Assembling a Drug Policy

(Mr. Nadelmann is director of the Lindesmith Center,a drug policy research institute in New York, and the author of "Cops Across Borders: The Internationalization of U.S. Criminal Law Enforcement." Supporting documentation for this article is available on line at (http://www.lindesmith.org). Reprinted in the Orange County Register with permission from Foreign Affairs magazine.)

In 1988 Congress passed a resolution proclaiming its goal of "a drug free America by 1995." U.S. drug policy has failed persistently over the decades because it has preferred such rhetoric to reality, and moralism to pragmatism. Politicians confess their youthful indiscretions, then call for tougher drug laws. Drug-control officials make assertions with no basis in fact or science. Police officers, generals, politicians and guardians of public morals qualify as drug czars - but not, to date, a single doctor or public health figure.

Independent commissions are appointed to evaluate drug policies, only to see their recommendation ignored as politically risky. And drug policies are designed, implemented and enforced with virtually no input from the millions of Americans they affect most: drug users.

Drug abuse is a serious problem, both for individual citizens and society at large, but the "war on drugs" has made matters worse, not better. Drug warriors often point to the 1980s as a time use be teenagers peaked around 1980, then fell more than 50 percent over the next 12 years.

During the 1996 presidential campaign, Republican challenger Bob Dole made much of the recent rise in teenagers' use of illicit drugs, contrasting it with the sharp drop during the Reagan and Bush administrations. President Clinton's response was tepid, in part because he accepted the notion the teen drug use is the principal measure of drug policy's success or failure. At best, he could point out that the level was still half what it had been in 1980.

In 1980, however, no one had ever heard of the cheap, smokeable form of cocaine called crack, or drug-related HIV infection or AIDS. By the 1990s, both had reached epidemic proportions in American cities, largely driven by prohibitionist economics and morals indifferent to the human consequences of the drug war.

In 1980, the federal budget for drug control was about $1 billion, and state and local budgets were perhaps two or three times that. On any day in 1980, approximately 50,000 people were behind bars for violating a drug law. By 1997, the number had increased eightfold, to about 400,000. These are the results of a drug policy overreliant on criminal justice "solutions," ideologically wedded to abstinence-only treatment and insulated from cost-benefit analysis.

Imagine instead a policy that focuses on reducing not illicit drug use per se but the crime and misery caused by both drug abuse and prohibitionist policies.

And imagine a drug policy based not on the fear, prejudice and ignorance that drive America's current approach but rather on common sense, science, public health concerns and human right, Such a policy is possible in the United States, especially if Americans are willing to learn from the experiences of other countries where such policies are emerging.

Americans are not averse to looking abroad for solutions to the nation's drug problems. Unfortunately, they have been looking in the wrong places: Asia and Latin America, where much of the world's heroin and cocaine originates.

Decades of U.S. efforts to keep drugs from being produced abroad and exported to American markets have failed. Illicit drug production is bigger business than ever before. The opium poppy, source of morphine and heroin, and cannabis sativa, from which marijuana and hashish are prepared, grow readily around the world. The coca plant, from whose leaves cocaine is extracted, can be cultivated far from its native environment in the Andes.

Crop-substitution programs designed to persuade Third World peasants to grow legal crops cannot compete with the profits that drug prohibition makes inevitable. Crop-eradication campaigns occasionally reduce production in one country, but new suppliers pop up elsewhere.

International law-enforcement efforts can disrupt drug trafficking organizations and routes, but they rarely have much impact on U.S. drug markets.

Even if foreign supplies could be cut off, the drug-abuse problem in the United States would scacely abate. Most of America's drug-related problems are associated with domestically produced alcohol and tobacco. Much if not most of the marijuana, amphetamine, hallucinogens and illicitly diverted pharmaceutical drugs consumed in the country are made in the U.S.A.

The same is true of the glue, gasoline and other solvents used by kids too young or too poor to obtain other psychoactive substances. No doubt such drugs, as well as new products, would quickly substitute for heroin and cocaine if the flow from abroad dried up.

While looking to Latin America and Asia for supply-reduction solutions to America's drug problems is futile, the harm-reduction approaches spreading throughout Europe and Australia and even into corners of North America show promise.

These approaches start by acknowledging that supply-reduction initiatives are inherently limited, that criminal justice responses can be costly and counterproductive and that single-minded pursuit of a "drug-free society" is dangerously quixotic.

Demand-reduction efforts to prevent abuse among children and adults are important, but so are harm-reduction efforts to lessen the damage to those unable or unwilling to stop using drugs immediately, and to those around them.

Most proponents of harm reduction do not favor legalization. They see legalization as politically unwise and as risking increased drug use. The challenge is thus making prohibition work better, but with a focus on reducing the negative consequences of drug use and prohibitionist policies.

Countries that have turned to harm-reduction strategies for help in alleviating their drug woes are not so different from the United States. Drugs, crime and race problems, and other socioeconomic problems are inextricably linked.

As in America, crinimal-justice authorities still prosecute and imprison major drug traffickers as well as petty dealers who create public nuisances. Parents worry that their children might get involved with drugs. Politicians remain fond of drug-war rhetoric.

But by contrast with U.S. drug policy, public-health goals have priority, and public-health authorities have substantial influence. Doctors have far more latitude in treating addiction and associated problems.

Police view the sale and use of illicit drugs as similar to prostitution - vice activities that cannot be stamped out but can be effectively regulated. Moralists focus less on any inherent evils of drugs than on the need to deal with drug use and addiction pragmatically and humanely. And more politicians dare to speak out in favor of alter natives to punitive prohibitionist policies.

Harm-reduction innovations include: Efforts to stem the spread of HIV by making sterile syrings readily available and collecting used syringes; Allowing doctors to prescribe oral methadone for heroin addiction treatment, as well as heroin and other drugs for addicts who would otherwise buy them on the black market; Establishing "safe injection rooms" so addicts do not congregate in public places or "shooting galleries;" Employing drug analysis units at the large dance parties called raves to test the quality and potency of MDMA, known as Ectasy, and other drugs that patrons buy and consume there; Decriminalizing (but not legalizing) possession and retail sale of cannabis and, in some cases, possession of small amounts of "hard" drugs; and integrating harm-reduction policies and principles into community policies and principles into community policing strategies.

Some of these measures are under way or under consideration in parts of the United States, but rarely to the extent found in growing numbers of foreign countries.

Moral of the story: America, wise up!