Interview with Peter Cohen. The short version of this interview has been published in the Hungarian journal, "Esély".
Peter D. A. Cohen, Ph.D. has been researching drug use, drug policy and drug use epidemiology at the Universiteit van Amsterdam, as director of the first Amsterdam Drug Research Program, and since 1996 as director of CEDRO, the Centre for Drug Research. A member of the Hungarian Civil Liberties Union had the pleasure to talk with him about his research results, the meaning of addiction and integrated drug use, and the relationship between drug research and politics.
A short version of this interview has been published in hungarian with the following title: Takács István Gábor: Tudományos Drogmítoszok (interjú Peter Cohennel) Esély 2006/1 17. évf. 1. szám, Hilscher Rezső Alapítvány, Budapest 2006
You can access the full hungarian version here.
photo source: CEDRO – Centrum voor Drugsonderzoeg
HCLU: What is your main field of scientific interest?
Peter Cohen: I have always tried to create information and knowledge about 95% of the drug users who strangely enough are almost never the topic of observation. And this is of course not arbitrary, this is because of our perception of drugs. We have to amplify a particular vision of deviance and we don’t even see, or create language to see the other drug users. I think that for drug policy the real hardships are not in the area of clinical or so called problematic drug users, or the ones who are the most extreme victims of our policy. It sounds strange, but the extreme victims already have some type of attention although not much is done for them, and the organisations that are created to help them, in reality create more marginalisation and not less. Here in Amsterdam for instance we have a lot of organisations that ‘take care’ of our most marginalised drug users, and only these organisations take care of those people. If you are asked to go to that organisation that means you socially dont exist. You have no status. You are a pariah. Fifty percent of intense drug users change their drug use relatively fast, and they did not use those organisations for that. So I consider drug treatment as part of our problem instead of our solution. And this is what I tell people in the drug treatment industry all the time. When they are interviewed on TV they speak about how terrible the life of these drug users is, implicitly or explicitly saying that this is because of their drug use, so in very different areas of our society, they take care of establishing the terrible image of drugs, instead of breaking it down. And research very often is being designed by these people.
HCLU: Why is it so? Because of political reasons?
Peter Cohen: No its a mixture of political and cultural reasons. Because our culture is created, you could say, to mainly accept knowledge about this very small group, and create knowledge and create new mythology. That is why our funding agencies are full of treatment industry people, who don’t even know that there are many other types of drug users than the ones they usually see. So knowledge is not created around all the other patterns of drug use, which than in turn serves to further establish the political and cultural position of these ‘treatment’ organisations. And they will say we need more, and not only in Budapest but everywhere, and soon they become like weed in the garden. So I see the drug treatment industry more as an enormous problem.
HCLU: What could be the solution than, for those people who have problems?
Peter Cohen: We have all kinds of organisations. It depends on which country you are in, but for instance if you have marital problems or life problems you go to institutions of social work and they will help you. They are not saying, ’hey do you earn more than five hundred euro a month? No? than we don’t help you. Or do you drink alcohol? Than we don’t help you. Or are you homosexual? Than we don’t help you!’ If this would happen, people would say this is discrimination! But when they ask, ’are you addicted?’ – whatever that means – ’yes? Than we can’t help you, you have to go to your own pariah organisations’. So I have always asked for integrations of these services into the general institutions. But this is more easier said than done, because keeping them apart in an apartheid system of care is so engrained in our culture.
HCLU: What do you mean under the term controlled drug use?
Peter Cohen: I used to use the word controlled drug use. I no longer do that. Now I speak about integrated drug use. People live in so many different ways, some people are students, some people are workers, some are ambitious, some are not at all. Depending on what type of person you are and what cultural and social environment you live in, drug use may or may not be functional. If you only want to work one day a week, the rest of the days of the week you can go out to the disco and go out late and sleep late, which means that the way that you use alkohol or other drugs can be completely different than when you are very ambitious, and you work eight days a week, and you get up early and you work late, and there’s not much drinking going on there, and dining or going to the movies. So the functionality of drug use is very much dependent on what lifestyle people have. And as long as drug use is integrated, functional for a particular lifestyle, that is O.K. If you are living on the streets and you beg, the functions of drug use are completely different than when you are trying to do your masters or a dissertation. Whatever the type of drug use, you should look at the lifestyle in which it is functional. Of course people have different lifestyles at the same time. In the weekend they may be sportspeople and go sailing on a lake, and be very competitive, during the week they can be something else. So people are not constantly in the same social circle and social circumstances, which means that drug use functionalities can also shift through the week. You can see that in Sweden, where people are very industrious, and work hard during the week, but very often once it is friday six o’clock, the bottle goes to the mouth and they are drunk the rest of the weekend. You don’t see this much in the Netherlands, altough you see some of it, binge drinking we call it, or drinking to intoxication. The swedes have a name for drinking a glass of wine at the dinner, and they call this ’european drinking’, isn’t that funny? And they say ’yes, we see more and more european drinking in sweden’, which means not getting loaded from the moment you put some alcohol in your body. As long as patterns of drug use have some sort of functionality within your lifestile, I call it integrated. Controlled drug use is much more ideological, it is within an ideology of Kalvinist self control, and the whole concept of „loss of control” is a Kalvinist concept, it is not a scientific concept.
HCLU: But still, it plays a major role in science or what we percieve as science, doesn’t it?
Peter Cohen: Yes. What we percieve as science is mostly morality. It is a higher level of complexity of morality discourse, but science it is not. For all this nonsense about addiction which is called loss of control, my famous example is people getting killed in London. The people that go to London usually are not accustomed to traffic on the left side of the road, so when you approach the road and you want to cross, you look left, this is what you do in Budapest or in Paris, and then you get killed, because you had to look to the right. This is the habituation and ritualisation of a behaviour, you come to the side of the sidewalk, you want to cross, and this opens a whole series of ritualised behaviours, and you stick to these rituals even under circumstances that can be very bad for you. We would never think of calling this addiction. I see patterns of drug use, also intense patterns of drug use as ritualised behaviours that have a particular function in a lifestile, and they are learned. People learn to smoke. I was a smoker and I learned to smoke when the phone would ring. And at a certain moment when I was thinking about my own smoking behaviour I could see, I am smoking when I’m stressed. I’m smoking when I’m angry. I’m smoking when I want to take some sort of relaxation, I discovered that this ritual would be triggered in a particular amount of sets. But on holiday I would have a completely different smoking pattern. Than I started to read about smoking and about nicotine and I started to understand some of this. Understanding also that the nicotine mythology is a little bit like our heroin mythology. Smoking behaviour is not seen as learned behaviour, becoming part of your identity. No, it is seen as the reactions to a pharmacological compound. So people don’t smoke because they have taught themselves to smoke in particular situations. No, they smoke because they take nicotine and became ‘addicted’ to that compound.
HCLU: This is the logic behind saying that illicit drugs are more dangerous because their pharmacological effects are much harder, therefore more easily produce addiction.
Peter Cohen: It’s all nonsense. When you give people enough nicotine, they still go on smoking. Our medical people who are dominant in our field, they say ’oh, you give the nicotine and they continue smoking, that means they have some psychological disorder, and we have to treat them for depression, because they are depressed and they have this and they have that’. There is no scientific discussion about this thing. There is a power discussion. Which group of people with which type of criteria and discourse is the most important for establishing the ‘scientific’ agenda.
HCLU: Lets talk about the connection between science and politics. Could you tell me your opinion about NIDA for example?
Peter Cohen: I call this the construction of knowledge. And there is also the politics of the construction of knowledge. I always call NIDA the Holy Office of Addiction Science. They take care that there is no knowledge created, that goes counter to american drug policy interest, and again they do this very well. They have committees that evaluate research proposals, they create a whole aura of scientific neutrality around it, and than they say yes or no at the top. It looks as if the yeses and nos are related to scientific merit, and sometimes they are. For instance the science that I did together with Reinerman and some german collegues, you could only get NIDA money for the american part if you speek nidese. If you say, when you compare american drug users to dutch drug users you will see that because of dutch drug policy, access is so much easier for dutch people, so they must have many more problems with drugs. That is what they want you to find. So if you make a research proposal, you expect those findings.
HCLU: But do the findings show this result?
Peter Cohen: No. And than the findings disappear. NIDA will never quote findings that are against their ideas of what findigs should do. I call this the Galileo complex. Galilei could look at the moon and the sun, he could do whatever he wanted, the catholic church would never say these data were relevant. Between Galileo and the Church saying that he was right was four hundred years. Can you imagine? This is what churches do. They are dataproof. They are dogma based. If you have a ‘scientific’ organisation within a dogma based system, you are not creating science, you are creating dogma based amplifications.
HCLU: In Hungary we just saw some presentations on TV about drug use, given by some famous neurologists, and these presentations were the most hard core biological reductionist pharmacological theories.
Peter Cohen: They don’t have a clue about drug use. They don’t even have a clue about brains. Because the brain is so difficult to research. So every small new discovery they do in the brain, they use within an already created understanding of drug use. So they don’t help us understand drug use. They only create new language for our old understandings. Here, I read the NIDA Notes, „Brain glutamate concentrations effect cocaine seeking”, they have not a clue about human drug use. There’s also a brain scientist, she is the new director, Volkov writing, „Exploring the whys of adolescent drug abuse”, we can find this in the brain. For these people there is no world, there is only a brain. And substances.
HCLU: And this ideology can be used very well for prohibition isn’t it? Because you can say that the evil is the substance.
Peter Cohen: Yes, but that has allways been said. But now you only have new quasy scientific images to create the quasy scientific racionalisation for that. There’s nothing new in what these people say, except the use of words. But their images of drugs and their discription of what addiction would be is very very primitive. So they use a lot of money to keep us stagnant, to not add any information about what drug use is about. If people overeat or overplay, or oversex, it is all somehow substance related in their eyes. It doesn’t have to do with suffering or poverty. They do not even know what that means. So for these people men are braincells. Not social beings. It is very interesting in a way, its extremely interesting, but it is such a poor social construction. Like in Hungary. Who is invited to speak about drug use? The people that understand least of it. If I have the energy, I will write an article, a criticism of this neurological reductionism, but I am not sure that I have the energy to do so, because there’s so much work involved. There is so much nonsense to be quoted, that it is staggering. It’s like climbing the himalaja without ropes. And also, you can write this article, but it doesn’t influence our culture. Our culture invites these types of reductions, they want them to be made. So hungarian TV wants these people to talk, because they carry the image of scientific knowledge.
HCLU: But there exists another kind of scientific knowledge which can be understood, and should be heard on television.
Peter Cohen: Yes, I speak already on television quite regularly, and people respond, but our institutions do not change. And people like me are not funded. Because we speak a language and ask questions which are not treatment industry friendly, and they are not UN treaty friendly. If I do a proposal for research, and I say, ’listen our Ministry of Justice has just issued reports about ecstasy production, we would like to see the documents on which this is based, and try to come out with an alternative interpretation’. ’No, these documents are very secret’. And than you say, ’listen here you quote a report of the australian police, is it secret?’. ’Yes its highly secret’. I asked the dutch government to ask the american government why on the DEA website they constantly say that the Netherlands is the biggest producer of ecstasy. I asked them to ask the americans who is the second biggest, and how does DEA know this? And I would ask the Dutch government to ask the DEA, how much ecstasy the netherlands are producing? And how they know that 80% of ecstasy in america comes from the Netherlands? ’This is not polite, you should not ask these questions’. Of course they do not know. Of course this is ideology. On Dutch TV we would see Dutch politicians saying 80% of the ecstasy production comes from our country. ’Oh my god!’ people would say, ’terrible!’ But how they would know this, or how people could know this? Nobody asks this, not even a journalist. ’Where does the other 20% comes from?’ You could ask, and ’how much ecstasy is produced in the US, and how much in Mexico, and how much in Thailand?’ Very simple questions you could not even ask, because this would not support particular voices and interests in american drug policy, or in european drug policy. So asking the right questions can already be seen as very threatening, and that is why it’s so good to ask the right questions. But it will not bring you any funding to do research that according to you is intersting or worthwile.
HCLU: Why is it important for the society to have certain drugs claimed to be evil, and their users also claimed evil?
Peter Cohen: It’s not only about drugs. It doesn’t really matter. We have had a time, in which some kinds of human relationship makings were more evil than others, like homosexual relationships were evil and heterosexual relations O.K. Some sorts of sexual behaviour were evil and other sexual behaviours O.K. This devide can be created anywhere. In religions you very often see it, but also in secular movements. Some foods are O.K. and other foods are evil, some sorts of energy are O.K and some sorts of energy like nuclear energy, which has a whole mythology around it, is bad energy. So it is not only about drugs, that you have these divisions, these completely irrational divisions. Apperently people make these divisions. They structure their lives and their social world in good and bad. And only a few scientists are able to put themselves on a level where you can look at that. Most scientists are inside the divide. You have scientists who say that drug use is good, and there are scientists who say that drug use is bad. There’s few scientist who say,’listen look, there are people fighting about good and bad drugs, isn’t that funny? Or good and bad sex. Isn’t that funny?’ So on the basis of these ideas you can divide people in good people and bad people, and sometimes this goes very far.You become entitled to kill the bad people. And you get to political structures that are very dangerous, simply on the basis of some sort of idea. And that is also why the area of human rights is so important in our field. From the human rights vision you may be able to develop the idea that all this thinking in good and bad is O.K. as long as it doesn’t infringe on your human rights, but it mostly does. Once you are categorised bad, you have no more human rights. In the United States, people have no human rights. Because all people are bad. Some people can buy human rights, if you have enough money you can buy a lawyer and you have some rights. But for some people even that is impossible. So once you are in jail, you have no more human rights. You are less than a beast. And also when you put prisoners outside the boundaries of the United States, they have even less human rights. They don’t even have the rights of beasts. You put them in small cages in Guantanamo or in Syria or in Afghanistan. You can treat people according to the idea that they are bad, and this is very primitive. That is also why the United States has never signed the declaration of Human Rights. They say they think their vision of human rights is superior to everything else.
HCLU: Can this american vision influence the european drug policy, and if they can, how much power do they have to achieve their goals in europe?
Peter Cohen: Oh yes they have a lot of power. You should not forget that the americans have a long experience in exporting foreign policy. First they looked at the British, how they were doing that. The British were the absolute masters in forcing countries into their line. The british empire was a masterpiece of political organisation, and the americans learned a lot of that. To give you just one example, the branch of the state department that deals with drug policy has over one billion dollar per year, to buy people, to go and fight people. So they organised their export of interests to a very high professional level. The DEA has highly qualified people in over fifty countries all over the world, where they look at what is happening and they tell their bosses in washington, ’listen Mr. So and So needs some workup’. ’Invite him or threaten him or do so and so’. This is not only a conceptual war. Europe is very often losing professionaly. The Eurpoeans don’t have these organisations. The French have them a little bit. Within europe the French are usually much better organised and informed than the other countries, but it is no match for the americans. The americans are super professional in these areas. They know exactly what is playing in Ivory coast, and who to bribe and who to invite in order to get Ivory coast to vote for you in that and that meeting. This has more to do with your quality of organisation, than with the quality of your arguments.
HCLU: What do you think about the future of this influence?
Peter Cohen: It will go on.
HCLU: Do they have the chance to get the European drug policy go backward?
Peter Cohen: Yes. They have. For instance, under the present President Bush the americans have even easier access to the christian democrats in Europe, than they had before. The christian democrats in southern germany have very many contacts with the americans. And their drug policy remarks sometimes come directly from washington. The americans know how to approach, but in Europe there are also people you can approach and you can bribe. I’ve been looking at the organisation of the DEA very well at the 80’s and I could se exactly how they worked. And I must say I had some sort of admiration for that, because they were sharp. Every change at the dutch ministry of health, somebody would write a memo about that. I by chance could read the memos that were made about me. I stole them from the american embassy. They do clever work, and as long as europeans or individual governments are not working at that same level of professionalism, no chance. It is also very funny, the americans who say that they are bringing democracy all over the world, but democratic regimes in southern america, if they were not in favour of the US, they would shut down. They dont bring democracy, they bring US friendly regimes, that is what they want and they are clever in calling this democracy.
HCLU: Could you tell us about your research findings? For example the study conducted in San Francisco and Amsterdam?
Peter Cohen: We looked at patterns of Cannabis use in San Francisco and in Amsterdam, and basically we did not find much difference. Our interpretations are that the functionality of cannabis use in both countries is almost the same. And that the drug policy around it is irrelevant.
HCLU: It is irrelevant on the epidemiology.
Peter Cohen: Yes.
HCLU: But is it also irrelevant on the problems associated with drug use?
Peter Cohen: No. If you are arrested for simple drug use, or for complicated drug use all the time, like for instance Billy Holliday the jazz singer who was also a heroin user, it can ruin your life. She spent very many years of her life in jails, and her life was ruined by the DEA. She was also a Human Rights fighter, she was protesting against racism in the United States, and through the topic of drugs, they could ruin the life of this woman to a terrible degree. So drug policy can be the difference between a ruined life and a completely normal life. If you would live in England in the period from 1927 to 65, you would be maintained on heroin and cocaine as much as you wanted, and you could have a completely normal life, or an integrated lifestyle. From the moment on that you are marginalised, the level of marginalisation will create problems. For most people who use drugs this does not apply. Even in the US, where very many cannabis users are arrested. Most cannabis users are never arrested and people smoke easily. Even in the United States. I’ve never seen people have difficulties about cannabis smoking or taking a line of cocaine. Although prohibition is very dangerous, its not dangerous enough to wipe it out. Only if you would organise secret police around drug use, you would get real trouble. And so far the americans have not gone.
Peter Cohen: I don’t think they will go that far, because most of the drug war is about simbolism. Of course there is no bigger prison system in the world than the „american goulag”. There are so many people in jail in the United States, over 2 million people. The country is literally covered with prisons. A city like New Orleans has a whole part of the city dedicated to prison building. They are now building their eigth prison there. And they are all big prisons, they are like bunkers without any window. The american average is seven hundred prisoners per hundred thousand people. The european average is about a hundred per hundred thousand.
HCLU: And how much proportion is for drug use, or drug related crimes?
Peter Cohen: I’m not shure about that. Some people say one third, some say one half. Its very complicated to make these computations. But some people are in there for invisible actions. You have a legislation in the US, that if you have been in a car, and at the same time there was five grams of cocaine in that car, you are made responsible for ‘drug dealing’. You can make these automatic sequelae. If you are in a car or in a house, and there is over a certain amount of drug in the house, you are drug dealing and you are part of a criminal organisation. And you ask the judge, ’but who were there in the organisation?’ ’Doesn’t matter’. Thats almost like secret police. ’If you know Mr. So and So, and we know that Mr. So and So has a friend who is a state enemy, you are a state enemy as well’. So you are guilty by association and not by proof. And this association legislation is very very dangerous, and has nothing to do with Human Rights. It is one of the most perfidius anti human rights legislations that exist. ’You have twenty thousand dollars in your pocket? You are a drug dealer! We put you in jail for seven years’. And than you ask, ’but how do you know it is related to drugs?’ ’It usually is! And you know Mr. So and So who is a drug user’. That’s how it goes. People have no idea on what is happening in american courts. It would be very good if you would have a group in Hungary of people who would visit these courts and look at drug convictions. And all the automatic assumptions that are put in to the verdict are just staggering. ’You knew Mr so and so? That means that…’ and theres no level of proof, no legal specification of quality of proof. And we are getting it in the Netherlands as well. For instance the DEA in this country will follow particular people or will ask the Dutch police to arrest particular people and send them to the United States. And when you ask the Dutch judge who has to answer to the request of the americans, ’could you ask the americans some sort of proof that this is true?’ And the judgre will say, ’yes’. And than the americans will say, ’we don’t give you any proof. We want this guy and thats enough’. In the Netherlands the christian democrats now support almost every action of the americans. And the americans made the dutch cristian democrats chief of NATO and the Dutch are completely in their pocket.
HCLU: Will this influence the Dutch drug policy?
Peter Cohen: It already does, very much. So it has became easier to extradite dutch citizens to the United States. The dutch police now has to help the american police. The dutch police never wanted to do that, but now our government forces them to do so. This is the most important impact.
HCLU: Do they have any influence on cannabis policy, and the system of coffeeshops?
Peter Cohen: They wanted to but it doesn’t work, because the coffeeshop policy is very local, and much more supported by the municipalities, and even by christian democrats in municipalities. That is why I always focus on local drug policies instead of the national ones, let alone international ones. International ones are developed outside any observation of real drug use. It happens in the dungeons of international relations and we have not a clue what happens there. That is also why I am against a larger european integration. What they call integration, is grabbing power by eurocrats away from the populations. So Im against the euro-constitution, and I was against increasing the size of the European Union. Actually I’m in favor of desintegration, because the plans with Europe is not integration, it is burocratisation, it is maffialisation, but that’s a nother question again.
HCLU: What is it that you call harm refusal?
Peter Cohen: I by chance talked about harm refusal and harm acceptance in Columbia, because what is happening there by the americans and the columbian elites is simply so beyond imagination. The killing of millions and millions of hektars of land, and the rich columbians gladly help, because they want to open these lands for woodcutting, and all the people who were living there are in the way. These americans chase them out and the impact this has on cities is enormous. I have seen small cities where around these cities hundreds of thousands of people that fled from the inlands are living under incredible conditions. Everything is destroyed there, and you have to hide deeper and deeper to the jungles in order to survive. And many don’t, so they go to the cities and hang on. So I said we have to refuse this type of harm. We don’t want policies that say we have to destroy this village in order to save it. Just like the famous Vietnam frase. This is a type of harm that we should by principal refuse. And also harm acceptance. We accept harm done by traffic or by industry or by alcohol. We say ’yes this is part of our life, we have to accept this stuff’. So harm acceptance and harm refusal are different ways of thinking. I’m not against harm reduction, but it is so often a kind of excuse to not do more. It is a little bit too meager for me. And harm refusal and harm acceptance are just play with words. For some types of harm, created by our drug policy, there is no harm reduction, there is only harm refusal. And here, what is happening here in Amsterdam as the treatment industry is developing and lying. I now refuse to sit on the same table with them. If I’m invited to the meetings where these treatment industry people are, I say I’m not coming. I dont want to listen to the lies of the treatment industrialists. It doesn’t get me very far, but at least for me it is satisfactory. I can’t listen to them any more. And I fight them wherever I can, and I write against them, and I say they create harm instead of reducing it. The burocratic organisations they have created, and the money they cost because of the so called junkies, it is amazing. Fortunately we have an organisation of drug users which is called MDHG, they kind of see that but they are quite powerless to change it. But the existence of junkies is usually a very good way of getting money to pay some sort of director a very high salary.
HCLU: Finally have you heard of this Civil Obedience Movement in Hungary?
Peter Cohen: Yes, I think it may help, or it may be functional in some political context. I think people have to use their brains and think about inventions, that would put the so called problem on a different agenda, so I think it is a good thing.
HCLU: Thank you very much for this interview. It was a pleasure talking to you.
István Gábor Takács
Hungarian Civil Liberties Union
Dr Peter Cohen: Should we continue to socially construct cocaine and amphetamine use as deviance or pathology? 2005 National Drug Treatment Conference, London (audio record)
CEDRO – Centre for Drug Research, University of Amsterdam