This is an article from the September-October 2019 issue: Making a Killing

Making a Killing

How Mild Local Drugs Became Global Epidemics

Making a Killing

Unfortunately, merchants of death have reached the remaining Frontier People Groups before any missionaries. Deadly practices among unreached tribes are not new, such as feuding, infanticide, and cannibalism; however, finding the people groups already crippled and dying due to lucrative international drug industries only began in the 19th century.

Realizing that addiction is a major barrier to successfully discipling people in the Lord, evangelical missionaries fought against these death industries for 100 years (1820– 1920) and evangelical believers became globally known for clean living. But powerful modern drugs are spreading again at an unprecedented rate with significantly less resistance from the missionary and church communities. So drug profits and global addiction epidemics soar. “The drive to maximize profit—individual, corporate and state—underlay the explosive global increase in drug use,” wrote David Courtwright in Forces of Habit: Drugs and the Making of the Modern World.1

But how did the drug industries create a global explosion of addictive drug use, both legal and illegal, killing millions annually? Relatively mild addictive drugs have been locally available for centuries. However, there was no means of mass production or distribution and abuse was neither affordable nor acceptable. As relatively mild local drugs became concentrated, mass produced and globally distributed, they became more profitable. Powerful drug industries arose and invested in propaganda to change public perception of the use of addictive drugs from reprehensible to recreational and respectable. Increasingly they are concentrating their efforts on Asia, where 25% of the world’s population that are Frontier People Groups mainly live.

Over the last 200–300 years, four components of drug epidemics have come together in a perfect storm: availability, affordability, acceptability and addictability. The drug industries have been diligently increasing all four components using global manufacturing and distribution, mass media propaganda, spurious denials of harm and development of increasingly concentrated and habit-forming drugs. The industrial, transportation and chemical revolutions have made this possible.

TOBACCO: 300 Years of Denial

Because it does not cause intoxication, deaths due to tobacco were invisible to even missionaries for over 100 years. Now it is clear that of all of the addictive drug industries, tobacco causes the most deaths globally, and after abortion is the leading cause of preventable deaths. According to the World Health Organization (WHO), tobacco causes more than eight million deaths per year worldwide and brings serious illness to 30 times as many people.2 In the USA, where tobacco use has been declining, tobacco is still responsible for 40% of cancer deaths3 and 20% of all deaths.4 The CDC notes that “In 2017, $9.36 billion was spent on advertising and promotion of cigarettes and smokeless tobacco combined—more than $1 million every hour,” adding that smoking costs the USA $300 billion per year, or $34 million per hour.5  Meanwhile, WHO tries to beat the global tobacco epidemic with laws that merely list warnings and promote smoke-free spaces!6

The Native American tribes discovered the addictive stimulation of tobacco, but the British colonists were the first to grow huge fields and figure out how to effectively dry and ship it to an ever-expanding global market. Since then, a series of factors have contributed to tobacco use becoming a worldwide epidemic.  First, slave labor made both the crop and production affordable, followed by the cigarette-rolling machine invented in the 1880s. The invention of matches in 1900 made use easier and cigarette vending machines in the 1920s greatly increased availability, along with railways, powered ships and airplanes. Acceptability became widespread through advertising, fundraising to donate cigarettes to allied troops and Hollywood movies glamorizing smoking for men and women.7

Despite increasing evidence in the first half of the 20th century that cancer of the mouth and lungs resulted from smoking cigarettes and tobacco chewing, global consumption of cigarettes continued to climb.8  The tobacco industry refused to concede the reality of tobacco hazards until the late 1990s. Instead, the industry sought to target physicians and others with its message of “no proof,” using subtle techniques of deception, including the funding of spurious research, duplicitous press releases, propaganda efforts directed at physicians and the employment of historians to construct exculpatory narratives.9  It was not until 1996 that the tobacco industry executives admitted that tobacco was even addictive, much less dangerous!

A pattern of willful deception is seen in all of the industries profiting from addictive drugs.

The tobacco industry is concentrated in a handful of large companies who cover up the fact that their product causes 15% of all male deaths and 7% of all female deaths globally.10  Despite setbacks in some countries, the 500 billion dollar tobacco industry continues to expand with impunity, increasing production by 16% in the last decade.11

Unfortunately, while evangelicals have opposed the spending of resources on addictive tobacco, very few missionaries have realized the full danger of smoking enough to oppose it. As Ralph Winter wrote,

     When the Bible does not speak about a specific problem, such as the U.S. pushing off cigarettes on the whole world, then theology should come to the rescue to make           application of Biblical truth to the new circumstances. Again, it was not a theologian but the World Health Organization that pointed out that the U.S. kills more people in         the country of Colombia by our government-subsidized nicotinelaced cigarettes than are killed in the U.S. by hard drugs from all foreign sources put together. What does       the Bible want us to think and do about this?12

ALCOHOL: From Helpful to Harmful

In the mid-1700s a missionary named David Brainard walked from tribe to tribe in New England seeking to share the gospel. Everywhere he went the Indians were drunk almost every day, so much so that he often despaired of talking to them. Finally communicating to one tribe that God loved them and wanted to deliver them from alcohol, the tribe wept for days, both in sorrow for their people and in hope of deliverance. God answered their prayers and Brainard writes of their amazing transformation:

A principle of honesty and justice appears in many of them, and they seem concerned to discharge their old debts, which they have neglected….Their manner of living is much more decent and comfortable than formerly, having now the benefit of that money which they used to consume upon strong drink. Love seems to reign among them…they rejoice with joy unspeakable.13

But Brainard began to receive intense opposition from the colonists who depended on the addiction of the Indians to trade rum for furs. In helping unreached people groups escape addiction today, missionaries should also expect intense opposition.

However, believing Native American tribes created “sobriety circles” in the 1750s led by tribal leaders, 150 years before Alcoholics Anonymous.

Recovery circles and abstinence-based cultural movements included the Delaware prophet movements, the Christian Indian revivalists who used their own lives as proof Christian conversion and worship could cure alcoholism, the Shawnee Prophet and Kickapoo Prophet movements, Indian temperance societies, the Indian Shaker Church, and the Native American Church.14

When older Christian denominations (pre-18th century) were formed, common alcoholic beverages were quite weak, produced through natural fermentation. However, they became deadly when machines for mass distillation were invented. Until 1600, diluted wine or beer with 1% to 5% alcohol were commonly consumed in Europe and helped to sterilize polluted water. The maximum “strong drink” through natural fermentation was 14% alcohol.

But the Industrial Revolution changed all that. By the mid-17th century distilleries sprang up in Europe, Britain and the New World colonies, mass-producing distilled alcohol from sugar and grain with 30% to 50% alcohol. American colonists not only decimated Native American tribes by trading rum for furs, they used rum to buy slaves from the African tribes resulting in widespread addiction, poverty, sickness and death in Africa, too.

Gin became so popular in London that it caused an epidemic of social disintegration. In the first half of the 1700s, annual production of spirits in England went from 500,000 gallons to 11 million gallons.15 England attempted to cut alcohol consumption with taxes and regulation, but without much success. As an unfortunate side effect, the government became dependent on alcohol tax revenue. As increasingly efficient distilling machines increased addictiveness, the global transportation revolution of the 19th century made concentrated alcohol ever more widely available and affordable.

Societal acceptance or rejection is a key factor in drug and alcohol abuse. Only the Evangelical Awakening’s opposition to spirits and promotion of tea instead helped to rein in England’s “gin craze” epidemic in the 18th century. The Awakening was not so much a revival of religion as a revival of focus on godliness and holiness in the life of committed believers. It is admitted that Wesley changed the spirit of the age in which he lived. It is impossible to estimate the magnitude of that change unless we form some idea of the condition of England at the time when the great evangelist did his revolutionary work.16  Every wide-spread revival of evangelical faith in the USA since then has opposed the use of drugs and alcohol. For 200 years, evangelical missionaries took abstinence to a global level, helping countless tribes struggling with drug and alcohol addictions.

The Alcohol Industry Fights Back

However, the alcohol industry has fought back with an extensive propaganda campaign to glamorize and normalize recreational alcohol consumption in movies and media, even during Prohibition in the US (1920-33).  They pushed acceptability while simultaneously increasing affordability and availability. So today, instead of buying alcohol only by the expensive glass or shot in bars, people buy inexpensive quarts and multi-packs in supermarkets and corner stores and take them home. Movies have progressively normalized drinking after work, at family and sports events and even normalized binge drinking for fun. One out of six adults binge drinks at least four times a month, according to the CDC,17 or 40% of those who drink, globally.18

Since 1900, alcohol has gone from a justified reputation of ruining people’s health, lives and families to the glamorous position of being the foremost recreational drug on the planet through relentless media propaganda and cover ups. Alcohol is arguably the most destructive and most lucrative drug on the planet, killing over three million directly but doing far more damage to the health, relationships, families and communities than any other drug including tobacco. The global alcohol industry brings in $1.5 trillion annually.19

Muslim people groups are somewhat protected from alcohol by the prohibition in the Qur’an, but most Muslim countries do not ban alcohol. Pakistan, who bans it for Muslims, has an increasing alcohol problem, even among the young.20  The British set up the first modern alcohol distillation factories in India and Pakistan (1860), and three of the largest tax-paying companies in Pakistan are alcohol industries.21

Every slum in the world reveals alcohol’s devastation to families. Data on alcohol’s harm is widely available but largely ignored. A study of 195 countries concluded that alcohol directly kills 10% of all adults aged 15-49.22  Death rates are actually much higher for drinkers since only 38% of the global population drinks alcohol.23

Additionally, alcohol is causally implicated in 60 more diseases and a factor in 200 other diseases24 (causing 5.8% of all cancers, according to the American Society of Clinical Oncology, 201725). Alcohol is also known to be a significant factor in crime, domestic violence, child abuse and divorce.

Without any remaining visible opposition from missionaries or churches, the alcohol industry markets alcohol with impunity. Now it also profits from alcohol addiction treatment programs. Along with private providers, the treatment industry earns close to 35 billion dollars in the USA alone, with less than a 5-10% cure rate.26  Unfortunately, the lives of addicts are often permanently damaged even if they become sober, and most of those who die from alcohol-related causes never considered themselves “alcoholics.” 

From OPIUM Wars to OPIOID Epidemics

Today Frontier People Groups are heavily involved in opium and heroin production, including terrorist groups. According to the UN Office of Drugs and Crime, global opium production increased by 65% in ONE year, from 2016 to 2017, reaching 10,500 metric tons ($1.6 billion), the highest on record, with 9000 alone coming from Afghanistan.27 For comparison, at its height, British merchants shipped 6000 metric tons of opium per year just to China (c. 1880).28

 Having learned that addictive drugs are a lucrative way to ensure continued markets and to balance trade, 17th century British merchants introduced China to smoking, first of tobacco and later of opium. In the name of “free trade” the British fought two opium wars to block Chinese attempts to stop their illegal smuggling of opium into China! In the 1830s before the Opium Wars an estimated three million Chinese were addicted to opium, but after forcing legalization (1880) that number climbed to approximately 15 million by 1890 and 21 million by 1906.29 Opium was destroying Chinese families as addicts would even sell their wives and children to purchase more. Missionaries to China fought for over 100 years to help end the opium epidemic.

Meanwhile, opium was spreading in more addictive forms. Morphine, first distilled from opium in 1803, was easier to transport and ten times stronger than opium. Touted as a medical treatment for opium addiction, Western doctors were also thrilled with its pain alleviating properties, assuring acceptability. An estimated 400,000 soldiers in the American Civil War became addicted,30 triggering an epidemic in America. Opium became the cure-all which essentially cured nothing but masked all forms of pain, even in children. The accidental addictions of the 19th century later became industry-marketed addictions in the 20th century through pharmaceutical opioids.31

Thanks to the work of 19th century missionaries, temperance societies and churches in America, opium use is less widespread today and still illegal; however, opium has developed extreme concentrations and more synthesized forms than any other drug. As a result, the deaths due to opium/opioids, are due to overdoses not drug-induced diseases.

Heroin, 30 times stronger than opium, was invented by Bayer (c.1900), and first prescribed to cure morphine addiction. But it proved even more addictive, especially when injected with the newly invented syringe, and quickly became a serious global problem.32

Next, strong synthetic opioid pain killers, products of the chemical-drug revolution, became widely available (such as Demerol, Tramadol and Vicodin). Legally marketed through doctors who were falsely assured they were not very addictive, by 1998 OxyContin ushered in the modern opioid epidemic. Making over $25 billion on just opioids in 2018, pharmaceutical companies have continued to invent and market new opioids many times stronger than natural morphine (see graph on pdf version). 33 By 2010 over 13 million people were addicted to opioids and opium derivatives worldwide, despite the fact they were highly controlled.34

Opioid addictions are not only lethal but horrific for family members. However, so far deaths due to illegal drugs pale in comparison to the deaths caused by tobacco and alcohol, with the UN reporting global overdose deaths due to the majority of trafficked drugs (including opioids, cocaine, amphetamines, sedatives, marijuana, ecstasy) running a mere 190,000 (to 250,000).35 Most opiate deaths are overdose related, 118,000 per year—78,000 of those in the USA.36  Global deaths due to illegal drug use climb to 450,000 if you include deaths due to HIV and Hep C transferred by non-sterile syringes.37 Illegal use of legal synthetic opioids are fueling the modern epidemic.

Addictive PHARMACEUTICALS: Wolves in Sheep’s Clothing?

Missionaries have traditionally been on the side of pharmaceutical drugs, which have saved lives and alleviated pain. And no one can deny the great help to mankind of pain-killing opioids, along with many other pharmaceutical drugs. But recently pharmaceutical companies are being called to account for their reckless over-production and relentless promotion of opioids and other addictive drugs. In many developing countries, these can be easily bought without a prescription from multiple pharmacies and doctors who are quick to drugs for every ailment with no apparent awareness of interaction dangers.

Millions of people worldwide have become addicted to doctor-prescribed medications, some moving on to illegal drugs. Western drug companies lead the way with ever younger children being prescribed addictive medications. In the USA, as of 2017, over 100,000 children under the age of one are on psychotropic medications and over 500,000 under the age of five.38

In addition to opioids, the pharmaceutical companies also produce hundreds of other addictive mind-altering drugs, including tranquilizers, sedatives, anti-depressants and stimulants. These are intended for lifetime use and are often mixed in “cocktails” of untested combinations when one drug proves ineffective, especially lethal when combined with alcohol.39

In 2015, the total number of individual prescription medications filled at pharmacies was just over four billion. That’s nearly 13 prescriptions for every man, woman and child in the United States, according to the 2015 census. It’s little wonder that overdose deaths caused by prescription medication have taken off to such a degree.40

Prescription drugs are now the third leading cause of death in America and Europe, after cancer and heart disease, totaling nearly 400,000 per year41  (tobacco and alcohol were not included in the study). Increasingly deaths of those on medical prescriptions are viewed as unavoidable and therefore acceptable because, unlike other drugs, prescribed drugs are considered necessary, not recreational.

Pharmaceutical companies, like drug inventors in the past, regularly invent and market new miracle drugs as safe and healthy without adequate testing for difficulties in withdrawal. Most shocking is the exponential growth of new psychoactive substances (NPS), with the UN Office of Drugs and Crime (UNODC) World Drug Report of 2017 showing between 2009 and 2016 there were 739 new psychoactive substances created.42

The pharmaceutical industry is rapidly spreading its drugs around the globe, making them available and affordable in even the poorest nations. One study of 500 products from 150 drug companies showed they regularly market drugs to the third world by grossly overstating their benefits and obscuring dangers.43  It is extremely profitable to treat but not cure illnesses, requiring lifetime-use of drugs and putting heavy financial loads on families. Alarmingly, there is a higher death rate in areas with the most prescription drug advertising.44

Who will call the pharmaceutical companies to account? Today the pharmaceutical industries control public perception by heavy advertising through mass media. Their money ensures that the news sources do not publish anything against their products. Despite rare fines for deceptive advertising, their tactics continue. Drug companies lobby for government funding of prescription drugs which will increase affordability, acceptability and availability. The global pharmaceutical industry revenues have reached 1 trillion dollars per year, with a 5.8% annual increase.45

Will Legalizing MARIJUANA Help?

Opioid addiction is so quick and strong that historically other drugs have been proposed to help people escape the addiction without success. The latest drug to enter this cycle is marijuana, with a low chance of death by overdose.

Causing an intoxication that is distinct from alcohol, marijuana has been used for centuries by Frontier People Groups in India and Muslim countries with a reputation of sometimes triggering psychotic episodes, paranoia and schizophrenia. These reports were long questioned but finally statistically verified by a number of recent rigorous studies done in Sweden, Holland, New Zealand, Australia and Britain. “The scientists estimated that cannabis use might be responsible for as much as half of the serious psychosis in previously healthy adults,” after controlling for many factors including the use of other drugs.46 Also, multiple recent studies in peer-reviewed psychiatric journals link repeated cannabis use, especially by teens, with development of permanent psychotic disorders such as schizophrenia that are independent of genetic factors.47

But, has medical marijuana saved people from opioid addiction as hoped? After some first hopeful studies by pro-legalization scientists, by “July of 2017 the Journal of Opioid Management found that cannabis laws were associated with a 22 percent increase in age-adjusted opioid-related mortality between 2011 and 2014. Worse, mortality increased as time passed.”48 The death rate from opioids in the USA is now triple that of the UK, though it used to be the same in 2000. The UK did not legalize marijuana, even for medical purposes, but many states in the USA did.49 So while marijuana legalization itself may not be causing many deaths, it is certainly not preventing deaths by opioids.

Legalization Increases Addiction, Epidemics and Deaths

Some Christians wonder if legalization will help stem the drug problem here and abroad. Legalization has a number of proponents. Legalization of illegal drugs makes drug production and sales more transparent, taxable and profitable to governments and reduces enforcement costs. It also puts crime based illegal drug cartels in direct competition with legal drug industries, making it more difficult for them to stay in business. People thrown in prison for drug trafficking and possession could be released. Some also argue that people will use drugs anyway, but if they are made legal, they will use them in safer ways or in safer company.

Many of the Frontier People Groups live in countries that partially or completely ban some drugs, like alcohol or opium, though most have robust black markets going. The West has vacillated between banning and legalizing addictive substances. Let’s look at the results of legalization:


Legalization Greatly Increases the Four Factors


Four factors were crucial to turning a mild local drug into a powerful global addictive money-maker: availability, affordability, acceptability and addictability. Legalization greatly increases all four factors as well as the power and profitability of the related drug industries, which greatly expand. Also, governments, now profiting through taxation, have little motivation to stem the tide or expose any problems. Media, movies, ads and campaigns for legalization all try to romanticize and normalize usage. Once legal, advertising becomes ubiquitous. People assume it is relatively safe and so it becomes a socially acceptable form of recreation or coping with life. For example, 1960s movies successfully normalized binge drinking for (under legal drinking age) students, especially during spring break; however, as a result the annual death rate just during spring break became 1800 US students, with 600,000 injured and 100,000 sexually assaulted. Though most are under the legal drinking age, some 40% of college students regularly binge drink, demanding it as a right. Trying to educate students instead of enforcing the legal-drinking-age laws has totally failed.50

Legalization also makes drugs more available and affordable. Legal drugs, tobacco and alcohol are sold in multiple outlets on every corner. Opioids are dispensed from many local pharmacies. The legal drug industries entice young people into lifetime use by marketing cheap and fun versions of alcohol and tobacco, and now marijuana, even though it is illegal for young people to use these drugs. Candy and cookie flavored e-cigarettes, “vaping,” and nicotine-containing e-liquids have proven very popular among middle and high school students and start them on the nicotine addiction path, by design, while being promoted as safer.51

Legalizing a formerly illegal drug, like marijuana, has made young people see it as safer and significantly increased their usage, even though it was still illegal for them.52 The false perception that marijuana has “no risk of harm” has gone up 270% since states began legalizing medical marijuana according to the UN Office of Drugs and Crime.53 Well-funded marijuana advocacy groups used deception to persuade the US public to legalize “medical use” of marijuana, though it was never approved by the FDA and many studies failed to show any medical benefit. “Medical use cards” now allow unlimited purchases at marijuana dispensaries, without even a specified disease, unlike any other prescription drug. Partial and full legalization has resulted in doubling the usage rate of marijuana54 and creating an 80 billion dollar business,55 but it has not diminished illegal production or the crime associated with marijuana.56 Predictably, plants with increasingly concentrated amounts of the psychotropic THC have been bred (pre-1990 2-4% THC and now 20-30% THC).57 And more concentrated forms of the THC drug are being invented with no control over dosage. 100% THC tinctures, powerful edibles including “candies,” and odorless vaping are now more socially acceptable than smoking.

Legalization Promotes Invention of More Addictive Drugs
 

Legalization motivates the industries to invent even more addictive drugs, as lifetime use is highly profitable. Since the early 20th century, chemical and pharmaceutical companies have led the way in inventing and patenting thousands of new addictive synthetic drugs as well as strengthening existing ones. But earlier reform movements quickly found out that concentrated addictive substances cannot be used in moderation by most people. Nevertheless, the medical establishment is increasingly referring to “use disorders” rather than “addictive substances,” putting the blame on the person’s habits rather than the drug, though they are increasingly designed for addiction. But after decades of trying, research has found no personality traits consistently associated with addicts nor abstainers.58

The only consistent predictors of drug epidemics are the four factors: availability, affordability, acceptability, and addictability, which lead to trying the drug and beginning regular use—and the inevitable rewiring of our brain to need that repeated pleasure stimulation. David Courtwright points out that organized opposition is the only thing that has worked to expose and reign in the industrial purveyors of addiction, in his 2019 book Age of Addiction: How Bad Habits Became Big Business, including things like gambling and pornography.


Black Markets and Crimes Continue After Legalization

 Addictive drugs are not subject to usual market forces because addicts will do anything to get their next dose. So black marketing of drugs is not eliminated by legalization
either. Concentrated drugs are cheaper and easier to transport illegally. Vast amounts of pharmaceutical drugs end up on the black market, bypassing the legal controls, greatly increasing the sales of the pharmaceutical companies who ignore the problem.59 Legalizing drugs only makes formerly illegal drug-pushing safer and easier and  fuels illegal distribution to avoid taxes. Crime is not reduced by legalization because most crimes committed in relation to drugs are due to being under the influence, and these crimes increase after legalization because usage increases.60


Industry-backed Solutions Avoid Abstinence


Modern solutions proposed by some, especially the drug companies, have given up the goal of keeping people off drugs entirely. Instead they propose things that have already failed in history, for example: making supposedly less addictive opioids widely available; setting up “safe” drug consumption sites; legalizing less dangerous drugs, even though they have been gateways to stronger drugs; establishing stricter laws to prevent accidents under the influence; including larger warning labels on dangerous substances; and providing more clinics to treat people who are addicted.

Notice, all of these “solutions” do not propose to keep people off of drugs or alcohol but instead to actually facilitate their use with hopefully less destructive consequences. And they preserve the income of the drug industries and governments! They do not take into account the ongoing consequences to families of drug addicts, to society with non-functioning members, and to the addicts themselves who lose decades of their lives trying to get off and stay off of these drugs. The drug industries push legalization as a  “solution” because it increases the number of drug users and greatly expands both legal and illegal drug businesses, as marijuana legalization has most recently shown once again.61 Having cheap addictive drugs available on every corner makes sobriety extremely difficult and greater epidemics inevitable.


A Message of Hope and Freedom to Frontier People Groups


Unlike governments and media, only missionaries and other believers with no profits to lose can expose the deceptions marketed by the drug death industries. Revivals have repeatedly shown that people long for freedom from their addictions and for the “natural high” of Jesus, who came to give people Spirit-filled abundan life, full of faith, hope and love. Every evangelical revival in the last 300 years, since drugs and alcohol have become so powerful and widespread, has shown the power of the Holy Spirit and shared sober fellowship to free people from drug and alcohol addiction. Globally, evangelical churches, wherever they have grown up, by the power of Jesus, have pulled addicts out of their addictions into loving social sober fellowships. This transformation was awesome for me to see as a child growing up in a Mayan tribe. I long to see this powerful gospel come to the hurting families I knew in the shanty towns of North Africa and South Asia, where every family was being beaten down by addictions.

 

Endnotes
  1. 1  Courtwright, David T., Forces of Habit: Drugs and the Making of the Modern World, Harvard University Press, Cambridge, MA, 2001, page 206. Be sure to check out his new book Age of Addiction, May 2019.

  2. 2 http://www.who.int/news-room/fact-sheets/detail/tobacco

  3. 3 http://www.cdc.gov/media/releases/2016/p1110-vital-signs-cancertobacco.html

  4. 4 http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm

  5. 5 http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/
    index.htm

  6. 6 http://www.who.int/whr/media_centre/factsheet2/en/ And also see
    WHO Report on the Global Tobacco Epidemic, 2017.

  7. 7 US Congress Office of Technological Assessment: Technologies
    for understanding and preventing substance abuse and addiction.
    US Government Printing Office, Washington DC, 1994. Pg. 59

  8. 8 http://www.cdc.gov/media/releases/2016/p1110-vital-signs-cancertobacco
    . html

  9. 9 http://www.ncbi.nlm.nih.gov/pubmed/15217537

  10. 10 http://www.maurerfoundation.org/tobacco-industry-profitsestimated-
    35-billion-with-almost-6-million-annual-deaths/

  11. 11 http://www.maurerfoundation.org/tobacco-industry-profitsestimated-35-billion-with-almost-6-million-annual-deaths/

  12. 12 Frontiers in Mission, pg. 69.

  13. 13 The Journal of David Brainard, Nov. 1745 entry.

  14.  14 http://www.thefix.com/content/native-american-sobriety-circles

  15. 15 Chapter 3: http://www.revival-library.org/index.php/cataloguesmenu/1725/the-revival-of-religion-in-the-eighteenth-century

  16. 16  Ibid, Chapter 2.

  17. 17 http://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm Binge drinking is defined as five drinks for a man or four for a woman within two hours or one event. A drink = one oz of spirits, four-five oz of wine or 12 oz of beer. Many cocktails equal two to three drinks, and a cup of wine is equal to two drinks.

  18. 18 onlinelibrary.wiley.com/doi/full/10.1111/add.14234

  19. 19 http://www.statista.com/statistics/696641/market-value-alcoholicbeverages-
    worldwide/

  20. 20 http://www.bbc.com/news/world-asia-24044337

  21. 21 http://www.medium.com/@nayadaurpk/spirits-having-flowna-
    pictorial-history-of-alcohol-consumption-in-pakistana34ad435e0e1

  22. 22 http://www.usatoday.com/story/news/nation-now/2018/08/24/
    alcohol-death-disease-study-beer-wine/1082443002/

  23. 23 http://www.who.int/substance_abuse/facts/en/

  24. 24 http://www.who.int/news-room/fact-sheets/detail/alcohol

  25. 25 Cancer and Alcohol: A Statement of the American Society of Clinical Oncology: DOI: 10.1200/JCO.2017.76.1155 Journal
    of Clinical Oncology 36, no. 1 (January 1 2018) 83-93. www.
    ascopubs.org/doi/full/10.1200/JCO.2017.76.1155

  26. 26 http://www.forbes.com/sites/danmunro/2015/04/27/inside-the-35-billion-addiction-treatment-industry/#5936b33a17dc

  27. 27 http://www.unodc.org/wdr2018/prelaunch/WDR18_Booklet_2_GLOBAL.pdf (p. 28)

  28. 28 http://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1949-01-01_1_page005.html

  29. 29 http://www.unodc.org/documents/wdr/WDR_2008/WDR2008_
    100years_drug_control_origins.pdf

  30. 30 http://www.history.com/topics/crime/history-of-heroin-morphine-
    and-opiates

  31. 31 http://www.smithsonianmag.com/history/inside-story-americas-
    19th-century-opiate-addiction-180967673/

  32. 32 http://www.pbs.org/wgbh/pages/frontline/shows/heroin/etc/history.html

  33. 33 http://www.grandviewresearch.com/industry-analysis/opioids-market

  34. 34 http://www.drugfreeworld.org/drugfacts/heroin/international-statistics
    . html

  35. 35 http://www.unodc.org/wdr2017/field/Booklet_1_EXSUM.pdf

  36. 36 http://www.who.int/substance_abuse/information-sheet/en/

  37. 37 http://www.unodc.org/wdr2018/prelaunch/WDR18_Booklet_2_
    GLOBAL.pdf (p. 23)

  38. 38 http://www.cchrint.org/psychiatric-drugs/people-taking-psychiatricdrugs/

  39. 39 http://www.thefix.com/content/drugs-cocktails-kill-combinations90237

  40. 40 http://www.unityrehab.com/blog/prescription-drugs-more-deathsthan-
    illicit-drugs

  41. 41 http://www.ncbi.nlm.nih.gov/pubmed/25355584 These pharmadrug
    deaths include deaths due to drug interactions, drug
    side effects and drug overdoses, but do not include physician
    error, illegal usage or medication deaths that cause heart
    attacks, strokes or suicides.

  42. 42 http://www.unodc.org/documents/wdr/WDR_2008/WDR2008_
    100years_drug_control_origins.pdf

  43. 43 http://www.ncbi.nlm.nih.gov/pubmed/7141775

  44. 44 http://www.vox.com/future-perfect/2019/1/25/18188542/opioidepidemic-
    marketing-overdose-death-purdue

  45. 45 blog.marketresearch.com/the-growing-pharmaceuticals-market-
    expert-forecasts-and-analysis

  46. 46 Berenson, Alex, Tell Your Children the Truth: The Truth About Marijuana, Mental
    Illness and Violence, Simon and Schuster, NY, 2019., pp. 94-97.

  47. 47 Berenson, pp. 121.

  48. 48 Berenson, pp. 112.

  49. 49 Berenson, pp. 118.

  50. 50 http://www.nytimes.com/2014/12/15/us/why-colleges-haventstopped-
    binge-drinking.html

  51. 51 truthinitiative.org/news/4-marketing-tactics-e-cigarette-companies-
    use-target-youth

  52. 52 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365078/

  53. 53 http://www.unodc.org/wdr2017/field/Booklet_1_EXSUM.pdf (an
    executive summary of UNODC 2017 report)


  54. 54 http://www.sanpatrignano.com/what-we-do/sanpa-international/
    marijuana-legalization-has-led-more-use-and-addiction-
    while-illegal-market-continues-thrive/

  55. 55 finance.yahoo.com/news/cannabis-poised-80-billion-industry-
    222331008.html

  56. 56 http://www.theatlantic.com/magazine/archive/2019/01/california-
    marijuana-crime/576391/

  57. 57 http://www.livescience.com/53644-marijuana-is-stronger-now-than-
    20-years-ago.html

  58. 58 http://www.scientificamerican.com/article/the-addictive-personalityisn-
    t-what-you-think-it-is/

  59. 59 http://www.bbc.com/news/health-42810148

  60. 60 Gorman, Myths of Legalization, wise.fau.edu/~tunick/courses/
    pos3691/gorman_drugs.html

  61. 61 https://www.politico.com/magazine/story/2019/07/21/legalmarijuana-
    black-market-227414

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