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From: harelb@math.cornell.edu (misc.activism.progressive co-moderator)
Subject: DRUG POLICY & PROGRAM (_Z Papers_)
=========================================
_Z Papers_, 1992, Vol 1, No 1
=========================================
S T E P H E N R . S H A L O M
* * *
D R U G P O L I C Y & P R O G R A M
=========================================
Transcribed by Joseph Woodard <jhwood1@srv.PacBell.COM>
First I describe what the basic principles of a drug policy might be
like in a good society. Then I offer a program on drugs for the left
to pursue today, one that attempts to be consistent with these
principles, though constrained by current realities. The utopian
vision is not without its uncertainties, but in some respects it is
less tentative than the programmatic section, a reflection of the fact
that the drug problem, like many other problems, may not be solvable
under our present system.
=================================================
D r u g s I n T h e G o o d S o c i e t y
=================================================
In a good society, many of the most important factors that promote
drug abuse in the United States today would not be present.
Crack addiction in particular is notoriously a product of the
desperation of our inner cities: homelessness, worsening poverty, and
continuing racism. To those whose prospects for getting a job are 80
dismal and whose adult life expectancy in the richest country on earth
is below that in Bangladesh, the use of crack or heroin or PCP has a
certain appeal. Family disintegration also breeds drug abuse, and
though family problems have many sources, the current Depression-level
economic conditions in urban America are surely a major cause.
Another factor that encourages drug abuse among people of all income
levels is alienation. A society that merely provided for its citizens'
economic well-being could still be abysmally alienating. Being forced
to defer to the whims of bosses or an all-knowing Central Committee,
to perform mindless work, or to adhere to narrow cultural norms: these
generate alienation. A good society would have to give people
substantial control over their lives, opportunities to engage in
creative work, and diverse cultural options. In a society that did
these things, the temptations of drug abuse would be minimal.
This is not to say that no one would be unhappy. There will always be
unrequited love, frustrated personal goals, illness, and death. But
the number of depressed people in a decent society would be far less
than today, and humane mental health services would be available to
help deal with the problems. Those few individuals who, nonetheless,
became drug abusers would be an even smaller number, easily dealt with
by the public health system, not the criminal justice system.
Drug addiction in the United States is also driven by the capitalist
profit motive. Corporations pushing the drug with the most serious
public health consequences -- tobacco, responsible each year for
nearly 400,000 deaths -- spend $1 billion a year on direct advertising
and more than $2 billion on other promotions. Cigarette company
executives maintain that advertising only gets smokers to switch
brands, with no effect on total sales. But, as the former chairperson
of advertising giant McCann-Erickson commented:
This is complete and utter nonsense. The industry knows it is
nonsense. I am always amused by the suggestion that advertising, a
function that has been shown to increase consumption of virtually
every other product, somehow miraculously fails to work for tobacco
products.
Alcohol, the drug with the second highest death toll (about 100,000 a
year), is likewise massively advertised, particularly to young people.
In a good society where private interests did not benefit from drug
addiction, no effort would be made to glamorize nicotine and alcohol.
To be sure, a non-capitalist bureaucracy might have an interest in
pushing drugs on its own population (to pacify them or to extract
money from them), but a democratically-organized non-capitalist
society would have no interest in encouraging its young people to
stupefy or kill themselves.
Some drug addiction may have a biochemical basis: alcoholism, in
particular, is suspected of having a genetic component. In the United
States today, someone who might have such a predisposition but yet who
would like an occasional high or convivial entertainment has no legal
options. The choices are either to forego these pleasures entirely or
risk the very real and very serious dangers of alcoholism. If this
person used marijuana for the occasional high, there would be clear
benefits to the individual (and to society in terms of less chronic
illness, less violence, and 80 on). A society that provided drug
options would have fewer cases of biologically caused addiction.
In the contemporary United States there is a strong component of our
culture that opposes pleasure. We can see this particularly in many
existing sex education programs that emphasize abstinence. Abstinence,
it is said, is the only way to be safe from AIDS, pregnancy, and other
dangers. But if these health concerns were the real motive, rather
than hostility to pleasure, why not teach students how to masturbate?
Likewise, there are real dangers to drugs.
Some are inherently harmful, some are harmful only if misused or
abused. A good society would warn people about the first category and
educate people how to properly use those in the second. Pleasure is
good.
Yes, drug highs are artificial. But aside from sex and listening to
whale songs, watching the sunset, and eating alfalfa sprouts, most
pleasures are artificial. Reading a cheap novel or watching a movie --
these aren't real, they are escapes from reality and they are
pleasurable. If someone spent all day at the movies, seven days a
week, this would be a problem. Aside from the fact that the individual
would be unable to perform his or her fair share of work, this sort of
movie obsession would preclude experiencing other sorts of pleasures.
But there is nothing wrong with going to an occasional film,
artificial though it may be; in fact denying oneself any such
pleasures (that is, being a workaholic) may itself be harmful.
Drug-induced pleasures are no different.
Although marijuana is a far more benign substance than alcohol and
nicotine, it is not without its dangers (smoking it, for example, is
bad for the lungs). In a good society, a society committed to
furthering pleasurable opportunities for its citizens, research would
continually be done on finding safer drugs and safer ways of using
them.
At the same time that American culture displays a hostility to
pleasure, there is the contradictory value of pleasing oneself
regardless of the social consequences. Indeed, this is in some sense
the fundamental value of capitalism: capitalism works only if most
people are thoroughly self-regarding, oblivious to the suffering their
actions may cause to others. In a good society people will not be
saints, but the thrust of decent economic and political systems would
be to make us take account of others, to see that our fates are
intertwined, that if our neighbor suffers, we will be hurt too.
Education in the contemporary United States aimed at convincing people
that they should be socially responsible in their sexual and
drug-taking activities is hindered by the fact that such
responsibility runs counter to the prevailing ethic of selfishness
(and sexism) reinforced in all other spheres of life. Being told not
to drink and drive by the likes of George Bush or drug czars William
Bennett and Bob Martinez is not likely to be very compelling. On the
other hand, a society that tries to promote socially responsible
behavior in all realms will have a much better chance of discouraging
anti-social drug behavior.
Would all drugs be legal in a good society? To ban a drug because it
might be misused seems as foolish as banning baseball bats because
they might. We do ban chain saws without safety guards because the
social benefit of unguarded chain saws is negligible while the risks
of accident are high We need, then, to weigh the potential benefits of
the drug against the likelihood of misuse. It would make sense to ban
drugs that uncontrollably or unpredictably led to anti-social
behavior. Alcohol can (and does) lead to violence, but most drinkers
can regulate their intake to avoid violent behavior. Hypothetically,
there might be a drug that leads to violent behavior whose intake
cannot be regulated because its effects are random or incompletely
understood. (PCP is apparently such a drug.) Drugs that cause direct
social harm should be illegal.
What if the high provided by such a drug were so exquisite that people
wanted to use it despite the harmful social consequences? Perhaps we
could set up rubber rooms for people who wanted to go berserk for a
few hours. Otherwise we should have no more problem with outlawing
the drug than we would with outlawing rape or other socially harmful
activities that may give pleasure to some.
What about drugs that are harmful only to the user? In a good society,
for reasons given above (the lack of poverty and alienation, the lack
of glamorizing advertisements, the availability of safer
alternatives), the number of people who would want to use such drugs
would not be large. But there might be some, and they ought to be
legally allowed to do so. Public health education ought to discourage
such use (just as we try to discourage the eating of foods high in
cholesterol) and every support service ought to be available to help
people break their habit (as they are not available today). But
ultimately if some enjoy the activity enough despite the harm it may
cause, they should be as free to pursue it as they are to skydive.
The distinction between things that harm only the user and those that
hurt society is a standard distinction in political theory. The rise
of the welfare state, however, has made the distinction somewhat
unclear. Since tax money pays for the health care of the very poor, it
can be argued that anything the poor do to their own health affects
all of society. On one level, this claim is correct, and many (if not
all) things that are said to be simply private decisions in fact have
social consequences. But should this give society a say in those
"private" decisions? In a society with a socialist economy, everything
anyone does will have social implications, but we will have to be
careful not to allow this to become the basis for authorizing society
to dominate everyone's private life. A good society ought to value
diversity, and this means that people will have to be allowed to
choose to do what others, even a majority, judge to be inadvisable.
The relative roles of the individual and society in making decisions
ought to be proportional to the consequences of the decision on each
Thus, even though my eating habits may have a social impact (in terms
of my ultimate health care costs or my work productivity) they affect
me far more and the decisions ought to be essentially mine. Society
ought to provide information on the repercussions of my actions on
myself and on society, and sometimes ought to urge one particular
behavior rather than another, but ultimately I must have the right to
decide. In some situations society might ban particular uses of a drug
that have a substantial social impact (say, smoking cigarettes in a
restaurant) while discouraging but permitting private use.
Under these principles, marijuana, heroin and other opiates,
hallucinogens, nicotine, alcohol, and possibly cocaine would be legal.
Only those drugs which caused direct social harm (probably PCP,
possibly crack, among others) would be banned. Of the legal drugs,
those that could not be used safely (cigarettes and, when serious
studies are undertaken, maybe others) would be strongly discouraged,
with support to help end addiction. For those that could be used
safely, education would emphasize how to do so.
Two complex issues remain to be considered. What about taking drugs
during pregnancy: is this a private or a public matter? And what about
children: should most drugs be legal for them as well?
On the first matter, it is crucial to keep in mind that mothers want
to have healthy babies. The reasons why a pregnant woman might,
nevertheless, continue taking drugs that are harmful to her fetus are
some combination of ignorance and addiction. In the U.S. today, where
so many women are without adequate prenatal care, ignorance is
widespread. In addition, war on drugs rhetoric makes many people
skeptical of government-provided health advice. Presumably, these
would not be problems in a decent society. In the case of addiction,
most women are enough in control to realize that they need treatment
for the sake of their babies. In the U.S., however, (to quote from a
study by the U.S. General Accounting Office) "demand for drug
treatment uniquely designed for pregnant women exceeds supply." The
"lack of adequate treatment capacity and appropriate services is the
primary barrier to treatment for many women." Women reported waiting
as long as a month to get into treatment, which means an additional
month of harm to the fetus. This too, one would hope, would not be a
problem in a decent society.
Might there be a woman in a good society, neither addicted nor
ignorant, but just so into pleasure that she values her high over the
health of her fetus? If so, it is hard to imagine that she wouldn't
have gotten an abortion given that motherhood is likely to interfere
with her pleasure for far more than nine months.
In any event, if one is concerned about the health of the baby (as one
ought to be), it is clear that the criminal justice system is not the
appropriate mechanism for dealing with the problem. To quote the GAO
again: "Criminal prosecution of women with drug-exposed infants, while
rare, has occurred, and has created fear of prosecution among pregnant
women, discouraging them from seeking treatment."
Children and drugs is a more complicated issue. Some distinctions
between adults and children are not based solely on adult hypocrisy: a
mind-altering substance has more deleterious effects on someone still
trying to establish her or his identity than on an adult; likewise,
adolescents' view of their own invulnerability makes them less
well-suited to judging the pros and cons of an action with long-term
consequences (which is why many societies have found that teenagers
make such good cannon fodder). These characteristics are probably
natural developmental traits of adolescents, rather than a product of
growing up in an alienating society, though one can't be sure. On the
other hand, as cigarette advertisers have long been aware, the surest
way to encourage kids to do something is to tell them that they can't,
while adults can. In 1975, a marketing research report prepared for
the tobacco giant Brown & Williamson gave this advice on reaching
young smokers: "Present the cigarette as one of a few initiations into
the adult world...part of the illicit pleasure category of products
and activities." A reasonable policy might be to prohibit children
from taking drugs that are rarely used, since without the constant
example of adult usage (and without advertising) there wouldn't be
much temptation to break the law. For frequently used drugs (say
alcohol or marijuana) it probably makes more sense to permit their use
while working to establish strong cultural norms on what are
appropriate use levels at different ages. This may seem a utopian
solution, but given that 85 percent of high school students use
alcohol illegally, prohibition obviously has its drawbacks as well.
=====================================
A P r o g r a m F o r T o d a y
=====================================
In some respects drugs are a side issue in America today. No drug
policy, no matter how ingenious, is likely to be effective as long as
the government refuses to attend to the urgent social agenda. Studies
report that most drug treatment programs, for example, have a very low
success rate, but that the best predictor of treatment success is
whether the addict has a job.
This shouldn't be surprising. If people are driven to abuse drugs by
the hopelessness of their lives, a treatment program that returns
addicts to the same hopeless life isn't going to work. On the other
hand, if American society were to funnel massive resources into
serving human needs, the drug problem would become much less serious
almost regardless of the particular drug policy followed. So why does
drug policy matter?
It matters because the current war on drugs makes the prospects for
addressing the social agenda even more remote.
*** The war on drugs diverts us from the real problems. Much of the
$10 billion a year in direct drug war costs have not been added to the
budget, but taken out of other programs: immigrant assistance, the
Economic Development administration, public housing subsidies, and
juvenile justice.
*** The drug war strengthens those institutions in American society
most antithetical to the necessary social agenda -- the police, the
prisons, the military, and organized crime. Government funds have
poured into the first two, and expected cuts in the defense budget
have been slowed using the rationale of the drug war. According to the
Presidential Commission on Organized Crime, the drug trade is the
mob's main source of revenue. "There's no question," declared a U.S.
lawyer for the Medellin drug cartel, "the U.S. crackdown is good for
business."
*** The drug war forces addicts to support their habits by crimes that
make the cities more dangerous and less livable. Businesses that might
provide jobs and investment, and dedicated teachers and residents with
skills that might have contributed to the community, have been
frightened away.
*** The drug war puts the blame for the nation's ills on the poor and
people of color, reducing still further society's concern for their
plight.
*** The drug war furthers the spread of AIDS, which is currently
decimating inner cities. Clean needle exchanges could help even while
drugs remain illegal, but criminalization keeps addicts from health
services and forces many into prostitution, both of which spread HIV
infection.
*** The drug war condemns to the wasteland of jail or the asocial
morass of drug trafficking a whole generation of young people who
might help the country reorder its priorities. It is estimated that in
Washington, DC, one quarter of the black male population will be
involved with drug selling before their 30th birthdays.
If the war on drugs could work -- that is, if it could succeed in
ridding the country of the scourge of drug abuse -- some might argue
that despite its excesses and overblown rhetoric it deserves our
support. Some go even further and suggest that we haven't really tried
serious repression yet as a solution to the drug problem. But
widespread use of the death penalty has failed to stop drug abuse in
Malaysia or Khomeini's Iran. The strictest narcotics legislation in
the United States was the Rockefeller Drug Law of the early 19708,
with high mandatory minimum sentences, including life imprisonment for
selling or possessing more than a fraction of an ounce of heroin, even
for 16-year-olds. As one study summarized the results:
So far as we can tell, it caused essentially no decrease in
heroin activity, but did lead to a drop in the number of
heroin offenders arrested and convicted, a considerable
increase in the court and correctional resources necessary to
process those apprehended, and a significant increase in the
overcrowding of the state's prison system.
The current level of drug repression in the United States has overwhelmed
the criminal justice system. What the American Bar Association called
"extraordinary" efforts to arrest and prosecute drug offenders have not
controlled the drug problem, but have overburdened the police, the courts,
the prisons, and the probation system. Three-quarters of a million people
are arrested each year on drug charges, the majority of them solely for
possession, usually of marijuana. In Florida under former Governor and now
drug czar Bob Martinez, a tough drug law with mandatory minimum sentences
forced the state to release murderers from prison early to make room for
the drug offenders. With an incarceration rate second only to South Africa
in the industrialized world, the U.S. has not reduced its drug problem, and
indeed the prison system itself is swimming in illicit drugs.
Going after the small time drug dealers and users not only overwhelms the
criminal justice system, it encourages rampant police corruption and
infringements upon civil liberties. Since drug dealing is a crime with no
complainant, the discretion of individual police officers determines
whether an arrest is made, a situation that breeds bribery and extortion.
Additionally, the lack of a complainant means that police need to use
undercover operations, informers, and intrusive surveillance, all of which
are readily abused. The alternative strategy -- that of just going after
Mr. Big -- is equally futile. Mr. Big (it's never Ms. Big) is in fact
easily replaced, and oftentimes it is his replacement who supplies police
with the evidence. Given the job prospects in the inner cities, the
conviction of a drug dealer, rather than serving as a deterrent, is like an
advertisement for a replacement.
Nor are the prospects for the drug war any more promising on the borders or
in foreign countries where illicit drugs are grown and processed -- even if
we ignore the U.S. complicity in the drug trade when it served Washington's
larger political agenda in Indochina, Central America, or elsewhere.
Almost every U.S. official who has thought about the problem at all
has concluded that it is impossible to interdict drugs crossing the
U.S. border. The U.S. coastline is 90,000 miles long, and 600
vessels, 700 private aircraft, 1,200 commercial flights, 20,000
containers, 25,000 motor vehicles, and 800,000 people enter the
country each day. As the Bush administration acknowledged, though
without drawing the obvious conclusion:
"Every time we disrupt or close a particular trafficking route, we
have found that traffickers resort to other smuggling tactics that
are even more difficult to detect."
A Pentagon-sponsored study of the prospects for more effective
interdiction concluded that "interdiction probably cannot much further
reduce the availability of cocaine and marijuana." Marijuana, because
of its greater bulk, i8 easier to stop at the border, but the result
of interdiction efforts has been to stimulate domestic cultivation of
marijuana (one-quarter is now homegrown), while encouraging many
smugglers to turn to cocaine, which is more easily concealed and
transported.
If the United States is unable to suppress the growing of marijuana
within its own territory, it will have even more difficulty
eradicating the coca plant or opium poppy in Third World countries.
Moreover, even if we were able to totally destroy foreign coca and
opium crops, synthetic drugs, with probably more dangerous side
effects, could easily be produced in clandestine U.S. laboratories. In
short, repression -- whether at home or abroad -- cannot solve the
drug problem.
One fundamental flaw in current drug policy is that it denies the
distinction between drug use and drug abuse. But the distinction is
real. Evidence shows that a majority of heroin users are not addicts,
and that occasional users are able to take it for pleasure with few
negative side effects. Crack has been portrayed in the media as
instantly addictive. ("Using it even once can make a person crave
cocaine for as long as they live," Peter Jennings exclaimed on "World
News Tonight.") In fact, it takes a few months of smoking crack to
become addicted. The official guess is that 20 to 25 percent of
cocaine users will become chronic abusers. This is not to say that
heroin or cocaine are harmless. But occasional use causes negligible
harm to society, and the harm to the individual is generally far less
than that caused by spending time in jail, getting a criminal record,
or losing one's job.
By encouraging the view that the crucial line is between zero use and
use, instead of between use and abuse, current policy is ill-equipped
to confront the real problems. There is, for example, a real problem
with predatory crime, but reducing the number of people who
occasionally use drugs will not affect its incidence at all. By
criminalizing all drug use, social sanctions that might keep moderate
users from abuse are replaced by a criminal milieu which discourages
moderation. Current drug education is inevitably handicapped by the
fact that whatever information is taught, the message ultimately is
zero tolerance. The result is that false information is often taught,
with predictable results. As a Bush administration official
acknowledged: "If the kids find out you're lying, they'll think you're
lying about other things too" (which they are, but not about the fact
that crack is bad for you).
Government officials have spoken optimistically of their progress in
the war on drugs. There are good reasons to doubt their numbers -- the
most accurate data show hard-core cocaine users to be four times as
numerous as the Administration claims -- but even on their own terms,
Administration figures provide no cause for satisfaction. They show
that the number of people who reported using cocaine at least once in
the last year declined nearly 50 percent from 1985 to 1990, but that
those reporting daily cocaine use increased 37 percent. "The first
goal of our strategy," declared William Bennett, "is to reduce the
number of Americans who choose to use drugs." By administration
figures, this first goal was met, yet the problem has gotten worse.
What is the alternative to the current war on drugs? Our first
priority, to repeat, must be to urge the funding of human needs:
providing jobs, education, and health care. But as part of our
program, we must call for the controlled legalization of drugs, at
least of marijuana and the opiates.
Some right-wingers have urged uncontrolled legalization, letting the
free market do what it will. Under this model, drugs would be freely
available and widely advertised, just as cigarettes and alcohol are
now. A humane drug policy can have no illusions about the free market.
Not only must we oppose the free market for currently illegal drugs,
we ought to oppose it for cigarettes and alcohol as well. We ought to
call for an end to all drug advertising and all drug pushing. (The
drug pusher is a myth when it comes to illicit drugs, because the
illegal market is too unstable and the dangers of dealing with
strangers too great for drug sellers to give away free samples. But in
the legal market cigarette companies give out free samples, not to
mention posters and prizes.)
In fact, the only way to really end drug advertising and promoting is
to nationalize the alcohol and tobacco companies. This may seem
extreme as a plank in a program for today, but the record of the
cigarette companies should help us convince our fellow citizens that
such a step is necessary. Cigarette ads invariably feature beautiful
models in order to make smoking more glamorous. Critics appealed to
the companies' social conscience and asked them to stop this practice.
The Tobacco Institute responded, "What do they want us to use for a
model, a hobo wearing a torn raincoat and standing in front of a porno
store? We have a product to sell." When cigarette ads were barred from
TV in the U.S., the tobacco companies started sponsoring sporting
events, thereby getting their brand name displayed on the screen for
hours at a time. In Belgium, when cigarette ads were restricted,
Marlboro advertised its matches and lighters, which just happened to
use the same models, the same cowboy and horse, and the same logo as
its cigarettes.
The problem is not just that ads glamorize harmful substances, but
that the economic clout of the cigarette companies creates strong
incentives for those dependent on advertising revenues not to offend
their sponsors. A 1982 study by the American Council on Science and
Health, for example, found that magazines that ran a lot of cigarette
ads -- among them Cosmopolitan, Mademoiselle, and Ms. -- tended to
underplay the health risks of cigarettes in their articles. Newsweek
even had a cover story on the causes of cancer without a section on
cigarettes. Today, even a cigarette ad ban wouldn't give the media the
courage to tell the truth about smoking, because the tobacco companies
have become diversified: Philip Morris, for example, now owns General
Foods and controls its advertising budget. Thus, a few years ago
Readers Digest (which has always refused cigarette ads) rejected a
supplement by the American Heart Association for fear of offending the
food company advertisers which were owned by tobacco firms.
Bans on cigarette ads have been shown to cut smoking (not so much
among established smokers, but among new smokers). If we nationalize
the tobacco companies, we can prevent them from getting around the
ban, and the smoking reduction should be even greater. This is the
same model that ought to be followed for alcohol and other drugs as
well.
To be sure, governments can and do behave just as irresponsibly as
private firms. Taiwan, for example, calls its government-produced
cigarette "Long-Life." In the U.S., government advertising for
government-run lotteries has probably created more self-destructive
gamblers than the numbers racket ever did. Many states have used the
lottery as a way to balance the budget in lieu of raising taxes,
judging this to be the most politically acceptable way to generate
funds. To prevent this sort of thing, we should demand that the
nationalized drug company be run under the office of the Surgeon
General, with all proceeds earmarked exclusively for treating problems
of drug abuse.
Along with controlled legalization there must be massive funding of
education and treatment programs. This does not exist today. Leaving
aside for the moment the futility of the "Just Say No" approach to
drug education, only one state in fifty has been given enough funds to
deliver what the Bush administration considers an effective drug
education message to all of its students. A majority of states don't
have enough funds to reach even one-third of their students. The
Administration claims that 50 percent of all drug addicts could be
helped by treatment, yet fewer than half of these have received
treatment. New York City, with licensed treatment capacity for 42,000
drug abusers, has an estimated 550,000 addicts. A study by the U.S.
General Accounting Office found that in some of eight cities studied
there were lengthy waiting lists for treatment; in Atlanta the wait
was a year, with many receiving inadequate or even no treatment at
all. In prison, fewer than one out of seven addicts received
treatment; in 1989 alone, 3.6 million criminal drug users were
released without receiving treatment. Only one school system in the
entire country (Little Rock) hopes to provide full insurance for drug
and alcohol abuse treatment to all its students; this is to be paid
for not out of government funds but from private contributions, which
so far have covered only a quarter of the costs.
Some Democrats have proposed sharply increasing spending on education
and treatment while keeping drugs illegal. There is no doubt this
would be a great improvement over the war on drugs, but many of the
negative features of current policy would remain.
First, treatment is likely to be less effective under conditions of
criminalization. Mention has already been made of how arresting
pregnant women frightens many away from treatment. Fear of punishment
has caused others as well to shun medical assistance. Len Bias, the
young basketball player who overdosed, died because his friends,
scared of the police, waited until after his third seizure before
calling an ambulance.
Second, many of the most serious medical emergencies resulting from
drug use are actually consequences of the illegality of drugs rather
than inherent properties of the drugs. On the street, drugs are
adulterated, subjecting users to potentially toxic substances and
making it impossible to know the exact dose one is taking.
More fundamentally, however, treatment and education are unlikely to
be very successful without massive reinvestment in our cities. And
that reinvestment is unlikely as long as the drug war rages. If we
persist in criminalizing 80 many of our urban youth, who will employ
them? How can a teacher or parent convince young people to work hard
when drug dealers are the successful role models?
Drug addiction doesn't usually turn law abiding citizens into
criminals, but there is no doubt that addiction increases the crime
rate, not because of the pharmacological properties of the drugs, but
because of their price. (A crack addict typically needs $1,000 a
week.) And it is the crime, far more than the drug abuse itself, that
makes our urban centers 80 unlivable. As Kurt Schmoke, the
African-American mayor of Baltimore, put it:
It is very easy for people living in communities where drugs
are not a problem (and those are becoming fewer all the time)
to argue that drug-related violence cannot justify
decriminalization. But if you have to live with that violence
day in and day out -- as millions of people in large urban
areas do -- and live in terror of being gunned down, robbed or
assaulted, or having the same occur to one of your loved ones,
you soon start wanting results.
The drug war, by fueling organized crime, police corruption, and
violations of civil liberties, sets back the progressive movements
that must be mobilized to bring about social justice. The mob in the
U.S. has not established death squads to use against the left as have
the narco-traffickers in Colombia, but it does provide the thugs and
corrupt union leaders who debilitate the labor movement. Police forces
are never on the side of progressive politics, but widespread
corruption makes them even less susceptible to public control. And
outrageous laws violating civil liberties have been enacted without
much protest because they have been aimed at evil drug dealers, but
can always be used against anyone with unpopular views.
As long as this drug war continues, the underlying social roots of
addiction are not likely to be addressed.
=============================================
C o n t r o l l e d L e g a l i z a t i o n
=============================================
Any policy of controlled legalization has to decide how currently
illegal drugs would be made available. If drugs were sold
inexpensively, then there would be the danger that many new users and
new abusers would purchase them. On the other hand, if drugs were kept
expensive (using the additional proceeds to fund treatment programs
and the like) then addicts would still need to turn to crime to
support their habits (and they wouldn't even have their usual option
of drug-dealing to make some money).
A two-tiered approach would seem to make the most sense. Addicts
should be able to get affordable drugs at government supported
clinics, while recreational users should have to pay high prices. The
idea here is to minimize the incentive to crime among the former
group, while discouraging too frequent use among the latter. Drugs
whose abuse does not lead to crime (marijuana, for example) would only
have a recreational price. Recreational prices would be proportional
to the harm of the drug as a way to encourage use of the less harmful
alternative. For example, because of its greater dangers to society
and to the individual, alcohol would be priced higher than marijuana
Addicts would not just be handed their fix and sent on their way. They
would need to meet with doctors and social workers who would try to
determine the best strategy for the individual addict. For some,
gradual weaning would make sense; for others methadone maintenance or
heroin maintenance; and for still others every effort would be made to
switch them to a safer drug or means of administration. For all,
treatment would be offered and urged. (And the left would have to keep
reminding the public that for treatment to really work, there must be
full employment.) To really do their job, these clinics would have to
provide the full range of medical and social services to addicts,
services that of course we should demand for all citizens. In the
Netherlands, where heroin use is illegal but treated as a public
health not a law enforcement problem, some 60-80 percent of drug
addicts are estimated to be in touch with health and welfare
institutions. This makes addiction a far less damaging condition both
for society and for the addict.
One problem with a two-tiered system is leakage: addicts who get their
drugs at the cheaper price may try to sell them to others,
undercutting the recreational price. To do this, of course, the addict
would have to forego taking the drug, which is something addicts tend
not to like to do. But some addicts, presumably, would be able to dupe
the doctors into believing they need more than they actually do. This
would create an illicit market of sorts, but, as one expert on drugs
and crime has noted, it would likely resemble the current illicit
market for amphetamines and tranquilizers, which presents fewer
organized-crime problems than does the current system. Moreover,
people who want to use illegal drugs today have no choice but to break
the law; under controlled legalization the temptations to lawbreaking
(buying on the illicit market) would be less powerful since one can
still get the drug legally, though at a higher price.
There would be less danger that organized crime would undercut the
recreational price. Although addicts are not a majority of drug users,
they use a disproportionate share of drugs. So once they are removed
from the market, the demand for drugs should decline considerably, and
this reduced demand would make it hard for drug trafficking
organizations to maintain profits at prices much below those of the
government. In addition, users would likely be willing to pay more for
assurances of quality control, just as prescription drug abusers today
seem to be willing to pay for the security of the brand name.
The biggest question raised by any system of legalization is what
would happen to the number of drug addicts? Some claim that the number
would swell to 60 million or even half the adult population of the
United States. There are good reasons to believe that these dire
predictions are wholly unwarranted.
The critical question, it must be kept in mind, is not the number of
drug users, but the number of abusers. And even then some of those who
become drug abusers may switch from alcohol or nicotine abuse, which
might be more harmful. (In the late 19th century, opiates were
considered by doctors to be a useful substitute to get alcoholics off
alcohol. In the other direction, China's much heralded success at
dealing with opium addiction may not have been such a public health
triumph: two-thirds of Chinese men now smoke cigarettes, which is
predicted to have a devastating impact on China's mortality rate in
coming years.)
Under legalization, the recreational price of drugs might well be more
than the current illegal price. Even so, since the drug would be far
safer and one wouldn't have to risk arrest or, more importantly, the
dangers of traveling into high crime areas, one would expect the
number of users to go up. But there is no fixed relationship between
the number of users and the number of abusers. (As noted above,
current U.S. policy might well have the effect of reducing the former
while increasing the latter.) Presumably, those who are most likely to
abuse drugs are those who are willing to use them today when they are
illegal; put another way, those who now avoid drug use because of the
various dangers of the illegal drug market are less likely than
current users to become abusers. Thus, we would expect the number of
abusers under legalization not to rise proportionately nearly as much
as the number of users.
Some use drugs precisely because it is an illegal activity: it is a
way to express disdain for social convention and rejection of
society's values. Few addicts determine to become abusers: it won't
happen to them, they believe, so they can flaunt social mores by
living on the wild side. But if the social norm became opposition to
abuse rather than use, much of the appeal would be lost.
Where use is not shunned, social conventions often develop that help
people avoid abuse. This is not invariably the case: France, for many
years, had extremely high levels of social drinking combined with one
of the world's worst alcoholism problems. But France also did
negligible alcohol education. In fact, there were no laws against
drunk driving until 1962, and when the government belatedly tried to
warn against the dangers of alcohol abuse, the powerful wine lobby
took out ads declaring "Water is for frogs." But public health efforts
are apparently finally beginning to take effect. So to promote the
development of social norms encouraging moderation, under controlled
legalization massive education against drug abuse would be undertaken.
And the education would have a level of credibility lacking in the
zero tolerance messages of nicotine-addicted William Bennett, in the
exhortations by White House endorsed "Just-Say-No" officials that we
turn in drug-using family members to the police, or in the "pleasure
is sin" sermons delivered from pulpits and government offices.
In those places where marijuana has been decriminalized (Alaska,
Oregon for a time, the Netherlands, etc.), studies show no discernible
effect on the number of users or the frequency of use. On the other
hand, the record for heroin decriminalization has not been very
encouraging, but it is important to see how the policies that have
been tried have differed from controlled legalization.
Britain used to allow doctors to prescribe heroin to addicts; in the
late 1960s the law was changed so that only special clinics could do
80. The heroin problem remained quite minimal until the 19808, when
the number of addicts grew rapidly. But the new addicts were in no way
a result of the clinics (in fact, the number of clinic patients who
were being maintained on heroin in the mid-eighties was under 200).
The new addicts were people for whom heroin had been treated exactly
the same way as it is in the U.S., that is, it was totally illegal for
them and was smuggled into the country. Additionally, the less
dangerous drug marijuana has always been illegal in Britain, and
indeed the bulk of the British law enforcement effort has been aimed
at this drug rather than heroin. Finally, it should be noted that the
rise in addiction in Britain coincides with the disintegration of the
British welfare state under Thatcher, and the heroin addiction is
correlated with high levels of unemployment. Even 80, the British
addiction rate is still about a tenth that of the United States.
Some European countries have decriminalized possession of small
amounts of drugs for personal use, while still going after the drug
dealers. Such a policy has the major advantage of not turning a large
fraction of the population into criminals, but it has other serious
drawbacks. Because selling is illegal, quality control is absent and
overdoses are common; organized crime continues to reap the profits;
and, since prices are high, addicts must still steal to support their
habits. In addition, the policy seems often not to have been combined
with a comprehensive program of drug education and treatment. In any
event, the drug education message is obscured by the policy: instead
of the crucial distinction being use versus misuse, it becomes defined
as personal use versus selling (a difficult distinction to sustain
morally given that those who personally use need sellers).
The Netherlands has permitted the sale of cannabis in coffee houses
and, while heroin is illegal, the government emphasizes harm reduction
in its handling of hard drugs. Its marijuana use rate is below that of
the U.S. and its heroin addiction rate i6 typical for Western Europe
and lower than in the United States, even though it is inflated by the
inclusion of foreigners attracted by the more tolerant Dutch attitude.
More importantly, the harm to society and to the addict from drug
dependence is far less in the Netherlands than in the U.S.: the spread
of HIV infection has leveled off due to needle exchanges; instead of
being forced to be outlaws, addicts are given a government-subsidized
union to advocate for their rights; and the police reluctance to use
informers and undercover operations has kept the level of violence
down. If controlled legalization were to drastically increase the
level of drug abuse in the inner cities, which have already suffered
so disproportionately from the ravages of drugs, there might be good
reason to reject the legalization option. But the risks of such a
policy are actually far less in the urban areas than elsewhere. Those
who want to use drugs in these areas today don't have any problem in
finding a dealer; they are not deterred by the dangers of traveling to
a dangerous neighborhood since they already live there; they are not
deterred by law enforcement officials because the police are so
ineffective in preventing ghetto crime and are held in such low regard
by ghetto residents. And the temptations in the form of the
financially successful drug dealer are extremely powerful. In short,
those who want to use drugs are largely doing so. Like vise, those in
the inner cities who despite their poverty are sufficiently obedient
to the law to refrain from drug use today are likely to respect other
relevant authorities who would continue to warn against the dangers of
drug abuse: parents, teachers, religious leaders, or political
organizers.
So far, the issue of cocaine, and especially crack, has been ignored.
The effects of crack are still not very well understood: the extent to
which it may cause violence, the dangers of unpredictable overdoses,
the degree to which one can function at a job while addicted. Until
more is known about it, it probably makes sense to keep crack illegal.
It might seem that this leaves the biggest problem untouched. But
first, the legalization of other drugs may shift some crack users to
less harmful alternatives. Second, the dangers of leaving crack
illegal -- the continued crime, etc. -- are no worse than the
situation today. As our knowledge about crack increases, after we've
had some experience with legal marijuana and opiates, an informed
decision could be made on crack.
Some other objections to legalization point to the greater dangers of
family violence, reckless driving, reckless operation of subways, and
so on. If people abuse their families or drive recklessly or mug
someone because of drug misuse, these actions of course would still be
illegal under drug legalization. Those who committed such actions
would be subject to criminal sanction and, where appropriate, could be
given the option of treatment as an alternative to punishment. The
effectiveness of such coercive treatment is debatable, but in any
event it can be just as available under legalization as it is today.
Insuring the safety of our subways by random urine tests is not only
highly objectionable on grounds of invasion of privacy, hut is not
very effective. If the goal is to have subway drivers (or other
machine operators) whose reaction time is sufficiently quick to
maintain safety, then tests of reaction should be given. (One might
have to play and win a little Nintendo-like game before being able to
turn on the motor.) This would prevent those who were impaired for
some non-drug related reason (say, exhaustion) from endangering the
public, and, if hooked up to the ignition of automobiles, such a
device would assure far more traffic
safety than laws on arbitrary alcohol blood content levels whose
effects vary from individual to individual and which are difficult to
enforce.
It would be wrong to suggest that controlled legalization would not
involve problems. One of the incentives to maturing out of addiction
is the hassle of maintaining one's habit, an incentive that would be
lessened under legalization. Some rightwingers would try to use the
availability of dangerous drugs as an excuse to dismantle the Food and
Drug administration and other regulatory agencies. An increase in the
number of addicts on the public charge might undermine support for the
welfare system. And, finally, large numbers of people would still be
driven by poverty, misery, and alienation to throw away their lives on
drugs.
These are real problems. But no solution to the drug problem can be
more than a palliative under capitalism. The problems from continuing
the drug war, however, are even more serious. Controlled legalization
alone won't end the drug crisis. But it may make it slightly easier to
undertake the massive reconstruction of American society that is so
desperately needed.
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