandem with technology: his Neuralink brain-machine interface is set to commence human trials in 2023.

This language goes beyond aspiration, or even idealism: it’s a simulated religion. Inconveniently, there are dangers in viewing our search for God as a technical problem — one that can be solved through human ingenuity. The current psychedelic landscape is greatly influenced by Carl Jung, whose acolyte Stanislav Grof administered LSD in more than 5,000 sessions in communist Czechoslovakia. Yet Jung was famously suspicious of what he called “the pure gifts of the Gods”, described and promoted by early “psychonauts” such as Osmond and Huxley. More than anything, Jung suggests, we ought to engage with the psyche on its own terms, as a mysterious and subterranean layer of reality that can’t necessarily be gauged in the terms of Reason that govern our everyday lives.

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Similarly, indigenous and mystical traditions have warned the West against conquistador exploration of ecstatic states for centuries. The Eastern Orthodox tradition, for instance, has a rich literature of prelest, a spiritual malaise in which the seeker of private mystical experiences becomes possessed, obsessed, deluded, or corrupted by egotism. It’s hard not to see a grain of truth in the old Christian warning against demons: a warning levied by various Iberian conquerors against peyote and ayahuasca centuries ago, and now being revived by religious communities alerted to the psychedelic trend.

Despite these warnings, there are growing communities of self-declared “psychonauts” heading deep into DMT space for hours before sharing their experiences on online messageboards. And people do often return from that space with entirely different metaphysical paradigms, with users convinced that the entities they saw were very Real. Yet in an era when the idea of evil has lost much of its cultural currency, it is curious that many report encountering entities that are exceptionally malicious — or, indeed, demonic. So wedded are we to the idea of Reason, we might laugh and pat the heads of these omens, or reduce them solely to psychic projections. But here we fall for a transhuman fallacy: that humans are in control of what’s real. No wonder: it’s easy to fall for that fallacy when you’re in an transcendent state, if it’s a state provoked by a drug humans made (and patented).

Part of the problem is the decline in “ecstatic literacy”: we just don’t know how to discuss or understand — or draw non-delusional conclusions — from “profane illumination”. While the proliferation of psychedelic products has changed the game by normalising such extraordinary experiences, we lack the language, the elders, the tradition that helps us make meaning of them.

Indeed, the ancient roots of psychedelic use, which might have guided their explosion, are in grave danger. In Peru, fully onboarded to the ayahuasca tourism trend, the influx of gringos has fuelled a rise in “pseudo-shamans” who adulterate their brews for extra kicks. Peyote and the bufo alvarius frog, whose venom contains the powerful compound 5-MeO-DMT, are now endangered, and the sustainability of ayahuasca reserves is now a “legitimate concern”. The price of ayahuasca has spiked as much as ten-fold. Where once its sale was fiercely guarded, it’s now touted in Coke bottles by impoverished rickshaw drivers who need extra cash.

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The emergence of the psychedelic industrial complex only accelerated the up-rooting that globalisation has been enabling for decades. Filament Health, a firm whose USP is to use “natural psychedelics”, made headlines recently for its creation of “ayahuasca in a pill”: an absurd peak for an industry long-trained in extracting, stripping and distilling the fruits of the natural world. Anthropologists observe that the whole “healing” paradigm predominant in ayahuasca tourism in Peru is an exotic distortion, with “shaman” itself described as a “made-up, Western category”.

“Start your own religion,” Timothy Leary told his followers in the Sixties. Many tried, although their operations would swiftly descend into power-sustained cults. There recently came allegations of a similar cultishness emerging in a corner of Silicon Valley, at the Centre for Applied Rationality and the Machine Intelligence Research Institute; one of the problems cited was frequent drug-enhanced “debugging” rituals. This is further evidence that attempts to wrench the numinous from its roots, then commodify it, are archetypally foolish — or, in the unfashionable language of religion, sacriligeous. While attempts are being made to draw psychedelics into existing traditions like Judaism and Christianity, it’s not clear how these religions can guide us through the epistemic and personal challenges of still relatively little-researched drugs that spur such swift ascents.

Little in life is really reducible to Damascene moments, but a trip at its best can unlodge something: cause us to remember something we forgot. Yet rather than set us free, the release offered by the psychedelic state — in the absence of any real programme or tradition, or “container” in the current language — seems to dissipate without leaving a meaningful trace. Even those who do experience relief from depression through psychedelics, for instance, reliably relapse after a few months.

Perhaps it is worth heeding what acclaimed psychonaut Aldous Huxley said, while lying on his deathbed in November 1963. He requested a dose of 125 micrograms of LSD to ease his passage to the afterlife, and while it’s said that his passage was uniquely peaceful, his final words are telling: “It is never enough. Never enough. Never enough of beauty. Never enough of love. Never enough of life.”

This situation has radically changed since March, however, when President Nayib Bukele launched an unprecedented and brutal crackdown on gangs, involving mass imprisonment. “It’s a huge improvement,” Alas tells me, explaining that the maras on her block have disappeared. “Now we can go outside when we like. Our family can come and visit us. No president has cared about us here before.”

Alas’s comments reflect the widespread support for the anti-gang offensive and for Bukele: a December survey found 87.8% of voters approved of him, making him the most popular president on the continent, perhaps even the world. Such popularity contrasts sharply with the harsh rebuke of Bukele’s crackdown by human rights groups, journalists and members of the US Congress.

This gang offensive, though, is ruthless and violates human rights. Following a record 62 murders in a day, Bukele beseeched his legislative assembly to pass a State of Emergency on March 27, and ordered heavily-armed military units to move into the barrios — the poor neighbourhoods where most people live. “No terrorist involved in the wave of violence against the Salvadoran people will go unpunished,” Public Security Minister Gustavo Villatoro posted on Twitter, a favoured communication tool of the government. “We will take them off the street and put them behind bars.”

Since then, more than 60,000 people have been imprisoned — 1% of the entire population — adding to another 40,000 already in jail. It’s a mass incarceration comparable with some of the harshest regimes and wars in history — the equivalent of locking up more than three million in the United States in under a year.

Outside the Mariona prison, in the northern outskirts of the capital San Salvador, hundreds of family members are gathered, mostly mothers and wives, waiting to pass on packages of rice, cornflakes, soap and even prison uniforms to their loved ones. Javiera Maricela, 37, describes how police and soldiers called on her house in a farming village in April and took away her 20-year-old son, saying he would be processed and returned. She has had no contact with him since and does not know if he is still in that prison, let alone alive.

“The lack of information is torturous,” Maricela says. Like most of the detainees, her son is charged with a crime called “agrupaciones ilícitas”, roughly translated as “gang affiliation”, although it applies to those who help gangs as well as actual members. It carries a maximum sentence of 30 years, or 45 years for gang leaders.

Through a contact, I meet a prisoner who succeeded in getting his charges dropped and being released from Mariona. He describes how he was crammed into a cell with 162 inmates and the stink of faeces, had his ribs broken by guards, and frequently heard the screams of prisoners being tortured. During his month in jail, he says, he saw five corpses being carted out. Human rights groups have documented 90 deaths in prisons since the emergency was declared, although many believe the real number is much higher.

“Many of those captured are innocent,” says Samuel García, a former government official who has founded the Victims of the Regime Movement. “The families have proof but the regime doesn’t care. Bukele is very Machiavellian… What he is doing is illegal. He has broken the rule of law.”

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Despite this, the crackdown remains popular and has certainly had an immense impact on reducing crime. For decades, the two main gangs, the MS-13 and Barrio 18, brazenly controlled barrios, towns and villages across El Salvador. New members committed murders as part of their initiation and continued to kill to elevate their status in their “clique”, or gang chapter. And it was not only other gangsters who were gunned down. Civilians could be murdered for simply walking on the wrong street. I recently spoke to one woman who was gang-raped when she travelled from a Barrio 18 neighbourhood where she lived to visit her mother in MS-13 turf. In the worst atrocity, in 2010, maras torched and shot up a bus killing 17 people.

I have interviewed dozens of gang members in visits over the years; you could often find them openly hanging out in the centre of neighbourhoods. But since the state of emergency, their presence has been greatly reduced: Maras are largely in prison, have fled, or are underground. The number of murders, as a result, has plummeted. Last year, El Salvador’s government reported that there were 496 homicides — a murder rate of about 8 per 100,000, which is lower than the United States for the first time on record. Back in 2015, El Salvador suffered 105 murders per 100,000, making it the most homicidal country on the planet.

“It’s like if you have a patient with cancer, the doctor has to use chemotherapy,” says Tito Elias Ponce, who works in a government agency for barrio outreach. “These criminals are like a cancer for El Salvador.” When I meet Ponce, he is working with youths painting up walls of a slum. As well as wielding the stick, Bukele offers the carrot of rehabilitating poor areas, building football pitches and community centres.

Nearby, I spot a 23-year-old soldier from the motorised infantry who has pulled over at a stand to buy pupusas, a popular Salvadoran food. The soldier claims that the troops are welcomed in the barrios and he denies that innocent people are being carted off. “Some of them may not be full gang members but they are involved in some way,” he says. “We have found messages on their phone or something. Of course, the mothers will protest. For a mother, her son is always an angel.” This claim that no innocent people are swept up seems dubious considering the sheer scale of the arrests. Detainees are stood before judges in mass closed hearings, so it is unclear how convincing the evidence is. Meanwhile, citizens are urged to inform on gang members, which could encourage people to finger anyone they have a beef with.

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One reason the crackdown is so popular is that Salvadorans are fed up with gang extortion. Unlike Mexican and Colombian gangsters, maras are not big players in drug trafficking but make their money shaking down everyone from bus drivers to grocery store owners. The emergency has reduced extortion, according to reports, but lingering shakedowns remain a part of daily life. I meet a taxi driver whose base used to pay both the main gangs, but now only pays one, whose member actually drives a taxi there. “I am paying these criminals half the amount I used to,” he says “But at least that means I have more money in my pocket.”

The second reason so many Salvadorans support the offensive is more deep-rooted, a consequence of them living most of their lives in warlike conditions. Between 1980 and 1992, a civil war between a series of Right-wing US-backed governments and a Left-wing guerrilla movement tore the country apart. Young refugees largely fled to Los Angeles, where they formed gangs to protect themselves in violent inner-city neighbourhoods. And when they were deported, they turned to crime in their shattered homeland and found plenty of willing recruits among the war orphans and scarred veterans. El Salvador’s new rulers promised peace, democracy and respect for human rights. But the country was drowned in the blood of gang warfare.

Bukele, the son of a wealthy businessman of Palestinian descent, first joined the party of the former guerrillas, the Farabundo Martí National Liberation Front. I interviewed him in 2017 when he was mayor of San Salvador and he spoke of rehabilitating the barrios and rescuing young men from a life of crime. He won the presidency on a populist platform, railing against the corrupt elites, and formed his own party to smash the power of the old guard in the midterms.

By 2021, Bukele had halved the homicide count, but he is accused of doing this by reviving a truce with the gangs. According to reports by the independent news outlet El Faro, the truce gave gang leaders better treatment in prisons and allowed the gangs to carry on with their shakedowns while they dialled down the murder rate. It was only after this truce broke down with a spree of killings that Bukele launched his State of Emergency. Bukele denies this pact, though many Salvadorans I spoke to don’t care much if it is true; they simply want less violence.

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Yet it remains to be seen if the drop in murders now secured by the State of Emergency will hold in the long run. The gangs may be in hiding now but they could regroup, and perhaps turn to guerrilla tactics. It is also tough and expensive to keep almost 2% of the population behind bars. To achieve this, Bukele is constructing a new mega prison, baptised the “Centre for Confinement of Terrorism”, which he claims will hold 40,000 inmates.

Meanwhile, the external criticism looks unlikely to make Bukele shift course. US Congressman James McGovern called the crackdown “draconian”, while Amnesty International warned of “a human rights crisis”. Elsewhere, the US Treasury has sanctioned several officials close to Bukele on corruption allegations, freezing their bank accounts and banning them from entering the States. But there is not much more leeway for Washington to pressure Bukele. Sanctions on Cuba, Venezuela and Nicaragua have not stopped human rights abuses there. What’s more, the idea of a return to a more interventionist US foreign policy in Latin America inspires wrath on both the Left and Right these days.

On the flip side, other Latin American governments are taking note of Bukele’s approach. Over the border in Honduras, President Ximora Castro, the country’s first female leader, has launched her own partial state of emergency to fight gangs. In Mexico, President Andrés Manuel López Obrador has largely abandoned his call for “hugs not bullets” to bolster the army.

Outside a San Salvador church, I watch a dozen mothers light candles and pray for their loved ones behind bars. They share stories, their faces full of torment from not knowing whether their sons will ever return. I wonder if support for this mass incarceration shows a tyranny of the majority, and these are the victims. Or if the benefits could outweigh the injustices. Or if one evil has simply been replaced by another evil. But the truth is, Bukele has only arisen because of a failure to deal with an immense problem of organised crime that is a central issue for most people here. And unless liberal governments in Latin America can find a better solution that works in practice, not just rhetoric, we will surely encounter more authoritarian populists and more mega prisons in the years to come.