Date: Thu, 11 May 1995 08:51:00 -0700
From: Eric Sterling (ESTERLING@IGC.APC.ORG)
To: drctalk-l@netcom.com
Subject: Re: Atlanta Mayor's Drug Education


                      OPENING A DISCUSSION ABOUT
                    EFFECTIVE ANTI-DRUG STRATEGIES


                             May 15, 1995
                          by Eric E. Sterling
           President, The Criminal Justice Policy Foundation


  There is a movement, gathered here in Atlanta, Georgia, that 
argues that the means to fight the drug problem cannot be discussed.  
This movement is based on a false fundamentalism:  society's fight 
against drugs can be carried out either by means of prohibition 
(namely the status quo) or it must surrender to what it calls 
legalization.  The arguments of those who advocate legalization are 
too dangerous even to be heard.  Thus the Atlanta Resolution's first 
point is to reject all proposals to legalize illicit drugs.  This is 
simplistic thinking at its worst.

  Ninety-five percent of The Atlanta Resolution is plain common 
sense, but that is not what the Atlanta conference has gathered to 
discuss. 

  The conference agenda describes the catastrophe that would result 
from legalization, but no person who advocates any version of 
legalization has been invited to present their view or to answer 
questions.  The conference characterizations of drug legalization 
are as fair and as realistic as using Star Wars movies to describe 
the outcome of the NASA manned space flight program.  Implicit in 
the conference agenda is that our current strategy is simply dandy.

  But the American people don t think our current strategy is dandy 
at all.  A nationwide survey in February 1995 by Peter Hart Research 
Associates for Drug Strategies, Inc. found that 50% of the American 
people gave the Federal government a grade of F or D for dealing 
with the problems of drug use and addiction, and 59% gave those 
grades for the problem of drug-related crime.  Only 10% would give 
the Federal government a grade of A or B for dealing with drug use, 
and only 11% for drug-related crime.  Only 6% of Americans thought 
that drug abuse was less of a problem today than 5 years ago.

  A strategy must set forth goals and means.  The 1995 National Drug 
Control Strategy (the Strategy) promulgated by President Clinton 
sets forth clear and worthwhile goals that are a distinct 
improvement from previous strategies (Table 1-1).  The means 
proposed, however, are largely the same ones -- prohibition, and its 
enforcement -- which have failed.

  The National Drug Control Strategy is, in a sense, schizophrenic 
-- it reads as though it were drafted by a committee of Dr. Jekyll 
and Mr. Hyde.  It reflects an internal conflict between realistic 
goals and priorities, and the exaggeration characteristic of 
politicized discussions of the drug problem.  The Strategy writes 
about various drug problems oblivious to the causes of the problems 
and reasonable methods to correct those problems.

  Prohibition has failed to reduce crime or addiction.  There is no 
prohibition-based strategy that will substantially address those 
problems.  A drug-free society is unrealistic.  Our strategy of 
punishing drug addicts is akin to expelling from school students 
with learning disabilities.  To claim to be taking the profits out 
of $50 billion of a year's drug trafficking through the yearly 
forfeiture of $1 billion in property is absurd.  Even sales taxes 
would be more effective in taking the profits out.  Certainly much 
more extensive taxation is required but it is only possible when 
prohibition is repealed.

  We must change our strategy, but we must do so cautiously.  A 
regulatory, management approach to the myriad drug problems is 
called for.  It should be tailored to specific issues and adopted 
incrementally.  There will be addicts and crime no matter what we do.  
An example of regulatory complexity is the regulation of alcohol, 
one legal drug.  There are probably 10,000 different alcohol laws 
reflecting multiple goals from revenue collection to reducing 
consumption.  For this one drug, the regulation of the sale, 
advertising, taxation, and places of distribution and consumption 
vary in every jurisdiction depending whether it is beer, wine or 
whiskey.  Alcohol regulation has evolved since 1933.  In some ways 
it has improved, and in others it has gotten worse.  Developing a 
comprehensive regulatory scheme for dozens of classes of drugs can t 
be accomplished overnight.  There is much necessary market and 
regulatory research.


       National Drug Control Strategy -- A Strategy Founded on
                        Deceptions and Failures

  A strategy for action should identify the most important problems 
and recognize the limits of what the strategy can effect -- it must 
be honest.  The first problem identified in the White House's 
National Drug Control Strategy -- February 1995:  The crime-drug 
cycle continues.  Second, More teenagers are smoking pot.  The third 
problem is described as:  Less of them [America's teenagers] think 
cocaine use is dangerous.

  What does the Strategy say about the crime-drug cycle?  It simply 
sets forth the number and percentage of drug-related murders for the 
past eight years which ranged between 751 (3.9%) in 1986 and 1403 
 (7.4%) in 1989, down to 1287 (5.2%) in 1993, and states that there 
has been a marked increase youth homicide reported by Dr. Alfred 
Blumstein.  The Strategy provides no analysis of the problem.  It 
fails to explain the crime- drug cycle and how to break it.

  Mostly, the crime-drug cycle exists because drugs are prohibited.  
Prohibition inevitably requires violence.  All businesses are 
subject to conflict among market- participants.  Such conflict is 
resolved nonviolently for legal businesses by means of the courts or 
other nonviolent dispute resolution programs.  Prohibited businesses 
are forced to resolve conflict illegally -- either through violence 
or through adjudication by organized crime figures who rely upon 
violence for enforcement.

  Prohibition markets are especially attractive robbery targets 
because of the inevitably high volumes of cash and over-priced 
contraband.  Unlike legitimate businesses that can take checks or 
credit cards, illegal drug markets take only cash.  Legitimate 
business can hire licensed security guards.  Prohibition businesses 
only hire for protection those who demonstrate they are prepared to 
kill.  Legalizers share the nation's goal of ending the crime-drug 
cycle.

  Second, certainly teenage marijuana use is a problem.  But more 
teenagers start a lifetime of addiction to cigarettes every year 
than use marijuana one time, and the smoking prevalence is 
increasing.  More teenagers got drunk in the past two weeks than 
used marijuana once in the past year, and the alcohol consumption 
prevalence is up.  The Strategy presents strong evidence that 
teenage use of liquor is a more serious problem in violence and 
suicide than teenage marijuana use. Teen drunkenness is also a major 
factor in teen pregnancy, sexually transmitted disease, school 
failure, and crime.  Dr. Lloyd Johnston pointed out over a decade 
ago that teen tobacco use is one of the best predictors of teen hard 
drug use, but aside from a couple of paragraphs in the 150-page 
Strategy, alcohol and tobacco are ignored.

  Teen smoking and drunkenness are not political hot-buttons.  There 
is no multi- billion Federal, State and local tax-funded 
establishment to address those problems.  The sponsors of the 
Partnership for a Drug Free America earn millions of dollars 
annually from the promotion of tobacco and alcohol.  And the tobacco 
and alcohol industries are among the biggest of corporate 
contributors to political campaign committees of both political 
parties.  They fight every effort to increase the taxes on alcohol 
and tobacco and to limit the advertising of these drugs.  Public 
health and safety is not on their agenda.  Our political leadership 
is craven in failing to challenge these industries.  Most legalizers 
share the nation's goal of reducing teenage drug, alcohol and 
tobacco use.

  Typically, the Strategy is given to exaggeration.  Saying fewer 
teenagers think cocaine is dangerous, the Strategy implies that 
children are largely misled about the dangers of drugs.  In fact, 
89.3% of last year's high school seniors believed that they would be 
at great risk if they took cocaine regularly.  Or the Strategy says, 
"Drug using adults from every social strata are clogging court 
dockets, crowding emergency rooms..."  Clogged court dockets, a top 
national emergency...or some trial lawyers nightmare?  The serious 
problems are often nowhere near as widespread as implied by the 
Strategy.  In 1991, there were 93.5 million emergency room visits 
according to the 1993 Statistical Abstract, and less than 500,000 of 
them were drug-related, hardly crowding emergency rooms.  Emergency 
room episodes involving drugs have tripled since 1985 -- when the 
war on drugs was kicked into high gear under President Reagan.  This 
data is actually more evidence that our prohibition-based strategy 
is failing to protect the public.

  Outside the realm of exaggeration, hype and political posturing, 
in the real world of 1995, the three most pressing problems from 
drugs in America are the violence in the drug trade, the spread of 
AIDS, and the immense and growing power of the criminal underworld.  
This has been the case for at least a decade:

  *  Drug trade violence was identified as the cause of 40% of the 
homicides in New York City in the late-1980s.  More importantly, the 
drug trade is responsible for the proliferation of guns among 
American youth.  Since 1985 the white juvenile homicide rate grew by 
80%, and the black juvenile homicide rate more than doubled, growing 
120%.  According to Dr. Alfred Blumstein, this is directly linked to 
the prohibition-created crack cocaine trade.

  *  In 1993, AIDS became the biggest killer of Americans between 
the ages of 25 and 44.  In 1992, there were 24,000 new AIDS cases 
where the infection involved the injection of drugs.  By 1992, 
roughly 40% of all new AIDS cases involved injection of drugs.  On 
average, each AIDS case costs the taxpayers $100,000.  Unless 
checked, dirty needle - related AIDS will soon cost $24 billion per 
year.

  *  Large, international criminal organizations -- funded with drug 
profits -- are steadily growing more powerful.  They are subverting 
democratic governments on every continent around the world.  In the 
1990 election, the drug cartels assassinated four candidates for 
President in Colombia.  Last year, the leading candidate for 
President of Mexico was assassinated in a crime linked to political 
protection of the drug traffickers.  These criminal organizations 
have acquired enormous economic power rivaling that of the largest 
corporations on the Fortune 500.  Only one drug trafficking cartel, 
based in Medellin, Colombia, has been put of out business, but 
dozens of others around the world are growing, and increasingly 
collaborating.  The Strategy claims success because the number of 
casual users of cocaine has gone down.  However, the consumption of 
cocaine in the U.S. has actually remained stable since 1985. The 
profits from supplying that cocaine (as well as heroin and 
marijuana) is the greatest transfer of wealth to criminals in the 
history of the world.

  Americans have been given a Strategy that denies the reality of 
prohibition economics, that ignores the law of supply and demand, 
and that is blind to the relation between cause and effect.  What is 
needed is a more effective national drug strategy that is no longer 
bound by the counterproductive paradigm of prohibition.

  This paper outlines a strategy to fight violence and reduce AIDS 
that could be more effective.  It is based not on polls, but on what 
is humane and realistic.  It is based on what can be accomplished, 
not on political slogans such as attaining a drug-free America.


    1.  Remember that drug laws and drug policy should help people, 
                              not hurt them

  People who have drug problems should not be demonized, they need 
help.  People with drug problems are usually in some kind of 
physical or psychological pain.  Addicts should not be treated like 
lepers in the Old Testament who were stoned by their neighbors or 
banished.  People who don t have drug problems, and who aren't 
hurting anyone, should be left alone.

  Everyone who wants to quit using drugs should be able to get 
appropriate treatment.  Addicted single parents need residential 
treatment that won t break up families.  Pregnant addicts need 
treatment, not imprisonment -- but most treatment programs won t 
accept pregnant addicts.  HIV positive addicts should be the top 
priority for treatment, yet many programs won t take HIV positive 
people.  All drug addicted prisoners should get treatment, but no 
one should be prosecuted or imprisoned simply to get treatment.

  Relief of physical pain is one of the oldest medical traditions 
and a basic human value.  Our policy should be compassionate toward 
those who are in pain from disease or from its treatment.  Marijuana 
has well documented medical uses.  Even the Chief Administrative Law 
Judge at the Drug Enforcement Administration, Francis L. Young, 
after hearing evidence gathered from around the nation over a four-
month period, agreed that marijuana has medical uses.  Those 
Americans who can benefit from using marijuana medically should get 
it legally from their doctors.  This is a perfectly respectable 
position, and it was endorsed by the National Association of 
Attorneys General on June 25, 1983.

  Heroin relieves pain for some people who obtain no relief from 
other drugs -- those people should get heroin legally.  In the late 
1980s, without weakening the severe penalties for the unauthorized 
use of heroin, the conservative Canadian government joined the 
United Kingdom in legalizing heroin for medical use only.

  The medical uses of marijuana and heroin do not mean these drugs 
are good.  Nor does it mean these drugs are better than other drugs.  
Simply, these drugs are useful for some people.  The people who can 
benefit from these drugs should not be denied them.

  Some persons, justifiably concerned about the abuse of these drugs 
by drug addicts and by children, oppose even the very carefully 
controlled medical use of these drugs because medical use of 
marijuana or medical use of heroin supposedly sends the wrong 
message.  First, drug abusers aren't listening for this message.  
Cocaine, Valium , Dilaudid , and most controlled substances have 
uses in medicine, but many addicts who abuse those drugs don t care, 
even if they are actually aware of such uses.  Drug abusers don t 
rationalize their drug use as medical.

  Secondly, there isn't a single positive value we want our children 
to learn that is not being undermined by a host of wrong messages.  
For every virtue -- honesty, thrift, industry, studiousness, 
cleanliness, chastity, charity, responsibility, civic-mindedness, 
moderation, non-violence, or sobriety and abstinence from drugs -- 
movies, television, advertising and popular music are sending 
messages that directly conflict with positive values.  Every 
teenager everyday has to deal with, and we hope disregard, seductive 
messages that conflict with virtue.

  Exaggerating the dangers to children of the wrong message when it 
comes to subtleties of medical practice is unwarranted and 
irrational.  It is the job of drug abuse prevention programs to 
teach children the important differences between drugs prescribed by 
doctors and street drugs.  People who are dying or going blind 
should not be forced to endure more suffering because drug abuse 
prevention programs might sometimes be ineffective in helping 
children draw the necessary distinctions between the legitimate and 
the inappropriate uses of drugs.

  The Controlled Substances Act makes cocaine, THC, methadone and 
other synthetic opiates perfectly legal -- when their use is 
prescribed for by a physician in the proper circumstances.  Debating 
how systems of control can be improved does not undermine the drug 
abuse prevention effort.  To say that the American public should not 
openly debate other forms of drug legalization because children 
might get the wrong message, is like saying the public should not 
debate gun control, militia groups or the Second Amendment because 
children might get the wrong message.  It is fundamental to the 
health of democratic governments that public policies be debated.


   2.  Adopt a public health approach toward all drugs and drug users

  This requires a comprehensive approach toward all drugs, not 
simply  now illegal drugs.  What we should be concerned about is the 
drug abuse problem -- not just the illegal drug problem.  Illegal 
drug use does not exist in legal or >social isolation.  Treatment 
professionals recognize cross-addiction and polydrug abuse.  
Prevention professionals recognize a gateway relationship between 
legal drugs and use of illegal drugs.  Tighten the regulations 
surrounding alcohol and tobacco -- for adults and for children -- 
and this will help reduce the use and abuse of other drugs as well.  
In order to delay the onset of teen alcohol and tobacco use, which 
delays the onset of other drug use, we must reduce the promotion and 
availability of tobacco and alcohol to children.

  To respond to our drug problem we must expand honest anti-drug 
education.  Honest comprehensive prevention programs work.  
Cigarettes kill more than 400,000 Americans in a year and are as 
addictive as heroin or cocaine, according to the U.S. Surgeon 
General.  Yet forty-four million addicted cigarette smokers have 
quit in the past thirty years.  This is the result of a tremendous, 
successful public health campaign.  This campaign succeeded without 
jailing or urine-testing cigarette smokers, without prosecuting 
tobacco sellers, without prohibition, and in spite of the annual 
expenditure of billions of dollars to promote tobacco-use.  Most 
policy makers reject the idea of prohibiting cigarettes because it 
would be a disaster of corruption and crime, and wholly inconsistent 
with American values.

  Cigarettes, alcohol, or marijuana can be gateways toward use of 
harder drugs.  Therefore prevention programs need to focus on all 
drugs.

  We must continue to evaluate drug abuse prevention programs.  
Mathea Falco in The Making of a Drug-Free America (1992) pointed out 
that most programs have not been evaluated.  Research Triangle 
Institute reviewed 18 studies in September 1994 and found D.A.R.E., 
America's most common drug abuse prevention program, was 
substantially less effective in reducing drug use among the children 
who took the program than certain other approaches.  If we are 
serious about prevention, we must be willing to abandon programs 
that don t work well, even if they are politically popular.

  Quality medical care and drug abuse treatment must be easily 
available for those who need it.  Heroin addicts, crack addicts, the 
mentally ill, the homeless, the uninsured, and everyone at risk of 
catching or spreading contagious disease are the highest treatment 
priority.  This will help halt the transmission of disease, and 
reduce the use of illegal drugs as pain killers for untreated 
disease.

  To stop the spread of blood borne disease among injecting drug 
addicts, clean needles should be exchanged for used ones.  This is 
the recommendation of the National Commission on HIV and AIDS, and 
top government scientists who have studied the issue.  Distribution 
of hypodermic syringes is a crime in eleven states which should be 
repealed.  Until 1965 (Griswold v. Connecticut), distribution of 
condoms to any person was a crime in some states.  Thirty-years ago 
sale of condoms in supermarkets and convenience stores was 
unthinkable.  Now, for the widely accepted public health purpose of 
fighting sexually transmitted disease, condoms are widely 
distributed to the sexually active as one component of a public 
health program.  When we think about drugs and disease in less 
judgmental terms, public health distribution of hypodermic syringes 
to drug injectors will no longer be shocking.

  Under appropriate controls and supervision, drugs must be made 
available to addicts to reduce harms.  Smoking tobacco is the most 
dangerous means for ingesting nicotine.  If Nicorette gum were 
cheaper and more freely available many more smokers and snuff 
dippers would be likely to quit.  Cigarettes, after all, are only 
crude, disposable nicotine ingestion devices -- of the most 
dangerous kind.  Nicotine is addicting but is not as dangerous as 
the tars, particulates and gases in cigarette smoke.  Heroin is 
addicting but is not as dangerous as HIV, hepatitis, and the 
adulterants added by criminals who distribute street drugs.

  Heroin addicts who can t or won t quit should not be banished to 
the underworld, nor put at risk of death from criminally 
contaminated drug supplies.  They ought to be able to get clean, 
affordable opiates under medical and pharmaceutical supervision if 
it will prevent them from spreading disease or committing crimes.  
Incidentally, Dr. Alfred Blumstein, former president of the American 
Society of Criminology, whose work on the crime-drug cycle is cited 
in the Strategy, endorses this approach to certifiable addicts.  
(Of course, the use of heroin by addicts must not violate the 
principle of user accountability discussed below.)

  In considering why some people use and abuse drugs, we must 
address the causes and contributing factors.  One major cause is 
family violence and sexual abuse.  Another co-factor with drug abuse 
is teenage pregnancy.  Public health and family-strengthening 
programs to address those problems are key parts of an anti-drug 
strategy.  To further prevent addiction and overdoses, patients and 
doctors need to know more about prescription drugs and their risks 
and interactions.


   3.  Insist Upon Drug and Alcohol User Accountability and 
                        Responsibility

  People who hurt or endanger others must be held responsible for 
their actions.  Drug or alcohol use is not an excuse for criminal or 
negligent conduct.

  Protection of public safety (e.g. safety on the streets, of 
travelers, medical patients, etc.):  In critical safety situations 
we should require performance tests to detect actual impairment by 
drugs (legal and illegal), alcohol, exhaustion, etc.  Following any 
kind of accident, it is perfectly appropriate to immediately test 
the blood of pilots, engineers, drivers, surgeons, etc. for evidence 
of use of alcohol and drugs -- legal and illegal.  This would be 
appropriate not only for airplane, rail, maritime or motor vehicle 
accidents, but also for medical accidents such as administering 
medications improperly or making mistakes in surgery.  Past use of 
intoxicants identified by urine or hair tests is irrelevant to 
public safety and drug user accountability.

  We must encourage increased professional responsibility and peer 
supervision of professions like medicine, airline piloting, etc. to 
police against on-the-job recklessness such as alcohol or drug use.  
Suspected misconduct that threatens public safety must be 
investigated and prosecuted where criminal recklessness has occurred.

  Criminal conduct:  Drug or alcohol use is not an excuse for 
criminal conduct such as robbery, theft, forgery, etc.  All drug 
addicted offenders and prisoners should get treatment.  But in the 
absence of actual harm or substantial risk of endangering others, 
Americans should not be prosecuted or imprisoned as a means to get 
treatment.

  Convicted predatory criminals such as robbers, rapists, 
assaulters, and burglars should be drug and alcohol-abstinent while 
on probation and parole.  This requires frequent and extensive 
surprise drug and alcohol testing, and a system of consistent 
sanctions for violations.

  Drug and alcohol user licenses:  Drug and alcohol use are 
privileges, and should be subject to licenses which can be revoked 
for misuse.  Some states adopted alcohol use licenses after national 
prohibition was repealed.  Persons who use drugs or alcohol might be 
required to get special liability insurance coverage.  It should not 
be presumed that persons over 21 are responsible alcohol or drug 
users.


  4.  Insist upon vendor accountability and responsibility

  Just like users, vendors of drugs and alcohol need to be held 
responsible for their actions.

  Violence, corruption, product adulteration, tax evasion, and 
antitrust violations by drug, alcohol and tobacco sellers are crimes 
and should be investigated and punished.  Adulteration and 
mislabeling of drugs and alcohol should also be subject to product 
liability civil law remedies.  Vendors must comply with reasonable 
regulations and inspections, pay taxes, and resolve marketplace 
conflicts through the law, not violence.  These provisions are much 
more easily investigated and enforced in a regulated environment 
than under prohibition.

  Convicted criminals can t be licensed to legally sell alcohol now 
-- they shouldn't be allowed to sell other drugs after the repeal of 
prohibition.

  The prohibition against sales to minors of tobacco, alcohol and 
other drugs must be enforced.

  Sales to those who have been denied or deprived of their privilege 
to use alcohol or drugs should be prohibited.  Like alcohol dram-
shop laws, over-the-counter sales of drugs to those who are already 
intoxicated should not be permitted.

  Promotion of alcohol, tobacco and drug use should be severely 
limited.  Advertising that either targets kids or is placed in media 
in which kids have legitimate interest in (e.g. professional and 
amateur athletics, popular music, motion pictures, etc.) should be 
disallowed.


  5.  Maximize the reach of law and respect for the law

  Drug and alcohol buyers should be discouraged from patronizing 
criminals.  For example, growing one's own marijuana is today a 
felony, and growers risk the forfeiture of their homes or land.  
Every marijuana user today (between 9 and 20 million persons) either 
becomes a felon or has to patronize criminals.  Shouldn't home 
cultivation for personal use be encouraged, even under prohibition?  
We should be reducing the commercial opportunities of criminals, not 
expanding them.  Even under prohibition, decriminalizing home 
marijuana cultivation would sharply reduce the tens of billions of 
dollars in annual profits now funding organized crime.

  Almost no police officers or revenue agents are killed or injured 
enforcing the liquor laws.  Marijuana, the most widely consumed 
illegal drug, should be taxed and sold to adults with warning 
messages -- but with prohibition of the promotion we suffer from 
with tobacco and alcohol.  Very few law enforcement officers will be 
killed or injured enforcing a managed, regulated drug trade.