Harry G. Levine/Craig Reinarman
FROM PROHIBITION TO REGULATION
LESSONS FROM ALCOHOL POLICY FOR DRUG POLICY

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Effects of Prohibition on Consumption, Production, and Distribution

Consumption

It has frequently been observed that drug prohibition tends to drive out weaker and milder forms of drugs, and to Increase the availability and use of stronger and more dangerous drugs (see, e.g., Brecher 1972). This has been so often reported that many analysts speak of it as an iron law of drug prohibition. This "law" holds because milder drugs are usually bulkier, harder to hide and smuggle, and less remunerative. People involved in the illicit drug business therefore frequently find it in the it interest to do business in the more compact and potent substances. For example, current interdiction efforts are most successful at capturing boats carrying many large bales of marijuana; therefore, many drug smugglers have turned to smuggling cocaine or heroin because it is easier and far more lucrative than smuggling marijuana (see Murphy, Waldorf, and Reinarman 1991).

This "law" of drug prohibition captures what happened during prohibition. The major effect of the Eighteenth Amendment and the Volstead Act on drinking was to dramatically reduce beer drinking (and therefore total alcohol consumption). At the same time, however, prohibition increased consumption of hard liquor (especially among the middle class). The fashionableness of the martini and other mixed drinks among the middle class is in part a historical legacy of prohibition, when criminalization made hard liquor the most available form of beverage alcohol.

TABLE 1: Alcoholic Beverage Consumption in the United States From 1710 to 1975

Spirits Wine Cider Beer Total
YEAR Bev. alc. Bev. alc. Bev. alc. Bev. alc.
1710 3.8 1.7 0.2 <.0.5 34 3.4 - - 5.1
1770 7.0 3.2 0.2 <.0.5 34 3.4 - - 6.6
1790 5.1 2.3 0.6 0.1 34 3.4 - - 5.8
1800 7.2 3.3 0.6 0.1 32 3.2 - - 6.6
1810 8.7 3.9 0.4 0.1 30 3.0 0.3 0.1 7.1
1820 8.7 3.9 0.4 0.1 28 2.8 - - 6.8
1830 9.5 4.3 0.5 0.1 27 2.7 - - 7.1
1840 5.5 2.5 0.5 0.1 - - 2.3 1.0 3.1
1850 3.6 1.6 0.3 0.1 - - 2.7 0.1 2.1
1860 3.9 1.7 0.5 0.1 - - 6.4 0.3 2.1
1870 3.1 1.4 0.5 0.1 - - 8.6 0.4 1.9
1880 2.4 1.1 1.0 0.2 - - 11.1 0.6 1.9
1890 2.2 1.0 0.6 0.1 - - 20.6 1.0 2.1
1900 1.8 0.8 0.6 0.1 - - 23.6 1.2 2.1
1905 1.9 0.9 0.7 0.1 - - 25.9 1.3 2.3
1910 2.1 0.9 0.9 0.2 - - 29.2 1.5 2.6
1915 1.8 0.8 0.7 0.1 - - 29.7 1.5 2.4
1920 -b - - - - -
1925 2.1 0.9 1.0 0.2 - - - 0.3 1.4
1930 2.1 0.9 1.0 0.1 - - - 0.4 1.5
1935 1.5 0.7 0.4 0.1 - - 15.0 0.7 1.5
1940 1.3 0.6 0.9 0.2 - - 17.2 0.8 1.6
1945 1.5 0.7 1.1 0.2 - - 24.2 1.1 2.0
1950 1.5 0.7 1.1 0.2 - - 24.1 1.1 2.0
1955 1.6 0.7 1.3 0.2 - - 22.8 1.0 1.9
1960 1.9 0.8 1.3 0.2 - - 22.1 1.0 2.0
1965 2.1 1.0 1.3 0.2 - - 22.8 1.0 2.2
1970 2.5 1.1 1.8 0.3 - - 25.7 1.2 2.5
1975 2.4 1.1 2.2 0.3 - - 28.8 1.3 2.7

Consumption and Public Health Under Prohibition

The new public debate about drug laws has increased interest in the effects of prohibition on public health, the economy, and social problems. These were very lively questions during prohibition period but have been largely ignored since. However, in the last two decades alcohol researchers in a number of countries have investigated at length the relationship between total per capita alcohol consumption an specific illnesses, especially cirrhosis of the liver. The data available for the prohibition years in the United States will always be poor because it is impossible to get accurate consumption figures for an illegal substance.

Nonetheless, changes in the last 50 years in many countries that have kept accurate consumption and health statistics do allow some inferences about the relationship between overall alcohol consumption and cirrhosis. Although not all liver cirrhosis is caused by heavy drinking, much is. Furthermore, cirrhosis rates generally follow overall per capita consumption rates. These effects are mediated by dietary patterns, by type of alcoholic beverages consumed, and by when they are consumed. The level of health care people receive also affects cirrhosis death rates. In general, however, the positive relationship between alcohol consumption and cirrhosis holds: when consumption increases, cirrhosis increases (Bruun et al. 1975; Makelaa et al. 1981; Moore and Gerstein 1981; Single et al. 1981).

One important way to evaluate the public health consequences of alcohol policies, then, is in terms of how they affect consumption. In 1932 Warburton pointed out that "except for the first three years, the per capita consumption of alcohol has been greater under prohibition than during the war period [1917-1919], with high taxation and restricted production and sale" (260). As table I suggests, both prohibition and postprohibition alcohol regulation kept overall consumption down compared with the decades prior to prohibition. Indeed, postprohibition regulatory policies kept alcohol use sufficiently low that it was not until the end of the 1960s, 35 years after repeal, that per capita alcohol consumption rose to the levels of 1915. Whatever public health benefits prohibition achieved in terms of reducing consumption, alcohol regulation in the 1930s and early 1940s accomplished them as well. Further, this occurred despite the fact that the postprohibition regulatory system had little or no public health focus, and despite the fact that the liquor industry (like most other US industries) gained increasing influence over the agencies that were supposed to regulate it. Our point here is not that US alcohol control is a model of effective public health oriented regulatory policy (it certainly is not). Rather, until at least 1960, alcohol control worked almost as well as prohibition in limiting alcohol consumption, and more effectively than preprohibition policies.

It is also important to note that other nations achieved even greater reductions in per capita consumption than the United States - without the negative consequences of prohibition. Robin Room (1988) has shown that in Australia a series of alcohol control measures instituted in the early twentieth century substantially reduced spirits consumption. More important, Australias regulatory policies significantly reduced total alcohol consumption as well as the incidence of alcohol-related health problems, notably cirrhosis mortality. From a peak of 9.15 cirrhosis deaths per 100,000 in 1912, Australias cirrhosis rate fell to 3.83 in 1933, and fluctuated between 3.15 and 5.12 for over 20 years. Room reports that mortality from alcoholic psychosis experienced a similar drop. All of this happened under regulated sale, not prohibition.

Great Britains experience parallels that of Australia. England reduced overall consumption by instituting fairly stringent alcohol regulation at about the same time as the United States instituted prohibition. Moreover, as Nadelmann notes, it reduced "the negative consequences of alcohol consumption more effectively than did the United States, but it did so in a manner that raised substantial government revenues." By contrast, the US government not only spent large sums attempting to enforce its prohibition laws, but was also unable to prevent the flow of money into criminal enterprises (1989b~ 1102-3).

It is difficult to disagree with Nadelmanns conclusion that the "British experience and, we would add, the Australian experience] strongly indicates that the national prohibition of alcohol in the United States was, on balance, not successful." Prohibition of course failed to fulfill the fantasies of prohibitionists about eliminating major social problems like poverty, unemployment, crime, and so on. Yet even in the less utopian terms of reducing total alcohol consumption, US prohibition was no more effective than regulated sale in the 1930s and early 1940s. Prohibition, however, produced far more substantial negative side effects than did regulation.

Only a few other nations even tried prohibition laws, and only Finland instituted constitutional prohibition (repealing it before the United States and for many of the same reasons). Although there are today neotemperance movements in some Nordic and English-speaking (Great Britain, Canada, Australia, and New Zealand) countries, which focus on the public health dangers of alcohol, these are not prohibitionist groups. Contrary to the claims and worries of the US alcohol industry, there are no neoprohibitionist movements and no serious discussion anywhere about returning to prohibition. In the United States even many local prohibition laws have been replaced by regulation of some kind. Over 50 years after repeal of the Eighteenth Amendment, the consensus remains that alcohol prohibition was not sound public policy.

Alcohol Production and Distribution During Prohibition

In the criminalized context of prohibition, alcohol consumption was influenced by the requirements of illicit production. It was much more profitable and cost effective to make and distribute distilled spirits (gin, vodka, whiskey, or rum) than been Beer is mostly water - only 3 to 6 percent alcohol. Production and storage of beer require enormous tanks, many barrels, and huge trucks and demand a substantial investment in equipment Hard liquor is 40 to 50 percent alcohol; it contains up to 15 times more pure alcohol than beer. I Because alcohol content was the main determinant of price, a gallon of spirits was much more valuable than a gallon of beer and also could be hidden and transported more easily. Furthermore, spirits could be preserved indefinitely, whereas beer spoiled very quickly. Large-scale beer bottling and refrigeration only developed in the 1930s, after repeal (Baron 1962; Kyvig 1979).

The rising supply of hard liquor came from many sources. Tens of thousands of people produced it in small, compact stills in sheds, basements, attics, and in the woods. It was also smuggled from Mexico, Europe, and Canada. Some of the largest names in distilling today entered the business or grew wealthy during the prohibition era - notably the Bronfmans of Canada, who own Seagrams. A considerable amount of alcohol was also diverted from purported industrial or medical uses.

Wine consumption also increased during prohibition, to about 65 percent more than the pre-World War I period, according to Warburton (1932). Standard table wine contains 10 to 14 percent alcohol. Much of the wine was made for personal consumption and as a profitable side business by immigrants from wine countries, especially Italy. After the first few years of prohibition, the California wine-grape industry experienced a boom and vineyard prices increased substantially. California grape growers planted hearty, thick-skinned grapes that could be shipped easily and used for small-scale and home wine making. Much of the California wine-grape crop was shipped to Chicago and New York in newly developed refrigerated boxcars. The grapes were bought right off the train by wholesalers, who resold them in immigrant neighborhoods. The home-made wine was then distributed to smaller cities and towns, where it was sometimes called "dago red" (Muscatine, Amerine, and Thompson 1984).

Although it is true that prohibition provided a major boost for organized crime, it is not true (although widely believed today) that gangsters and large criminal organizations supplied most prohibition-era alcohol. In Chicago and a few other large cities, large criminal gangs indeed dominated alcohol distribution, especially by the end of the 1920s. Most of the alcohol production and distribution, however, was on a smaller scale. In addition to homemade wines and family stills, people took station wagons and trucks to Canada and returned with a load of liquor. Lobster boats, other fishing boats, and pleasure boats did the same. Spirits and wine were also prescribed by physicians and available at pharmacies. Many people certified themselves as ministers and rabbis and distributed large quantities of "sacramental wine." Alcoholic beverages were made and sold to supplement other income during hard times. Prohibition thus shaped the structure of the alcohol industry in a distinctive way: it decentralized and democratized production and distribution (Lyle 1960; Allsop 1961; Sinclair 1965; Everest 1978; Cashman 1981).

Today as well, most people in the illicit drug business are small-scale entrepreneurs. Supporters of the drug war frequently suggest that elimination of the currently large-scale drug producers and distributors would have a lasting effect on drug production and distribution. There is no more evidence supporting this now than there was during alcohol prohibition. Much illicit drug production today is also decentralized and democratized. There is no criminal syndicate that, when eliminated, would stop the distribution of any currently illicit drug, or even reduce the supply for very long. Today some groups, families, and business organizations (like the so-called Medellin cocaine cartel) have grown very rich in the illicit drug business. However, just as Al Capone was quickly replaced, so have new producers taken the place of those cocaine "kingpins" who have been arrested. Indeed, after billions of dollars on interdiction have been spent by Customs, the Drug Enforcement Agency, and even the armed forces, there has been no lasting drop in the supply of cocaine. Even when interdiction does affect the supply of a criminalized substance, the effects are often ironic. The partial success of the Nixon administrations "Operation Intercept," for example, gave rise to what is now a huge domestic marijuana industry (Brechcr 1972), which produces far more potent strains of marijuana and has become ever more decentralized and democratic as armed helicopter raids have increased.

In short, whereas prohibition regimes tend to be a boon to organized crime, they also increase the number and types of people involved in illicit production and distribution (Williams 1989; Murphy, Waldorf, and Reinarman 1991). Whether production occurs in a mob syndicate or a family marijuana patch, the result tends to be a shift toward production and sale of more concentrated forms of intoxicating substances. Re-cognition of such tendencies in the prohibition era accelerated the process of repeal and informed the search for alternative regulatory systems.

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