America has had considerable experience with prohibition. The term has become synonymous with the ban on alcoholic drinks during the 1920s and early 1930s, but the United States has tried on several occasions to ban things that some viewed as immoral or dangerous. On each occasion the outcome has been the same: if millions of people wanted what the law said they could not have, they got it any way they could.  Getting the illegal item or activity routinely enriched people with no regard for human life or social tranquility. The bootlegging syndicates that wreaked havoc on the social fabric of America after passage of the Volstead Act are legendary, not only for their wealth and power but also for their cold-bloodedness. Banning the industrial production and distribution of alcoholic beverages did little to restrict America’s consumption of gin, whiskey, rum and other high octane drinks, but it did enable those most indifferent to laws and life to blossom into the crime syndicates with which America is still dealing.

Despite its experience with the prohibition of alcoholic beverages, America repeated this stupendous blunder in dealing with the growing popularity of marijuana, narcotics, and illegal immigration.  You might argue that the laws adopted to regulate these items and activities were drafted to protect America from potentially lethal materials and from the alleged “rapists and murderers” flooding our nation, but history has established there were more sinister motives behind the policies and policing adopted.

The argument that marijuana was more dangerous or more needful of regulation than tobacco arose out of its popularity in poor and nonwhite communities and the obvious competition it posed with tobacco. Tobacco caused numerous diseases and obvious addiction, problems not evident with marijuana, but tobacco in America went unregulated for more than 150 years after the establishment of the United States because it was a source of wealth for southern landowners. Even now, restrictions on tobacco use are minimal, despite the enormous public health costs incurred by easy access to tobacco products. To those people (like me) who were indoctrinated with such classics as “Reefer Madness,” I assure you that the psychosis, hypersexuality, and suicidal tendencies depicted in these films as consequences of marijuana use were fantasies worthy of Walt Disney or George Lucas. As a physician who has treated thousands of men and women addicted to tobacco products, I can assure that those small warnings printed on the sides of cigarette packs and chewing tobacco containers are accurate. Marijuana may make you temporarily euphoric, easily amused and hungry, but tobacco will make you permanently dead.

Narcotic use was not deemed a public health problem until after World War I. There were Americans addicted to opium and morphine, but it was not until soldiers returning from the war exhibited a high incidence of drug addiction that the general public became concerned. That sending young men to Europe to see their friends and comrades blown up might be the underlying cause of drug use apparently never occurred to the powers that be. It had to be the power of the drugs, rather than the psychic fragility of their troops and the horror of war, that led to addiction. Heroin was introduced (by your friendly aspirin inventors at Bayer) to relieve opium and morphine addiction, but this made the addiction problem worse. Cocaine was also touted as a cure for narcotic addiction, and that too was disappointing, but it did give Coca-Cola a little extra kick.

Needless to say, Richard Nixon’s War on Drugs failed, but its enforcement continues. Countries with more success in narcotic addiction management have been those which have addressed it as a medical problem rather than as a law enforcement dilemma. While America spends billions of dollars on enforcement of laws that have done nothing to blunt the demand for illegal drugs, other countries have developed cost effective techniques to minimize drug addiction and to limit the profitability of the illegal trade in narcotics.

One of the other prohibitions enacted and enforced by America has been that dealing with the entry of non-citizens into the country.  We refer to it as an immigration crisis, but, like the drug addiction in soldiers returning from war, the crisis is not so much a consequence of policies as it is of desperation. The people of Japan, Australia, Germany, France, and Egypt are not paying their life-savings and borrowing money from relatives to be transported across America’s southern border. The people of Kuwait, South Korea, South Africa, and Denmark are not risking being kidnapped, murdered or raped to get into the United States. The people trying to get across the border or at least get their children across the border are literally fighting for their lives. They are coming from countries in endless combat or suffering from unprecedented drought or depriving them of the most basic human rights. They are not coming to the United States to vacation or to steal microwave ovens or to push drugs.  They are coming here to survive, just as the Irish did during the potato famine and the Jews did during the eastern European pogroms and countless other ethnic groups did when they were left with no alternative.

There are numerous reasons why our neighbors to the south are marching north. This a reaction, not an invasion.  Some “experts” blame global warming that has led to droughts that have turned much of Central America into an agricultural desert. Some point to overdependence on oil revenues in countries like Venezuela. Some blame longstanding government corruption that has funneled the wealth of nations into the pockets of a few families. Some blame centuries of foreign (including U.S.) intervention in the economies of Central and South American countries that has left them drained of resources. Whatever the cause or causes, the nations not facing collapse must deal with the consequences. 

We have tried building walls and separating children from their parents. We have financed private and national armies to stop the flow of people with nothing left to lose. We have barred or hindered entry for people of specific religions or from specific ethnic groups.  None of this has worked.  People will drink whiskey, smoke hemp, snort cocaine, and move out of hopeless circumstances regardless of what laws are passed and what penalties are imposed. The barriers we build will be compromised. The more intimidating the barriers are the richer the crime families, the cartels, the coyotes, the sex traffickers, the kidnappers will get as desperate people flock to them for a better future, regardless of how slim the chances of achieving that life for themselves or their children are.

Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan.  He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the USA, as well as in England, Germany, and France.

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