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Illegal Drugs: What Should We Do Now? An Issue Book.National Issues Forums, Dayton, OH.; Public AgendaFoundation, New York, NY.Charles F. Kettering Foundation, Dayton, OH.ISBN-0-7872-3738-81997-00-0032p.; Charts/figures may not reproduce clearly.Kendall/Hunt, 4050 Westmark Drive, Dubuque, IA 52002;toll-free phone: 800-228-0810.Reports Research (143)MF01/PCO2 Plus Postage.*Drug Abuse; *Illegal Drug Use; Law Enforcement; *Policy;*Prevention; Public OpinionUnited States

Increasing frustration with the illegal drug problem isfueling public discussion about the effectiveness of the nation's antidrugefforts. This document offers three choices for dealing with the drug abuseproblem in the Untied States. Each choice presents "what can be done" andinformation "in support" and "in opposition" (choices are illustrated withmultiple graphs, charts, and figures). Choice 1: "Step Up Enforcement toFinish the Job." This choice points out the effects of enforcing existingantidrug laws and proposes redoubling current efforts to keep drugs out ofhomes, schools, workplaces and neighborhoods. Choice 2: "Change AttitudesAbout Illegal Drugs." This choice assumes that government cannotsignificantly reduce the supply of illegal drugs, thus demand must be reducedby changing tolerant behaviors. Choice 3: "Treat Substance Abuse as anIllness." This choice approaches drug abuse as a treatable illness andillegal drugs as primarily a public health problem, therefore requiringmedical, social, and legal remedies. The document concludes with a summarythat addresses renovating public policy and ballots for readers to registertheir views. (MKA).

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Illegal DrugsWhat Should We Do Now?

By Michael deCourcy Hinds

Introduction: Illegal Drugs - What Should We Do Now?

One in two Americans has a drug problem or knows someone who does. And now, afterdeclining for years, teenage drug use mostly of marijuana has doubled since 1992.Increasing frustration with the illegal drug problem is fueling public discussions aboutthe effectiveness of the nation's antidrug efforts.

Choice I

2

Step Up Enforcement to Finish the Job

The nation's war on drugs has already reduced casual druguse by 53 percent since 1979. Now is not the time to second-guess success, but rather, to redouble our efforts to keepdrugs out of the country and out of our homes, schools,workplaces, and neighborhoods.

Choice 2

6

What Can Be Done? 7

In Support & In Opposition 10

Change Attitudes About Illegal Drugs I I

Since government cannot significantly reduce the supply ofillegal drugs, we must reduce the demand for them bychanging tolerant attitudes. Parents, schools, and the enter-.tainment media must say, with one voice, that illegal drugsare dangerous and socially unacceptable.

Choice 3 Treat Substance Abuse as, an Illness

What Can Be Dane?

In Support & In Opposition IS

Drug abuse is a treatable illness-,-latid illegal drugs are primarily,a public health problem, demanding medical, social, and legalremedies. Government must jail drug.traffickerS, but shouldtreai.drug users. Prevention programs, should be expandedto reach more troubled families before they turn to drugs.

16

What Can Be Done? 17

In Support & In Opposition 20

Summary: Renovating Public Policy 21

Comparing the Choices 22

What Are the National Issues Forums? 24

Ballots: Register Your Views 25

Acknowledgments, Credits, and Ordering Information 29

3

Viinniitt !MIMI t " "00

Illegal Dr gWhat Should We Do Now?

After declining for a dozen years,marijuana use among teenagershas doubled since 1992.

----"Wf.11111141,

\\

California factory worker uses

amphetamines to stay alert during

the overnight shift. An Ohio teenager

plays the harmonica stoned on marijuana.

A New York stockbroker married,

with two small children experiments

with heroin and dies of an overdose.

Illegal drugs have become so enmeshed

in American life that one out of two

Americans say they have a drug problem

or know someone who does. Illegal

drugs are no longer somebody else's

issue, they are everyone's.

2 ILLEGAL DRUGS NATIONAL ISSUES FORUMS

Marijuana use among teenagers has doubledsince 1992, against a national backdrop of stabilityin illegal drug use, a 1996 government surveyreported. Experts speculate that more teenagersare smoking marijuana and trying LSD becausethey think drugs provide more pleasure thanrisk. "I smoke pot because it feels good... Duhhh,"Mary, 16, told The Philadeliphia Inquirer shortlyafter the government survey was released.

Not surprisingly, the government report stirredup public discussion about the effectiveness ofthe nation's war on drugs. More than ever,Americans see the issue as one in which theythemselves have to take a more active part aproblem too big for government alone to solve.Public discussion is evolving, in part, because somany people have now had personal experiencewith illegal drugs, and in part, because so manypeople are terrified by the random violenceassociated with drug-related crimes.

One measure of public concern about drugpolicy is that some states voted in 1996 to try awhole new approach. In Arizona, 65 percent ofvoters approved the medicinal use of marijuana,heroin, LSD, and methamphetamines if there isa scientific basis for doctors to prescribe thesedrugs. Under Arizona's Drug Medicalization,Prevention and Control Act, use of these drugswithout a prescription remains a crime, butfirst- and second-time offenders convicted ofpersonal possession will be placed in mandatorytreatment and probation as an alternative toprison. Supporters of the measure included for-mer U.S. Secretary of State George P. Shultz,former U.S. Senators Barry Goldwater and AlanCranston, and Nobel Prize-winning economistMilton Friedman. Opponents included BarryR. McCaffrey, director of the U.S. Office ofNational Drug Control Policy, and U.S. SenatorsOrrin G. Hatch and Jon Kyl.

Voters in California also approved a ballotinitiative endorsed by the California MedicalAssociation that permits any citizen to cultivateor use marijuana for medicinal purposes on adoctor's verbal recommendation.

This issue book first outlines the nation'sproblem with illegal drugs and, in subsequentsections, presents three approaches for addressingthe problem.

The Drug Problem Isn't MewUse of illegal drugs is linked to crime, AIDS,workplace injuries, failure in school, unemploy-ment, domestic violence, and the disintegrationof families and communities. Drug abuse mayseem like a quintessentially modern scourge, butit isn't. Societies have long struggled with thedifficulty of drawing the line between a drug'sbenefits and its dangers, between its responsibleuse and its abuse.

After all, marijuana plants were among theprized possessions brought to Virginia by Englishsettlers in the early 1600s. Between 1886 and1905, Coca Cola advertised cocaine as the "re-markable therapeutic agent" found in the beveragefor combatting fatigue. And for many years, SearsRoebuck sold needles and morphine through themail. In the 1890s Bayer Pharmaceutical intro-duced two wonder drugs and named them aspirinand heroin, which was sold as a cough suppres-sant. At the turn of the century, U.S. public healthofficials estimated that 300,000 Americans wereaddicted to opiates; most were female victims ofpatent medicines, poor medical care, and limitedoptions for treating pain. Until Congress beganrestricting drug use in 1914, druggists and generalstores routinely and freely sold opium, morphine,heroin, cocaine, and marijuana.

The nation's early efforts to regulate drugswere supported by organizations with very dif-ferent agendas. They included medical societiesconcerned about quack remedies, consumerprotection advocates who favored disclosureof drug products' addictive ingredients, anti-immigration groups that blamed foreigners forbringing drugs into the country, temperancesocieties that favored banning alcohol andother intoxicating drugs, and members of theProgressive movement, who saw drug restric-tions as part of their plan for a more democraticand moral society.

Congress first imposed controls on the sale ofopiates and cocaine in 1914 and, over the years,built up a sizable body of narcotics laws. In 1951Congress set mandatory minimum prison senten-ces, which required courts to send drug dealersto prison for a minimum of two years for the firstoffense, with longer mandatory terms for secondand third offenses. In 1965, Congress repealedthe mandatory minimum sentences, on thegrounds that they removed judicial discretionwithout reducing the rate of drug offenses; in1986, Congress reversed itself again, reestablishingmandatory minimum sentences for drug offenses.

Following a surge of drug use in the 1960s,President Richard M. Nixon in 1973 declared an"all-out global war" to end "the drug menace."

By 1988, the nation'santidrug crusadeunder PresidentRonald Reagan cost$4.8 billion a year; by1995, the antidrug $15

budget had almostquadrupled, to $13.2billion, under ;Presi-dent Bill Clinton. Thenation's war on drugshas placed top priorityon enforcement ofcriminal laws, followedby treatment, educa-tion, and interdictionof illegal drugs-at ourborders. Communityantidrug campaignshave also proliferatedin recent years, as people around the countryfelt they had to get-involved to protect theirneighborhoods.

When discussing ways to shift priorities andspending, people often assume that since theantidrug budget was $13.2 billion in 1995,there is $13.2 billion on the table to spend,possibly in new ways. But much of this moneyis allocated for programs to which the govern-ment has made long-term commitments thatcannot be stopped at the drop of a hat. Prisonsmust be built and run to house offenders alreadyconvicted of drug crimes; international inter-diction operations by the military must besupported; and contracts with treatment pro-grams must be carried out. Therefore, shiftingpriorities would require new spending andthat means raising taxes or reducing programsunrelated to illegal drugs. Community programs,however, have grown like weeds with little or nopublic funding.

Illegal drug use fluctuates considerably, butit is widespread. Contrary to stereotypes andcriminal conviction rates, three-quarters ofAmericans who admit using illegal drugs arewhite and employed, according to the govern-ment's National Household Survey on Drug

Illegal Drugs,,,14; 4, 7 7

0 S 0

The RisingrlbatingDrugsFederal spending on drug control, in billions of dollars,. adjusted forinflation, 1981-1995

Billions

$12

$9

$6

$3

111111981 1989 1991 1993 1995

Source U.S. Of of National Drug Control Policy

c

I I For Further Reading/Illegal Drugs

Coca leaves/National Library of Medicine

Rod L. Evans and Irwin M. Berent, editors, Drug Legalization: For and Aping

(Peru, Ill.: Open Court Publishing Company, 1992).

Melvyn B. Kraus and Edward P. Lazear, editors, Searching for Alternatives: Drug -

Control Policy in the United States (Stanford, Calif: Hoover Institution:press, 1991).

William 0. Walker, editor, Drug Control Policy: Essays in HistoticariintreiiiiParative

Perspective (University Park, Penn.: The Pennsylvania State University;Piess, 1992).

BEST COPY MANILA LE 5 ILLEGAL DRUGS NATIONAL ISSUES FORUMS 3

trioducticin Illegal Drugs

verall Drug Use Has Fallen...Percentage of Americans over age 12 who reported using an illegal drug in the previous month,selected years, 1979-1995

15%

12%

9%

6%

3%

1979 1988 1990 1991 1992 1993 1994 1995

...But Teen Drug Use Is Rising AgainPercentage of children from age 12 to 17 who reported using marijuana and cocaine in the previousmonth, selected years, 1979-1995

15%

12%

9%

6%

3%

Marijuana

Cocaine

1979

1 i I -I 1 I f I

1985 1985 1988 1990 1991 1992 1993 1994 1995

Source: Department of Health and Human Services, National Household Survey on Drug Abuse, 1995

Abuse. Marijuana is America's favorite drug:65 million have tried it and 10 million smoke itmonthly. The government survey also reports:

E In 1979, illegal drug use peaked, with 25.5million Americans, or 14 percent of the popula-tion over 12, saying they had used illegal drugsin the previous month.

sa By 1992, only 11.9 million Americans reportedusing drugs in the previous month, a 53 percentdecline from 1979. Self-reported drug use

declined among all demographic groups, butdrug use among young people between the

ages of 12 and 25 plummeted by nearly300 percent.

ti Between 1992 and 1995, overallillegal drug use increased slightly, butteenage drug use (mostly of marijua-na) more than doubled, increasingfrom 5.3 percent to 10.9 percent. Inthe same period, illegal teenage use ofalcohol and tobacco remained flat,with just over 20 percent of adoles-cents drinking and smoking.


Substance AbuseThis issue book is about illegal drugs, but discuss-ion of illegal drugs inevitably touches on thebroader topic of substance abuse, which includesthe abuse of legal drugs like alcohol, tobacco,and prescription drugs like Valium and codeine.

By some measures, alcohol and tobacco aremore costly and kill more people than do illegaldrugs. For example, annual healthcare costs andlost productivity due to substance abuse amountto $67 billion for illegal drugs, $72 billion fortobacco, and $100 billion for alcohol, accordingto a 1993 study at Brandeis University. Alcohol-and tobacco-related diseases and accidents killabout 600,000 people a year, about 20 timesmore people than die from drug-related crimes,overdoses, and diseases. The numbers give aglimpse of the problems' costs, but interpretingthe numbers demands caution: alcohol andtobacco are legally sold and freely used, whileillegal drugs are not.

Crime sets illegal drugs apart from legal drugs.Alcohol has a strong statistical link to some violentcrimes, but alcohol's link to crime in general isweaker than that of illegal drugs. According toinmate surveys conducted in 1987 by the U.S.Bureau ofJustice Statistics, nearly 40 percent ofincarcerated youths said they were under theinfluence of illegal drugs at the time of theiroffense. In 1991, 17 percent of all state prisoninmates said they committed their offense to buyillegal drugs, and a third said they committedtheir crime under the influence of illegal drugs.

Because of the strong link between crime andillegal drug use, many people see the nation'sdrug problem primarily as a criminal problem.But others say that illegal drug use represents afailure by parents, schools, and our popular cul-ture to educate people about destructive druguse and to stigmatize illegal drugs as socially un-acceptable. Still others say that drug abuse is atreatable disease, and that the widespread use ofillegal drugs is primarily a public health problem,one that will grow worse without adequate pro-grams for treating and preventing substance abuse.

Where 1 o n we Go From Here?In deciding how to address the drug problem,Americans confront some tough questions,including the following:

n To fight illegal drugs, are we willing to expandthe use of strategies like wiretapping andrandom drug testing?

Should we put drug users in prison or intreatment or both?

Are the entertainment media glamorizing druguse or merely reflecting society?

A Framework for DiscussionTo promote discussion about the illegal drugproblem, this issue book presents three per-spectives, or choices, concerning the directionthe nation might take:

Choice One says the nation's antidrug effortsover the past 20 years have cut drug use by half.This is the time to expand successful programs,not experiment with new ones. In this view, wemust continue to make drug enforcement a topnational priority, increasing efforts to attack druguse and trafficking at the community, national,and international levels.

Choice Two says we must continue enforcingdrug laws, but the nation must expand educa-tional efforts to reduce the public appetite forillegal drugs. Parents, schools, and the entertain-ment media must take much stronger standsagainst illegal drug use. We must make it clearthat illegal drugs are destructive and sociallyunacceptable.

Choice Three says drug abuse is a treatable ill-ness. The epidemic of illegal drug abuse, in thisview, is best addressed with a broad publichealth approach, including an expansion of pre-vention and treatment programs as well as legalreforms. - Government must jail drug dealers, buttreat drug abusers as sick patients and helptroubled families deal with problems that putthem at risk of drug abuse.

IA note to the reader about NIF booksEach book in this series for the National Issues Forumsoutlines an issue and several approaches, or choices,

that address a problem and its solution. Rather thanconforming to any single public proposal, each choice

reflects widely held, but contrasting, concerns and prin-ciples. Panels of experts review manuscripts to make

sure the choices are presented accurately and fairly.

Unlike most periodicals, issue books do not identifyindividuals or organizations with partisan labels such as

Democrat, Republican, conservative, or liberal. Thegoal is to present ideas in a fresh way that encourages

readers to judge them on their merit. Issue books include

quotations from experts and public officials when theirviews appear consistent with the principles of a choice.

But these quoted individuals might not endorse everyaspect of a choice as it is described here.

Illegal DrugsI qt.!? YO9KIL'

A Century of 'Drug Use and. Drug Policy

1900 US. public health officials estimate'that 300,000

Americans are opiate addicts. Opium, morphine, and

'cocaine are commonly used in health remedies and

leially sold even in grocery stores.AmeriCari 'opfuni

The nation's first antidrug law, the Harrison Act late 1800s.

requires doctors and pharmacists to regiSter prescriptions for cocaine and opiates.Other use of narcotics becomes illegal.

EnCongress enacts the Narcotic Drugs Import and Export Act tomonitor illicit traffic in narcotics.

gaiCongress outlaws heroin.

Federal Bureau of Narcotics, the forerunner to the Drug

Enforcement Administration, is created.

WMCongress outlaws marijuana.

1123,

OPiumPoPPt

Congress passes the Boggs law, which establishes uniform penalties for violations of

_drug laws. A first conviction rest-As in a mandatory minimum sentence of two years; .

a second conviction, 5 to 10 years; a third conviction, 10 to 20 years.

gePresident Richard M. Nixon declares an "all-out global war" on drugs.

IraCocaine makes a comeback as a popular euphoric, and

is embraced by the media. A New York Times Magazine

piece, "Cocaine:The Champagne of Drugs," states,

"For its devotees, cocaine epitomizes the best of thedrug culture which is to 'say, a good high achieved

without the forbiddingly dangerous needle and addic-tion of heroin."

COCAINETOOTHACHE DROP8i

Inelantaneou. Cure IRICIES

ureCl

cs

ENTO.

._

Cocaine toothache drops

BE A presidential task force recommends shifting the emphasis of federal drug policy from

law enforcement to treatment and prevention, noting that elimination of drugabuse is unlikely?'

IM172-Testifying before Congress. OW* from four government agencies reconvnenddim-

`inating criminal penalties for the use of marijuana.The federal governmenttakei noaction, but 10 states decriminalize the possession of small amounts of marijuana

gePresident Jimmy Carter asks Congress to abolish all federal criminal penalties for

possession of less than one ounce of marijuana.

1980 President Ronald Reagan increases funding for the war on drugs, and First Lady NanCy

Reagan launches the "Just Say No" campaign.

MCIU.S. Representative Newt Gingrich, now Speaker of the House, proposes

legislation to legalize marijuana for medical purposes.

The military begins random drug testing of enlisted personnel.

CMCongress allows the use of military for intelligence-gathering in the war on drugs,imposes mandatory life sentences on adults who sell drugs to a juvenile for the second

time, and permits the introduction of illegally seized evidence in drug offense trials.

11121 Congress creates a "drug czar" to coordinate drug control strategies as head of the

White House Office of National Drug Control Policy, and makes drug offenders ineligiblefor college loans or public housing.

ainVoters in California and Arizona approve ballot initiatives that legalize the medical

use of marijuanaPlot= National Library of Medicine

ILLEGAL DRUGS NATIONAL ISSUES FORUMS S

flANIECIEE113121M '

o

Step Up Enforcementto Finish the Job

\:SA

"..9

,,rfLS.

es 40 it

Enforcement of antidruglaws has helped reducedrug use by 53% since 1979. early 70 percent of the cocaine sold

on American streets comes from

drug cartels in Cali, Colombia. Organized

Mexican gangs help transport the cocaine,

with a street value of $6,000 per pound,

across the U.S. border in secret compart-

ments of thousands of vehicles.

6 ILLEGAL DRUGS 0 NATIONAL ISSUES FORUMS

The operators of this network are "a new breedof international organized criminals whosepower and influence make America's mafialook like child's play," Thomas A. Constantine,administrator of the Drug Enforcement Admin-istration, told Congress in June 1996.

Constantine was testifying about a just-completed investigation documenting thedomination of the U.S. drug trade by Colombianand Mexican wholesalers, who, in turn, supplyAmerican drug dealers on the street. By the endof the eight-month investigation in May 1996,police had arrested 156 people, and had seizedsix tons of cocaine and $17 million in drug profits.The international investigation, dubbed Opera-tion Zorro II, serves as a model of cooperation,involving law enforcement officials from 11federal agencies and 42 state and local agencies.

Illegal drugs, by definition, are a criminalproblem, one that will only worsen without acommitment to substantially increase enforcement,according to Choice One supporters. In this view,a tough, uncompromising response to the illegaldrug problem is required because Americans aredeeply concerned that drugs are destructive toindividuals and threaten our entire way of life.Government statistics indicate that our antidrugefforts over the past 20 years have produced sig-nificant success: more than a 50 percent drop inthe number of people in every age group whotry drugs or use them casually. But current levelsof enforcement and existing community antidrugcampaigns are not nearly enough. How else canone explain the vast quantities of drugs thatdaily slip into this country in cars driven bynoncitizens? How else can one explain the publicsale of drugs on American streets everywhere?And how else can one explain the proliferationof crack houses, where everyone, including thepolice, knows that cocaine is sold to a traffic jamof addicts?

8

A Role for EveryoneChoice One supporters say that Americans mustmake drug eradication a top national priority,with innovative strategies to break every link inthe chain of drug production and distribution atthe international, national, and community levels.

Internationally, the U.S. should increaseeconomic assistance to help other governmentseradicate drugs from their farms, factories, andeconomies. U.S. military forces should cooperatewith foreign governments in destroying the drugfactories and prosecuting the drug lords. As a lastresort especially when a foreign governmenthas been corrupted by drug money, as isapparently the case in Colombia the U.S. shouldbe willing to intervene on its own, much as itdid in 1989 by removing Panama's GeneralManuel Noriega and imprisoning him for allow-ing drug traffickers to operate from his nationwith impunity. The government must also sealour leaky international borders against drugs,expanding border patrols on land and sea andin the air.

On a national level, we must strengthen criminallaws so that law enforcement officials can do thejob Americans want them to do. Governmentmust significantly expand its drug enforcementefforts, putting many more police on the streets,building more prisons, and expanding the useof the National Guard and perhaps other militaryforces in demolishing crack houses and protectingcommunities. The nation must deal strictly withdrug dealers and drug users alike, strengtheninglaws so that offenders are punished more severelyand drug profits are seized.

But getting serious about eradicating drugsmeans much more than increasing the govern-ment's role. Drugs have saturated our communitiesso thoroughly that we cannot expect the govern-ment alone to solve the problem as individualsand members of community organizations, wemust take responsibility for stopping drug useand sales in every community. For our own good,we must insist that schools conduct locker-roomsearches, that employers conduct random drugtests, and that police help communities developneighborhood watch patrols. The nation'smessage must be simple and unambiguous:zero tolerance for illegal drug use.

Keep Drugs *tatThe war on drugs, in this view, should not bejust a federal and state responsibility but also alocal effort in every American city, town, suburb,and rural area. For example, urban communities

Step Up Enforcement

47): - 9

I

Supporters of Choice One generally favor the following measures:

Seal our international borders to illegal drugs and demand internationalcooperation in breaking up drug cartels. If necessary, impose stiff economicsanctions against drug-exporting countries. As a last resort, especially incases where drug profits have corrupted a foreign government, use militaryforce to destroy drug factories and cartel strongholds.

El Substantially increase funding for enforcement. Put more police on thestreets, expand border patrols, and strengthen state and federal drug.enforcement efforts, including surveillance and undercover programs.

MI Have police help citizens develop antidrug campaigns and patrols toprotect their communities.

l Expand canine sniff searches and random testing for illegal drugs to allschools and workplaces. Make public benefits like welfare and unemploy-ment compensation contingent on passing drug tests. Encourage parentsof teenagers to use newly available at-home drug tests.

I Impose mandatory minimum prison sentences on drug users and dealersmost drug offenders now serve only a third of their prison terms.

IN Support the investment in effective enforcement by building more prisons.

Destroy drug dealers' business by expanding seizures of their property anddrug profits.

i of

L

r

C. B. Kimmins, executive director of Mantua Against Drugs, leading one of many citizens'patrols that keep drug dealers and addicts out of the Mantua section of Philadelphia.

9 ILLEGAL DRUGS 0 NATIONAL ISSUES FORUMS 7

k,

.11QicLetiPlIAPA: Step Up Enforcement

that have succeeded in fighting drugs oftencombine two strategies: 1) antidrug campaigns,in which citizens make it clear that they will nottolerate drug dealing in their neighborhood; and2) community policing, which generally involvesa municipality assigning more police to footpatrols, regular beats, and community meetings.In Philadelphia, where the police work side byside with community group members, the crimerate declined by 20 percent between 1989 and1993. In one formerly drug-infested neighbor-hood called Mantua, the combined strategyresulted in a whopping 40 percent decrease in

Testing for Illegal Drugs Deters Their Use

The Workplace: Testing has increased since 1989Percentage of employees testing positive at firms that test for illegal drugs, 1989-1995

10%

8%

6%

4%

2%

1989 1990 1991

Source: American Management Association

1992 1993 1994 199S

The Military: Testing began in 1981Percentage of armed forces enlisted personnel reporting drug use in the previous month, 1980-1995

30%

25%

20%

15%

10%

5%

1980 1982 1985 1988 1992

Source: 1995 Department of Defense Survey of Health-Related Behavior Among Military Personnel


1995

crime during those years. Leading the commu-nity effort is a citizen's group called MantuaAgainst Drugs. MAD, as it's called, has becomea national model for citizen involvement in thewar on drugs.

Wearing white construction helmets andarmed only with bullhorns, the mostly elderlymen and women of MAD occupy street cornersand block off access to tenements where drugdealers operate. "We get neighbors to know it'stheir responsibility to take the lead in this," saidC.B. Kimmins, MAD's executive director. "Weget in the drug dealers' faces, telling them to getout of the neighborhood. We're not vigilantes,but we don't back down." Working with police,MAD has closed down more crack houses thanits members can count.

Make Sure Dealing Drugs Doesn't PayToo often, drug dealers are back on the streetthe day after they are arrested. And when theyare sent to prison, they usually keep their illegaldrug profits and often serve only a portionof their sentence. To deter drug trafficking,government must ensure that drug dealing isa losing, dead-end business, in this view.

Mandatory minimum sentences, which specifythe minimum period of incarceration for somecrimes, should be applied to all drug-related crimes

and the minimum sentences should be length-ened to make prison a more effective deterrent.

Seizing drug profits is another way to deterthese crimes, as well as a way to offset someenforcement costs. In 1995, for example, federalprosecutors seized more than $150 million indrug profits from Swiss bank accounts of a singleColombian family, the Nassers, who had exportedan estimated 27 tons of cocaine and 1,500 tonsof marijuana to the U.S. since 1976. Since thelate 1980s, U.S. seizures of drug traffickers'assets have averaged $600 million annually,according to government statistics.

Choice One supports city and state efforts tomake greater use of seizure and forfeiture laws atthe local level. In Detroit, for example, policeseize the automobiles of drivers who cruisethrough neighborhoods to buy drugs. To redeemtheir vehicles, drivers have to pay $950; theprogram generated more than $630,000 in 1995and chased drug buyers out of city neighbor-hoods now only 1 in 100 seized vehicles isowned by a repeat offender.

1_0

Don't Tolerate DO legal Drugs AnywhereIf this country is to eradicate illegal drugs,Americans must stop tolerating any illegal druguse and must, for the good of all, accept someminor inconveniences.

In 1996, for example, Debbie Sandland, atrustee of the Simi Valley School District inVentura County, California, cast one of the fewvotes against having police dogs conduct random"sniff-searches" of students' lockers. Sandlandexpressed concern about disrupting student pri-vacy, but was overruled by a majority of boardmembers and, as it turned out, by two out ofthree students in a survey following six searches."Seeing the feedback makes me feel a lot better,"Sandland told The Los Angeles Times. "It hasnot been nearly as disruptive as I thought."

The workplace provides another majoropportunity to combat drugs, as 74 percent ofthe nation's 12 million drug users are employed

and nearly 2 million of them usedrugs on the job, according to theNational Institute on Drug Abuse.Surveys of employees indicate over-whelming support for random drugtests of urine samples, and employ-ers are rapidly recognizing theirobligation to provide drug-freeworkplaces especially as they realizethat employee drug use causes acci-dents, lost productivity, and higherhealthcare costs.

Employer drug testing is highlyeffective, according to Dr. Robert L. DuPont,president of the Institute for Behavior and Healthin Rockville, Maryland. "I have seen hundredsof drug abusers who have recovered controlover their lives because their employers puttheir employment on the line," he says.

Step Up Enforcement

The most powerful success story comes fromthe military, which began random drug testingafter a Navy jet crashed on the deck of the air-

craft carrier Nimitz in 1981, killing14 sailors and pilots; autopsiesindicated recent marijuana use by6 of the 14 men. Today, the militaryservices say they are becomingdrug-free. A Department of Defensesurvey in 1995 indicated that only 3percent of all military personnel hadused drugs in the prior month orabout one-third the rate for civiliansof the same ages. By comparison, a1980 survey indicated that 26.7percent of military personnel were

using drugs. The military's policy for everyenlisted member and officer is zero tolerance forillegal drugs; if drug use persists after warningsand treatment, offenders are discharged fromthe service.

of drug abusers who

have recovered control

over their lives because

their employers put

their employment on

the line."

Drug Use Often Leads to CrimePercentage of inmates who said they committed crimeand most serious current offense

Crime committed Federal prisoners

to get money for drugs, by prison system

State prisonersCounty/cityjail inmates

1991 _1991 1989

Li ,J1

Burglary 32% 30% 31%

,Laicenyjihofe--'

Drug trafficking 10% 25% 19%

.7.

Source: Bureau of Justice Statistics

11

Eliminating the drug probleminvolves eliminating the drugbusiness by stepping upenforcement and strippingdealers of their drug profits.

BEST COPY AVAILA

ILLEGAL DRUGS NATIONAL ISSUES FORUMS 9

Choke One

In Support..3.1L,

Step Up Enforcement

Illegal drugs are destroying the country and can nolonger be tolerated.

The war on drugs has been very successful, reducingcasual drug use by more than 50 percent since 1979. But

winning the war on drugs will require adequate funding anda strong commitment from government, businesses, schools,communities, and citizens.

If the nation curtails the supply of drugs, people won'tbe able to sell them, use them, or abuse them.

Cracking down on drugs will reduce crime, because asignificant number of people commit crimes to support

their drug habit, and a third of all crimes are committedunder the influence of drugs.

If would-be drug dealers know they will be punishedseverely and stripped of property and profits, they will

look for another business venture. Drug users must alsoknow that illegal drug use will result in swift, certainpunishment and long prison sentences.

Incarceration works. Studies show statistical relation-ships between rising prison populations and falling crime

rates, with significant reductions in the number of burglaries,robberies, assaults, and rapes.

Deterrent measures such as canine sniff searches andrandom drug testing for illegal drugs are very effective, as

the military has proven.

Since most of the drugs sold on American streets comefrom abroad, we must do everything possible to seal our

borders and force drug-exporting nations to curtail theirdrug trade.


:Choice One supports spending more money tryingto reduce the supply of illegal drugs. But government

reports indicate that despite spending many billions ofdollars, the U.S. intercepts only about 5 percent of drugshipments coming into the country

/ This approach calls for zero tolerance of illegal druguse. But the nation can't possibly lock up everyone,

including children, who experiments with drugs. Drugusers need counseling and treatment, not punishment.

:// Most crime linked to drugs results from the illegality*. of drugs, just as the illegality of alcohol during Prohib-

ition not alcohol use itself created a major crime wave.

Choice One treats marijuana as though it were asdangerous as heroin, but research indicates that mar-

ijuana is a nonaddictive drug that is safer than alcohol. Tenstates including Maine, Minnesota, and Ohio havealready eliminated criminal penalties for possession ofmarijuana for personal use.

/ This choice calls for strategies like random drugtesting, which invades privacy, and asset forfeiture,

which violates civil liberties by forcing people to prove thattheir property was not used in committing a crime.

Locking up drug users isn't the answer. Public officialsin many states say that, without substantial tax

increases, they cannot continue providing prison cells for allnonviolent drug users.

Some opponents say Choice One fails because it putsthe cart before the horse: it tries to change people's

behavior before changing their attitudes about illegal drugs.

For Furher=linStep Up Enforcement to Finish the Job

Vincent T. Bugliosi, The Phoenix Solution: Getting Serious About

Winning America's Drug War (Beverly Hills, Calif.: Dove Books,

1996).

John Dilulio, Jr., "The Next War on Drugs," The Brookings

Review, The-Brookings Institution, June 1, 1993.

Robert L. DuPont, Jr., M.D., Getting Tough on Gateway Drugs:

A Guide for the Family (Washington, D.C.: American Psychiatric

Press, Inc., 1984); The Selfish Brain: Learning From Addiction

(Washington, D.C.: American Psychiatric Press, Inc., 1996).

12

Change AttitudesAbout Illegal Dry gs

Damon Mitchum, a sixth grader,says he's learned too much aboutillegal drugs to ever use them. othing is more powerful than a

person's attitudes in determining

his or her behavior. And no strategy for

curbing illegal drug use is more promising

than a nationwide effort to change tolerant

public attitudes about illegal drugs,

according to Choice Two.

13

Take cigarette smoking. Thanks to the power ofeducation and the dominance of antismokingmessages across American culture, 15 millionfewer Americans smoke today than did in 1985.As people learned the health and addictive risksof smoking, their concerns crystallized into amass movement that has branded smoking asdestructive and socially unacceptable. That mes-sage is expressed everywhere, including the media,shopping malls, the workplace, and schools.

"You don't have to smoke to be cool, you canbe cool for just who you are," says DamonMitchum, a sixth-grader at Terry Mill ElementarySchool in DeKalb County, Georgia. In school, hehas studied why people smoke and what it doesto them. "I won't ever try it," he says emphatically.

Damon has the same attitude about alcoholand illegal drugs, too, thanks to Terry Mill'saward-winning programs on substance abuse.The programs involve hundreds of communitymembers as role models, mentors, and teachers.But schools alone can't turn around the drugproblem, says Terry Mill's principal, Shirley C.Reams, whose educational work has been hon-ored at the White House. She said the school'sefforts are undermined by what Damon andother students see on television, in movies, andin magazines, where illegal drugs are portrayedas a part of life, if not actually glamorized. "It'sa mean world," says Reams.

[It's the Right Thing to DoAs a society, Americans take pride in theirwillingness to work together on something justbecause it's the right thing to do. With regard toillegal drugs, American society has not yetmobilized to counter this scourge. Governmentmust continue antidrug enforcement efforts attheir current level, but the nation must do muchmore to curb the appetite for illegal drugs.In homes, workplaces, communities, and


1:1filitILI` r ta, t,

- Change Attitudes About Illegal Drugs

: - ptt -

Supporters of Choice Two generally favor thefollowing measures:

GE Use every means possible to impress upon parents the need for them totalk frequently with their children about the problem of illegal drugs.

Make antidrug education a top priority in schools, and expand curriculaand teaching methods that have been proven effective.

Gil Encourage the media to reaffirm antidrug messages and stop underminingthem with programming that glamorizes drug use.To accomplish this, useevery persuasive strategy, including letter-writing campaigns to media organi-zations, boycotts of advertised products, and, where appropriate, regulations.

I Stigmatize drug use as a socially unacceptable, destructive habit.

3 Promote antidrug education as a nationwide and community-wide effort,involving every citizen and requiring leadership from every business, civic,school, and religious organization. In every place, and with one voice,America must say no to drugs.

"I've been asked to

try drugs and I say no.

If I was ever using

drugs and my mom

found out, it would be

all over for me, because

she's very strict."

throughout our culture, Americans must attackillegal drugs with a unified message that theyare destructive and socially unacceptable. Todo this, we must expand antidrug educationprograms and promote antidrug messages in theentertainment media. Advocating this approach,Reams says, "We need to have the media, theschools, the churches, the community, the busi-nesses, the government - everyone workingtogether on this. We have the resources to do it,let's just do it."

Choice Two sup-porters say noenforcement effort, nomatter how vigorous,can stop illegal drugswhen public tolerancefor casual drug use isgrowing in our culture.Many schools offerantidrug educationalprograms, and antidrugmessages pop up inthe media but theseefforts are vastly inade-quate, in this view,merely paying lip ser-vice to the problem.Choice Two calls for amassive expansion ofeducational programs

12 ILLEGAL DRUGS Ell NATIONAL ISSUES FORUMS

by parents, schools, and community organizations.In addition, we need a society-wide campaignto stigmatize drug users as social pariahs.

Among other things, Americans should boy-cott films, fashion designers, and TV programsthat glamorize illegal drugs. TV networksshould be pressured to run far more antidrugmessages, such as the ads produced by thePartnership for a Drug-Free America, a non-profit organization. One of its more memorableTV ads shows an egg frying while a narrator says:"This is your brain ...This is drugs ...This isyour brain on drugs."

Early Lessons Last a LifetimeThe best way to reduce substance abuse is toprevent early experimentation. And the bestplaces to start the educational process are athome and in school, in this view.

Consider the scope of children's drug use.More than a third of all eighth-graders have usedan illegal drug, as have nearly half of all 12th-graders, according to the U.S. Office ofJuvenileJustice and Delinquency and Prevention. Thecritical importance of preventing early drug useis demonstrated by research that has found thatpeople who pass age 21 without using illegaldrugs almost certainly will never use them.

Drug Abuse Education and Preiention:A small slice of the federal pieFederal spending on drug education and prevention programs, as a percentage of the $13.2 billion

drug control budget, 1995

Criminal justice49.4%

Treatment20.3%

Intelligence2.5%

Interdiction9.7%

"17.C11; ViiiMBIE

Source: U.S. Office of National Drug Control Policy

Research4.1%

International2.2%

educadop anddon

Drug education must start at home, in thisview. Studies show that teenagers who havelearned about the risks of illegal drugs fromtheir parents are half as likely to use drugs asthose who didn't learn aboutdrugs at home. Parentsneed to be strict, butthey also need toexpress the love that'sbehind their concernabout children using drugs,as Daren, a 15-year-oldboy, explained to The NewYork Times in October 1996:"I've been asked to try drugsand I say no, I don't want tostart that. If I was ever usingdrugs and my mom found out, itwould be all over for me, becauseshe's very strict. When my momtalks to me about drugs, she reallyputs a lot of emotion into it."

Studies also conclude that r a

some school programs, like StudentsTaught Awareness and Resistance, or STAR,reduce the use of alcohol, tobacco, and illegaldrugs like marijuana and cocaine by 20 to 50percent and reduce the likelihood of partici-pants' using drugs in the future. STAR worksbecause it provides students with essential infor-mation about illegal drugs and teaches the socialskills needed to resist them. Among other things,this program:

Change Attitudes About Illegal Drugs

In Kansas City, the STAR program combines a12-week curriculum with homework for parentsas well as students, a local media campaign,

sports events, and recreation. In addition,local leaders from civic, religious, busi-ness, government, and schools worktogether on community strategies tostop substance abuse and provide alter-native activities.

The program is also cost-effective:a 1995 study concluded that forevery $1 spent on STAR, $4.83was saved in likely counseling andtreatment costs.

Most schoolchildren thesedays do learn about the dangersof illegal drugs. But whileeffective programs exist, mostschool programs have eithernot been evaluated or havenot demonstrated success.

Experts say it's not a mystery whymore schools don't use proven, effective

antidrug programs: they take time, effort, andmoney away from other school programs. Butcommunities and schools must change theirpriorities, if they are serious about curbingsubstance abuse, say Choice Two supporters.

o Provides students with accurate and relevantinformation about illegal drugs and their effects;

Ea Helps teenagers identify cultural pressures touse drugs;

n Reduces peer pressure, in part, by stressingthat 9 out of 10 teenagers don't use drugs on aregular basis, and that about 8 out of 10 ado-lescents haven't tried alcohol or tobacco;

0 Teaches skills in making decisions, settinggoals, and being assertive so teenagers won'tfeel a need to use drugs to overcome awkwardnessor to cope with stress; and

0 Engages students in role-playing, discussion,and group activities to give them practice insaying "no" to their peers.

At left: Antidrug advertisingcampaigns, like this onefrom the Partnership for aDrug-Free America, canmake kids more aware ofthe dangers of drugs.

rug Education Drives Substance Abuse DownPercentage drop in substance use, comparing substance use reported in 1987 by 12,000 seventh

graders before participating in the ISTAR (Indiana Students Taught Awareness and Resistance)

drug education program and, in 1991, four years after completing the program

-5%

-10%

-15%

-20%

-25%

-30%

Alcohol Cigarettes

Source: Institute for Health Promotion and Disease Prevention. University of Southern California

15

Marijuana


,9iggaZT

At right:Typical of themixed messages in themedia,TV's Roseannegets upset when she findsmarijuana, but then sherolls a joint and gets highwith Dan.

Change Attitudes About Illegal Drugs

Mhzed Messages

Choice Two calls forAmerica's culturalleaders to present asingle, clear messageabout illegal drugs:that they are dangerousand socially unaccept-able. Instead, theentertainment mediaand other cultural pur-veyors flirt more andmore openly with illegaldrugs, as the followingexamples suggest:

In one episodeof her TV show,Roseanne finds a bag of marijuana, wondershow to confront her kids, and then recognizesthe bag as her own 20-year-old stash. She andDan get stoned, then righteous, vowing to stayoff the stuff as the laugh track kicks in.

I Kids Are Getting Less Guidance About Illegal DrugsPercentage of teens who report learning about the risks of drugs from various sources,according to surveys in 1993 and 1995.

Teens "learned a lot" aboutthe risks of drugs from

School programs

TV shows, news, or movies

TV commercials

Parents or grandparents

Print ads

15%

Video rentals

Radio-4?0.04

.14fr,tat,

Source: Partnership for a Dr.i2-Free America

11%

12%

10%


50%

II 1993 1995

m In the film Clueless, the modernized versionof Jane Austen's classic novel Emma, all theteenagers get stoned on marijuana at a party.While it's stupid to use drugs during the schoolday, one popular teen says, it's the cool thing todo at parties.

In alternative rock music, drug use is a stan-dard theme of the songs and an integral part ofthe scene. Newsweek reports that least one mem-ber of each of the 15 most popular bands hasadmitted using illegal drugs or has been arrestedfor using them.

o In the fashion industry, advertising shows afascination with seedy surroundings anddisheveled models who have the vacant, wastedlook of addiction. Calvin Klein even features aheroin addict recruited from the street in adver-tising that promotes his unisex scent, CK One."The '90s may be remembered as the decadewhen fashion served as a pusher as pusher ofwhat appear to be the best-dressed heroinaddicts in history," fashion critic Amy Spindlerwrote in The New York Times.

When American culture glorifies illegal druguse, that's trouble. With the average teenagerlistening to the radio and watching TV sixhours a day, "the media may be the single mostpowerful force that shapes American attitudesabout acceptable behavior," writes MatheaFalco, president of Drug Strategies, a nonprofiteducational organization.

Choice Two calls for much greater account-ability from the leaders and creators of popularculture. If we as a society can't clean up ourculture, the fight against drugs is a lost cause.

16

Change Attitudes About illegal Drugs

Ii Support--4611

Since we cannot significantly reduce the supply ofillegal drugs, we must make a very substantial effort to

reduce the demand for them by changing public attitudes.

We can't lock up everybody who experiments with ille-gal drugs, but we can educate them. Education is the best

strategy for changing attitudes about illegal drugs; onceattitudes change, behavior will follow.

Studies show that parents can be extremely effective inpreventing children from using illegal drugs. Encouraging

parents to use their influence will help turn around the illegal

drug problem.

Some school antidrug programs have been very effec-tive in reducing the number of children who use illegal

drugs, and these proven programs can be expanded if edu-cators and citizens make the commitment.

Studies suggest that the least expensive and most effectiveapproach to solving the drug problem is taking steps to

prevent drug abuse from starting.

Because the media have such a significant effect onpeople's attitudes, society must address the all-too-common

portrayal of illegal drugs as chic and cool.

Advertising, in the fonn of public service announcements,can also influence people's attitudes about drugs and pre-

vent their use of drugs. In one study, conducted before andafter an extensive antidrug campaign by the Partnership fora Drug-Free America, the number of people who said theymight want to try drugs fell by 29 percent.

IFor Further ReadingReading/Change Attitudes About Illegal Drugs

Mathea Falco, The Making of a Drug-Free America: Programs

That Work (New York: Times Books, 1994).

E "Making the Grade: A Guide to School Drug Prevention

Programs" (Washington, D.C.: Drug Strategies, 1996).

MI Paul B. Stares, Global Habit: The Drug Problem in a

Borderless World (Washington, D.C.: Brookings Institution,

1996).

At a time when the nation's war on drugs hasreduced casual drug use by more than half, Choice

Two wrongly calls for a major shift in priorities and spend-ing. We need to expand our enforcement efforts educationdoes not put drug criminals behind bars.

Making education a top priority would inevitablyforce reductions in enforcement, resulting in a likely

increase in crime rates and more drug dealers aroundschool buildings.

/ This approach puts a great deal of emphasis on chang-ing people's attitudes through education. Someday,

school programs may become an effective strategy in reduc-ing drug use by children, but right now these programs arenot having much effect'.

How much more stigma can society heap on illegaldrug use? This approach also mistakes candid public

discussion for a growing tolerance of drug use. Americansneed no education in the problems of drug abuse.

It's easy to blame the entertainment media for all ofsociety's ills, but the media, for the most part, simply

reflect what's going on in America. Anyway, efforts tomuzzle the media would violate the right of free speech,which is fundamental to democracy.

Other opponents say that the nation is simply on thewrong track, and that our enforcement and educa-

tion efforts have not lived up to expectations. The only waythe nation can hope to control the problem of drug abuse isby treating it as a public health problem, not a criminal one.

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ILLEGAL DRUGS D NATIONAL ISSUES FORUMS 15

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Treat SubstanceAbuse as an Illness

_Lt_ 3_4G

Randi Anderson gottreatment for substanceabuse and is now drug-free. hen Randi. Anderson was 10, a

dentist prescribed the tranquil-

izer Valium to relieve headaches, thought

to be caused by Randi grinding her teeth

at night. "I really liked Valium," she recalls.

By age 12, she was drinking hard liquor,

and by age 16, she was snorting cocaine.

Randi, who grew up on New York's

Long Island, managed to graduate from

college and even from New York Law

School, all the while supporting her

cocaine habit by stealing money from

friends and from her middle-class family.


But at age 33, when she was unable to hold ajob and her life was crumbling, Randi soughthelp from Hazelden, a nonprofit foundation thatruns treatment programs around the country.After completing a five-month residential pro-gram in 1993, she was back on her feet, startinga new job counseling teenagers in foster homes.Today, drug-free for four years, Randi is stillworking with foster children and is going for amaster's degree in social work. "I'm really fortu-nate," she says. "I was headed toward a life ofmisery and an early death."

Addiction Os an DullnessDrug addiction is a treatable illness of the brain,according to the National Institute on Drug Abuse.Researchers there say drug abuse should beconsidered a chronic, relapsing disease such asdiabetes or hypertension that requires lifelong

18

management. Scientists say that overuse ofaddictive drugs essentially short-circuits thebrain, jamming neural pathways in a way thatstops the brain from signaling "no more drug."Instead, it keeps signaling for "more drug."Consider the impact on laboratory animals: inone study that measured the strength of addictivebehavior, monkeys pressed a leveran average of 12,800 times to obtaina single dose of cocaine, eventhough it was always accompaniedby a painful electric shock. In anotherstudy, monkeys chose cocaine overfood and water, to the point of death.

Public health officials say thatabuse of illegal drugs is part of theoverall problem of substance abuse,which they consider the nation'snumber one preventable health pro-blem. Arresting more drug users orconducting a more extensive public informationcampaign tactics advocated by Choices Oneand Two, respectively would not address fun-damental public health issues of drug abuseany more effectively than current drug policies.

Since chemical dependency is a treatable andpreventable illness, Choice Three calls for abroad public health approach to the epidemic.In this view, government must ensure that alldrug abusers have access to comprehensive drugtreatment; as it is, fewer than 3 in 10 addictsreceive adequate treatment, according to a 1995report from the National Institute on Drug Abuse.

Choice Three's public health approachincludes reforming public programs, policies,and drug laws so that they emphasize treatmentand prevention. In this view, illegal drug traffick-ers should continue to be sentenced to longprison terms, but Americans whose only crimeis substance abuse should be treated, not pun-ished. Incarceration, in this view, is a blunt andcostly instrument for containing an epidemic ofdrug abuse.

To increase public confidence and compliancewith drug regulations, a public health agencylike the U.S. Food and Drug Administrationshould have primary authority for regulatingillegal drugs. Drug policy would then be drivenmore by science than by political expediency, asit often is today, in this view. Research-based

Treat Substance Abuse as an Illness

drug policies, Choice Three supporters assert,would open the way for doctors to prescribesome currently illegal drugs for medicinal pur-poses along the lines of the law Arizona voterspassed in 1996. A science-based policy, in thisview, would also lead to reclassifying marijuanaas a nonaddictive drug with less harmful effectsthan alcohol or tobacco. A strategy for regulat-ing marijuana sales to adults, moreover, wouldalso be the best way to reduce sales to minors,

in this view.Choice Three also calls for

expanding prevention programsbecause so many people, especiallythe poor, use drugs to try to escapetheir miseries. In particular, familiesthat suffer from domestic violenceor joblessness face a high risk ofdrug abuse. Expanded preventionprograms would reach out to thesefamilies and provide social services,job training and, as a last resort, jobplacement in public works projects.

Having a job, and the stability and self-esteemthat come with it, is one of the most effectivepreventions for drug use, according to a 1989study published in the American Journal ofAlcohol and Drug Abuse.

.tv4117fflrikTP

Drug traffickers should

be sentenced to long

prison terms, but

Americans whose only

crime is substance

abuse should be

treated, not punished.

1. ' D

-ree g

c

Supporters's' hoite Thine fiVor-

the following measures:

aoieeThree

A San Antonio jobs programhelped Cynthia Scott get offwelfare and become a nurse.Such social programs do doubleservice as drug preventionprograms.

ED Refocus public policies and drug laws so that their mission is to help people

who abuse drugs or are at risk of abusing them.

II Make comprehensive drug treatment available to all substance abusers.

II Expand prevention programs,. including job training programs

the social and economic reasons many people turn to

I Authorize a public health agency like the U.S. Food and bi,cig Administration

to regulate illegal drugs. Among other things, this research7baseckpproach

would permit the mediCinal use of some illegal drugs ihireatinent,prOgrami,

and would permit,marijUana. a nonaddictive drug that,nikrir,eiearCher

consider-leii.harrnful,than:alcohol to be,sold,to adult in {pharmacies'or

regulated. shops. ..

Eliminate criminal penalties for the perscinal use of all drugs.

l Concentrate enforcement efforts against illegal drug traffitkers, especially

dealers who sell to minors.

BEST COPY AVAILABLE

ILLEGAL DRUGS 0 NATIONAL ISSUES FORUMS 1719

1

Treat Substance hue as an Bigness

'Treatment Is the Least Costly Way to Reduce Drug UseAdditional spending required to achieve a I% reduction in cocaine use by employing variousstrategies, in millions of dollars per year

$800

$700

$600

$500

$400

$300

$200

$100

Helping controldrugs abroad

Source: Rand Corporation, 1994

Drug interdictionat our borders

Drug treatment programs areeffective, and greatly needed inprisons, where most inmates havedrug problems.

Enforcementwithin the U.S.

Treatmentprograms

Treatment WorksLike most people who become dependent ondrugs, Randi Anderson wasn't able to stopusing drugs on her own even though shehated what they did to her and her family.But now, following treatment, she's a recover-ing addict with a new life in social work. Drugaddiction is a treatable disease, and there aremany types of successful treatment programs,ranging from residential care to drug replace-ment therapy, which involves weaning addictsaway from heroin with daily doses of metha-done, a non-euphoric narcotic. A hallmark ofsuccessful programs, say experts, is that theyprovide comprehensive medical, psychologi-cal, and social services along with follow-upcare and support.

Study after study demonstrates that mostpeople can be treated successfully and thattreatment is a bargain compared to other alter-natives. Just two findings:

Heroin use declined by 79 percent amongaddicts in a comprehensive methadone treat-ment program studied in 1993 by researchers atthe University of Pennsylvania. From the firstday of treatment, methadone programs provedeffective in reducing illegal drug use and criminalactivity. The National Academy of Sciencerecommends expanding methadone treatment,which is currently available to fewer than one infive heroin addicts.

A 1994 study in California concludes thatevery $1 invested in comprehensive drug treat-ment programs saves $7 in future costs of crimeand incarceration. Yet government statisticsindicate that more than half of the nation's hard-core drug users cannot obtain treatment. Andeven though most prison inmates have drugproblems, the government says only about onein six receives any kind of drug treatment, andonly 1 in 50 participates in comprehensive pro-grams proven effective in reducing crime anddrug addiction.

Reform Drug LawsThough U.S. drug laws are well-intended, theyare causing more harm than the drugs themselves,in this view. Consider just a few consequencesof treating the use of some drugs as a crime:

o When law enforcement reduces the supply ofillegal drugs, drug prices automatically rise,forcing addicts to commit more crimes to supporttheir habits, according to a National Academy ofSciences study.

Criminal gangs in the drug business aredestroying American communities. About 20

18 ILLEGAL DRUGS 1:1 NATIONAL ISSUES FORUMS

20

a

What's the Drug Crime?Mostly PossessionType of drug offense, as a percentage of all drug-related

arrests, 1994

Possession

73.3%

Sale/manufacturing26.7%

Source: Federal Bureau of Investigation

percent of nation's homicides are related todealers' turf battles, often affecting innocentpeople who get caught in the cross fire.

Enforcement and incarceration costAmerican taxpayers about $10 billion a year.

Banning drugs, instead of regulating theirsafety and sale by prescription, creates an envi-ronment where the AIDS epidemic flourishes.One out of three AIDS cases is now linked tothe sharing of infected needles.

Police arrest 700,000 people annually for thepossession of drugs, mostly marijuana. One insix Federal inmates is serving time for havingbroken drug possession laws.

Choice Three calls for focusing enforcementefforts on illegal drug dealers, removing criminalpenalties for illegal drug possession, and regu-lating the medicinal use of some illegal drugs aswell as permitting the sale of marijuana to adults.If this sounds radical, consider that Holland hastaken this approach for 20 years, and its crimeand drug use rates have dropped dramatically, tolevels that represent small fractions of comparableU.S. rates.

In addition to expanding drug treatment, theDutch government permits doctors to prescribeillegal drugs to patients in treatment. And as partof an effort to reduce adolescent drug use, thegovernment has licensed 2,000 coffee shops tosell small amounts of marijuana to adults.Marijuana use has been slowly rising, but theDutch see it as a lesser:evil than alcohol notingthat many American researchers consistentlyfind that problematic alcohol use, not marijuanause, is the most common stepping-stone to drugslike heroin and cocaine.

Treat Substance Abuse as an [Illness

"For us, this is normal behavior," Frits Rater,a criminologist at the University of Amsterdam,told Time magazine in 1996. "We don't solve aproblem by making it taboo and pushing itunderground. Our traditional enemy is water.We know you can't stop it from rising; you haveto channel it."

Prevention Is the est PolicyResearch links drug abuse to a number of socialproblems, ranging from teenage pregnancy tospousal abuse and joblessness. One study, forexample, reports that having a job is one of thebest preventions for drug use yet joblessnessamong men of employable age is itself at epi-demic levels: 33.2 percent of blacks, 27.9 percentof Hispanics, and 18.4 percent of whites areeither unemployed or have given up looking forwork, the U.S. Bureau of Labor Statisticsreported in 1995.

Choice Three calls for an expansion of publicand private programs that reach out to troubledfamilies at risk of drug abuse. In San Antonio, forinstance, the closing of a Levi's factory and thelayoff of 1,000 workers in 1990 created the kindof crisis that typically leads to substance abuse,drug experts say. But business, community, andpolitical leaders teamed up to develop a compre-hensive program to provide unemployed peoplewith up to 17 months of counseling and jobtraining for specific, decent-paying jobs in thecity. About the program, one worker said, "Therewas an opportunity at a time I needed a lifeline."

Ghoice

ISubstance Abuse: Prescription drugs and illegal drugsEstimated number of people over 12 who reported using various drugs in the previous month,

in millions, 1995

Marijuana and hashish

Nonmedical use ofprescription drugs

Cocaine

Hallucinogens

Inhalants

Heroin 1112 4 6

Source: Department of Health and Human Services. National Household Survey on Drag Abuse. 1995

21

8 10


Treat Substance Abuse as an Illness

It's time to recognize that substance abuse is primarilya public health problem, not a criminal issue or a matter

of public ignorance.

Chemical dependency is a chronic but treatable dis-ease. Consequently, treatment should be expanded.

Eliminating criminal penalties for using drugs wouldend the hypocrisy of allowing 2.6 million people to abuse

prescription drugs annually while threatening to jail the12.8 million people who abuse illegal drugs. It also makesno sense to permit a drug like alcohol but not marijuana,which many researchers say is less harmful.

Regulating the sale of illegal drugs through prescriptionwould make them safer, and restrict drug use by minors.

Crime rates would decline with this approach. First,the violence of the drug trade would diminish as drugs

become available by prescription and as marijuana sales toadults are permitted in licensed shops. Second, this approachwould reduce drug prices and, thus, reduce crime by addictswho steal to support their habits.

Even the most expensive drug treatment programs payfor themselves by reducing crime and the costs of lost

productivity and healthcare, according to a 1990 study bythe National Academy of Sciences.

If we don't help prison inmates recover from drugaddiction, they will only cause more trouble when they

are released.

The nation's drug problem is a symptom of deepersocial problems. Expanding prevention programs for

families at risk of domestic violence, joblessness, and othercrises would not only address these social problems butalso reduce drug abuse.


Treatment programs are useful, but are not the wholeanswer to the drug problem. Many treatment pro-

grams have low success rates because so many peoplerelapse into drug use.

Medicalizing drug abuse would have the unintendedeffect of relieving people of responsibility for their

actions. Problems like drug abuse or illegitimate births donot go away by renaming them or shifting blame for them.

With drugs more accessible, less expensive, and lack-ing stigma, many more people would use them.

Who wants to live in a country where it would belegal to use heroin and crack cocaine, even under a

doctor's care? Laws convey shared social norms, and legal-izing drug use would condone destructive habits.

Drug abuse is not a victimless crime. Drug users, forexample, give birth to drug-damaged babies and

cause accidents on the roads.

Is it possible to make drugs legal for adults, but keepthem away from children? Not judging from our experi-

ence with cigarettes or alcohol.

Increased drug use would bring increased crime.Criminals commit six times as many homicides, four

times as many assaults, and almost one-and-a-half times asmany robberies under the influence of drugs as they commitin order to get money to buy drugs, according to the U.S.Department ofJustice.

This approach says other social problems lead todrug abuse. If so, legalizing drugs will only make

things worse, since social problems won't disappearovernight.

IFor Further Reading /Treat Substance Abuse as an Illness

Ronald Bayer and Gerald M. Oppenheimer, editors,Confronting Drug Policy: Illicit Drugs in a Free Society

(New York: Cambridge University Press, 1993).

Milton Friedman and Thomas S. Szasz, On Liberty

and Drugs: Essays on the Free Market and Prohibition

(Washington, D.C.: The Drug Policy Foundation Press, 1992).

Ethan A. Nadelmann, lead author, "The Harm ReductionApproach to Drug Control: International Progress," TheLindesmith Center, New York (June 1995).

22

Renovating Public Policy

n a way, remaking public policy is like

renovating an old kitchen: both projects

always seem to require far more time and

money than we ever thought was possible.

Looking back at kitchen and policy

renovations, it's usually clear that even

Albert Einstein could not have predicted

the disaster lurking behind a kitchen wall

or a government program; and it's usually

just as clear that a bit more comparison

shopping, planning, and just plain talking

would have prevented some unpleasant

surprises and costs.

This issue book presents three general approachesto renovating the nation's drug policies. Eachapproach has its cadre of advocates and architectsclaiming their approach addresses the nation'sdrug problem most effectively. Each approachwould certainly generate predictable and unpre-dictable costs, tradeoffs, and risks. In comparingthe three approaches, it may help to considerthe following discussion points:

How do the choices define the drugproblem? Choice One says it's a global crimeproblem, ruining communities and spawningviolence and addiction. Choice Two considersit a cultural problem, with schools and parentsinsufficiently effective in teaching children notto use drugs, while drugs are glamorized in

film, fashion, and TV. Choice Three claimsit's primarily a public health probleminvolving a treatable disease, which festers

because of inadequate treatment.

What can be done? Choice Onecalls for strengthening laws and stepping

up enforcement; Choice Two calls for aopmoral campaign, including educational pro-

4-.4ellle 17:

C.11-7;-4, "oit4k-

mre 1.410,aa

grams and antidrug messages throughout

23

popular culture; Choice Three calls for expandingtreatment and prevention programs as well as elim-inating criminal penalties for personal drug use.

o What role should the government play?In Choice One, the government expands bothits war on drugs and its support for citizeninvolvement, especially in community antidrugcampaigns. In Choice Two, government maintainscurrent enforcement activities, and governmentand citizens work more closely together to clarifyand promote antidrug messages in schools andthe entertainment media. Choice Three shiftsgovernment priorities away from enforcement andtoward treatment and prevention programs, includ-ing those that expand job training opportunities.

What's an important risk posed by eachchoice? Choice One, which advocates anaggressive effort to stop the flow of drugs intothis country, could result in extensive militaryactions abroad. Choice Two, which argues thatsociety must change peoples' attitudes aboutdrugs before their behaviors will change, couldtake a long time to turn around the drug prob-lem. Choice Three, which calls for eliminatingcriminal penalties for drug use, could encouragemore people to experiment with drugs.

o What are some likely tradeoffs? ChoiceOne, in calling for expanding enforcement at alllevels, would substantially increase the cost offighting drugs. Choice Two, in concentrating onpreventive programs to deter drug use, offersfewer answers for dealing with existing drug prob-lems. Choice Three, in legalizing personal druguse, would likely lead to more drug abuse amongthe most vulnerable people, especially the poor,who turn to drugs as an escape from hopelessness.

Could we combine elements of thethree choices? The choices overlap in someways, and readers might want to craft a fourthchoice that, say, calls for increased enforcement,public education efforts, and treatment. Butthat's not practical when resources are limited,and priorities must be set. Also, each choice leadsthe nation in a very different direction considerthat Choice One calls for stronger criminal lawsand Choice Three calls for removing all criminalpenalties for drug use.


Frr112,.. ,,t

Summary Renovating Public Policy

Co paring the Choices

eenage drug use is rising, and half of

Americans either have a drug problem or

know someone who does. More and more

Americans worry about drug-ruined lives and

drug-related crime in their communities. What

approach to the issue should the nation take?

To stimulate discussions, the three approaches

described in this issue book are summarized

and compared on these pages.

22 ILLEGAL DRUGS EI NATIONAL ISSUES FORUMS

Step Up Enforcement to Finish the jobWe've already reduced casual drug use by half. To win thewar, we must increase enforcement and stop toleratingillegal drugs in schools, workplaces, and communities.

What Can Be Done?

Substantially increase funding for enforcement efforts atall levels of government.

Expand drug searches in schools and drug testing in theworkplace.

Support citizen efforts to eliminate drugs from theircommunities.

In Support

Illegal drugs aredestroying thecountry and can'tbe tolerated.

We've made much progress in 20 years, bid weexpand enforcement efforts to win the Wan:

. .School searches, randorifdrug testing, and7CoMniunity.:antidrug campaigns are all proven strategies to combat.

.illegal drugs.

In Opposition

This is a :wasteful expansion of a failingpolicy:::-' ..

Most drug-related crimes merely involve the possessionof drugs often marijuana, a nonaddictive-drug iliai-:many researchers consider safer than alcohol.

Random drug searches and drug tests violatepeople's privacy.

A Likely Tradeoff

In calling for more enforcement at all levels, this approachwould substantially increase the cost of fighting drugs.

24

Change Attitudes About Illegal DrugsDrug laws are difficult to enforce, because many peopleeither think drugs are safe or don't care. Only changingpublic attitudes about drugs will change behavior.

What Can Be Done?

Help and encourage parents to frequently discuss the`problems of illegal drugs with their children.

Eli Expand proven drug education programs in schools.

0 Insist that the entertainment media affirm, rather thanundermine, antidrug messages.

In Support

Having failed to reduce the supply ofdrugs, we mustincrease efforts to reduce the demand.

We can't lock up every adult and child who tries drugsbut we can educate them.

Because the media sets trends, it must join the fightagainst drugs instead of undermining it.

In Opposition

This approach callsfor fixing a national

drug strategy that

isn't broken. r

DRUG Pa

Educational programs overall demonstrate relatively littlesuccess in reducing drug use.

O The entertainment media merely reflect society andsocial trends, and should not be muzzled.

A Likely Tradeoff

By focusing on preventive programs to deter druguse, this approach offers few answers for existingdrug problems.

Renovating Public Policy

Treat Substance Abuse as an IllnessDrug abuse is a treatable illness, not a crime. A broadpublic health approach that includes regulating drug useprovides the best prospects for managing this epidemic.

What Can Be Done?Make comprehen-sive drug treatmentavailable to all sub-stance abusers.

Eliminate criminalpenalties for personal drug use. Focus enforcement ondrug traffickers.

Deter drug abuse by attacking its root causes.Expand prevention programs, including childcareand job training.

I

In Support

Drug abuse is a sickness, an illness that responds totreatment, not punishment.

Decriminalizing drug use would destroy the criminalmarket for drugs and decrease the amount of drug-related crime.

Effective programs that prevent drug abuse are muchless costly than coping with drug problems as they arise.

In Opposition

Who wants to live in a country where it's legal to usecrack cocaine, even under a doctor's care?

Legalizing drug use would encourage more adults touse drugs and make it more difficult to restrictteenage drug use.

Increased drug use would bring more crime.

A Likely Tradeoff

Legalizing drugs could lead to a disproportionateincrease in drug abuse among poor people, who havemore reasons to use drugs as an escape.

25ILLEGAL DRUGS NATIONAL ISSUES FORUMS 23

What Are the National Issues Forums?

Want to start a forum?Forums are initiated at thelocal level by civic andeducational organizations.For information aboutstarting a forum and usingour materials, write theNIF Institute, P.O. Box75306, Washington, D.C.20013-5306, or phone800-433-7834.

ational Issues Forums bring together citizensaround the nation to discuss challenging

social and political issues of the day. They haveaddressed issues such as the economy, education,healthcare, foreign affairs, poverty, and crime.

Thousands of civic, service, and religiousorganizations, as well as libraries, high schools,and colleges, have sponsored forums. The spon-soring organizations select topics from amongeach year's most pressing public concerns, thendesign and coordinate their own forum programs,which are held through the fall, winter, and spring.

A different kind of discussionNo two forums are alike. They range from smallstudy circles to large gatherings modeled aftertown meetings, but all are different from every-day conversations and adversarial debates.

Since forums seek to increase understandingof complicated issues, participants need notstart out with a close knowledge of an issue.Forum organizers distribute issue books such asthis one, featuring a nonpartisan overviewof an issue and a choice of several publicresponses. By presenting each issue in anonpartisan way, forums encourage par-ticipants to take a fresh look at the issuesand at their own convictions.

In the forums, participants share theiropinions, their concerns, and their knowl-edge. With the help of moderators andthe issue books, participants weigh several .

possible ways for society to address a problem.They analyze each choice, the arguments for andagainst it, and the tradeoffs and other implicationsof the choice. Moderators encourage participants,as they gravitate to one option or another, toexamine their basic values as individuals and ascommunity members.

considered. This happens because the forumprocess helps people see issues from differentpoints of view; participants use discussion todiscover, not persuade or advocate. The bestdeliberative forums can help participants movetoward shared, stable, well-informed publicjudgments about important issues.

Participants may hold sharply different opin-ions and beliefs, but in the forums they discusstheir attitudes, concerns, and convictions abouteach issue and, as a group, seek to resolve theirconflicting priorities and principles. In this way,participants move from making individual choicesto making choices as a public the kind ofchoices from which accepted, even sharedaction may result.

Building community throughpublic deliberationIn a democracy, citizens must come together tofind answers they can all live with whileacknowledging that individuals have differing

opinions. Forums help people find theareas where their interests and goalsoverlap. This allows a public voice toemerge that can give direction topublic policy.

The forums are nonpartisan and donot advocate a particular solution to anypublic issue, nor should they be con-fused with referenda or public opinionpolls. Rather, the forums enable diverse

groups of Americans to determine togetherwhat direction they want policy to take, whatkinds of action and legislation they favor, andwhat, for their common good, they oppose.

NATIISSUFOR

The common groundForums enrich participants' thinking on publicissues. Participants confront each issue head-on,make an informed decision about how to addressit, and come to terms with the likely consequencesof their choices. In this deliberative process,participants often accept choices that are notentirely consistent with their individual wishesand that impose costs they had not initially


ONALESUMS

From agreement to actionForums can lead to several kinds of public action.Generally, a public voice emerges in the resultsof the forums, and that helps set the government'scompass, since forum results are shared withelected officials each year. Also, as a result ofattending forums, individuals and groups them-selves may decide to take action individually orin association with others to help remedy apublic problem, taking actions that citizens cantake outside of government.

26

Illegal DrugsWhat Should We Do Now?One of the reasons people participate in the National Issues Forums is that they want leaders to know how they feel about the issues.So that we can present your thoughts and feelings about the issue, we'd like you to fill out this ballot before you attend forum meetings(or before you read this book, if you buy it elsewhere), and to fill out a second ballot after the forum (or after you've read the material).Before answering any of the questions, make up a three-digit number and write it in the box below.

The moderator of your local forum will ask you to hand in this ballot at the end of the session. If you are not attending a forum,send the completed ballot to the National Issues Forums, 100 Commons Road, Dayton , Ohio 45459-2777.

Fill in your three-digit number here.

1. Here is a list of principles on which proposals to fight drug abuse might be based.Very Somewhat Not at all

How important do you think each is? important important important Not sure

a. Tougher punishment will discourage people from using and selling drugs.

b. We should pressure the media to stop glamorizing drug use.

c. We should focus on reducing the demand for drugs rather than trying to stop the supply.

d. Drug abuse is an illness to be treated, rather than a crime to be punished.

e. The war on drugs should focus on social problems, such as joblessness, that leadto drug abuse.

f. We should punish' countries that export drugs to the U.S.

2. Look at the list in Question #1 again. How strongly is each principle reflectedSomewhat

in what we're actually doing today? Strongly strongly Not at all Not sure






f. We should punish countries that export drugs to the U.S.

3. Are there any other principles that you think should guide public policy on illegal drugs? Please explain.

Very Somewhat Not at all4. How concerned are you about the following? concerned concerned concerned Not sure

a. Too much tolerance for the use of some drugs, such as marijuana.

b. Too few drug abuse treatment and prevention programs.

c. Locker searches might violate students' rights.

d. Laws for punishing drug dealers are not tough enough.

e. The costs to the taxpayer for fighting the war on drugs are too high.

f. It's too easy for drugs to come across our borders.

27Continued on next page

ILLEGAL DRUGS O NATIONAL ISSUES FORUMS 25

I 1.,tr

a

5. Do you have any other concerns about public policy in this area? Please explain.

6. How do you feel about these approaches to the problem of illegal drugs? Favor Oppose Not sure

a. Drug testing should be required in the workplace, EVEN IF it means people mustgive up some of their privacy rights.

b. We should spend more on school antidrug programs, EVEN IF they have nothad much success so far.

c. We should legalize drug use, EVEN IF more people might then use them.

7. Which statement best describes how you feel? (Please choose only one answer.)

a. I am not at all certain what our public policy on fighting illegal drugs should be.

b. I have a general sense of what our public policy on fighting illegal drugs should be.

c. I have a clear, definite idea of what should be done.

8. Are you male or female? Male Female

111

9. How much schooling have you completed?

Less than 6th grade 6th-8th grade Some high school High school graduate

Some college College graduate Graduate school

10. Are you:

White African-American Hispanic

Asian-American Other (specify)

11. How old are you?

17 or younger 18-29 30-49

50-64 65 or older

12. Have you attended an NIF forum before? Yes No

13. If you answered "yes" to #12, how many forums have you attended?

1-3 4 or more Not sure

14. Do you live in the:

Northeast South Midwest

West Southwest Other

15. What is your ZIP CODE?

26 ILLEGAL DRUGS NATIONAL ISSUES FORUMS 28

Illegal DrugsWhat Should We Do Now?Now that you've had a chance to read the book or attend a forum discussion, we'd like to know what you think about this issue. Youropinions, along with those of thousands of others who participated in this year's forums, will be reflected in a summary report preparedfor participants as well as elected officials and policymakers working on this problem. Since we're interested in whether you havechanged your mind about certain aspects of this issue, the questions are the same as those you answered earlier. Before answering thequestions, please write in the box below the same three-digit number you used for the Pre-Forum Ballot.

Please hand this ballot to the forum leader at the end of the session, or mail it to: The National Issues Forums, 100 Commons Road,Dayton, Ohio 45459-2777.

Fill in your three-digit number here.

1. Here is a list of principles on which proposals to fight drug abuse might be based.Very Somewhat Not at all

How important do you think each is? important important important Not sure







2. Look at the list in Question #1 again. How strongly is each principle reflectedSomewhat

in what we're actually doing today? Strongly strongly Not at all Not sure







3. Are there any other principles that you think should guide public policy on illegal drugs? Please explain.

Very Somewhat Not at all4. How concerned are you about the following? concerned concerned concerned Not sure

a. Too much tolerance for the use of some drugs, such as marijuana.

b. Too few drug abuse treatment and prevention programs.

c. Locker searches might violate students' rights.

d. Laws for punishing drug dealers are not tough enough.

e. The costs to the taxpayer for fighting the war on drugs are too high.

f. It's too easy for drugs to come across our borders.

29Continued on next page


L4,1-11P stiFctru I t916_

5. Do you have any other concerns about public policy in this area? Please explain.

6. How do you feel about these approaches to the problem of illegal drugs? Favor Oppose Not sure

a. Drug testing should be required in the workplace, EVEN IF it means people mustgive up some of their privacy rights.

b. We should spend more on school antidrug programs, EVEN IF they have not hadmuch success so far.

c. We should legalize drug use, EVEN IF more people might then use them.

7. Which statement best describes how you feel? (Please choose only one answer.)

a. I am not at all certain what our public policy on fighting illegal drugs should be.

b. I have a general sense of what our public policy on fighting illegal drugs should be.

c. I have Yclear, definite idea of what should be done.

8. If you answered "c" to Question 7, please tell us below what you think our public policy should be.

9. What is your ZIP CODE?

30


For the National Issues Forkums

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Issues Research: at odom :0)110no \.119 \ 1301105

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Copy Editor: Mama Bond

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