Drug Policy Options
There are two significant policy choices to deal with drug abuse: Prohibition/Decriminalization or Regulation/Legalization. Shown below are a number of drug policy experts (with the exception of myself) that discuss different approaches to drug policy.
You can also use the Forum to join a discussion on the various policy options. The Wiki is designed for hard core users that wish to participate in developing each policy option with significantly more detail.
Prohibition with Changes
by Robert DuPont, M.D.
American drug policy began as a centerpiece of the Progressive Movement at the end of the 19th century. It was updated with the addition of major investments in treatment, prevention and research during the past four decades. During these years the United States faced the modern drug epidemic—the first time in world history that a nation’s entire population was exposed to a wide variety of addicting drugs by powerful routes of administration, particularly by smoking and intravenous injection.
This still-evolving balanced and restrictive drug abuse prevention policy has enjoyed strong bipartisan support from the past eight U.S. Presidents and by Congress which has been controlled by both parties over this extended period of time. The use of illegal drugs peaked in 1979 when 14% of Americans aged 12 and older used one or more illegal drugs within the past 30 days.i
In 2008, a total of 129 million Americans aged 12 and older (51.6%) had consumed alcohol and 70.0 million Americans (28.4%) had used cigarettes at least once in the past 30 days.ii In comparison, 20.1 million Americans (8.1%) had used one or more illegal drugs. The social costs of alcohol and tobacco each dwarf the total social costs, including the criminal justice costs, of all the illegal drugs combined.
Consideration of the future of American drug policy starts with the recognition that illegal drug use fell nearly 43% between 1979 and 2008 and the recognition that the social costs of all illegal drug use combined are less than the social costs of either alcohol or tobacco alone.
The fact that dozens of illegal drugs (including marijuana, cocaine, methamphetamine, Ecstasy, and heroin) are more biologically attractive than either alcohol or tobacco demonstrates that it is the illegal status of these drugs that limits their use – and their social costs – rather than their biology.iii The relative biological attractiveness of alcohol and tobacco compared to illegal drugs is easily seen in animal experiments. Animals are less likely to use alcohol or tobacco but will use many illegal drugs immediately and in some cases, when animals have free access to drugs, will consume drugs until they are killed by them.
No one is satisfied with the current American drug policies. While the policies developed in the past four decades have succeeded in containing the drug epidemic, they can be substantially improved. Encouraging this improvement is the mission of the non-profit organization, the Institute for Behavior and Health, Inc. (IBH).
A powerful new drug policy idea is to leverage the criminal justice system to reduce the demand for illegal drugs among one of the largest and most problem-generating population of users: the 5 million Americans on probation and parole. HOPE Probation (Hawaii’s Opportunity Probation with Enforcement) offers a model for curbing drug and alcohol use in this high-risk population with intensive monitoring linked to swift and certain – but not severe – sanctions for any use of alcohol or other drugs. This program dramatically reduces drug and alcohol use. It also reduces new crimes and incarceration. A similar model has been developed for the 1.4 million Americans arrested each year for Driving While Intoxicated (DWI). Developed in South Dakota, the 24/7 Sobriety Project also reduces recidivism and incarceration.
While the routine use of long prison sentences is not a cost-effective way to reduce the demand for drugs, to abandon the role of the criminal justice system in drug policy is to lose one of the nation’s best opportunities not only to reduce drug demand but to reduce crime, to promote recovery and to save lives.
Another promising new drug policy is to curb drugged driving, a serious highway safety problem that rivals the better known problem of drunk driving. Any detectable amount of a controlled substance in a driver’s body constitutes a per se violation or drugged driving laws. This standard has been used successfully for 12 million commercial drivers for the past two decades. Use of per se laws linked to widespread drug testing on the nation’s roads and highways will reduce the demand for illegal drugs and significantly improve highway safety.
The nation’s Physician Health Programs (PHP) link active, ongoing drug testing to treatment.iv They have established a new standard for long-term outcomes for substance use disorders. PHPs utilize strategies similar to those used in HOPE Probationv and 24/7 Sobriety.vi This growing body of evidence dealing with dramatically different populations of substance users points the way forward to significant improvements in the nation’s substance abuse treatment system.
The future of American drug policy is not to choose between the status quo or drug legalization. The policy choice today is between maintaining the status quo or an improved policy that builds on the past and current successes to create smarter, well-focused, cost-effective responses. The improved policy would not only reduce the demand for illegal drugs; it also would improve public safety and public health.
For more information on IBH, please visit http://www.ibhinc.org.
i Substance Abuse and Mental Health Services Administration. (1999). National Household Survey on Drug Abuse: Main Findings 1997. (Office of Applied Studies). Retrieved November 30, 2009 from http://www.oas.samhsa.gov/NHSDA/1997Main/toc.htm.
ii Substance Abuse and Mental Health Services Administration. (2009). Results from the 2008 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-36, HHS Publication No. SMA 09-4434). Rockville, MD.
iii DuPont, R. L., Madras, B. K. & Johansson, P. (In Press). Drug policy: A biological science perspective. In J. H. Lowinson & P. Ruiz (Eds.) Substance Abuse: A Comprehensive Textbook (5th ed.). Lippincott Williams & Wilkins.
iv DuPont R. L., McLellan A. T., White W. L., Merlo L., and Gold M. S. (2009). Setting the standard for recovery: Physicians Health Programs evaluation review. Journal for Substance Abuse Treatment, 36(2), 159-171.
v Hawken, A. & Kleiman, M. (2008, July). Research brief: Evaluation of HOPE Probation. Retrieved December 1, 2009 from http://www.pewtrusts.org/uploadedFiles/HOPE_Research_Brief.pdf.
vi Long, L. (2009). The 24/7 Sobriety project. The Public Lawyer (17), 2: 2-5.
Decriminalize all Drugs
By Jim Hilsenteger
It is illegal to sell and use prohibited drugs. Decriminalization is a form of prohibition and typically it is illegal to sell the specified drugs and a civil offense (i.e., a fine) for personal use.
Some of the benefits of Decriminalization of Illicit Drugs are:
- people are not incarcerated for personal use and, therefore, not impacted by the prison experience
- Governments do not pay the cost of imprisoning users
- drug user’s children do not risk losing their parents to incarceration
- the work load of police, lawyers, judges, parole officers is reduced
- the social stigma of using illicit drugs is reduced and encourages users to seek assistance for their addiction problems (see Cato’s Report on Portugal experience with decriminalizing drugs)
Decriminalization does not impact the high profit margins associated with the black market for selling illicit drugs.
Consequently, some of the disadvantages of Decriminalization of Illicit Drugs are:
- no reduction in violence associated with Drug Cartels
- no reduction in crime associated with users trying to find their next drug fix
- no reduction in corruption of government officials by Drug Cartels to ensure their business prospers
- no reduction in social/political unrest in third world countries producing marijuana, cocaine and heroin.
- no reduction in drug dealers motivation to sell to children in schools
Re-Legalize Marijuana, without commercialization
By Mark A. R. Kleiman (see bio)
People whose use of a drug becomes a problem to themselves and others are a minority of all users of any drug (save nicotine in the form of cigarettes) but account for the vast bulk of the volume consumed, and therefore of the revenues of the industry that produces and sells that drug. For example, half of all the alcohol consumed in the U.S. goes to the top 10% of the drinking distribution, which means to people who average at least four drinks per day, year-round.
That fact constitutes a strong argument against the outright commercial legalization of any more drugs, even of cannabis. A licit cannabis industry, like the licit alcohol industry, would be fundamentally in the business of creating and sustaining drug abuse. That new industry will use all of the ingenuity of its marketers and product innovators to create and sustain substance abuse, and use all of the political power it can buy to lower taxes, weaken regulation, and prevent any effective abuse-prevention effort, just as the booze lobby has. (John McCain’s father-in-law made the fortune that allowed him to bankroll McCain’s political start as a beer distributor. Somehow McCain as Chairman of the Senate Commerce Committee never offered any legislation to restrict alcohol marketing. And just in case you think that legalization at least gets organized crime out of the business, Jim Hensley was a convicted felon, having taken the fall to protect Arizona’s Mafia boss.)
But commercial legalization is not the only alternative to prohibition. Why not let cannabis users produce cannabis and give it away, but not sell it? That “grow-your-own” idea runs into two reasonable objections.
First, since not everyone has a green thumb, there would certainly be continued illicit growing for sale. It’s a bad idea to have one more law that is routinely broken and which can be enforced in an arbitrary way. Second, it would be an inconvenience to cannabis-smokers not to have access to professionally-grown material. For example, an open market might lead to labeling various products according to the amounts and ratios of the several different psychoactive chemicals in cannabis. A less potent objection is that if there are no sales there can be no revenue to the government.
Perhaps, then, the “grow-your-own” policy should also allow the formation of consumer-owned co-operatives, limited in size, barred from advertising and from selling other than by mail-order. Each co-op would be required to produce its own material rather than buying it from manufacturers or wholesalers. That system would provide much though not all of the convenience, choice, and potential tax revenue of the alcohol model, without creating another addiction-promotion industry.
Re-Legalize all Drugs
By Retired Narcotics Undercover Officer, Jack A Cole (see bio)
Jack Cole is the founder of Law Enforcement Against Prohibition (LEAP) and has written a very personal and emotional account of the failure of the War on Drugs and the need to repeal Prohibition (See full article). Shown below is a brief summary of Jack’s essay.
The first thing we must do is admit a few things: most of the incidence of death, disease, crime, and addiction, attributed to drug use are actually caused by drug prohibition and that prohibition coupled with the war on drugs has increased the number of people in the US above the age of twelve who have used illegal drugs from 4 million (two percent of the population) in 1965 to 112 million (46 percent of the population) in 2005, while maintaining the percent of the population addicted to drugs at exactly same the level for the past hundred years; 1.3 percent of the population. Once we have acknowledged those facts as the US Conference of Mayors unanimously did in June 2007, we can stop the horrors associated with prohibition by removing the profit motive generated within the drug culture.
Step 1: How do we do that? — simple — we end drug prohibition! We legalize drugs! We legalize all drugs — legalize them so we can regulate and control them and keep them out of the hands of our children.
“Ah…” I hear you saying, “But won’t legalization cause everyone to use drugs? Won’t we become a drugged-out zombie nation within a year?” The answer is NO! Drugs were not illegal in this country until 1914 and we seemed to get through the first 200 years without that occurring.
Step 2: The US government should import or produce the drugs and control them for quality, potency, and standardized measurement.
This policy would virtually end drug overdoses. Those deaths don’t have to happen any more than the deaths attributed to “bathtub gin” during alcohol prohibition had to happen. These deaths are a result of drug prohibition not drug pharmacology. Consumers of bathtub gin and consumers of today’s hard drugs don’t overdose because they take more and more of the substance but because they don’t know how much drug is mixed with cutting-agent in the concoction. Too much drug and you are dead. It is impossible in the illegal market to know what is in the packages being sold on the street. Legalization and regulation of drugs can stop the carnage. And if we can keep from overdosing, those people who feel they must continue to use drugs, perhaps we can wean them off their addictions. And folks, these are our children. They are our parents; our sisters and brothers. We should be trying to help them by bringing them back into our society as productive citizens, not by burying them in prisons years before they should have died.
Step 3: There are many possibilities for how drugs may be distributed once they are make legal. They could be sold in package stores such as those selling alcohol in some states; stores with no advertising, where drugs are sold only to adults, and highly taxed.
Hard drugs might be distributed via prescription by doctors.
My personal favorite would be to set up clinics where maintenance doses of drugs could be distributed on a sliding monetary scale to any adult requesting them (including free to those users with no money). This is the most important point, the one that actually removes the profit motive from drug dealers. This sounds radical but it really isn’t. We have been giving drugs to addicted people for over 25 years, in what is called the methadone maintenance programs.
Methadone helps some heroin users stop using that drug. The trouble with the methadone maintenance programs is that methadone is about ten times more potent than heroin and about ten times more addictive than heroin. There is a reason we call it “methadone maintenance.” For the most part, those who start it will be maintained on it forever. Those problems are avoided by treating heroin addiction with heroin. Canada’s British Columbia Medical Health Officer Perry Kendall asserts, “Heroin, if it’s used on a maintenance basis, in pharmacological doses without any risk of overdose or contamination, is actually a very safe drug.” The North American Opiate Medication Initiative, known as NAOMI, recently started offering hundreds of heroin addicts “haunting the slums of Vancouver and Montreal the chance to join a research study that provides free heroin.”
Can giving free drugs to addicted people help end those addictions? The answer is YES! In Switzerland, Holland, Germany, and Denmark heroin users have been treated by giving them heroin. The country with the longest record (14 years) is Switzerland. In 1994 the Swiss decided they were tired of treating their children as criminals because they made the mistake of using heroin. They decided to treat heroin use as health problem. Switzerland set up 23 clinics around the country where users were allowed to come in and inject government heroin up to three times a day, with clean needles, under medical supervision. But there are also social workers there, educators and job specialists, trying to wean their clients off heroin. They saw the heroin users three times every day of the year and they quickly became trusted friends. We know how much power a friend has in modifying someone’s behavior — certainly a lot more than a judge has when ordering that person to rehabilitation. With the heroin-assisted programs, they also offer drug substitution programs, such as methadone and buprenorphine.
The outcomes of those policies are nothing short of amazing. In Switzerland, thanks to the quality-controlled drug production, there hasn’t been an overdose death related to this project since in 15 years. Because heroin users are now “fixing” with clean needles Switzerland and The Netherlands registers the lowest per capita rate of AIDS and Hepatitis of any country in Europe. Cocaine use among those heroin addicts has also plummeted from 35 to 5 percent. Crime was slashed by 60 percent. The heroin is provided on a sliding monetary scale but if a user has no money the drug is free. That means users don’t have to prostitute themselves or steal goods to pay for their drugs. If these clinics were available to everyone there would be no heroin dealers on the streets because you can’t beat free; who would buy from a street dealer? That means drug dealers would no longer be shooting each other to protect their turf, no longer killing cops charged with fighting this useless war, no longer killing children caught in crossfire or drive-by shootings. And even more important, if drug dealers are not on the streets they are no longer enticing young novices to start using heroin. On June 2, 2006 the prestigious medical journal, “Lancet,” released a report on the Swiss project stating that over the past ten years Zurich has “seen an 82 per cent decline in new users of heroin.”
This tremendous decrease in incidence of expected new heroin users was masked by “a stable prevalence rate” of current users, which up till now no one bothered to look beyond.
When addicted people wake up in the morning they have only one thought, “Where will I get my fix?” If they know where they might score, the next thought is, “How do I pay for it?” And if they also have money for the drugs then their next thoughts are, “When I go down there is the dealer going to sell me talcum powder and cheat me out of my money? Is he going to beat me up, steal my money and my drugs?” Or worse, “Is he going to sell me a ‘hot-shot’ and end my life?”
Because of these thoughts the addicted person’s life is in constant chaos every waking hour. But in Switzerland and the Netherlands, because of these harm reduction programs the addicts were able to stabilize their lives. They are no longer treated as criminals but as people with health problems. Health problems can be solved. Homelessness among the addicts fell from 12 percent to zero and fulltime employment more than doubled to 42 percent of participants. Many participants quit using free government heroin.
Why would they do that? At LEAP we maintain it was because they got their lives back — they once again had hope for the future.
That is the answer to America’s drug problem. Give people hope for the future and they will leave drugs behind. In recent years similar programs to those of Switzerland and Holland have been initiated by Belgium, Canada, Denmark, England, Germany, and Spain.
So what are the outcomes of free governmental distribution?
- No profit motive for drug distribution
- No individuals selling drugs anywhere
- Less people begin using drugs
- No crimes committed to obtain drugs
- No criminal association for drug users
- No diseases passed by sharing needles
- Users able to stabilize their addictions and get on with their lives
- No shootings of drug dealers by other drug dealers
- No kids caught in crossfire
- No police killed fighting drug war
- No one killed by police in the drug war
- No advertisements to aggrandize or romanticize drug use
- Nobody will solicit one more drug user for any reason!
- And no terrorists will make any money from illicit drug sales.
Step 4: Take a portion of the billions of dollars we save each year thanks to ending drug prohibition and redirect it. According to a Harvard University study by Economist Jeffrey Miron, which was released in December 2008 the United States Treasury would realize an additional 76.8 billon dollars every year if we legalize, regulate and tax today’s illicit drugs. We should use that money to first create programs that offer hope for the future. In the more than 35 years I have worked in this field I have found that addicted people tend to have one thing in common — they have very little or absolutely no hope for the future. Give them hope and the vast majority will leave their addictions behind them.
There is little difference between alcohol prohibition and drug prohibition but what difference exists made things better under alcohol prohibition. For instance with alcohol prohibition we didn’t arrest users, only sellers and distributors. The drive to arrest drug-users came with the Reagan Administration. So now, we enforce a policy that says we have to arrest our children in order to save them.
When will we ever learn? This is a picture taken in Boston, in front of Copley Plaza during 1932, one year before that nasty law fell. It’s a picture of those folks who were probably the most responsible for ending that sad stain on American history; members of the Women’s Organization for National Prohibition Reform. Why would women want to end alcohol prohibition? They wrote their reason right on the side of their car. “SAVE OUR CHILDREN! — STAMP OUT PROHIBITION!”
That is all we are saying at LEAP, “Save our children — stamp out prohibition!”
Re-Legalize all Drugs
By Jeffrey Miron (see bio)
What government policy can single-handedly lower the crime rate, reduce the spread of AIDS, ameliorate race relations, enhance respect for the law, and shrink the deficit?
Answer: the re-legalization of all currently illegal drugs.
This is not to say legalization would eliminate all drug-related problems; no policy can do that. But legalization would have clear and substantial benefits, with little increase in the problems related to drug use itself.
The foundation of the case for legalization is the indisputable yet oft-ignored fact that drug prohibition does not eliminate drug markets or drug use; instead, it moves them underground. Drug prohibition does raise some costs of supplying drugs, and it likely reduces demand by some consumers, implying reduced total consumption of drugs under prohibition as compared to a legal market. But substantial drug consumption persists even in the most repressive prohibition regimes known, and this means prohibition has enormous adverse consequences.
Perhaps the most important negative of prohibition is increased crime. While it is incontrovertible that many criminals consume drugs, this fact in no way demonstrates that drug use causes crime. Instead the available evidence suggests that drug prohibition causes most “drug-related” crime. Prohibition prevents buyers and sellers of drugs from using the criminal justice system to resolve disputes, so these persons use violence instead. Prohibition diverts criminal justice resources from the deterrence of non-drug crime, as when non-drug offenders are released early to ease drug-war-induced prison over-crowding. And prohibition facilitates the corruption of police, judges, and politicians, partly because huge profits are at stake, partly because the legal channels of influence are not available to black market suppliers.
Prohibition also means diminished health for drug users and even some non-users. In a black market, drug users face heightened uncertainty about the quality and purity of the drugs they purchase, plus an incentive to consume drugs using techniques, like injection, that are unhealthy but give the biggest bang for the buck. These characteristics of illegal markets lead to accidental poisonings and overdoses, plus the sharing of contaminated needles and increased transmission of AIDS. In a legal drug market, inadvertent overdoses and accidental poisonings would be rare. Moreover, aided by lower drug prices and the legal sale of syringes, more users would practice safe means of administration, obviating the question of whether governments should fund programs like needle exchange.
A still further harm of prohibition is heightened racial tension. In any society, the underground sector attracts especially those persons who believe their chances of advancement in the legal sector are limited by racism, poor schooling, and the like. In the United States, this means that black and certain immigrant groups have participated disproportionately in the drug trade, not because they are more likely to use drugs nor because they are inherently less law-abiding, but simply because it has been rational for them to do so. But this over-representation of blacks and immigrants in the drug trade tends to validate negative stereotypes, and it means police, even if non-racist, enforce prohibition especially against these groups. This fuels perceptions of selective enforcement and exacerbates racial animosity.
Another intangible but critical consequence of drug prohibition is diminished respect for the law. Under prohibition, millions of citizens sell and use drugs with relative impunity, while the rest of society bears witness. Everyone, therefore, learns that laws are for suckers: those who obey pay the penalties, while those who evade usually get what they want. Everyone is thus encouraged to violate other laws or social norms, whenever it is convenient to do so. This “disrespect for the law” destroys free society, since governments cannot maintain order and civility without widespread, voluntary compliance with the law.
On top of all these deleterious effects, using prohibition to deter consumption means society cannot levy sin taxes on sales of drugs or collect income taxes from those working in the drug trade. This means suppliers and drug users – persons who knowingly break society’s rules – gain at the expense of taxpayers generally, rather than contributing their fair share. Of course, sin taxes on drugs must be moderate, or they will themselves generate a black market and all the attendant undesirable consequences.
Substitution of a moderate sin tax for prohibition thus turns drug profits into tax revenues while simultaneously reaping diverse additional benefits for society. And the costs of enforcing a moderate sin tax are likely small in comparison to the costs of enforcing prohibition: most of the necessary apparatus already exists for the collection of alcohol and cigarette taxes, and voluntary complaince with a sin tax is far less costly to drug users than the complete abstinence required under prohibition. The beneficial tax and expenditure effects of legalization explain why this policy is preferable to decriminalization – under which small scale possession and purchase are permitted but production and sale are outlawed – since decriminalization by itself does little to convert the untaxed, black market into a legal, taxable one.
Of course, the enormous evils of prohibition might be tolerable if prohibition were highly effective in reducing the harms caused directly by drug consumption. But prohibition appears to reduce drug use mainly among casual users, whose consumption imposes little cost on society, while failing to deter drug use by more determined users, whose consumption accounts for the lion’s share and is more likely to harms users and others. Indeed, the forbidden fruit allure that prohibition creates might encourage consumption by certain groups, such as teenagers, who are particularly vulnerable to drugs’ negative consequences. The critical question is therefore to what extent prohibition reduces abusive kinds of drug consumption, and the answer, according to theory and abundant evidence, is not much.
The case for legalization of drug is thus overwhelming. This conclusion does not presume legalization would be accompanied by increased government funding for drug treatment, or even that existing funding must continue; the desirability of subsidized drug treatment is a logically separate issue, which requires its own analysis. Nor do the arguments above imply that full legalization is the only policy change that would be beneficial; certain partial steps toward legalization – imposing fewer restrictions on medicinal provision of drugs, or legalizing marijuana only, for example – would shrink the black market and thus produce substantial benefits. But dispassionate analysis of the evidence leaves little doubt regarding the folly of current policy, and it suggest just as clearly the appropriate direction for change.
