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AUTHORS OF THE EFFECTIVE DRUG CONTROL STRATEGY EXECUTIVE SUMMARY THE NEED FOR A NEW MODEL OF DRUG CONTROL THE NEED FOR A NEW MODEL OF DRUG CONTROL How many people must be incarcerated for current drug policy to work? Does the U.S. drug strategy protect children from drugs? Does the current drug control strategy reduce the supply of drugs and raise their price? Does the current strategy protect public health? It is time to develop a drug strategy that works. GOAL NUMBER ONE: REDUCE THE HARM ASSOCIATED WITH DRUG ABUSE FIND A SOLUTION TO DRUG ABUSE THAT REALLY WORKS Commission a non-partisan panel of experts to evaluate America's longest war Allow cities and states to experiment with their own approach to drug control Make efforts at all levels of government to separate the markets for marijuana from other illegal drugs REDUCE DRUG ABUSE AND USE AMONG YOUTH AND YOUNG ADULTS Triple the current National Drug Control Strategy budget share for reducing youth and young adult drug use Focus funding and efforts on strategies that have documented success in reducing youth drug use Use facts, not scare-tactics to educate youth Redirect DARE funding into more productive and effective programs Be responsible with the provision of anti-drug messages REDUCE DRUG USE AND ABUSE AMONG WOMEN Fund prevention programs that target women Increase services for women Fund research on women's experiences REDUCE DRUG ABUSE AND USE AMONG ALL AMERICANS Provide drug treatment upon request and a variety of treatment options Enact legislation that provides full continuum insurance coverage for substance abuse Reduce children's exposure to cigarette and alcohol advertising REDUCE THE SPREAD OF INFECTIOUS DISEASE Repeal State and Federal laws designed to prevent access to and possession of sterile syringes Make prevention and treatment of Hepatitis-C a high public health priority GOAL NUMBER ONE: CHAPTER SUMMARY GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" REDUCE CRIME AND VIOLENCE ASSOCIATED WITH THE DRUG WAR Commission a study on the relationship between drugs, alcohol and violence MAKE CRIMINAL PENALTIES FIT THE CRIME End mandatory minimum sentencing (statutory and guideline) Alter sentencing guidelines, so judges have more room to maneuver within Guideline boxes and make Guidelines advisory, rather than mandatory Allow judges to determine whether a drug prosecution is handled more appropriately by state, local or federal courts Cease the costly and ineffective targeting of marijuana possession cases END THE RACIAL BIAS IN DRUG LAWS End the disparity between crack and powder cocaine sentencing Stop targeting black and Latino communities for needle possession arrests DO NOT UNDERMINE EDUCATION IN THE NAME OF THE "WAR ON DRUGS" State governments should not spend more on prisons than on education Eliminate the ban on student loan guarantees to persons with a drug conviction ALLOW DOCTORS GREATER FREEDOM TO ADDRESS PUBLIC HEALTH ISSUES Transfer scheduling authority to the Department of Health and Human Services Begin clinical trials of drug maintenance therapy Allow doctors greater freedom in prescribing medications for pain control Allow a broader distribution of opiate agonist chemotherapy (e.g. methadone, LAAM) and move oversight of such programs to the Center for Substance Abuse and Treatment Recognize the rights of states, doctors and patients to make their own decisions regarding the usefulness of medical marijuana End the de facto moratorium on medical marijuana research Develop a distribution system for medical marijuana PROMOTE HEALTH SERVICES FOR ALL WOMEN, NOT PROSECUTION OF PREGNANT WOMEN Address the problem of drug abuse by women as a women's health issue not a criminal matter ENCOURAGE "FAMILY VALUE FRIENDLY" POLICIES AND FAMILY UNITY THROUGH TREATMENT AND SUPPORT SERVICES, NOT PUNITIVE RESPONSES Repeal section 115 of the TANF and Food Stamp benefits programs, and reform welfare to help, rather than penalize women struggling with drug abuse problems Fund alcohol and drug abuse treatment programs that work with women and their children PROTECT CIVIL LIBERTIES AND THE AMERICAN CONSTITUTION Stop the misuse of forfeiture laws Restore voting rights to non-violent drug offenders and allow unhindered public referenda and initiatives Restore civil liberties undermined during the drug war REDUCE GOVERNMENT AND LAW ENFORCEMENT CORRUPTION Establish checks and balances to oversee drug enforcement activities and establish strict hiring standards for drug enforcement officials REDUCE WASTEFUL SPENDING AND DAMAGE CAUSED BY INTERNATIONAL DRUG CONTROL EFFORTS Place less emphasis on drug interdiction and source country eradication strategies and greater emphasis on domestic drug prevention and treatment programs as well as alternative economic development End the drug certification process Stop encouraging a role for the military in counternarcotics activities properly performed by civilian law enforcement agencies, both at home and abroad Stop the use of herbicides and biological agents in efforts to eradicate illegal drugs outside of the United States as well as within the US GOAL NUMBER TWO: CHAPTER SUMMARY CONCLUDING REMARKS

List of Figures
Figure 1:	Incarceration for Drug Arrests and Drug Overdoses Deaths Rise after Mandatory Minimums
Figure 2:	Availability of Marijuana for Kids
Figure 3:	Lifetime Use of Any Illicit Drug (8th, 10th, 12th Grade)
Figure 4:	Heroin: Price Per Gram over Time
Figure 5:	Heroin: Purity Increases During Drug War
Figure 6:	Emergency Room Drug Episodes
Figure 7:	ONDCP National Drug Control Budget vs. The Effective Drug Control Budget
Figure 8:	A Brief Chronology of Independent Drug Policy Reports
Figure 9:	Adolescent Use of Crack and Heroin
Figure 10:	Youth Prevention Spending in National Drug Control Budget
Figure 11:	SAMHSA funding for women
Figure 12:	Partial List of Organizations Which Support Needle Exchange Programs
Figure 13:	Homicide Rates in the 20th Century
Figure 14:	Societal Costs of Drug Use in 1992
Figure 15:	Average Length of Imprisonment Federal Penitentiaries
Figure 16:	Partial List of Organizations Opposed to Mandatory Minimum Sentences
Figure 17:	Marijuana Arrests Over Time
Figure 18:	Drug Use vs. Incarceration Rate by Gender and Race
Figure 19:	Trends in State Spending: 1987 - 1995
Figure 20:	Partial list of Organizations Supporting Physicians' Right to Recommend or Discuss Marijuana with Patients
Figure 21:	Partial list of Organizations Supporting Access to Medical Marijuana
Figure 22:	Partial list of Organizations Supporting Legal Access to Marijuana Under Physician's Recommendation
Figure 23:	Partial list of Organizations Supporting Medical Marijuana Research
Figure 24:	Voter Approved Medical Marijuana Initiatives 37
Figure 25:	Public Letter to Kofi Annan, UN Secretary General 52-54

 

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EXECUTIVE SUMMARY The Effective National Drug Control Strategy is based on empirical evidence and studies which show that the policies recommended will be effective. It explicitly recommends that 2/3 of the entire drug control budget should be allocated for drug treatment and prevention. There are two main goals of the Effective National Drug Control Strategy: 1) reduce the harm caused by drug abuse; 2) reduce the harm caused by existing drug control policies. Within these two main goals, there are a number of objectives. The broad thrust of the Effective Strategy is to move from a law enforcement-dominated strategy to a public health-based strategy. GOAL NUMBER ONE: REDUCE THE HARM CAUSED BY DRUGS IN OUR SOCIETY Commission a non-partisan panel of experts to evaluate current drug control policy. Reduce adolescent drug use through fact-based education, prevention efforts, and supervised activity programs. Reduce drug problems among all Americans with treatment, education and prevention, with special attention to the specific needs of women. Reduce the spread of HIV and other communicable diseases through healthcare services for drug users. Provide treatment on request as mandated by Federal law since 1988. GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE “WAR ON DRUGS” Reduce crime and violence associated with the illegal drug market. End the racial bias in drug laws, particularly mandatory minimum sentencing. Allow penalties to fit crimes committed, by ending mandatory sentencing and altering sentencing guidelines. Reverse the trend toward cutting school budgets to invest in prisons. Allow doctors greater freedom in dealing with public health issues. Promote health services for all women, not prosecution of pregnant women. Enact “family value-friendly” laws which keep familial and social networks intact. Stop forfeiture abuse, overzealous search and seizure practices, cruel and unusual punishment, denial of legal counsel, denial of benefits, services, and student loans. Reduce corruption of government officials and law enforcement officers. Prohibit the use of military forces against U.S. citizens and in domestic policing. Demilitarize the border with Mexico, end the involvement of U.S. military in counter drug operations abroad, and end support for foreign operations that undermine human rights objectives.

 

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THE NEED FOR A NEW MODEL OF DRUG CONTROL The current model of drug control relies primarily on law enforcement to seize drugs and imprison drug offenders. While these efforts have produced large numbers of arrests, incarcerations and seizures, drug overdose deaths have increased 540% since 1980 and drug-related problems have worsened:1  emergency room visits, adolescent drug use, and the spread of disease (particularly AIDS and hepatitis) have also risen substantially and drug-related crime continues at high levels. In an effort to minimize drug-related crime, illness and death, the Effective National Drug Control Strategy advocates a policy which emphasizes public health approaches to drug control.
Incarceration for Drug Arrests	Drug Overdose Deaths
Figure 1 Sources: Bureau of Justice Statistics. Trends in US Correctional Populations, 1995. US Department of Justice; National Institute on Drug Abuse. Data from the Drug Abuse Warning Network (DAWN): Annual Medical Examiner Data, [1981-1991]; Substance Abuse and Mental Health Services Administration. Data from the Drug Abuse Warning Network (DAWN): Annual Medical Examiner Data, [1992-1997]. How many people must we incarcerate for current drug policy to work? The drug war has succeeded in arresting and incarcerating large numbers of people. There are over 1.7 million Americans behind bars. As of June 1996, 5.5 million Americans were under some form of control by the justice system. This translates into 1 out of every 35 adults in the nation.2  According to the Department of Justice, 85% of the increase in the federal prison population from 1985 to 1995 was due to drug convictions.3  Figure 1 illustrates the massive expansion of drug offenders in the jail and prison population, which has increased nearly 12-fold from 1980 to 1995, and a strikingly similar rise in drug overdose deaths over the same period. The graph cannot express the financial and psychological damage endured by the children and spouses of those incarcerated. Nor does it express the damage that certain communities and racial groups experience. For example, black males born today have a nearly one in three chance of going to prison.4
Figure 2 Percent of high school seniors who say marijuana is 'very easy' or 'fairly easy' to obtain. Source: NIDA. (1997). Monitoring the Future Survey. Table 12, “Long-term trends in perceived availability of drugs, twelfth graders.”   Figure 3 Source: NIDA. (1998) The Monitoring the Future Survey 1998. Washington, DC: Department of Health and Human Services.	Does the U.S. drug strategy protect children from drugs? Current government policy seeks to prevent children from gaining access to illegal substances. Since 1975, the federal government has been asking high school seniors how easy it is for them to obtain marijuana. Illustrated by Figure 2 on the left, adolescents' access to marijuana is virtually unchanged by the drug war. In 1975, 87% of youths said it was “very easy” or “fairly easy” to obtain marijuana. Twenty-three years and millions of arrests later, 89.6% said it was easily obtained. Has the drug war succeeded in reducing adolescents' access to drugs? Since 1992, federal surveys show there has been a rise in adolescent drug use. This has coincided with record spending, record arrests and record incarceration rates. The drug war has escalated for decades, but has not resulted in less adolescent drug use. Drug crimes receive some of the most severe criminal sanctions in our legal system. Based on federal surveys and by definition of state and federal law, more than 50% of all high school seniors are drug criminals who should be imprisoned. Is this a realistic or appropriate approach to controlling juvenile drug use? If not, then why should only some be arrested?
How do we determine who gets prison sentences and who does not? The current model of youth drug control essentially relies on the random chance of arrest, coupled with an increasing use of locker searches, drug-sniffing dogs, and “just say no” television ads to reduce adolescent drug use. These are unsophisticated approaches to youth drug use that are not based on strategies proven to work. The evidence shows that these strategies have not decreased the availability of drugs for school-aged kids, nor has it deterred their use of drugs. Does the current drug control strategy reduce the supply of drugs and raise their price?
Figure 4 Source: ONDCP. 1998 National Drug Control Strategy. Table 20.   Figure 5 Source: ONDCP. 1998 National Drug Control Strategy. Table 20.   Figure 6 Source: SAMHSA. (1996, August). Historical Estimates from the Drug Abuse Warning Network, p. 38. Washington, DC: Dept. of Health and Human Services.	The indicators of a successful supply-reduction effort are rising drug prices and decreasing drug purity levels.5  Using data supplied by the ONDCP (Office of National Drug Control Policy), it is clear that the price of heroin has instead dropped significantly over time, while its production has risen greatly. The price of cocaine has similarly dropped from $275.12 per gram in 1981 to $94.52 in 1996. Despite massive investments in border patrols, overseas crop eradication efforts, Department of Defense involvement and arrests of drug smugglers and drug dealers, the drug war has not reduced the supply of drugs nor made them more costly to obtain. The market prices for illegal drugs follow the same laws of supply and demand that apply to all commodities. The drug war creates an artificially high commodity price, and these huge profit margins have encouraged more drug producers to enter the market. Greater production has created economies of scale. Lower production costs allow drug cartels to earn the same high profit margins with lower retail prices. The cartels accommodate for interdiction efforts by over-producing their commodity to account for the losses. Since a kilogram of raw opium has been reported to sell for $90 in Pakistan, but is worth $290,000 in the United States, law enforcement seizures at our borders have very little impact on cartel operations or profitability.6  Does the current strategy protect public health? Easy availability, increased purity and lowered prices have resulted in high levels of overdose deaths and hospital emergency room drug episodes. Figure 6 illustrates the steady rise in emergency room drug episodes as recorded by the Drug Abuse Warning Network (DAWN).
Even more alarming has been the devastating expansion of the HIV and Hepatitis C epidemics due to the prohibition on needle possession. Sharing of needles is an engine for the spread of HIV and Hepatitis C. Each day 33 more people are infected with HIV due to injection drug use.7  The epidemics have been particularly onerous on African-American and Latino communities. By the end of 1997, it was estimated that more than 110,000 African-Americans and 55,000 Latinos were living with injection-related AIDS or had already died from it.8  These facts make it hard to avoid the conclusion that the current model of drug control: 1) does not reduce adolescent drug use; 2) does not reduce the supply of drugs; 3) does not reduce the harm caused by drugs. It is time to develop a drug strategy that works. Since we are failing to reduce the supply and use of drugs, while incarcerating record numbers of drug offenders, we need to accept that criminal laws cannot effectively solve the complex issue of drug use. Indeed, there is mounting evidence that the extreme criminal sanctions we employ today may actually worsen some of the problems of drug abuse. The Effective National Drug Control Strategy provides a detailed alternative model of drug control based on sound research and empirical evidence, and was developed by a wide range of professional associations. The Effective Strategy emphasizes public health approaches, investment in our children and confronting the underlying economic and social problems, which are the root causes of drug abuse. As can be seen from the chart below, the Effective Strategy seeks to balance law enforcement, treatment and prevention efforts. As this strategy takes effect we expect that law enforcement's role in drug enforcement can be reduced further. We urge that five years after implementation, the policy be evaluated and a longer term strategy be developed.
Figure 7 ONDCP National Drug Control Budget vs. The Effective Drug Control Budget.
1  Drucker, Dr. Ernest. (1998, Jan./Feb.). Public Health Reports, "Drug Prohibition and Public Health." U.S. Public Health Service. Vol. 114. 2  Bureau of Justice Statistics. (1997, August 14). Nation's probation and parole population reached almost 3.9 million last year. Press Release. Washington, DC: Department of Justice. 3  Bureau of Justice Statistics. Prisoners in 1996. Washington, DC: Department of Justice. 4  Bureau of Justice Statistics. (1997, March). Lifetime Likelihood of Going to State or Federal Prison. p. 1. Washington, DC: Department of Justice. 5  ONDCP. (1998). Performance Measures of Effectiveness. Washington, DC. p. 13. 6  Associated Press. (1997, June 26). "U.N. estimates drug business equal to eight percent of world trade." 7  Day, Dawn. Health Emergency 1999: The Spread of Drug-Related AIDS and Other Deadly Diseases Among African-Americans and Latinos. (1998). The Dogwood Center, p. 5. 8  Day, Dawn. (1998). pp. 1, 4.

 

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GOAL NUMBER ONE: REDUCE THE HARM CAUSED BY DRUGS IN OUR SOCIETY OBJECTIVE: FIND A SOLUTION TO DRUG ABUSE THAT REALLY WORKS
Rationale: For years U.S. drug policy has taken the approach of arresting anyone who can be connected with illegal drugs, and has gotten the same results – death, disease, violence and increasing adolescent drug use. It is time for a critical review of drug policy, not annual plans that promise more of the same. We need to recognize that the War on Drugs is a simplistic, politically motivated approach to a complicated health and social phenomenon. We need to develop a strategy based on more effective approaches. Recommendation 1: Commission a non-partisan panel of experts to evaluate America's longest war.9
The War on Drugs is approaching a century in length, having been initiated in 1914 with the Harrison Narcotics Act. The drug war gets more expensive each year – the 1999 federal budget of $17.1 billion is a record and is several times larger than the $3.6 billion appropriated in 1988. States and local governments spend an additional $20 billion annually.10 Yet, there is no objective review of the evidence to determine whether a law enforcement-dominated policy is the most effective policy option. In order to develop a truly effective drug policy, a national commission should be empowered to analyze our approach and recommend new strategies. This commission should be led by an independent commission and all options should be considered for tobacco, alcohol and illegal drugs. ONDCP Director General McCaffrey recently said that legalization is a “legitimate cause for debate in a democracy.”11 No doubt we need to consider whether criminal controls – relying on police, prosecutors and prisons – or legal controls – relying on regulation, taxation and administrative law – are more effective at controlling drug markets. However, in developing a more effective drug strategy we should remember that the vast majority of immediate policy options are not at the extremes of the debate, but rather involve moderate public health strategies and changes in budget priorities. This document represents a synthesis of centrist approaches to drug control. Recommendation 2: Allow cities and states to experiment with their own approach to drug control. Cities and states have always been important sources of innovation and experimentation in public policy. Closer to their citizenry, city councils and state legislatures are often better qualified to identify solutions to problems which seem impossible at the national level. For instance, the city of Boston has been widely recognized for developing an effective strategy for reducing juvenile crime, and it recently had the distinction of being the only large American city to enjoy no juvenile homicides for more than two years.12 The program was based on a mixture of community policing and providing at-risk youth with meaningful after-school activities. States and municipalities need greater flexibility from the federal government to address drug abuse as a public health issue. Federal drug policies that encourage states to adopt punitive approaches, including excessive penalties and limits to judicial discretion, are undermining productive state drug policy efforts. Federal drug policy must allow state and local governments the flexibility to develop new rational drug policies that emphasize education, economic opportunity, disease prevention, alternatives to incarceration and access to treatment and rehabilitation services, with some oversight to ensure that individual rights are not harmed in the process. Recommendation 3: Make efforts at all levels of government to separate the markets for marijuana from other illegal drugs. According to a recent report by the World Health Organization (WHO), the hypothesis that adolescent use of hard drugs is a direct effect of marijuana use is the “least compelling of all hypotheses.” The WHO report suggests that the current prohibition on marijuana may do more to introduce children to hard drugs than any other cause, stating, “Exposure to other drugs when purchasing cannabis on the black market increases the opportunity to use other illicit drugs.”13 This finding has important implications for public policy, and suggests that if we want to reduce heroin and cocaine use, we can move closer to that goal by separating the marijuana market from the market for harder drugs. The Netherlands is the only nation which has implemented such a policy, so it is important to note that even though marijuana is widely available, the Netherlands' heroin use rate is 160 users per 100,000 population,14 while the United States is estimated to have 430 heroin users per 100,000 population.15  Thus, when comparing the experience of the two countries, it appears the World Health Organization's hypothesis that the black market in marijuana increases the opportunity to use other drugs has some merit and also reinforces the hypothesis that marijuana can act as a terminus drug, rather than a gateway. The reality is, for every 104 Americans who have used marijuana, there is only one regular user of cocaine, and less than one regular user of heroin.16  By promoting an absolutist “zero-tolerance” policy for all substances regardless of relative dangers and by accepting the 'gateway' myth, we may actually expose those youths and young adults who would briefly experiment with a soft drug like marijuana to more dangerous substances like cocaine and heroin. A public policy that is blind to the reality of drug markets effectively abandons youth who experiment with marijuana – the most widely used illicit drug. This is a tragic example of how ideology and adherence to failed policy can prevent our society from making progress in reducing drug use.
A Brief Chronology of Independent Drug Policy Reports Indian Hemp Drugs Commission. Marijuana. 1893-94. (UK) A seven volume, nearly 4,000 page report on the use of marijuana in India by British and Indian experts who concluded, “the moderate use of these drugs is the rule, and that the excessive use is comparatively exceptional. The moderate use produces practically no ill effects.” Panama Canal Zone Military Investigations. 1916-1929. (U.S.) Recommended “no steps be taken by the Canal Zone authorities to prevent the sale or use of marihuana.” Departmental Committee on Morphine and Heroin Addiction. Report. (The Rolleston Report), 1926. (UK) Codified existing practices regarding the maintenance of addicts on heroin and morphine by doctors. Mayor's Committee on Marihuana. The Marihuana Problem in the City of New York, 1965. (U.S.) Concluded marijuana use was non-addictive, and did not lead to morphine, cocaine or heroin addiction. Committee of the America Bar Association and American Medical Association on Narcotic Drugs. Drug Addiction: Crime or Disease? Interim and Final Reports. 1961. (U.S.) Concluded drug addiction is a disease, not a crime; harsh criminal penalties are destructive; drug prohibition ought to be reexamined; and experiments should be conducted with British-style maintenance clinics for narcotic addicts. Interdepartmental Committee. Drug Addiction. (The Brain Report), 1961. (UK) Endorsed the Rolleston Committee's advice which recommended that doctors in the United Kingdom be allowed to treat addicts with maintenance doses of powerful drugs when it was deemed medically helpful to the patient. Interdepartmental Committee. Drug Addiction, Second Report. (The Second Brain Report), 1965. (UK) Made recommendations for the monitoring and licensing of doctors in the United Kingdom who prescribe maintenance doses of drugs. Advisory Committee on Drug Dependence. Cannabis. (The Wooton Report), 1968. (UK) Endorsed conclusions of the 1965 New York report which said marijuana was non-addictive and did not lead to morphine, cocaine or heroin addiction. Also endorsed the conclusions of the Indian Hemp Commission. Government of Canada, Commission of Inquiry. The Non-Medical Use of Drugs, Interim Report, (The Le Dain Report), 1970. (Canada) Recommended serious consideration be given to decriminalization of marijuana for personal use. National Commission on Marihuana and Drug Abuse, Drug Use in America: Problem in Perspective, 1973. (U.S.) Appointed by President Nixon, it recommended possession of marijuana for personal use be decriminalized. National Research Council on the National Academy of Sciences, An Analysis of Marijuana Policy, 1982. (U.S.) Recommended immediate decriminalization of marijuana possession and suggested the United States experiment with allowing states to set up their own marijuana controls, as is done with alcohol. Advisory Council on the Misuse of Drugs, AIDS and Drug Misuse, Part 1 1988, Part 2, 1989. (UK) Concluded that “The spread of HIV is a greater danger to the individual and public health than drug misuse.” Supported a comprehensive health plan that promoted abstinence, but above all health and life.
9 On April 16th, 1997, Rep. Cummings (D-MD) with 19 democratic cosponsors introduced H.R. 1345 a bill to create a Commission on National Drug Policy. 10 Drucker, Dr. Ernest. (1998, Jan./Feb.). Public Health Reports, "Drug Prohibition and Public Health." U.S. Public Health Service. Vol. 114, p. 17. 11 On December 3, 1998 when a caller to CSPAN's Washington Journal asked about legal access to marijuana General McCaffrey said: "... I think it's a legitimate cause for debate in a democracy. The country ought to do whatever it thinks is appropriate. Many of us are uncomfortable with the idea of more psychoactive drugs. We're opposed to it and that's a viewpoint I couldn't express more strongly..." 12 Associated Press. (3 March 1998). "Kennedy Proposes Crime Program." Washington, DC: Associated Press. 13 Hall, W., Room, R. and Bondy, S. (1998, March). WHO Project on Health Implications of Cannabis Use: A Comparative Appraisal of the Health and Psychological Consequences of Alcohol, Cannabis, Nicotine and Opiate Use, August 28, 1995. 14 Dutch Ministry of Health, Welfare and Sport [VMS]. (1995). Drug Policy in the Netherlands: Continuity and Change. The Netherlands. 15 Abt. & Associates, Inc. (1997, September 29). What America's Users Spend on Illegal Drugs, 1988-1995. Commissioned by the White House ONDCP; U.S. Bureau of the Census. (1996). Statistical Abstract of the United States: 1996 (116th Edition). Washington, DC. 16 Substance Abuse and Mental Health Administration, National Household Survey on Drug Abuse: Population Estimates 1997, Rockville, MD: Substance Abuse and Mental Health Administration (1998, July), pp. 23, 103, 113 [a regular user is someone who used a drug 51 or more days in the past year].

 

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GOAL NUMBER ONE: REDUCE THE HARM CAUSED BY DRUGS IN OUR SOCIETY OBJECTIVE: REDUCE DRUG ABUSE AND USE AMONG YOUTH AND YOUNG ADULTS Rationale: Our nation should focus its efforts on fact-based education as well as programs to dissuade adolescents from the use of alcohol, tobacco and illegal drugs. Adolescent drug use has been rising steadily since 1991, which is the longest sustained increase in adolescent drug use since the Monitoring the Future Survey began. After the release of the 1998 Monitoring the Future Survey,17 the ONDCP issued a surprising press release which stated “Second Straight Year of No Significant Increases, Many Categories of Youth Drug Use Fall Significantly.” General McCaffrey is quoted as saying, “The 1998 Study shows that we have turned the tide of youth drug use.”18 Unfortunately, a review of the actual survey data shows a sharply different result. Survey data indicate that modest declines in the use of the traditionally popular drug marijuana comprised the major portion of lowered numbers. This decline masked a continuing rise in hard drug use by our youth. For instance, the percentage of high school seniors reporting lifetime marijuana use dropped by 0.5%, but the percentage of high school seniors reporting lifetime crack use increased by 0.5%. Twice as many students reported using heroin by the 8th grade in 1998 as was reported in 1991. Nearly three times as many students reported using crack by the 8th grade for the same time period. Exchanging marijuana use for crack and heroin is clearly not the type of trade-off that most parents would like to see. The ONDCP's failure to mention any of these significant issues in their official press statement cheats parents, educators and journalists out of their ability to understand the dimensions of adolescent drug use.
Figure 9 Adolescent use of crack and heroin. Source: 1998 Monitoring the Future Survey, Institute for Social Research, University of Michigan.
Recommendation 1: TRIPLE the current National Drug Control Strategy budget share for reducing youth and young adult drug use.
Despite claims that the War on Drugs is being fought to save future generations of children from being hooked on drugs, and despite Drug Czar Barry McCaffrey's promise to focus his office's efforts on youth drug use prevention, the ONDCP is budgeting less than 12% of the $100 billion it is planning to allocate between 1998 and 2003 for reducing youth drug use.19 This number is appallingly low and should be significantly increased. For an effective drug control strategy, we believe that at least one-third of the budget should be focused on reducing youth drug use; therefore we recommend that the ONDCP TRIPLE its budget share to 34% for reducing youth and young adult drug use. Recommendation 2: Focus funding and efforts on strategies that have documented success in reducing youth drug use. According to SAMHSA, “alcohol and drug use tends to be a chosen activity engaged in during unstructured and unsupervised time.” 20 Therefore, existing and expanded funding should not be spent on simplistic anti-drug advertising campaigns, but rather should be invested in youth. Programs which provide positive and enriching activities, “offset the attraction to, or otherwise meet the needs usually filled by alcohol, tobacco and drugs.”21  Researchers have noted that “adolescence is a period in which youth reject conventionality and traditional authority figures in an effort to establish their own independence… drug use may be a 'default' activity engaged in when youth have few or no opportunities to assert their independence in a constructive manner.”22 Moreover, twice as many youths from low-income families are unsupervised for more than three hours per day than youths from high-income families.23 In an independent study of the Big Brother/Big Sister Program, researchers found that “Little Brothers and Little Sisters were 46% less likely to start using illegal drugs, and 27% less likely to start drinking.” Little Brothers and Little Sisters also did better in school, had better attendance records, and felt slightly better about how they would perform in school.24 Constructive activities and mentoring programs provide a strong environment for youths and young adults to reject all forms of drug use and provide benefits across a wide array of indicators, such as school performance and self-esteem. These kinds of strategies should be central to our efforts to reduce youth and young adult drug use because they actually work. Recommendation 3: Use facts, not scare-tactics to educate youth. Education is a key component of any plan to change self-destructive behavior. In order for it to be effective and not undermine its purpose, education must be completely factual and rational. By relying on scare-tactics and unfounded assertions, the current drug policy has failed to achieve its purpose. Nowhere can this be more clearly seen than where exaggerated claims about marijuana lead youth and young adults to disbelieve information about harder drugs as well.25 Statements like the one shown at right by Alan Leshner, director of the National Institute on Drug Abuse, can confuse children. Since half of all kids try marijuana before graduating from high school, there is a great deal of informal knowledge about the drug among youth. Being told by public officials that there is no substantive difference between marijuana and other drugs like heroin and cocaine, can “send the wrong message” to kids – leading to experimentation with more dangerous drugs. By focusing educational campaigns on information which is scientifically accurate, we can achieve our educational goals and become a more credible force with the younger generation. Recommendation 4: Redirect DARE funding into more productive and effective programs. Support for the DARE (Drug Abuse Resistance Education)26 program must to be reconsidered. Federally funded research conducted by the Research Triangle Institute found that DARE had no effect on youth and young adult drug use, and that DARE students were no less likely to use drugs than students who were not involved with the program.27  A key aspect of DARE's failure to be effective stems from the program's basic premise – the idea that police are appropriate teachers of health information. Police do not teach children about sex education, hygiene or dental care, so why are they teaching children about drugs? It sends the wrong message that drugs are a law enforcement issue, rather than a public health issue. More importantly, a police officer may intimidate adolescents who have experimented with drugs from asking lifesaving questions out of fear that they will get into trouble. In spite of DARE's documented lack of success and its inherent weaknesses, the federal drug education budget provides a 'set aside' for DARE, ensuring that it continues to squander the few prevention dollars this country spends on adolescent drug education. This a failure on the part of our government to protect children from the dangers of drug use and drug abuse. At the very least, DARE should be required to compete with other drug education programs and prove that it can be effective. Furthermore, since federally sponsored studies indicate that nearly 50% of all students try an illegal drug before they graduate from high school, and 85% of students try alcohol,28 the goal of drug education should be broadened to include reducing the harms related to alcohol and other drug use, as well as preventing adolescent alcohol and other drug use from the outset. Recommendation 5: Be responsible with the provision of anti-drug messages. The ONDCP's newly launched $2 billion advertising campaign to make children aware of the dangers of drug use has been approached in an unscientific and irresponsible way. There is no evidence that advertising is likely to prevent drug abuse, and in fact highlighting drug use may have the reverse effect. In the 1960s, media stories which promoted the dangers of using glue to intoxicate oneself only served to inform children that the common substance could produce a high, and “to popularize rather than to discourage the practice.” Prior to 1959, glue-sniffing was virtually unknown, but with its publicity, the number of high school students who reported trying it at least once rose to about 1 in 20 by the mid to late 1960s.30  Today, the ONDCP is running a series of advertisements on household inhalants which airs during children's cartoons and while parents are away at work. Just as with the glue-sniffing stories of the 1960s, it is very likely that most young people do not know that inhaling the vapors of everyday household products can produce a high, until they view the advertisements on television. Sending this information into the homes of children without parental consent is irresponsible and has enormous potential for tragedy as children may decide to experiment with the chemicals found under every kitchen sink. According to David Kiley, the Senior Editor of the advertising industry's Brandweek, the research relied upon by the ONDCP, “hardly stands up to the slightest breeze of inquiry. In some cases the validity of key parts of the research is even refuted by the people responsible for it.”31
17 The Monitoring the Future Survey is an annual survey of drug use by 8th, 10th, and 12th grade students. 18 ONDCP, "1998 Monitoring the Future Study: Tide of Youth Drug Use Turns" December 18, 1998 (press release). 19 McCaffrey, Barry R. (1998). The National Drug Control Strategy, 1998: A Ten Year Plan. Washington, DC: Office of National Drug Control Policy, p. 58. 20 Carmona, Maria and Kathryn Stewart. (1996). "A Review of Alternative Activities and Alternatives Programs in Youth-Oriented Prevention" CSAP Technical Report No. 13. Washington, DC: Center for Substance Abuse Prevention/ Substance Abuse and Mental Health Administration/ Department of Health and Human Services, p. 3. 21 Federal Register, Volume 58, Number 60, March 31, 1993. 22 Carmona and Stewart, p. 5. 23 Carmona and Stewart, p. 5. 24 Tierney, Joseph P., Jean Baldwin Grossman, and Nancy L. Resch. (1995 November). Making a Difference: An Impact Study of Big Brothers/Big Sisters. P. 49. Philadelphia, PA: Public/Private Ventures. 25 Perhaps the main justification for a "zero-tolerance" policy towards marijuana, even to prevent blindness in glaucoma patients or to ease nausea in cancer patients, is the belief that marijuana is a "gateway" drug which leads young people to seek ever more powerful drugs like cocaine and heroin. Some research institutions have tried to prove the existence of the gateway effect, but none have succeeded. The National Center on Addiction and Substance Abuse (CASA) is the leading proponent of the theory today, but even it has had to acknowledge that "what is lacking is the basic scientific and clinical research required to establish causality." [Merrill, Jeffrey C. and Kimberly S. Fox. (1994). Cigarettes, Alcohol, Marijuana: Gateways to Illicit Drug Use, "Implications for Future Action." New York, NY: CASA.] CASA's researchers have also had to acknowledge that "the majority of gateway drug users never move on to other drugs..." [Merrill & Fox, 1994]. Within its report, CASA acknowledges that the statistical correlation of cocaine and marijuana use "does not necessarily prove that a causal relationship exists." [Merrill & Fox, 1994]. And, although CASA's researchers note that "the majority of marijuana users never use any other illegal drug," CASA refuses to acknowledge that "for the large majority of people, marijuana is a terminus rather than a gateway drug." [Zimmer and Morgan, p. 32.] 26 DARE was created by former Los Angeles Police Chief, Daryl Gates. The program employs uniformed police officers to teach drug education to public school children. 27  Ennett, S. T., et. al. (1994, September). "How Effective is Drug Abuse Resistance Education? A Meta-analysis of project DARE Outcome Evaluations." American Journal of Public Health. 28  Half the high school students in the United States will try illegal drugs before they graduate. Johnston, L., Bachman, J. & O'Malley, P. (1996). National survey results from the monitoring the future study, HHS, National Institute on Drug Abuse. 29 Brecher, Edward M. The Consumers' Union Report on Licit and Illicit Drugs. "How to Launch a Nationwide Drug Menance." Ch. 44. (1972). Little Brown and Company. 30 Ibid. 31 Kiley, David. (1998, April 27). "Blind Support for Anti-Drug Ads? Just Say No." Brandweek.

 

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GOAL NUMBER ONE: REDUCE THE HARM CAUSED BY DRUGS IN OUR SOCIETY OBJECTIVE: REDUCE DRUG ABUSE AND USE AMONG WOMEN Rationale: Detailed information on women's drug use is limited. Data that examines gender and race-ethnicity and age are rarely published.32 The 1997 National Household Survey on Drug Abuse found that 34.3% of white women, 19.2% of Latinas, and 24.9% of African-American women reported using an illegal drug in their lifetime. This survey, presents an incomplete assessment of total drug use since it did not include women who were homeless, in colleges and universities, or in institutionalized populations. We do know that drug addiction has increased steadily among girls and women and, in the case of certain drugs, more rapidly than among boys and men.33 From 1992 to 1997, for example, regular use of cocaine increased for women while men's cocaine use declined slightly.34 Addiction to legally prescribed drugs is also a more serious problem for women than men.35  Emergency room visits by women because of drug-related problems rose 35% between 1990 and 1996.36  Women who abuse drugs often face a greater social stigma than men because they fail to fulfill our society's standard for female morality as well as their traditional role as the stabilizing force in the family.37  The extent of drug use among women, the causes of addiction, and its effect on women's lives and bodies are not fully understood because addiction has traditionally been treated as a male disease.38  However, the problem of drug addiction among women cannot be separated from other aspects of their social conditioning. Studies of women who seek treatment for alcohol and other drug problems have revealed a dramatic connection between domestic violence, childhood abuse, and substance abuse.39 Women substance abusers have high levels of depression, anxiety, and feelings of powerlessness, and low levels of self-esteem and self-confidence.40 Punishing women strips them of control over their lives, exacerbates underlying problems, and fails to provide any strategy for long-term prevention. Policy makers must recognize the connection between drug addiction among women and other health, social and economic problems that women face. The only effective way to address drug abuse is simultaneously to address the problems of violence and sexual abuse, unsafe housing, unemployment, stereotyped sexual roles, lack of health care and lack of child care which contribute to the depression and hopelessness that are underlying causes of substance abuse. The barriers to treatment for women must be addressed. First, only 41% of women who need drug treatment actually receive it.41 Second, most programs are based on male-oriented models that are not geared to the needs of women. The lack of accommodations for children is one of the most significant obstacles to treatment for women.42 Most clinics do not provide child care and many residential treatment programs do not admit women with children.43  Treatment programs have traditionally failed to provide the comprehensive services -- including prenatal and gynecological care, contraceptive counseling, appropriate job training, and counseling for sexual and physical abuse -- that women need. The typical focus on individual pathology may exclude social factors, such as racism, sexism and poverty that are essential to an understanding of drug abuse in women. Recommendation 1: Fund prevention programs that target women. Federal and state governments must increase the amount of funding for prevention efforts that target women and girls about the risks of alcohol and drug use. Prevention strategies and programs must be community-based and sensitive to women's diverse cultural backgrounds and must be developed with significant input from women from local communities. A critical component of a comprehensive national drug prevention strategy for women is widely available needle exchange programs. AIDS is the third leading cause of death among women of reproductive age in the United States, and the number one cause of death for African-American women.44 In 1997, women accounted for 22% of AIDS cases, compared to seven percent in 1985. Among teenage women ages 13 to 19, the number of cumulative AIDS cases multiplied over 16 times between June 1989 and December 1997; for women ages 20 to 24 the number has multiplied more than nine times. Injection drug use accounted for 28% and 14% of cases in women of these age groups, respectively.45 Women constitute the fastest growing group of new HIV cases in the United States.46  Recommendation 2: Increase services for women.
SAMHSA funding for women reached its peak in 1994 when gender-specific demonstration programs only represented three percent of SAMHSA's total budget. SAMHSA funding designated for women has dropped 38% since 1994.47  Congress should mandate increased funding for treatment facilities designed specifically for women. The goal should be universal access to both outpatient and residential treatment services for all women who are addicted to drugs and alcohol. Federal and state guidelines must be established to ensure that programs are geared specifically to the needs of women. Guidelines should be flexible enough, however, to enable local programs to adjust to the particular needs and experiences of the communities they serve. Programs must be designed to overcome the current barriers to women's access to and participation in treatment. The following features are essential to increasing the accessibility of treatment for women: Treatment should be provided on a sliding scale basis and Medicaid reimbursements should be accepted. Facilities must be accessible in light of poor transportation systems either by locating them at convenient sites within the community or by providing transportation. Programs must provide on-site child care and/or allow children to reside with their mothers. Programs should provide early education and pediatric services for children, either on-site or by referral. Gender sensitivity training must be provided for program staff. Programs must develop specific outreach efforts to draw women into treatment. Women should be contacted where they live, work and socialize and through community events. Recommendation 3: Fund research on women's experiences Congress should increase the amount and proportion of funding devoted to research that explores the particular experience of women who abuse alcohol and other drugs. Federal funding of research projects should be greatly expanded. The research should answer the following questions about women and drug abuse: How prevalent is drug use among women, both pregnant and non-pregnant? What are the underlying causes, including social, psychological, biomedical, and economic factors, of women's drug abuse? How effective are various addiction prevention and treatment programs, including gender-specific treatment models and women-only facilities? This research should not focus solely on the effects of drug use during pregnancy but throughout a woman's life span. All research should be done in the context of delivery of health care and its purpose should be to improve the health of all women.
32 Drug Strategies. (1998). Keeping Score, 1998: Women and Drugs: Looking at the Federal Drug Control Budget. Washington, DC: Drug Strategies. 33 Drug Strategies (1998), citing NIDA, Monitoring the Future, 1975-97; Drug Strategies (1998), citing SAMHSA, November 1997, Preliminary Estimates from the 1996 Drug Abuse Warning Network. SAMHSA (November 1997). 34 SAMHSA. (1998, August). Preliminary Results from the 1997 National Household Survey on Drug Abuse 35 H.A. Pincus, T.L. Tanielian, S.C. Marcus, M. Olfson, D.A. Zarin, J. Thompson and J.M. Zito. (1998). "Prescribing Trends in Psychotropic Medications: Primary Care, Psychiatry, and Other Medical Specialities." JAMA. 279(7), 526-531. 36 Drug Strategies (1998) citing SAMHSA (1997, November), Year End Preliminary Estimates from the 1996 Drug Abuse Warning Network. Washington, DC. 37 Roberts, Dorothy. (1991). Women, Pregnancy, and Substance Abuse. Washington, DC: Center for Women's Policy Studies. 38 Millstein, Richard A. (1998, December). "Gender and Drug Abuse Research." The Journal of Gender-Specific Medicine. 1(3); see also Roberts, Dorothy. (1991). 39 SAMHSA. (1997). Substance Abuse Treatment and Domestic Violence. Washington, DC: SAMHSA. 40 Dansky, B.S., Saladin, M.E., Brady, K.T., Kilpatrick, D.G., and Resnik, H.S. (1995). "Prevalence of Victimization and Post Traumatic Stress Disorder Among Women With Substance Use Disorders: Comparison Telephone and In-Person Assessment Samples." The International Journal of Addictions. 30(9). 1079-1099. 41 Woodward, A., Epstein, J., Gfroerer, J., Melnick, D., Thoreson, R., and Willson, D. (1997 Spring). "The Drug Abuse Treatment Gap: Recent Estimates." Health Care Financing Review. Vol. 18, No. 3. Table 3, p. 15. 42 Paone, D., Chavkin, W., Willets, I., Friedman, P., and Des Jarlais, D. (1992) "The Impact of Sexual Abuse: Implications of Drug Treatment." Journal of Women's Health. 1(2). p. 149-153.; see also Roberts. (1991). 43 Breitbart, V., Chavkin, W., and Wise, P. (1994). "The Accessibility of Drug Treatment for Pregnant Women: A Survey of Programs in Five Cities." American Journal of Public Health. 84 (10). 44 Anderson, , R.N., Kochanek, K.D, and Murphy, S. L. (1997). "Report of Final Mortality Statistics, 1995." Monthly Vital Statistics report, 45. (11) Supplement 2. Hyattsville, MD: National Center for Health Statistics. 45 Centers for Disease Control, 1997, HIV/AIDS Surveillance Report 9, 2. Atlanta, GA: Centers for Disease Control. 46 Centers for Disease Control, 1996, HIV/AIDS Surveillance Report, 8, 2. Atlanta, GA: Centers for Disease Control. 47 Drug Strategies. (1998).

 

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GOAL NUMBER ONE: REDUCE THE HARM CAUSED BY DRUGS IN OUR SOCIETY OBJECTIVE: REDUCE DRUG ABUSE AND USE AMONG ALL AMERICANS Rationale: Simple common sense tells us that government spending to reduce alcohol and other drug use should focus on the most effective tactics. Unfortunately, years of politicization and the creation of numerous bureaucracies which derive funding from drug control spending have diverted our drug control budgets away from effective tactics and toward entrenched bureaucratic interests. The ONDCP's 1999 drug control budget is a prime example of the misuse of public money. The RAND Corporation's thorough and scientific examination into the costs and benefits of treatment, interdiction, eradication and prison building has shown that investing additional resources in treatment is the most effective strategy to curtail drug use and abuse, yet the ONDCP's budget still focuses 2/3 of its budget on law enforcement and other ineffective tactics. According to RAND's widely respected study, for each additional dollar spent on cocaine treatment, a social benefit of reduced cocaine consumption, crime and increased productivity valued at $7.46 is received, while each additional dollar spent on eradicating coca overseas represents a loss of eighty-five cents.48 Amazingly, the Drug Czar's office is requesting $4.6 billion for source-country eradication and interdiction in 1999 (Goals 4 and 5), and plans annual spending increases in these areas over the next four years.49 Total spending on this approach would reach $23 billion between 1999 and 2003. Given the choice of investing one dollar in a bank that will give us 15 cents at year's end or one that will give us over 7 dollars, the government has opted for the 15 cents. By continuing this waste, the government is failing to help those in need of treatment and failing to reduce the consumption of drugs in our communities. Recommendation 1: Provide drug treatment upon request and a variety of treatment options. With so much talk by Congress and the White House about the damage that drugs cause our society, one would think our drug-treatment facilities were wide-open, and eagerly awaiting patients who have finally heeded the calls of our government to break their addiction. Not so. An addict can wait many months between a request for treatment and the availability of a treatment slot. A policy that chooses to provide prison cells rather than treatment beds makes a mockery of its claims to have a strategy to decrease drug use in America. The provision for treatment upon request has been Federal law since 1988. Section 2012 of the Anti-Drug Abuse Act of 1988 sets out the purpose of the law, which is: To increase to the greatest extent possible the availability and quality of treatment services so that treatment on request may be provided to all individuals desiring to rid themselves of their substance abuse problem.50  Yet, the 1998 National Drug Control Strategy, which provides a 10-year plan for US national drug strategy, makes no provision for making treatment-on-request a reality. The President, the Congress, researchers and drug abuse professionals all agree treatment on request should be made available, yet the ONDCP has not even mentioned it as a goal. Furthermore, treatment options need to be expanded to address the variety of needs persons with drug problems have. Some people will respond quite readily to abstinence-based programs like Narcotics Anonymous and Alcoholics Anonymous. Others will require methadone therapy to stave off the symptoms of opiate addiction, or a gradual weaning from their addiction through doctor-supervised maintenance programs. For more specific recommendations of treatment options, please see the section entitled, “Allow Doctors Greater Freedom to Address Public Health Issues.” Recommendation 2: Enact legislation that provides full continuum insurance coverage for substance abuse treatment. If our society is truly serious about reducing drug use, then we must make every effort to move those people who wish to be treated for drug addiction into treatment facilities. One of the most effective means to do so is to provide “full continuum” insurance for substance abuse. As stated in a report commissioned by the Connecticut State Legislature, this would “include screening, assessment, intervention, detoxification, short-term and long-term inpatient rehabilitation, outpatient and intensive outpatient services, family treatment, and methadone maintenance treatment.”51 This was also the goal of legislation introduced in the 105th Congress.52 By providing addiction treatment through medical insurance, we reduce the need for people to rely on public funding and facilities to treat substance abuse problems. Recommendation 3: Reduce children's exposure to cigarette and alcohol advertising. One of the main goals of advertising is to create demand for a product, industry or idea. As two of the largest sources of illness and death in America, it is not beneficial to glamorize or promote cigarettes and alcohol to young children. An effective drug control strategy would examine ways to reduce children's exposure to such marketing, perhaps by limiting alcohol ads to television programs which are rated for adult content. The marketing of addictive products to children must be addressed, while balancing the commercial speech rights of legal businesses to market their products or educate the public on policy issues related to their industry.
48 Rydell & Everingham. Controlling Cocaine: Supply Versus Demand Programs, RAND Corporation (Santa Monica, CA: 1994), p. xvi). 49 ONDCP, The National Drug Control Strategy, 1998, p. 59. 50 The Anti-Drug Abuse Act of 1988. Public Law 100-690. (1988, November 18). 51 Drug Policy in Connecticut and Strategy Options: Report to the Judiciary Committee of the Connecticut General Assembley. (1997, January 21). Connecticut Law Revision Commission. 52  The Moynihan-Levin Anti-Addiction and Drug Treatment Access Act of 1998.

 

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GOAL NUMBER ONE: REDUCE THE HARM CAUSED BY DRUGS IN OUR SOCIETY OBJECTIVE: REDUCE THE SPREAD OF INFECTIOUS DISEASE Rationale: As surprising as it may seem, many criminal laws to control drug use actually work against vital public health goals, such as the suppression of AIDS/HIV and Hepatitis-C. Clearly, any policy that sacrifices the health and well being of the entire community by spreading deadly communicable diseases in an effort to “send the right message” needs to be amended so that it does not cause greater damage to society than the drug use itself. Recommendation 1: Repeal all State and Federal laws designed to prevent access to and possession of sterile syringes and injection equipment.53  Needle exchange programs are one of the most effective means of stemming the devastating and costly tide of AIDS and Hepatitis in our communities. Each day, 33 Americans54 become newly infected with HIV, and 50% of these cases are due to the sharing of contaminated needles. 55 Women and children are even more severely impacted by needle contamination. Ninety (90%) percent of all new AIDS cases in women and in children under 13 for which the exposure group is known are injection related. 56 Each person living with AIDS will need approximately $195,000 in treatment over their lifetime and can potentially infect thousands of other individuals; meanwhile, a clean syringe only costs about eight cents. These needless deaths and costs can be avoided through the use and promotion of needle exchange programs and provision of syringes in pharmacies. Laws which exist to limit the supply of clean needles, simply ensure the proliferation of contaminated needles. While opponents claim that needle exchange programs “send the wrong message,” the U.S. Government has funded seven reports on clean needle programs for persons who inject drugs, and each of the reports concluded that clean needle programs reduce HIV transmission and do not increase drug use. The reports were conducted by the National Commission on AIDS, the General Accounting Office, the University of California, the Centers for Disease Control, the National Research Council, the Institute of Medicine, the Office of Technology Assessment, and the National Institutes of Health Consensus Panel. In fact, Baltimore's Health Commissioner Peter Bielenson, has found that instead of “sending the wrong message,” quite the opposite is true as stated in his testimony before Congress: Finally, although some legislators expressed concerns that the [needle exchange] program would make it more likely that injection drug users would use more frequently, that has not been the case - our clients report a 22% decrease in their frequency of [drug] use since joining the NEP [needle exchange program].58  Equally important, the National Institutes of Health have concluded that “individuals in areas with needle exchange programs have an increased likelihood of entering drug treatment programs.”59 Thus, needle exchange programs reduce AIDS and work toward reducing drug abuse. Recommendation 2: Make prevention and treatment of Hepatitis-C a high public health priority. Just as with the emergence of HIV, which was spread in part by the sharing of needles, a newly recognized strain of Hepatitis, known as Hepatitis-C Virus (HCV) is rapidly emerging as a major blood-borne disease. According to the Centers for Disease Control and Prevention, “HCV infection is a major cause of chronic liver disease in the United States and worldwide. At least 85% of persons with HCV infection become chronically infected and chronic liver disease with persistently elevated enzymes develops in approximately 70% of all HCV infected persons.”60 Unlike the inexpensive intervention of decriminalizing needle possession, the CDC says “the estimated cost for each [infected] person for a 6-month course of therapy is $200,000.”61 In 1998, it was estimated that approximately 4,000,000 Americans were infected with Hepatitis-C. The cost and devastation that will be caused by this epidemic can be greatly reduced through a strong and effective education campaign, combined with outreach to at-risk populations and access to sterile syringes. There is also a need for drug users to have access to medical care, accurate information about the possibility of disease progression once infected, an all out effort for a cure and for drug users to be included in developing new therapeutic interventions.
53 H.R. 2212, HIV Prevention Outreach Act, was introduced by Rep. Cummings (D-MD) with 7 co-sponsors on July 22nd, 1997. This bill would have required the Secretary of Healthand Human Services to make grants to "States and political subdivisions of States" for needle exchange programs. 54 AIDS Official Backs Needle Exchange. (March 27, 1996). Associated Press. Quoting the Director, Office of National AIDS Policy Sandra Thurman at a National AIDS UPDATE Conference. 55 Holmberg, S. (1996). "The Estimated Prevalence and Incidence of HIV in 96 Large US Metropolitan Areas." American Journal of Public Health, 86, 642-54. 56 Centers for Disease Control. HIV/AIDS Surveillance Report. HIV and AIDS Cases Reported through December 1997. Year-end edition, Vol. 9, No. 2. 57 Holtgrave, DR, Pinkerton, SD. "Updates of Cost of Illness and Quality of Life Estimates for Use in Economic Evaluations of HIV Prevention Programs." Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, Vol. 16, pgs. 54-62 (1997). 58 Bielenson, MD, Peter. (1997, September 18). Written testimony of Dr. Bielenson to Subcommittee on National Security, International Affairs and Criminal Justice. 59 National Institutes of Health Consensus Panel. (1997, February 11-13). Interventions to prevent HIV risk behaviors, 6. Kensington, MD: NIH Consensus Program Information Center. 60 Centers for Disease Control. Morbidity and Mortality Weekly Report. (1997, July 4). Vol. 46, No. 26. Atlanta, Georgia. 61 Ibid.

 

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GOAL NUMBER ONE: REDUCE THE HARM CAUSED BY DRUGS IN OUR SOCIETY CHAPTER SUMMARY We need to reduce the harm that drug use and abuse cause in our society. This requires that we find solutions to drug abuse that really work. Some important strategies to consider include forming a commission of non-partisan experts to evaluate the effects of the current drug control model and allowing cities and states greater flexibility to experiment with their own approaches to drug control. It is also important that drug policy not be based on clearly erroneous concepts like the 'gateway' theory which have been rejected by prestigious groups such as the World Health Organization. Separating the markets for marijuana and other illegal drugs may also be a wise approach because research shows that it is the black market which introduces youth to more harmful substances. Reducing drug use and abuse among youth and young adults is another important goal in reducing the harm caused by drugs. An effective drug control strategy would implement Drug Czar Barry McCaffrey's assertion that “The principal component of our drug strategy ought to be based on prevention programs aimed at adolescents.”62 Making this the principal component requires that it receive a principal share of the funding. To carry out this goal, we need to do two things: raise the spending on youth prevention from its current paltry level of 12% of the drug control budget to 34% and spend that 34% of the budget on programs that actually work as demonstrated by science and research. Investments in our youth, such as after school programs, Big Brother/Big Sister programs, and other enrichment activities are effective and the Federal government's research as published by SAMHSA confirms this. Meanwhile, programs like DARE, television ads and other scare-tactics have not been proven effective at reducing drug use. Funding for programs should be competitive and based on results, not politics. We must also seek to reduce drug use and abuse in all age groups and in all sectors of society, with special emphasis on the needs of women. Since treatment has been shown to be the most effective tool to reduce drug consumption in this country, it should be a serious component of our national drug control strategy. Instead of putting 2/3 of our funding into law enforcement measures, we should fully fund treatment centers so that treatment is available upon request, and enact legislation that provides full-continuum insurance coverage for drug and alcohol addiction. In the struggle against the harms of drug and alcohol addiction, the lack of treatment availability in the United States virtually ensures that we will continue to suffer horrendous social costs from these diseases. Finally, we must stop the spread of diseases associated with injection drug use. With the high number of new HIV and hepatitis infections, laws against the possession of clean needles are a virtual death sentence. Needle exchange programs do not increase drug use, but do save lives. A ban on federal funding for needle exchange programs is pure folly. Claims that decriminalizing needle possession will lead to increased drug use have been never been proven. Seven reports funded by the U.S. Government between 1991 and 1997 are unanimous in their conclusions that clean needle programs reduce HIV transmission, and none find that clean needle programs cause rates of drug use to increase.63
62 ONDCP Director 63 National Commission on AIDS, The Twin Epidemics of Substance Abuse and HIV, Washington D.C.: National Commission on AIDS (1991); General Accounting Office, Needle Exchange Programs: Research Suggests Promise as an AIDS Prevention Strategy, Washington D.C.: U.S. Government Printing Office (1993); Lurie, P. & Reingold, A.L., et al., The Public Health Impact of Needle Exchange Programs in the United States and Abroad, San Francisco, CA: University of California (1993); Satcher, D., (Note to Jo Ivey Bouffard), The Clinton Administration's Internal Reviews of Research on Needle Exchange Programs, Atlanta, GA: Centers for Disease Control (1993, December 10); National Research Council and Institute of Medicine, Normand, J., Vlahov, D. & Moses, L. (eds.), Preventing HIV Transmission: The Role of Sterile Needles and Bleach, Washington D.C.: National Academy Press (1995); Office of Technology Assessment of the U.S. Congress, The Effectiveness of AIDS Prevention Efforts, Springfield, VA: National Technology Information Service (1995); National Institutes of Health Consensus Panel, Interventions to Prevent HIV Risk Behaviors, Kensington, MD: National Institutes of Health Consensus Program Information Center (1997, February).

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" OBJECTIVE: REDUCE CRIME AND VIOLENCE ASSOCIATED WITH THE DRUG WAR.
Rationale: Violence itself can be successfully dealt with as a public health problem. It is important to consider the fact that most “drug-related” violence is actually drug trade related. In an analysis of New York City's homicides in 1988, Paul Goldstein and his colleagues concluded that 74 percent of drug-related homicides were related to the black market drug trade and not drug use. For instance, the leading crack-related homicide cause was shown to be territorial disputes between rival dealers, and not crack-induced violence or violence (predatory thieving) to obtain money for crack purchases.64  As reported in the Journal of the American Medical Association, the nationwide emphasis on arresting drug dealers may have produced a labor shortage, which contributed to the high mortality rate of the 1980s. “Every time you jail a drug dealer, you open up a new opportunity for an enterprising young man. What does he do to compete for this job? He kills for it.”65  The chart shown above illustrates the homicide rate in the United States for the 20th Century. Note that this century's two most violent episodes are concurrent with stringent prohibition policies. In a 1998 study on the social costs of alcohol and illegal drugs produced by the National Institute on Drug Abuse (NIDA), researchers estimated that illegal drugs cost our society $98 billion in 1992 (the most recent year that statistics were available). Approximately 60% of societal drug costs were due to drug-related crime and the black market. These included police, legal and incarceration costs, lost productivity of incarcerated criminals and victims of crimes, as well as the lost productivity due to drug-related crime careers. In fact, the researchers said that the rising societal costs of drug use “can be explained by the emergence of the cocaine and HIV epidemics, an eight-fold increase in State and Federal incarcerations for drug arrests and about a three-fold increase in crimes attributed to drugs.” Less than 30% of the costs were due to the actual biological effects of drug use – that is, drug-related illness or death. Moreover, this number probably includes a number of prohibition-related costs as well, since the prohibition on needle possession is a leading factor in the spread of HIV and Hepatitis C. This contrasts sharply with alcohol, where 2/3 of the costs were directly due to alcohol related illness and death. Overall, this study and figure illustrated below show that our failing War on Drugs actually creates the majority of costs our communities pay when considering illegal drugs. In light of these facts, the researchers did not call for a new offensive in the War on Drugs, new resources for the police, or new laws to put people in jail for longer sentences. Instead, NIDA director Dr. Alan Leshner said, “The rising costs from these and other drug-related public health issues warrant a strong, consistent and continuous investment in research on prevention and treatment.” From these facts, we know that the War on Drugs has created violence, addiction, and crime where once there was only addiction. Today, the cost of drug-related crime and violence actually exceeds the cost of drug use itself. This cycle could be broken by providing sufficient resources for treatment. Simply put, the policy of waging war on the sick and addicted has failed, while treatment and prevention are still waiting to be implemented in any meaningful way. Recommendation 1: Commission a study on the relationship between drugs, alcohol and violence. A recent study by the National Center on Addiction and Substance Abuse at Columbia University (CASA), entitled Behind Bars: Substance Abuse and America's Prison Population, indicates that only 3% of violent criminals in state prisons were under the influence of crack or powder cocaine at the time their crime was committed, and only 1% were under the influence of heroin. In jails, none of the violent criminals was under the influence of heroin at the time their crime was committed. These facts indicate that our policy makers need to become more sophisticated in their approach to crime and violence, if we are ever to see a meaningful reduction in these social ills. Currently, many policy makers operate under the assumption that drug use causes violence. If this is the case, it needs to be documented and understood, and not just assumed. On the other hand, many public health and criminal justice experts feel that most “drug-related” violence is actually a by-product of a black market and the types of people who engage in narcotics trafficking. According to members of the Panel on the Understanding and Control of Violent Behavior for the National Academy of Sciences, “Most of the violence associated with cocaine and narcotic drugs results from the business of supplying, dealing and acquiring these substances, not from the direct neurobiologic actions of these drugs.”67 Policy makers must focus their efforts on reducing the violence associated with the drug trade, not simply locking up non-violent offenders to increase arrest statistics.
64 Goldstein, Paul, J., Henry H. Brownstein, Patrick J. Ryan and Patricia A. Bellucci. (1989 Winter). "Crack and Homicide in New York City: A Conceptually Based Event Analysis." Contemporary Drug Problems. 16(4):651-687. 65 Cole, Thomas B. (1996 March 6). "Authorities Address US Drug-Related `Arms Race.'" Journal of American Medical Association. Vol. 275, No. 9. American Medical Association. 66 Dr. Alan Leshner, as quoted in NIDA press release "Economic Costs of Alcohol and Drug Abuse Estimated at $246 billion in the United States." (1998, May 13). 67 Miczek, Klaus A., Joseph F. DeBold, Margaret Haney, Jennifer Tidey, Jeffery Vivian, and Elise M. Weerts. (1994). "Alcohol, Drugs of Abuse, Aggression and Violence." In Understanding and Preventing Violence: Social Influences. Vol. 3. Albert J. Reiss, Jr. and Jeffery Roth, eds. Washington, DC: National Academy Press.

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" OBJECTIVE: MAKE CRIMINAL PENALTIES FIT THE SEVERITY OF THE CRIME
Rationale: The Sentencing Reform Act of 198468 radically changed sentencing in drug cases. The new law required judges to sentence individuals based on mandatory guidelines, eliminating most judicial discretion. Congress enacted mandatory sentencing statutes as part of the Omnibus Drug Control Act of 1986.69 Federal judges have strongly opposed mandatory sentencing as have many other law enforcement experts. In fact, every judicial circuit, as well as the Criminal Law Committee of the Judicial Conference and the Federal Courts Study Commission have opposed mandatory minimum sentencing. The combination of stringent guidelines and mandatory sentencing along with similar harsh sentencing penalties adopted by most states has produced a burgeoning rate of incarceration in the United States. Prisons should be a solution of last resort. Addiction is a disease, and no disease, whether it is cancer or addiction, is effectively treated by incarceration. Moreover, our nation's addiction to prison building has contributed to declines in education spending in many states and undermines the global competitiveness of our country. Recommendation 1: End mandatory minimum sentencing (statutory and guideline).70  Although few anticipated the outcome when these laws were being drafted, mandatory minimum sentencing has had an extremely negative impact on American society and has failed to meet its objectives. It is time to restore the traditional authority of judges to determine sentences on a case-by-case basis, so that punishments fit the crime. Consider the following facts: The United States is now the operator of the largest prison system on the planet.71  The Federal Bureau of Prisons budget has had to increase by 1,400% from 1983 to 1997.72  It costs nearly $9 billion per year to keep drug law violators behind bars73 , yet 55% of all Federal drug defendants are classified as low-level offenders, such as mules or street dealers. Only 11% are classified as high-level dealers.74  Combined, these facts tell us that mandatory minimum sentencing has forced us to build many new prisons to house low-level and non-violent offenders for extremely long periods of time. According to the Federal Bureau of Prisons, the sentence for the average drug offender is 2.5 times that of the average assault sentence. Ironically, even building new prisons to hold drug offenders for an average of 82.3 months does not provide enough prison space because new prisons are being built all the time. Considering the fact that 24 million Americans used illegal drugs in the past year, it is hard to see how increased incarceration has done anything to stop drug use in America.75 Moreover, the Department of Justice has acknowledged that, “the amount of time inmates serve in prison does not increase or decrease the likelihood of recidivism.”76  Unfortunately, mandatory minimum sentencing has been largely a failure at apprehending and holding high-level drug dealers.77  By removing a judge's discretion from considering the actions of a drug defendant during the sentencing phase of a case, prosecutors have been handed incredible power. By deciding how much of a drug to charge to a particular defendant, prosecutors can essentially determine what their sentence will be.78  Since prosecutors are empowered to reduce sentences for “cooperation,” high level dealers with information to trade receive reduced sentences, while low-level participants with no information to trade often receive the harshest penalties. Another problem with the prosecutors power to force witnesses to cooperate is the expansion of false testimony79 in drug cases and the abuse of conspiracy laws – which allow lengthy mandatory sentences based on the testimony of one witness who claims the defendant was part of a drug conspiracy.80 Clearly such a system which gives leniency to major drug dealers and gives low level offenders longer terms than more culpable parties must be eliminated immediately. Some senior Federal judges have refused to take drug cases because they do not want to be part of a process which they feel is unjust. Restoring the power to punish to judges will restore integrity to the system. Recommendation 2: Alter sentencing guidelines so judges have more room to maneuver within Guideline boxes and make the Guidelines advisory, rather than mandatory. Guidelines should also encourage greater reliance on role in the offense as a factor that mitigates or aggravates a sentence. As a result of mandatory sentencing guidelines, judges have too little discretion. By implementing the above recommendation, judges will benefit from the guidance of knowing what is expected in an ordinary case, but they will not be confined too tightly in unusual cases. Reducing the stakes of the calculation will also relieve other problems like 'charge bargaining' and congested appeals because more appropriate sentences will be passed. If our legal system can distinguish between different types of homicide defendants, then at the very least, drug defendants should be accorded the same consideration. Recommendation 3: Allow judges to determine whether a drug prosecution is handled more appropriately by state, local or federal courts. The federal government has developed a national criminal code that results in many cases being handled by federal courts which should be handled by local courts. With regard to drug prosecution, the power of federal prosecutors has been so greatly increased that prosecutors play a larger role in administering justice than judges in drug cases.81 Federal judges can be given some control over justice in drug cases by giving them the authority to issue a pretrial ruling that allows them to remand a case to the local courts. Judges can weigh whether the offenses charged are more locally based, whether local courts are better able to evaluate the circumstances of an individual defendant or whether a local drug court (which do not exist in the federal courts) would more appropriate for the offender. As an alternative, the Department of Justice could develop guidelines which reduce the number of inappropriate prosecutions they undertake. Recommendation 4: Cease the costly and ineffective targeting of marijuana possession cases. The most recent FBI Uniform Crime Reports indicate that there were 695,201 marijuana arrests in 1997, which is about a 100% increase since 1991. Eighty-seven percent (87%) of these arrests were simply for possession of marijuana. Since the vast majority of arrests are for possession, there is clear evidence that these cases consume a disproportionate share of law enforcement resources that could otherwise be devoted to fighting property and violent crimes. According to the same FBI data, nearly as many people were arrested for marijuana offenses as were arrested for murder, rape, robbery, and aggravated assault combined. In the November 1998 elections, Arizona and Oregon voters registered their support for fundamental change in our approach to drug policy by: 1) rejecting a measure to recriminalize marijuana possession (67% of voters in Oregon opposed making marijuana possession a criminal offense); 2) enacting a ballot initiative that removes criminal penalties for possession of any drug and substituting treatment in its place (51.7% of voters in Arizona opposed using incarceration even for repeat offenders of any drug offense). The FBI data indicate that small possession cases receive too much law enforcement resources and there is growing evidence of voter disenchantment with those policies. Therefore, law enforcement agencies should cease the costly and ineffective practice of targeting possession cases and local governments ought to develop alternatives to arrest, prosecution and incarceration of people who possess small quantities of drugs.
68 The Comprehensive Crime Control Act of 1984. (1984). Pub. L. No. 98-473, 8 Stat. 1937. 69 The 1986 Anti-Drug Abuse Act, Pub. L. No. 570. (1986). 9th Congress 2nd Session. 70 H.R. 957, The Sentencing Uniformity Act was introduced by Rep. Edwards (D-CA) and 36 cosponsors on Feb. 17th 1993, which would have repealed all federal mandatory minimum sentences. On April 8th, 1997, Rep. Barney Frank (D-MA) introduced H.R. 1237, a bill to Exempt Some Non-violent Drug Offenders from Mandatory Minimum Sentences. 71 Currie, E. Crime and Punishment in America. (1998). Holt Metropolitan Publishers. 72 Bureau of Justice Statistics. (1997) BJS Sourcebook, 20. Washington DC: US Government Printing Office. 73 Bureau of Justice Statistics, US Department of Justice. Sourcebook of Criminal Justice Statistics, 1994. (Estimate as $25,000/inmate). 74 US Sentencing Commission. (1995, February). Special Report to Congress: Cocaine and Federal Sentencing Policy, Table, 18. Washington, DC: U.S. Sentencing Commission, pg. 170. 75 NIDA. National Household Survey on Drug Abuse: Population Estimates 1997. (1998). SAHMSA, p. 17. 76 US Department of Justice. An Analysis of Non-Violent Drug Offenders with Minimal Criminal Histories. (1994, February). Washington, DC: U.S. Department of Justice. 77 A survey by the US Sentencing Commission found that only 11% of federal drug defendants were considered high level dealers. US Sentencing Commission. (1995, February). Special Report to Congress: Cocaine and Federal Sentencing Policy, Table, 18. Washington, DC: U.S. Sentencing Commission, pg. 170. 78 Caulkins, J., et.al. (1997) Mandatory Minimum Drug Sentences: Throwing Away the Key or the Taxpayers Money?, 16. Santa Monica, CA: RAND Corporation. 79 False testimony has become so common in drug cases that it is now known as "testilying" Eric E. Sterling, "Perpspective on Perjury: Lying is the American Way," Los Angles Times, Januay, 12, 1999. 80 See, 21 USC Sec. 846; "Snitches," Frontline, PBS, January 26, 1999; Cynthia Cotts, "Rat Pack," The Village Voice, January 6, 1999. 81 For an in depth analysis of the undue power of federal prosecutors, please see the Pittsburgh Post-Gazette series, "Win At All Costs: Government Misconduct in the Name of Expedient Justice," (November 1998) by Bill Moushey.

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" OBJECTIVE: END THE RACIAL BIAS IN DRUG LAWS Rationale: Current laws regarding mandatory minimum sentencing contain documented biases against minority groups at each stage in the criminal justice process – arrest, prosecution and sentencing. The negative impacts of these laws have had a devastating effect on black and Latino populations and must be changed.82 Figure 18 shows how the racial bias in drug laws has affected the black and Latino populations. Recommendation 1: End the disparity between crack and powder cocaine sentencing.83  The sentencing disparity between crack and powder cocaine has wreaked havoc on minority communities. First, the powder form of cocaine that is preferred by wealthier, usually white consumers, requires 100 times as much weight to trigger the same penalty as the crack form. These stiff penalties apply to the mere possession of crack, unlike any other drug which requires an intent to distribute.84 As an initial step to address this blatant inequity, the penalties for these two forms of the same drug should be harmonized at the current levels for powder cocaine.
In 1986, before mandatory minimums instituted the crack/powder sentencing disparity, the average sentence for blacks was 6% longer than the average sentence for whites. Four years later following the implementation of this law, the average sentence was 93% higher for blacks.85 Furthermore, this overly harsh approach encourages drug dealers to enlist young children in their trade in an effort to escape prosecution. The chart above illustrates how blacks and Latinos have been imprisoned disproportionately when compared to other racial groups. Today, one in four black men can expect to be incarcerated in his lifetime.86This widespread incarceration of black males has increased the burdens on the African-American family unit and the entire community. Our drug laws should not fall disproportionately on one ethnic group. This disparity undermines efforts to stabilize communities and reduce the impact of drug use and abuse. Recommendation 2: Stop targeting black and Latino communities for needle possession arrests. The policy of denying sterile needles to persons who inject drugs arose a number of years ago, in the pre-HIV/AIDS era. No research has ever shown that making needle possession illegal was effective in reducing drug consumption. But it was effective at making sterile needles scarce and in encouraging persons who injected drugs to share their needles and thus their blood-borne diseases.	Figure 18 The figure above illustrates that Blacks and Hispanics use less drugs, yet have significantly higher rates of incarceration than whites. Sources: SAMHSA: National Household Survey on Drug Abuse: Population Estimates 1997; Bureau of Justice Statistics (1998). Sourcebook of Criminal Justice Statistics 1997; *Estimates for Hispanics do not include the number of Hispanic men and women in local jails. Data on Hispanic incarceration provided by Bureau of Justice Statistics, (1997).
With the arrival of HIV/AIDS, we had an ineffective policy of drug control (criminalization of sterile needle possession) become a major factor in the spread of a deadly epidemic. In states where mere possession of a syringe is a crime, the person who carries his or her own safe needles risks arrest at all times. Race is a factor in the problem of inadequate access to clean needles because black and Latino communities have been particularly targeted for drug enforcement efforts. In 1994, there were 166,000 arrests for possession of heroin and cocaine among whites and 153,000 arrests for possession of heroin and cocaine among blacks. Among people who inject drugs, African-Americans are four times as likely as whites to be arrested for possession of heroin and cocaine.87  Since possession arrests for blacks and Latinos are higher, this means that police are more likely to confiscate the personal needles of non-whites. And because the non-white users know (correctly) that they are vulnerable to arrest, the black and Latino drug users are likely to “voluntarily” get rid of their own clean needles to avoid arrest. The end result of these types of policies, is that black and Latino people are nearly five times as likely to contract injection-related HIV, than to die from a drug overdose. Making needles scarce doesn't stop drug use, it simply spreads AIDS. The black and Latino communities are suffering greatly from this counter-productive policy.88
82 H.R. 118, Traffic Stops Statistics Act of 1997, was introduced by Rep. Conyers (D-MI) on January 7th, 1998. 83 H.R. 2031, Crack-Cocaine Equitable Sentencing Act of 1997, was introduced by Rep. Rangel (D-NY) and 26 co-sponsors (25 Dems., 1 Ind.) on June 24th, 1997. 84 U.S. Sentencing Commission. (1995, February). Special Report to Congress: Cocaine and Federal Sentencing Policy, iii. 85 Meierhoefer, Barbara S. (1992). The General Effect of Mandatory Minimum Prison Terms: A Longitudinal Study of Federal Offenses Imposed. Washington, DC: Federal Judical Center. 86 Bonczar, Thomas P. and Allen J. Beck, Ph. D. (1997) Lifetime Likelihood of Going to State or Federal Prison, Washington, DC: Bureau of Justice Statistics. 87 Day, Dawn Dr. Health Emergency 1999. (1998). Princeton, NJ: The Dogwood Center, p. 2. 88 Day, Dawn Dr. Health Emergency 1997. (1996). Princeton, NJ: The Dogwood Center.

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" OBJECTIVE: DO NOT UNDERMINE EDUCATION IN THE NAME OF THE "WAR ON DRUGS"
Rationale: Our nation's continued reliance on increasing penalties for non-violent crimes has led to a prison building expansion so costly that it has forced states to curtail important investments in other areas. Most notably, the education of our youth has been significantly cut, in order to pay for prison building and incarcerating citizens. The figure shown at right graphically illustrates the dramatic changes in spending that have taken place at the state level from 1987 to 1995, showing that the United States has chosen to build prisons by cutting investments in education at all levels. Recommendation 1: State governments should not spend more on prisons than on education.	Figure 19 Source: National Association of State Budget Offices. (April 1996). 1995 State Expenditures Report. Washington, DC.
Our national investment in prisons has placed a great obstacle on our ability to educate our children. Throughout the 1990's, college tuition continues to rise faster than inflation.89 States continue to favor investments in prisons over colleges.90 From 1982 to 1993, employment of instructors at public colleges has risen 28.5%, while the number of correctional officers has increased by 129.33%.91 Today, 50% of federal drug trafficking prisoners have not even graduated from high school, and only 3% have graduated from college.92 It is becoming increasingly clear that poorly educated and un-employable citizens are those who fill the prison beds.93  Recommendation 2: Eliminate the ban on student loan guarantees to persons with a drug conviction. In one of the most egregious and counter-productive moves yet, Congress wrote a law into the Higher Education Act of 1998 that denies student loan eligibility to those students who have been convicted of a drug offense. Even a first-time charge of simple possession of marijuana is enough to trigger a penalty. Penalties range from losing loans for a single year to a complete lifetime ban of federally guaranteed student loans for a person with 3 or more drug possession convictions. Considering the crucial role that education plays in the well being of our society, it is hard to understand how denying a college education to someone because of a past drug offense serves either the purpose of rehabilitation or producing well adjusted young adults. No other class of offender, including those convicted of rape or other violent offenses, faces similar restrictions on student loan eligibility. According to the National Council of Higher Education, student loans continue to be the largest source of student aid, with approximately $29 billion for the 1995-96 federal fiscal year provided to students to meet their post-secondary educational costs. The lion's share of this funding is devoted to low and middle income students. Recent government statistics show that while African-Americans comprise only 13% of the nation's illicit drug users, they make up almost 37% of those arrested for drug violations, over 42% of those in federal prisons for drug violations, and almost 60% of those in state prisons for drug felonies.94 The fact that minority groups are convicted for drug offenses at a much higher rate than whites, suggests that they will lose a disproportionate share of the student loans as well. This is especially troublesome at a time when affirmative action is being rolled back in many states. Considering the fact that 54% of high school seniors admit to having used illicit drugs,95 over time this law could have serious ramifications for the next generation of college seekers and the nation as whole. Denying a young person, or any person, the opportunity to get an education is irrational and should not be a part of our nation's drug control strategy.
89 Ambrosio, Tara-Jen and Vincent Schiraldi. (1997 February). From Classrooms to Cellblocks: A National Perspective. Washington, DC: Justice Policy Institute. 90 Ibid. 91 Ibid. 92 U.S. Sentencing Commission. (1998). 1997 Sourcebook of Federal Sentencing Statistics. p. 18. 93 Ibid. 94 NIDA. National Household Survey on Drug Abuse: Population Estimates 1997. (1998). SAHMSA, p. 19; Bureau of Justice Statistics, Sourcebook of Criminal Justice Statistics 1996, Washington D.C.: U.S. Government Printing Office (1997), p. 382, Table 4.10, and p. 533, Table 6.36; Bureau of Justice Statistics, Prisoners in 1996, Washington D.C.: U.S. Government Printing Office (1997), p. 10, Table 13. 95 Institute for Social Research. (1998). The Monitoring the Future Survey. University of Michigan, grant money from NIDA.

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" OBJECTIVE: ALLOW DOCTORS & PATIENTS GREATER FREEDOM IN HEALTH DECISION MAKING TO MEET INDIVIDUAL NEEDS
Rationale: No policy to control drug use should be implemented at the expense of the sick, elderly and dying, and no person should be denied access to a potentially beneficial medication because someone else might use it improperly. Pain management and disease control should be based on respect for individual rights and science, not politics. Recommendation 1: Transfer scheduling authority to the Department of Health and Human Services. The Controlled Substance Act of 1970 created five schedules (or categories) for various drugs. The authority to schedule a drug resides with the Drug Enforcement Administration. As a result, scheduling decisions are dominated by law enforcement interests rather than public health concerns. In order to give public health issues the proper role in the scheduling of drugs, this authority should be transferred to the Department of Health and Human Services, the only agency whose mandate is to manage public health issues.	Partial List of Organizations Supporting Physicians Right to Recommend or Discuss Marijuana Therapy With Patients American Medical Association (1997) American Society of Addiction Medicine (1997) Bay Area Physicians for Human Rights (1997) Alive: People With HIV/AIDS Action Committee (1997) California Academy of Family Physicians (1997) California Medical Association (1997) Gay and Lesbian Medical Association (1997) Medical Association (1997) Multiple Sclerosis California Action Network (1996) Francisco Medical Society (1997) Figure 20
Recommendation 2: Begin clinical trials of medically supervised drug maintenance therapy. In one of the most dramatic success stories in modern addiction treatment, doctors in Switzerland have discovered that the provision of medically determined doses of heroin to heroin addicts significantly improves their health, lifestyle and reduces the amount of crime associated with drug use when they are permitted to leave the black market environment. The Swiss researchers concluded that: Both the number of criminal offenders and the number of offenses decreased by about 60% in the first six months of the program. Most illicit drug use, including cocaine, rapidly and markedly declined. The number of participants on unemployment benefits fell by more than half (from 44% to 20%). Participants' housing situation rapidly improved, ending homelessness among the patients. The physical health of participants improved. More than half of the patients who dropped out of the program did so in order to switch to another form of treatment, including abstinence.96  The success of this program illustrates how deeply our current policies are failing to reduce most of the consequences of drug use in this country. In light of that failure, our country must be able to learn from the successes of other nations and experiment with techniques that might improve living conditions for everyone. Recommendation 3: Allow doctors greater freedom in prescribing medications for pain control.97  As stated by ONDCP Director Barry McCaffrey, we are not doing enough to help the millions of Americans who suffer from chronic pain. The restrictions for prescribing Schedule 2 drugs like morphine are so strong, and the penalties so great, that doctors consistently under-prescribe pain medication to those who need it most. In 1998, Rep. Henry Hyde introduced the Lethal Drug Abuse Act of 1998, which would have given the Drug Enforcement Administration the power to revoke the prescription license of any doctor who intentionally prescribes a lethal dose of pain medication to a patient. Such a law can only have a chilling effect on the type of pain alleviation doctors will be willing to provide. Giving greater freedom to doctors will allow them to prescribe drugs that work to those in need. Recommendation 4: Allow a broader distribution of opiate agonist chemotherapy (e.g. methadone, LAAM) and move oversight of such programs to the Center for Substance Abuse and Treatment. Methadone is the safest, most effective and least costly method to treat heroin addiction, yet it remains a strictly controlled method of treatment. For every 10 heroin addicts in America, there are only one or two methadone treatment slots. We must expand opiate agonist treatment facilities so that every heroin addict can obtain treatment on demand. Opiate agonist treatment and particularly methadone maintenance has many additional benefits, such as the reduction of criminal behavior. Studies show that arrests decline as patients no longer need to finance a costly heroin addiction. Methadone is a medication that stabilizes a dysfunctional neurological condition and produces no euphoric effects.98 Methadone allows patients to stabilize their lives, restore relationships with their families, return to legitimate employment and contribute to their community as any other individual. In order to meet the need for opiate agonist treatment, doctors must be permitted to prescribe methadone and other pharmacotherapies like any other prescription drug. Opiate agonist treatment should also be administered in the prison systems and through a variety of delivery systems to give opiate addicts easy access to treatment. Opiate agonist treatment should be a valid medical procedure for public and private insurance and not limited to one treatment experience. Opiate addiction is a chronic relapsing medical condition and coverage for treatment should reflect this. Incarcerated opiate addicts and methadone patients who need to be withdrawn should receive adequate medical care; the only approved medication for opiate withdrawal is methadone. However, since the medical condition of addiction is misunderstood, we recommend that some form of oversight be undertaken to protect patients from physicians who may decide they no longer want to treat them. Pain patients can also face a similar situation for a variety of reasons, such as when a clinician is afraid of DEA interference. The oversight of methadone maintenance programs should be transferred from the Food and Drug Administration to the Center for Substance Abuse and Treatment (CSAT). CSAT's oversight should include the concepts of a new accreditation system that will be based on reduced regulations, treatment outcome and quality treatment. We urge that state regulatory agencies and programs review their policies which have been based on the dysfunctional patient rather than the stable patient to reflect this new accreditation system. It is imperative that methadone patients and others participating in opiate agonist treatment be included in all levels of policy making with regard to treatment. Methadone patients have been excluded from policy decisions for too long. Finally the government should undertake a public relations campaign to destigmatize the users of illicit drugs and create a more caring environment for those desiring recovery. Recommendation 5: Recognize the rights of states, doctors and patients to make their own decisions regarding the usefulness of medical marijuana.99
Cancer and AIDS are horrific diseases that require inordinate amounts of strength and energy to overcome. In many cases, the harsh treatments required to combat the diseases kill patients long before the diseases ever do. A pervasive side-effect of treatment is intense nausea which prevents patients from obtaining the nourishment they need to fight the disease and endure treatment. The medical efficacy of marijuana in combating this particular type of nausea has been so well documented that the federal government and pharmaceutical companies have developed a synthetic form of marijuana's active ingredient, THC. However, the manufactured drug is not as effective in many cases because marijuana contains many other useful compounds that are not provided by synthetic THC, and nausea makes it difficult for patients to ingest pills. Over 90 published reports have documented that marijuana has medical value in controlling nausea, stimulating appetite, controlling muscle spasms and preventing blindness from glaucoma. In recognition of the efficacy of medical marijuana, the New England Journal of Medicine, the American Bar Association, and the American Public Health Association (among dozens of others) have all endorsed medical access to marijuana. The DEA's Chief Administrative Law Judge, Francis L. Young has ruled: “Marijuana, in its natural form, is one of the safest therapeutically active substances known. [The] provisions of the [Controlled Substances] Act permit and require the transfer of marijuana from Schedule I to Schedule II. It would be unreasonable, arbitrary and capricious for the DEA to continue to stand between those sufferers and the benefits of this substance.”100 In America today, patients face penalties of up to one year in prison for the possession of a single dose of this medication.101 This approach to medical marijuana must be changed immediately, and seriously ill patients should never be punished for obtaining or using any drug with the earnest intent of treating their illness, provided that their activities are not directly threatening the safety or well-being of others. Recommendation 6: End the de facto moratorium on medical marijuana research. Now that voters in states representing one-fifth the US population have voted for medical marijuana, the federal government needs to take urgent action to resolve the medical marijuana debate. The votes in the states, as well as other state laws, provide the Food and Drug Administration with an opportunity to research medical marijuana on a large number of people. When research stopped FDA research on the drug was in the final phase before market approval. Funding should be provided to take the final research steps necessary to make marijuana available by prescription. Many organizations, such as the American Medical Association, the American Cancer Society, and the National Academy of Sciences support unimpeded research of medical marijuana. When it comes to medicine, we should be doing everything we can to help those who suffer from a serious illness, not outlawing important areas of research. Recommendation 7: Develop a distribution system for medical marijuana. The current total ban on the use and distribution of medical marijuana forces thousands of critically ill patients to purchase their medication in dangerous black markets, where they are at risk of abuse by drug dealers. In order to prevent further harm to medical patients, and in light of the overwhelming public support for medical marijuana in every state that has had a vote on the issue, the federal government should develop a system of distribution for medical marijuana so that this medicine reaches patients in a safe and effective manner. Until the government can develop specific guidelines and regulations, it should allow states and local communities to work with medical marijuana providers, such as patient cooperatives, in order to ensure a safe and effective distribution system.	A Partial List of Organizations Supporting Access to Medical Marijuana AIDS Action Council (1996) AIDS Treatment News (1995) Alaska Nurses Association (1998) American Academy of Family Physicians (1995) American Medical Student Association (1994) American Public Health Association (1994) American Society of Addiction Medicine (1997) Alive: People with HIV/AIDS Action Committee (1996) California Academy of Family Physicians (1994) California Legislative Council for Older Americans (1993) California Pharmacists Association (1997) Colorado Nurses Association (1995) Florida Medical Association (1997) Kaiser Permanente (1997) Life Extension Foundation (1997) Lymphoma Foundation of America (1997) National Nurses Society on Addictions (1995) New England Journal of Medicine (1997) New York State Nurses Association (1995) North Carolina Nurses Association (1996) Oakland City Council (1998) San Francisco Mayor's Summit on AIDS and HIV (1998) Virginia Nurses Association (1994) Figure 21 A Partial List of Organizations Supporting "Legal Access to Marijuana Under a Physician's Recommendation" California Academy of Family Physicians (1996) California Nurses Association (1995) Los Angeles County AIDS Commission (1996) Maine AIDS Alliance (1997) National Association of People With AIDS (1992) New Mexico Nurses Association (1997) New York State Nurses Association (1995) San Francisco Medical Society (1996) Figure 22 A Partial List of Organizations Supporting Medical Marijuana Research American Cancer Society (1997) American Medical Association (1997) American Public Health Association (1994) American Psychiatric Association (1997) American Society of Addiction Medicine (1997) California Medical Association (1997) California Society of Addiction Medicine (1997) Congress on Nursing Practice (1996) Federation of American Scientists (1994) Florida Medical Association (1997) Gay and Lesbian Medical Association (1995) Kaiser Permanente (1997) Lymphoma Foundation of America (1997) NIH Workshop on the Medical Utility of Marijuana (1997) NIH Ad Hoc Group of Experts Studying the Medical Utility National Nurses Society on Addictions (1996) San Francisco Medical Society (1996) Figure 23 Approved Medical Marijuana Initiatives Alaska 58% Arizona 57% Colorado 60% * California 56% Nevada 59% Oregon 55% Washington 59% Washington DC 69% * * Based on exit poll data only. Medical marijuana has not become law in these two jurisdictions. Figure 24
96 Uchtenhagen, A. "Summary of the Synthesis Report." In Uchtenhagen, A., Gutzwiller, F., and A. Dobler-Mikola (Eds.), Programme for a Medical Prescription of Narcotics: Final Report of the Research Representatives (1997). Zurich: Institute for Social and Preventive Medicine at the University of Zurich. 97 S. 78 the Compassionate Pain Relief Act, introduced by Sen. Inouye (D-HI) on January 4th, 1995. 98 H. Joseph and J. S. Woods. (1995). "The Impact of Expanded Methadone Maintenance Treatment on Citywide Crime and Public Health in New York City 1971-1973," Archives of Public Health. (53) 215-231; Martin, W.R.; Wilker, A.; Eades, C.G. et al. (1963 ). "Tolerance and physical dependence on morphine in rats," Psychopharmacology. (4) 247-260. 99 HR 1782, Medical Use of Marijuana Act, introduced by Rep. Frank (D-MA) with 11 co-sponsors (8 Dem., 2 Rep., 1 Ind.) on June 4th, 1997. 100 In the Matter of Marijuana Rescheduling Petition. U.S. Department of Justice, Drug Enforcement Agency, Docket #86-22, September 6, 1988, p. 57. 101 Controlled Substance Act of 1970, 21 U.S.C. Secs. 801 et seq.

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" OBJECTIVE: PROMOTE HEALTH SERVICES FOR ALL WOMEN, NOT PROSECUTION OF PREGNANT WOMEN Rationale: Concern about exposure of fetuses to drugs, particularly cocaine, has led to the prosecution of pregnant women for their drug, use rather than the provision of treatment and health care services to women.102 This punitive reaction does more harm than good. First, this policy incorrectly assumes that women have access to drug treatment services and control of their reproductive choices. A 1998 survey by the Child Welfare League of America found that although child welfare agencies report that parental substance abuse and poverty are the two top problems faced by their clients, less than one-third of agencies link women to drug treatment services, and only one in five link pregnant women to services.103 The prevalence of domestic violence as well as economic and emotional dependence make it difficult or impossible for many women to negotiate the terms of their sexual lives.104  Second, the long-term impact of in-utero drug exposure on a child's physical and mental development is not established. It is clear that the drug effects cannot be separated from the negative outcomes from other risk factors, such as lack of prenatal care and poor nutrition. Research paid for by the National Institute on Drug Abuse (NIDA) and the Albert Einstein Medical Center in Philadelphia states, “Although numerous animal experiments and some human data show potent effects of cocaine on the central nervous system, we were unable to detect any difference in Performance, Verbal or Full Scale IQ scores between cocaine-exposed and control children at age 4 years.105 ”Moreover, we do know that research shows that the provision of quality prenatal care to heavy cocaine users has been shown to significantly improve fetal health and development.106 Criminalizing substance abuse during pregnancy discourages substance-using women from seeking prenatal care, drug treatment, and other social services that would ensure the health of both the woman and her fetus. Third, poor women and women of color are more likely to be reported for drug use (even though the estimated number of white women abusing drugs is substantially greater than the number in other race/ethnicity groups), because of their more frequent reliance on public health clinics and because of stereotypes held by some health care professionals.107  Legislators should promote a public health approach to substance abuse among women, including pregnant women. Doctors and other health professionals should be seen as allies of women. They should not be forced to betray a patient's trust by informing prosecutors and police of patient drug use. Recommendation: Address the problem of drug abuse by women as a women's health issue not a criminal matter. A public health approach requires universal availability of drug treatment for all women. This requires funding for treatment programs designed for women - including pregnant women and women with children. It requires an expansion of Medicaid coverage of drug treatment, including residential treatment, and other publicly-funded drug abuse prevention and treatment programs for low income women.108  A public health approach also requires an expansion of drug treatment for incarcerated women. Between 1985 and 1996, female drug arrests increased by 95 percent. More than two-thirds of women in federal prisons are incarcerated for drug offenses and today approximately 130,000 women are behind bars in the U.S.109 Mandatory minimum sentencing has increased the number of incarcerated women, most of whom leave children behind. Proposals for mandatory universal testing for drugs and alcohol in pregnant and postpartum women and newborns should be rejected. Testing should be a medical decision between a doctor and patient, not something mandated by law enforcement authorities. Testing of women and newborns should require a woman's voluntary and informed consent. Laws should provide that no pregnant woman or a parent of a newborn who tests positive for drugs will be subjected to criminal investigation or detention, nor should they be threatened with having their child taken away from them, solely on the basis of a drug test. Rather, testing should be part of a public health process of prenatal and parental counseling and linkages to health care and drug treatment services for women.
102 Figdor, Emily and Lisa Kaeser. (1998, October). "Concerns Mount over Punitive Approaches to Substance Abuse Among Pregnant Women." The Guttmacher Report on Public Policy; Nelson, Lawrence and Mary Faith Marshall. (1998). Ethical and Legal Analyses of Three Coercive Policies Aimed at Substance Abuse by Pregnant Women. Funding provided by the Substance Abuse Policy Research Program of the Robert Wood Johnson Foundation. 103 February, 1998 104 Center for Women Policy Studies, 1996 105 Hallam Hurt, MD; Elsa Malmud, PhD; Laura Betancourt; Leonard E. Braitman, PhD; Nancy L. Brodsky, Phd; Joan Giannetta, "Children with In Utero Cocaine Exposure Do Not Differ from Control Subjects on Intelligence Testing," Archives of Pediatrics & Adolescent Medicine, Vol. 151: 1237-1241 (1997) American Medical Association. 106 Chazotte, et. al., 1995 107 Roberts. (1991); Nelson and Marshall. (1998). 108 S. 147, Medicaid Substance Abuse Treatment Act of 1997, introduced by Sen. Daschle (D-SD) with 4 co-sponsors (3 Dems., 1 Rep.) on January 21st, 1997, would have amended title XIX of the Social Security Act to provide for coverage of alcoholism and drug dependency residential treatment services for pregnant women and certain family members under the Medicaid treatment program, and for other purposes. 109 Drug Strategies. (1998). Keeping Score, 1998: Women and Drugs: Looking at the Federal Drug Control Budget. Washington, DC: Drug Strategies.

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" OBJECTIVE: ENCOURAGE “FAMILY VALUE-FRIENDLY” POLICIES AND FAMILY UNITY THROUGH TREATMENT AND SUPPORT SERVICES, NOT PUNITIVE RESPONSES Rationale: According the U.S. Department of Health and Human Services, studies have found that 10-20 percent of welfare recipients have a substance abuse problem.110 Experts acknowledge that substance abuse is widely under-reported.111  The 1996 federal welfare reform law (Temporary Assistance to Needy Families - TANF) denies welfare benefits to women convicted of a drug felony since August, 1996 and give states broad authority to drug test women on welfare. Ironically, women on welfare receive their health care through state Medicaid programs that provide little or no coverage of drug treatment services. At the same time, women on welfare must meet strict work requirements and time limits. Many women will not achieve the transition from welfare to work until the welfare system provides access to drug abuse treatment. The GAO estimates that substance abuse is a key factor in at least three quarters of the foster care cases in the U.S.112 Women with alcohol and drug abuse problems should not be presumed to be unfit parents. Rather, public policy should help women keep their families together while accessing drug treatment. In fact, treatment outcome studies suggest that women who are allowed to have their children with them in residential programs are more successful than women who are separated from their children.113  Recommendation 1: Repeal section 115 of the TANF and Food Stamps benefit programs, and reform welfare to help rather than penalize women struggling with drug abuse problems. Congress should pass welfare reform that allows states to help women with felony records move toward healthy and productive lives through the TANF program. Currently, section 115 of the Welfare Reform Bill (also known as the Gramm Amendment) places a lifetime ban on TANF (Temporary Assistance for Needy Families) and Food Stamps benefits for convicted drug felons. Recently, the Justice Policy Institute issued an analysis114 of the impact of this provision. It concluded that this provision will: Disproportionately impact women and minorities, since women are the overwhelming majority of adult TANF recipients, and minorities systematically receive greater arrests and convictions for drug crimes. In California, the disparate impact is even more striking because single male drug felons can currently receive state General Assistance benefits, while mothers convicted of a drug felony cannot.115  Increase costs of state foster care, since mothers with criminal records have difficulty in obtaining work and will be less likely to be able to provide children with a stable income and housing, many more children will wind up in foster care. Increase costs to the criminal justice system, because “without any support services for ex-drug offenders immediately after their release from prison, we can expect recidivism to sky rocket. That means more and more taxpayers dollars for law enforcement, the legal system and prisons, more property loss, and more victims.”116  Decrease treatment opportunities, since many residential treatment programs depend on welfare programs to help defray the cost of room and board.117  Increase harm to children, since in addition to the financial loss of placing children in foster care, there is the huge emotional loss the children face by being separated from their mother and dropped in an overburden foster care system. In essence, states should not be allowed to tie welfare benefits (cash assistance, Medicaid, food stamps, or other aid) to drug convictions or involuntary submission to drug screening. Rather, Congress should fund welfare-to-work programs that provide drug treatment and services to women. Furthermore, congress should pass a specific exemption to TANF work and time requirements for women with drug abuse problems, similar to the one granted female victims of domestic violence. Recommendation 2: Fund alcohol and drug abuse treatment programs that work with women and their children. Maintaining family unity and social support networks are often key aspects of a person's recovery from addiction, and this “family value-friendly” factor should be at the forefront of substance abuse programs. This means treatment programs should be easily accessible, preferably located in the community. Child care services should be provided so women who are the primary care giver are able to attend treatment programs without having to find child care. While a person with a substance abuse problem may be unfit to have custody of children, that is not always the case and should not be presumed. Programs like foster care and child protective services should work in concert with alcohol and drug abuse treatment programs to enable women to obtain treatment without losing custody of their children. Furthermore if separation is absolutely necessary, efforts should be made to reunite women with their children once treatment is complete.
110 Gerstein, D.R., Johnson, R.A., Larison, C.L., Harwood, H.J., and Fountain, D. (1997). Alcohol and Drug Abuse Treatment for Parents and Welfare Recipients: Outcomes, Benefits and Costs. Washington, D.C.: Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. 111 Woodward, A., Epstein, J., Gfroerer, J., Melnick, D., Thoreson, R., and Willson, D. (1997 Spring). "The Drug Abuse Treatment Gap: Recent Estimates." Health Care Financing Review. Vol. 18, No. 3. p. 6. 112 Drug Strategies. (1998). 113 Drug Strategies. (1998). citing DeLeon, Ed. 1997 - three relevant articles 114 Rukaiyah Adams, David Onek, and Alissa Riker. (1998). Double Jeopardy: An Assessment of the Felony Drug Provision of the Welfare Reform Act. Washington, DC: Justice Policy Institute. 115 Ibid. 116 "Deny Aid to Those Who Need it?" (August 7, 1998). The Des Moines Register. Pg. 8. 117 Legal Action Center. (1996). A Fact Sheet for Policy Makers - Welfare Reform: Implementing Drug Felony Conviction Provisions. Washington, DC: Legal Action Center.

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" OBJECTIVE: PROTECT CIVIL LIBERTIES AND THE AMERICAN CONSTITUTION Rationale: Over the past 30 years, in the name of “winning the Drug War,” citizens have been subjected to a dramatic erosion of such constitutional rights as: protection against illegal search and seizure, excessive fines, double jeopardy, and cruel and unusual punishment; the right to due process before being punished with property forfeitures and economic penalties; and the presumption of innocence. Recommendation 1: Stop the misuse of forfeiture laws.118  In 1997, the DEA seized $552 million in assets, and the US Customs Service seized $1.65 billion in assets.119 Since the Supreme Court has ruled that being an innocent owner is not a constitutional defense against forfeiture and that double jeopardy doesn't apply to forfeiture,120 a person can lose property even if he or she had no knowledge of its illegal use,121 or if the owner is acquitted of the crime.122  When forfeiture is employed as a civil penalty, the owner has no presumption of innocence, no right to an attorney, and unfounded hearsay may be used at trial by the government but not by the property owner.123 This means that when there is insufficient evidence to make a criminal case against a defendant, the government can seize property and force the individual to challenge the civil-seizure in a costly and unpromising hearing.124 Since the burden of proof in these cases is reversed, it is up to the citizen to prove by a preponderance of the evidence that the property does not belong to the government.125  Compounding the difficulties innocent property owners have in reclaiming their property is that when people are stripped of all their assets prior to trial, it is sometimes impossible to obtain legal counsel. There is no right to court-appointed counsel at the government's expense in forfeiture cases, and in “small” civil forfeitures – those where the property is worth less than $500,000 – the property owner must post a bond worth 10% of the value of the property in order to have the right to a court hearing.126  Forfeiture laws have changed the nature of law enforcement itself. Both crime prevention and due process goals of our criminal justice system are compromised when salaries, continued tenure, equipment, modernization and budget depend on how much money can be generated by forfeitures.127 The Department of Justice occasionally places a higher priority on forfeiture than the prosecution of violent and property crimes. For instance, in 1989 all U.S. Attorneys were directed to divert resources to forfeiture efforts to meet their commitment “to increase forfeiture production,” suggesting they “divert personnel from other activities or …seek assistance from other U.S. Attorney's offices, the Criminal Division, and the Executive Office for United States Attorneys.”128  In an effort to prevent this type of conflict of interest, Missouri state law requires that all seized assets be used to improve public education in the state. This removes the temptation to abuse forfeiture powers and relieves taxpayers of the burden of education costs. Unfortunately, police in that state have consistently thwarted attempts to implement the law by giving seized assets to the DEA, which then returns the money to the police agencies after retaining a 20% “processing fee.” In a 1999 five-part series, the Kansas City Star investigated 14 cases of asset forfeiture where law enforcement agencies seized $1.4 million and sent it to federal agencies, for return after paying processing fees. In a 1998 ruling on such a case, the judge stated “By summoning the DEA agent and then pretending DEA made the seizure, the DEA and Missouri Highway Patrol successfully conspired to violate the Missouri Constitution,… the Missouri Revised Codes, and a Missouri Supreme Court decision.”129  This type of behavior indicates the lengths to which law enforcement agencies will go to pocket forfeited assets, and illustrates the corrupting influence of forfeiture laws. Crime-fighting should not be a profit-making venture for the government, nor should the seizure of property undermine our efforts to reduce drug abuse and violent crimes in America. Recommendation 2: Restore voting rights to non-violent drug offenders and allow unhindered public referenda and initiatives. An unanticipated side-effect of the War on Drugs has been the loss of voting rights on a massive scale, particularly among African-American men. According to a recent report by the Sentencing Project, 1.4 million or 13% of black men have lost the right to vote, which is seven times the national average (nationally about 2% of the population has lost the right to vote due to felony convictions). In seven states, 1 in 4 black men is permanently disenfranchised. The authors note, “In the late twentieth century, the [felony disenfranchisement laws] have no discernible legitimate purpose. Deprivation of the right to vote is not an inherent or necessary aspect of criminal punishment nor does it promote the reintegration of offenders into lawful society.”130 The authors also note that, “An offender who receives probation for a single sale of drugs can face a lifetime of disenfranchisement. Restrictions on the franchise in the United States seem to be singularly unreasonable as well as racially discriminatory, in violation of democratic principles and international human rights law.”131  Even those of us who have not been convicted of a crime, can find our constitutional right to vote curtailed because of the drug war. As citizens throughout the country are presented with ballot initiatives to allow medical access to marijuana, opponents of the concepts have sought to block citizens from even holding the vote. In Washington, DC, Congress barred the District government from expending any funds which would certify a law that reduces penalties for marijuana. District residents may vote, however, to increase penalties for marijuana. This means that for the first time in history, Congress has decided to control what types of elections can be held outside of the federal process and outlawed those votes which do not match the prevailing ideology of the Congress. At the time this document is being written, a lawsuit is pending in federal court on this very issue. Voters in Colorado and Arizona have faced similar obstacles, but Arizona voters have voted a second time in favor of medical marijuana and voters in Colorado have used the courts to force the election board to allow their initiative to proceed in 2000. The right of citizens to vote on any issue is the heart and soul of a democracy; any effort to derail that process subverts the will of the people and the spirit of our Constitution. Recommendation 3: Restore civil liberties undermined by current drug policies. Throughout the last two decades of the drug war, Congress and the courts have allowed a massive erosion of long-term, fundamental civil liberties. The warning of Justices William Brennan and Thurgood Marshall has come true: “…the first and worst casualty of the War on Drugs will be the precious liberties of our citizens.”132  As the United States moves to a public health-based drug control strategy it should restore constitutional protection for individual rights. Among the drug war decisions that need to be reconsidered by the courts or for which legislation is needed are those which:  Allow police to stop and detain travelers in airports merely because they fit a 'drug courier profile' without a search warrant or any evidence that the individual committed a crime. Currently, a person can be legally detained if he or she is carrying heavy luggage, is young, is casually dressed, is nervous, pays cash for a ticket, and leaves his or her address off of luggage. 133  Allow dogs to sniff travelers' luggage without probable cause. 134  Allow schools to drug test students without probable cause or warrant. 135  Allow police to search automobiles and containers in glove compartments (e.g., brief cases, trunks) without a search warrant. 136  Allow electronic surveillance of vehicles without a search warrant. 137  Allow police to search homes based on an anonymous tip from an unnamed informant. 138  Allow police to ignore “no trespassing” signs to search private property without a warrant or any probable cause that a crime has been committed. 139  Allow police to search barns and other buildings adjacent to a residence without a warrant or any probable cause that a crime has been committed. 140  Allow police to search private property through aerial surveillance without a search warrant or any probable cause that a crime has been committed. 141  Allow police to search bank records without the consent of the customer. 142  Allow police to record telephone numbers dialed from one's home without the consent of the subscriber. 143  Allow police to tape record telephone or face-to-face communications without the consent of the party being recorded and without a search warrant. 144  Allow police to search materials in a person's trash bag without a warrant or probable cause that a crime has been committed. 145  Allow police to instruct the U.S. Postal Service to record the return address and other information on the outside of a person's incoming mail without a warrant or even probable cause. 146 These rights can be restored by legislation or court decisions which recognize that the Fourth Amendment147 prohibits unreasonable searches – this means that searches of people or their property require either a search warrant or probable cause to believe a crime has been committed. If we develop a policy based on public health strategies there will no longer be a need for the intrusive police powers permitted in the last two decades of aggressive drug enforcement, nor the adversarial relationship between police and citizens.
118 HR 1835, Civil Asset Forfeiture Reform Act, was introduced by Rep. Hyde (R-IL) and 29 co-sponsors (17 Dems., 12 Reps.) on June 10th, 1997. 119 Bureau of Justice Statistics, US Department of Justice. Sourcebook of Criminal Justice Statistics, 1997. (1998), pp. 371-2. 120 Bennis v. Michigan, U.S. 116 S. Ct. 994 (1996).; United States v. Ursery, 518 U.S. 267 (1996) 121 Bennis v. Michigan, U.S. 116 S. Ct. 994 (1996). 122 United States v. One Assortment of 89 Firearms, 465 U.S. 354, 361 (1984). United States v. Real Property Located at 6625 Zumirez Drive, 845 F. Supp. 725, 733 (1994). 123 Argersinger v. Hamlin, 407 U.S. 25 (1972); 19 U.S. C. § 1615. 124 19 U.S.C. 1608 (1988). Also see "Win at All Costs: Government Misconduct in the Name of Expedient Justice," Pittsburgh Post-Gazette, (November - December 1998), Bill Moushey. 125 19 U.S.C. Sec. 1615. 126 Janzen, Sandra. (1992, January). Asset Forfeiture, Vol. 13 "Informants and Undercover Investigations." Bureau of Justice Statistics, U.S. Department of Justice. 127 Blumenson, E. and E. Nilsen. (1998, Winter). "Policing for Profit: The Drug War's Hidden Economic Agenda." University of Chicago Law Review, vol. 65, pp. 35-114. 128 Directive #89-1. (1989, June 21). Memorandum from Acting Deputy Attorney General Edward S. G. Dennis, Jr., to inter alia, All U.S. Attorneys, contained in DOJ Asset Forfeiture Manual, V. 3. See also Directive 91-7. (1991, May). Asset Forfeiture Talking Points. 129 Dillon, Karen. (1999, January 2). "Police Keep Cash Intended for Education." Kansas City Star. 130 Jamie Fellner and Marc Mauer. (1998). Losing the Vote: The Impact of Felony Disenfranchisement Laws in the United States. Human Rights Watch (New York) and The Sentencing Project (Washington, DC), p. 1. 131 Ibid. 132 Skinner v. Railway Labor Executives Association, 489 U.S. 602 (1989). 133  Florida v. Royer, 460 U.S. 491 (1983); Florida v. Rodriquez, 469 U.S. 1 (1984); United States v. Montoya de Hernandez, 473 U.S. 531 (1985). 134  United States v. Place, 426 U.S. 606 (1983). 135 Veronia School District v. Acton, 115 S. Ct. 2386 (1995). 136 United States v. Ross, 456 U.S. 798 (1982). 137 United States v. Knott, 460 U.S. 276 (1983). 138 Illinois v. Gates, 462 U.S. 213 (1983). 139 Oliver v. United States, 466 U.S. 170 (1984). 140 United States v. Dunn, 107 S.Ct. 1134 (1987). 141 California v. Ciraolo, 476 U.S. 207 (1986); Florida v. Riley, 488 U.S. 445 (1989).. 142  United States v. Miller, 425 U.S. 435 (1976). 143 Smith v. Maryland, 442 U.S. 735 (1979). 144 United States v. White, 401 U.S. 745 (1971). 145 California v. Greenwood, 486 U.S. 25 (1988). 146 Janzen, Sandra. (1992). Asset Forefeiture, Vol. 13, "Informants and Undercover Investigations." Bureau of Justice Assistance, U.S. Department of Justice. 147 The Fourth Amendment to the U.S. Constitution states: [T]he right of the people to be secure in their persons, houses, papers and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched or things to be seized.

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" OBJECTIVE: REDUCE GOVERNMENT AND LAW ENFORCEMENT CORRUPTION Rationale: Drug-related corruption has plagued federal, state and local law enforcement in many ways. While the United States draws attention to corruption outside our borders,148 we do not focus enough attention on corruption at home. Across the United States, our local communities have felt the burden of law enforcement officials involved in drug corruption scandals. Consider these examples culled from recent news articles: In Illinois, three Austin District police officers were caught on camera pocketing $25,000 in cash during a drug raid. Their 1998 trial showed a video with police stuffing cash into their pockets.149  In Cleveland the FBI arrested 44 police officers in 1998 who were involved in drug-related corruption including taking payoffs to protect dealers involved in drug trafficking. Each of the officers took part in at least one of 16 staged deals by the FBI.150  In Philadelphia, more than 100 drug convictions were dismissed, up to 2,000 cases tainted and the city was forced to pay millions of dollars to settle civil law suits as a result of a police corruption scandal. Six officers pled guilty to fabricating evidence and stealing from drug suspects.151 One of the convicted officers testified in a civil deposition that as many as 600 Philadelphia police lied under oath and justified their actions because “there was a War on Drugs” and “drug dealers do not have any rights.”152  In May of 1998, four former and suspended Chicago police officers were convicted of shaking down undercover agents posing as drug pushers. One of the officers convicted of racketeering, conspiracy and extortion was accused of being a high-ranking leader of the Conservative Vice Lords street gang; he is facing about 120 years behind bars. The other officers face sentences ranging from 11 years to 106 years for similar crimes.153  In Zapata County, Texas most of the county's leaders, including the county sheriff, judge and clerk pled guilty to drug charges.154  Along the U.S.-Mexican border 46 local, state and federal law enforcement officials have been indicted or convicted of drug charges in the last three years.155  In May of 1998, an investigator for the Shawnee, Oklahoma District Attorney's office pled guilty to submitting false receipts for drug informant funds and keeping the funds for himself. Two other investigators were charged, one pled guilty and the other is facing a retrial after a hung jury.156  This is just a sampling of cases reported in cities and small towns across the United States. The Public Integrity Section of the U.S. Department of Justice reports federal convictions of public officials have gone from 44 in 1970157 to 1,067 by 1988.158 Drug offenses are the driving force behind this increase. Corruption is not limited to state and local officials. It has also involved federal officials from many agencies.159 In some cases, such as the CIA-Contra-Crack controversy, government complicity in drug trafficking became de facto official policy. In 1982, during the early days of the Contra war, William Casey (irector of the CIA) and William French Smith (Ronald Reagan's Attorney General) drafted a “Memorandum of Understanding” whereby the CIA would not have to report allegations of drug trafficking involving its “agents, assets and non-staff employees” but would have to report allegations of assault, homicide, kidnapping, bribery, wiretapping, visa violations, perjury, etc.160 By its own admission, the CIA simply ignored or overlooked reports of drug trafficking by the Contras and their supporters.161 As the Washington Post reported, “Nearly a decade after the end of the Nicaraguan war – and after years of suspicions and scattered evidence of contra involvement in drug trafficking – the CIA report discloses for the first time that the agency did little or nothing to respond to hundreds of drug allegations about contra officials, their contractors and individual supporters contained in nearly 1,000 cables sent from the field to the agency's Langley headquarters.”162 According to The New York Times, internal government reports indicate that corruption is a prevalent and incessant problem. A memorandum from the El Paso Intelligence Center “to top drug officials in Washington, warns of 'increased and constant receipt' of reports from informants, government employees and ordinary citizens about 'the use of corrupt and compromised U.S. customs and immigration inspectors' to insure that drug shipments cross the border.”163 Other documents indicate that “scores of these reports have been passed on to drug agency administrators or federal prosecutors over the last few years.”164  Recommendation: Recognizing the inherent corruption in drug enforcement, it is critical to establish checks and balances to oversee drug enforcement activities and to establish strict hiring standards for drug enforcement officials. When a substance is prohibited it creates tremendous, untraceable profits, and when these large sums of money are involved, corruption of officials should be expected. In 1926, in the midst of alcohol prohibition, one out of every 12 prohibition agents had been dismissed for such offenses as bribery, extortion, conspiracy and submission of false reports. Between 1920 and 1928, 1,300 officials were removed for improper activities.165 During the Johnson Administration the Justice Department noted “evidence of significant corruption” in the Bureau of Narcotics including illegal selling and buying of drugs, perjury, tampering with evidence and even murder.166  These scandals were one reason why the federal drug enforcement was reorganized and the DEA created. Within a year of their creation the DEA was under investigation and the number two man in the agency was forced to resign due to his association with gamblers, felons and drug dealers.167  It is impossible to know the extent of corruption among public officials. Many of the corruption-related crimes merely involve looking the other way at the border or taking a portion of cash seized from alleged drug dealers, but other corruption cases involve working closely with violent drug traffickers. According to the Government Accounting Office (GAO), on average, half of all police officers convicted as a result of FBI-led corruption cases between 1993 and 1997 were convicted for drug-related offenses.168 Although uncomfortable, it is crucial to accept the fact that the drug war has created corruption. Once the problem is acknowledged, the next step is to realistically accept the difficulties in solving it. There is vast wealth in the drug market, and corruption will be inherent in drug enforcement as long as we rely on criminalization as our primary method of control. Law enforcement agencies must hire slowly and carefully, because corruption has consistently followed rapid expansions of police forces. Agencies need to put in place a series of checks and balances so that no individual official makes critical decisions or handles investigations without close supervision. Finally, the activities of police officials must be closely supervised by citizen review boards or some other mechanism that includes citizen participation. While widespread corruption does not necessarily translate into a high percentage of corrupt law enforcement officials, it does suggest that corruption exists at some levels in every agency. Wherever there are drugs, there is an opportunity for corruption; as a result, no law enforcement official should be above suspicion, as corruption has been documented at the lowest and highest levels.
148  While corruption has been reported in many countries, the country that has received most of the attention on this issue recently has been Mexico. In March, 1998 the former anti-drug czar of Mexico, General Jesus Gutierrez Rebollo, was sentenced to almost 14 years in prison. His arrest came in early 1997 (just after he had been briefed by the DEA on drug control issues and just after U.S. drug czar, General Barry McCaffrey, praised his leadership) when he was accused of protecting a Mexican drug lord. Five Mexican generals have been jailed since the beginning of 1997 on drug corruption charges. Michael Christie, "Mexico's Former Anti-Drug Czar Sentenced to Prison," Reuters, March 3, 1998. 149 Cam Simpson, "Jury Sees Video of Austin Cops `Drug Raid,'" Chicago Sun-Times, April 23, 1998. 150  John Affleck, "FBI Arrests 44 Cleveland Cops," Associated Press, January 22, 1998. 151  Enscoe, David. "What Price Corruption," UPI, August 27, 1996, 152  Smith, Jim. "Crooked cop: We were at war, Defend stealing from dealers," Philadelphia Daily News, May 29, 1996. 153 O'Connor, Matt. "Four Austin Officers Convicted, Face Stiff Prison Sentences." Chicago Tribune, May 22, 1998. 154 Johnston , David and Sam Howe Verhovek, "U.S. Finds That Drug Trade is Fueled by Payoffs at Mexican Border," New York Times, March 24, 1997. 155 Johnston , David and Sam Howe Verhovek, "U.S. Finds That Drug Trade is Fueled by Payoffs at Mexican Border," New York Times, March 24, 1997. 156  Godfrey, Ed. "Ex-Officer Guilty of Faking Receipt," The Oklahoman, May 12, 1998. 157  U.S. Department of Justice, Criminal Division, Report on the Activities and Operations of the Public Integrity Section for 1981, p. 20, Washington, D.C. 158 U.S. Department of Justice, Criminal Division, Report on the Activities and Operations of the Public Integrity Section for 1988, p. 29, Washington, D.C. 159 Branigin, William. "Probe of Customs Targets Corruption Along the Border, U.S. Officials Implicated in Drug-Smuggling Schemes," The Washington Post, Feb, 20, 1996; David Johnston and Sam Howe Verhovek, "U.S. Finds That Drug Trade is Fueled by Payoffs at Mexican Border," New York Times, March 24, 1997; "DEA Chemist Filed False Evidence Reports," San Antonio Express-News, July 18, 1996. 160 Central Intelligence Agency. Report of Investigation: Allegations of Connections Between CIA and The Contras in Cocaine Trafficking to the United States (96-0143-IG). Office of Inspector General Investigations Staff, January 29, 1998, Exhibit 1. 161 Central Intelligence Agency. Report of Investigation: Allegations of Connections Between CIA and The Contras in Cocaine Trafficking to the United States (96-0143-IG) Volumes I and II. Office of Inspector General Investigations Staff, 29 January, 1998. 162 Pincus, Walter, "CIA Ignored Tips Alleging Contra Drug Links, Report Says," Washington Post, November 3, 1998, p.A4. 163 Johnston , David and Sam Howe Verhovek, "U.S. Finds That Drug Trade is Fueled by Payoffs at Mexican Border," New York Times, March 24, 1997. 164 Ibid. 165 Kyvig, David E. "Repealing National Prohibition," University of Chicago Press, 1979, p. 106. 166 Cartwright, David. (1984). "Dirty Dealing," Atheneum, 167 Ibid. 168 Government Accounting Office, Report to the Honorable Charles B. Rangel, House of Representatives, Law Enforcement: Information on Drug-Related Police Corruption. Washington, DC: USGPO (1998 May), p. 35

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" OBJECTIVE: REDUCE WASTEFUL SPENDING AND DAMAGE CAUSED BY INTERNATIONAL DRUG CONTROL EFFORTS Rationale: Our international drug control strategy is ineffective and continues to follow seriously flawed approaches. The worldwide illicit drug business generates as much as $400 billion in trade annually according to the United Nations International Drug Control Program. That amounts to 8% of all international trade.169 The primary response of the White House's drug control strategy is for more interdiction and eradication which, according to the RAND Corporation, is the least cost-effective alternative available.170 Gains such as eradication of coca fields or destruction of laboratories tend to be temporary, as drug producers and traffickers adapt quickly to enforcement strategies. But the U.S. spends increasingly more money on these failed strategies: according to General Barry McCaffrey, “The Administration has submitted a FY 1999 drug control budget that includes 1.8 billion dollars for interdiction efforts – an increase of more than 36 percent since FY 1996.”171  Even as these strategies continue to fail, the response has been to pursue more dangerous approaches and set even more unreachable goals. At home and abroad we are employing dangerous herbicides to eliminate drug crops, which threaten the environment and public health. We are also expanding the role of militaries – both U.S. and Latin American – in drug enforcement activities, which threatens human rights and democratic development. In June 1998 the UN's International Drug Control Program set a goal of eradicating poppy and coca cultivation from the face of the earth within the next ten years. Trying to achieve such an impossible goal will create even more environmental damage and human rights abuses – as have already been seen in countries like Colombia, Bolivia and Peru. Rather than escalate unworkable strategies in an effort to achieve the unrealistic goal of a “drug-free world,” it is time for a review of international drug control policy. As hundreds of signatories to a letter to UN General Secretary Kofi Annan said this June: it is time for a drug policy based on “common sense, science, public health and human rights.” Signatories to this letter included political leaders, academics, business leaders, and Nobel Laureates who correctly noted that “the global war on drugs is now causing more harm than drug abuse itself.” [See figure 25] Recommendation 1: Place less emphasis on drug interdiction and source country eradication strategies and greater emphasis on domestic drug prevention and treatment programs as well as alternative economic development. Due to the massive flow of goods and people across our borders, and the small quantities of drugs that are needed to make enormous profits, interdiction efforts are truly like searching for a needle in a haystack. One of the major problems with supply reduction efforts (source control, interdiction, and domestic enforcement) is that “suppliers simply produce for the market what they would have produced anyway, plus enough extra to cover anticipated government seizures.”172  In order to develop a sensible international drug policy, the United States must recognize that drug control begins at home. The focus of our policy then shifts to its root cause – consumer demand for prohibited substances. Rather than escalating funds for eradication and interdiction, and blaming countries for producing and transporting drugs, the United States should focus its international drug control efforts on economic development in partnership with source countries and developing alternative economic activities for the impoverished farmers who grow drug crops. Recommendation 2: End the drug certification process. Every year, the U.S. government must decide whether or not to 'certify' foreign governments as partners in the War on Drugs. If a country is decertified, it loses foreign aid (other than counter-narcotics funding) and faces trade sanctions. The policy, enacted in 1986, was supposed to foster anti-drug cooperation. But, many poverty-stricken nations are struggling to overcome the violence and corruption caused by the drug trade, and resent the annual U.S. judgment of their efforts. According to a recent article by Bill Spencer, the Deputy Director of the Washington Office on Latin America, “Policymakers would do better to abandon the annual exercise of sounding tough and casting blame beyond our borders, and work instead to create more effective multilateral mechanisms for combating the violence and corruption of the drug trade.” Spencer explains that “Certification is bad drug policy because it sends mixed signals to other countries; it fosters conflict; and it reinforces the focus on the failed source-country control strategy. Certification is bad foreign policy because it holds other priorities such as human rights hostage to the single issue of drug control. Certification distorts our national conversation on foreign policy by focusing media attention and political debate on drugs, obscuring the search for common interests.”173 Instead, we need to enact a new policy that promotes real partnerships with other countries, stems the corrosive effects of the drug trade on democratic institutions, and embraces the principle that US drug control begins at home. Recommendation 3: Stop encouraging a role for the military in counternarcotics activities properly performed by civilian law enforcement agencies, both at home and abroad. The frustration over failed eradication and interdiction efforts has resulted in greater reliance on the Department of Defense (DOD) to enforce the “War on Drugs.” Since the National Defense Authorization Act of 1989, the DOD has been designated the “single lead agency” for drug interdiction under federal law. As a result the US military has become entrenched in the drug war and has enlisted Latin America's militaries as key partners in U.S. drug control strategy. This approach leads the United States into increasingly close alliances with military agencies with poor human rights records or which are involved in ongoing counterinsurgency campaigns. Counter-narcotics training provided by the United States differs little from counterinsurgency training, thus potentially involving the United States in these civil conflicts. Increased military involvement in civilian law enforcement has proven to be inconsistent with its traditional role in the United States and counterproductive to democratization in Latin America. The policy of certifying foreign governments on the basis of their success in curtailing illegal drug production and shipment has been an ineffective tool for drug control and has undermined other important U.S. interests in the Western Hemisphere. Crucial human rights objectives have been particularly affected by counter-narcotics funding, as the U.S. has funded numerous military units in Latin America with documented human rights abuses.174  Moreover, the steady flow of hundreds of millions of dollars each year into South American military forces175 reinforces the militaries' dominant role in domestic politics, which is contrary to the needs of nascent democracies. Colombia has emerged as the largest recipient of U.S. military aid in the Western Hemisphere. Increased aid began in 1990, with the Bush administration's “Andean strategy,” a five-year, $2.2 billion plan to try to eradicate cocaine at its source in Colombia, Bolivia and Peru. In March 1996, the Clinton administration reacted to evidence that President Ernesto Samper had taken money from Cali traffickers by cutting off almost all U.S. aid to Colombia except aid to fight drugs. Overall, U.S. anti-drug aid granted to the Colombian military and police rose from $28.8 million in 1995 to at least $95.9 million in 1997, according to State Department figures. Military sales to Colombia jumped from $21.9 million to $75 million over the same period. The most recent aid package, agreed to after the election of President Andres Pastrana, will total $289 million, nearly triple the recent annual American contributions to Colombia's anti-drug efforts. Our aid to Colombia and other Latin American countries has involved US military in human rights abuses and undermines trends toward civilian democracy in the region. In addition, the line between drug enforcement and other military activity is vague. By 1994, both the General Accounting Office and the Defense Department had found that the light-infantry skills taught in anti-drug training in Colombia were easily adapted to fighting rebels. When the U.S. Embassy in Bogota reviewed the matter in 1994, officials said they discovered that anti-drug aid had gone to seven Colombian brigades and seven battalions that had been implicated in abuses or linked to right-wing paramilitary groups that had killed civilians.176  In addition to working outside the United States, the military is being used for civilian law enforcement within the country as well. Active duty military troops have been involved in drug enforcement along the US border with Mexico. In addition, the National Guard currently has more counter-narcotics officers than the DEA has special agents on duty. Each day it is involved in 1,300 counter-drug operations and has 4,000 troops on duty.177  This has led to unacceptable conflicts between the military and US civilians. On May 20, 1997 four Marines on patrol fatally shot an American high school student, Esequiel Hernandez, Jr., while he was herding goats near his home. This incident resulted in greater restrictions in the use of the military domestically. While this is a positive step we should return to the traditional prohibition against the use of the military in domestic law enforcement. Encourage the trend toward democratization in Latin America; empower civilian leaders; and reduce the role of the armed forces in Latin America. Any drug enforcement aid to the region should be closely monitored to ensure it is used solely for anti-drug operations and does not contribute to human rights abuses. Recommendation 4: Stop the use of herbicides and biological agents in efforts to eradicate illegal drugs outside of the United States as well as within the US. Aerial spraying of herbicides in Latin America reinforces the role of the army and police as an occupying force in the countryside. Aerial spraying has a destructive environmental impact. For instance, when dispersed by aircraft, the herbicide Glyphosate can drift for up to approximately one-half mile. In Colombia, where the herbicide Glyphosate is sprayed from airplanes, children have lost hair and suffered diarrhea as a result of its application.178  Colombia uses aerial spraying to drop herbicides on illicit crops in order to comply with US demands to stop coca production. In its attempts to control peasant production of illicit crops, the Colombian government dumps chemical herbicides on over 100,000 acres every year. The environmentally risky strategy of herbicide spraying does not work. Despite a record year of aerial coca fumigation, Colombia's chief anti-narcotics officer, Ruben Olarte, labeled the program a failure, noting that coca production had increased from 111,000 acres in 1994 to over 195,000 acres by the start of 1998.180 Since these crops are the peasants' only source of income, once fields are fumigated the farmers move deeper into the Amazon rain forest and farm on steep hillsides. This constant push on peasants has led to the clearing of over 1.75 million acres of rain forest.181 Deforestation of Colombia is a risk to Colombia and the world: “Colombia's forests account for 10% of the entire world's biodiversity, making it the second most biodiverse country in the world in terms of species per land unit.” Drug war induced deforestation in Colombia has led experts to theorize that Colombia could become another Somalia or Ethiopia within 50 years, “i.e. a fast growing population that is larger than the food production can support due to poor agricultural soils or techniques.”182  The US Drug Enforcement Administration has proposed the use of herbicides in marijuana eradication programs in the US.183 The herbicides being proposed for use are toxic materials with serious adverse effects. They include: Trichlopyr,184 Glyphosate185 and 2,4-D.186 Marijuana is often intermingled with other crops or forest land so it is hidden from view. Aerial spraying of these plants increases the risk to the surrounding environment due to drift of the herbicides. For these reasons herbicide spraying as part of marijuana eradication should be rejected.
169 Associated Press, "U.N. Estimates Drug Business Equal to 8 Percent of World Trade," (1997, June 26). 170 Source: Rydell & Everingham, (1994), Controlling Cocaine, Santa Monica, CA: The RAND Corporation. 171 Testimony of Barry R. McCaffrey, Director, Office of National Drug Control Policy, Before the Senate Foreign Relations Committee and the Senate Caucus on International Narcotics Control, On the Western Hemisphere Drug Elimination Act, September 16, 1998. 172 Rydell, C.P. & Everingham, S.S., Controlling Cocaine, Prepared for the Office of National Drug Control Policy and the United States Army, Santa Monica, CA: Drug Policy Research Center, RAND (1994), p. 6. 173 Spencer, Bill. (1998, September). Foreign Policy In Focus, "Drug Certification." Vol. 3, No. 24. 174 Editorial. (24 January, 1998). "Illusions of a War Against Cocaine" New York Times. 175 Isacson, Adam and Joy Olson. (1998). Just the Facts: A Civilian's Guide to U.S. Defense and Security Assistance to Latin America and the Caribbean. Washington, DC: Latin American Working Group. 176 Diana Jean Schemo and Tim Golden. (1998, June 2). New York Times, "U.S. Aids Army in Colombia," San Jose Mercury News; Steven Lee Myers. (1998, December 1). "U.S. Pledges Military Cooperation to Colombia in Drug War," The New York Times. 177 Munger, M. (1997, Summer). "The Drug Threat: Getting Priorities Straight," Parameters. 178 Cox, C. (1995). "Glyphosate, Part 2: Human Exposure and Ecological Effects," Journal of Pesticide Reform, Vol. 15, Eugene, OR: Northwest Coalition for Alternatives to Pesticides; Lloyd, R. (1997). "Publisher Warns about Impacts of Drug War," World Rainforest Report 37, Lismore, NSW: Australia; Drug Enforcement Agency. (1998). Draft Supplement to the Environmental Impact Statements for Cannabis Eradication in the Contiguous United States and Hawaii, Washington D.C.: U.S. Government Printing Office. 179 Embassy of Colombia. (1998). White Paper on Narcotics Control, Washington D.C.: Embassy of Colombia. Table 8. 180 Reuters, "Colombia calls drug crop eradication a failure" (1998, September 9). 181 Trade and Environment Database (TED), TED Case Studies: Colombia Coca Trade, Washington D.C.: American University (1997), pp. 4-8 182 Trade and Environment Database (TED), TED Case Studies: Deforestation in Colombia, Washington D.C.: American University (1997); Trade and Environment Database (TED), TED Case Studies: Colombia Coca Trade, Washington D.C.: American University (1997). 183 "Cannabis Eradication in the Contiguous United States and Hawaii," (Supplement to the Environmental Impact Statements), DEA, April 1988. 184 Trichlopyr should not be used near ditches used to transport irrigation water or where runoff or irrigation may flow onto agricultural land. Nor should it be used near dairy animals or livestock and may be toxic to fish. There are also concerns that this herbicide has adverse effects on growth, development, sexual traits and other functions. 185 Glyphosate exposure in humans has caused respiratory effects and skin and eye irritation. It is the leading cause of pesticide-related illness in California agricultural workers. Glyphosate has the potential to contaminate surface waters, killing oxygen producing plants and leading to fish kills. 186 2,4-D is associated with a long list of chronic adverse health effects from neurological effects to liver and kidney function changes to reproductive effects to cancer. 2,4-D risks endocrine disruption and because of this probably should not be used in any weed control program. It has been linked to non-Hodgkin's lymphoma in farmers and under certain conditions can persist in soil for several months.

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" GOAL NUMBER TWO: CHAPTER SUMMARY Reducing the harm caused by the War on Drugs is a big task. Years of rhetoric, political grandstanding and adherence to failed policies have led to bureaucratic inertia. Fortunately, researchers and scientists have clearly outlined a number of public policy areas that require attention. The primary objective in reducing the harm from the drug war is reducing the crime, violence and disease it spawns. According to the National Institute on Drug Abuse, 58.5% of the costs of illegal drug use are directly related to crime and the black market, and these costs can be greatly curtailed. There are a number of steps to take toward this end. A good first step would be to study the relationship between drugs, alcohol and violence to see if there is a pharmacological relationship, or if it is mostly a product of the black market trade. Next, we should begin clinical trials of drug maintenance therapy. Doctors in Switzerland have achieved great success in these programs and their nation has received the benefit of reduced crime and drug use. Since heavy users of cocaine, for instance, consume 8 times as much cocaine as light users, removing them from the black market would remove the bulk of the profit from street level sales, protecting everyone from street violence associated with the black market.187 Lastly, violence prevention programs should be taught to school aged kids to help them learn non-violent conflict resolution. Ending the racial bias within drug enforcement is crucial to restoring the legitimacy of the criminal justice system. Today, one in four African-American men will be incarcerated in their lifetime, largely due to drug convictions and other black market effects. As an initial step, the 100 to 1 disparity in cocaine sentencing must be eliminated. Next, non-white communities should not be targeted for needle possession charges and paraphernalia laws which block successful needle exchange programs should be eliminated. Mandatory minimum laws must be repealed and other existing laws reformed. Federal judges must have the authority to impose appropriate punishments, instead of being required to impose unnecessarily high jail terms for non-violent offenders. Women should not be criminalized for drug use during pregnancy, and family value-friendly policies should be required in addiction treatment and rehabilitation to maintain family units. Finally, drug abuse must be seen as the public health problem that it is, and doctor and public health officials need to have greater freedom and power to participate in solving this health problem. As a first step, the Department of Health and Human Services (not the Department of Justice) should be given the authority to schedule drugs. Local authorities need to be empowered to deal with addiction at their own level, methadone should be made widely available and doctors need to have greater freedom in prescribing pain medication. States, doctors and patients should also be allowed to make their own decisions on the usefulness of medical marijuana. The federal government still provides 8 patients with marijuana to treat pain and glaucoma, yet it is denying this right to other seriously ill patients. Along with this, plans for the safe distribution of this medicine along with scientific studies of its potentials should be pursued. Once drugs are dealt with as a public health problem, instead of a law enforcement problem, our nation can begin to restore civil liberties that were lost due to the need to “search and seize” drugs on people, and in houses, cars, planes and buses. We can end the misuse of forfeiture laws and greatly reduce the government corruption that drug prohibition has spawned. We can also re-prioritize our foreign policies so that we do not wage wars or ignore human rights violations in foreign countries due to a misguided attempt to control a drug supply problem that only flourishes in response an existing domestic demand.
187 Rydel, Peter and Susan Everingham. Controlling Cocaine: Supply Versus Demand Programs, p. xi. Santa Monica, CA: Drug Policy Research Center, RAND

 

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GOAL NUMBER TWO: REDUCE THE HARM CAUSED BY THE "WAR ON DRUGS" CONCLUDING REMARKS Realistic Goals are Achievable, Unrealistic Ones Are Counterproductive This report does not claim to have all the answers. We have attempted to review the best available science in the field of drug policy and put forward strategies that have been proven effective. We have also attempted to highlight some of the questions that need to be faced about the costs and benefits of the "War on Drugs." Even though we know that making addiction illegal does not make it go away, for most of this century the United States has attempted to do just that, by prohibiting the possession, cultivation and sale of certain drugs. This effort has translated into unattainable goals like a "drug-free America"188 based on strategies of "zero tolerance" for illegal drugs. This political rhetoric is intended to give voters the impression that politicians are controlling drugs when in fact the policies that follow from the rhetoric result in an abdication of control. Simplistic drug war rhetoric masks the inability of our political leaders to face up to the complex social and health issues that surround drug use. Such political posturing is a rejection of responsibility for controlling the drug market and reducing drug-related harm, and leaves the real control in the hands of narco-traffickers and drug dealers. The unattainable goal of a drug-free America prevents us from moving toward realistic goals like minimizing adolescent drug use, reducing the spread of HIV, and reducing homicides. This results in a policy which ignores proven strategies like needle exchange, methadone maintenance, treatment on demand and after-school programs for youth. Policies that have been tried and shown effective both in the US and abroad are ignored even when they could improve the lives of many Americans by reducing drug abuse, preventing disease, decreasing racism and improving the lives of children. Government-backed drug policy experts claim their purpose is to protect America's youth. Yet by ignoring common sense and scientific evidence we have really abandoned our youth. We sacrifice their education to build more prisons, we pursue drug education programs that research shows does not work, we underfund programs that do work like Big Brother/Big Sister, and then we express outrage and call for new punishments when drug selling becomes an enticing employment opportunity for urban youth. Throughout the history of the modern drug war, nearly 90% of high school seniors have said it was very easy or fairly easy to get marijuana – easier to get than alcohol, which is regulated and controlled by the state. No matter how much is spent, how many are arrested or how many are imprisoned, easy access remains the standard for our youth. Claims of protecting our youth no longer pass the straight face test – they are laughable. Rather than facing the failure of the drug war, the U.S. government expands the failed strategy. The National Drug Control Strategy issued by General Barry McCaffrey, promises more of the same – a policy dominated by law enforcement, some funding for abstinence-based treatment programs and police-dominated drug education. Recently the United Nations has taken up the call moving toward a "World War on Drugs." In announcing a special session on drugs the UN states on its web site: "On the eve of the new millennium, we face an unprecedented opportunity to build a drug-free world. . . " We do not have to continue down this path. There are alternatives, many with widespread public and professional support. This strategy embraces the same goals as most Americans – safe communities, healthy kids and freedom from drug dependency for as many citizens as possible. We agree with Retired General Barry McCaffrey when he says we can't arrest our way out of this problem. In light of this we ask you to consider: how can our nation do better? We believe this document shows the way.
188 The Republicans recently committed to a drug free America again, this time promising to make America drug free by 2002, see "House Republican Vow to Make US Drug-Free," Reuters, May 2, 1998. The last time a promise like this was made was in the Anti-Drug Abuse Act of 1988, Public Law 100-690, signed by President Reagan on Nov. 18, 1988 which stated: in Title V, subtitle F -- Drug Free America Policy section 5251(b) "DECLARATION.-- It is the declared policy of the United States Government to create a Drug-Free America by 1995."