| THE FUTURE OF DRUG POLICY |
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Combating Illegal Drug Use | Demand Reduction | Harm Reduction
Medical Marijuana | Drug Legalization | International Perspectives Today, there is good evidence that America's drug prevention policies are working. The vast majority of Americans -- 92% of those 12 and over -- do not currently use any illegal drug, such as marijuana, heroin, methamphetamine or nonmedical prescription drugs. The IBH mission is to improve America's sound drug abuse policies.
Combating Illegal Drug Use: Are We Winning or Losing? The decline in illegal drug use is a major public health success, a resounding endorsement of the nation's bipartisan, balanced drug prevention policy. The 43% decline in the rate of illegal drug use from 1979 to 2007 would be lauded as a remarkable achievement for any type of health or social problem. The US drug policy for the past thirty-five years has been a balance of supply reduction (law enforcement) and demand reduction (treatment, prevention and research). The vociferous opponents of this strong drug prevention strategy call for the removal of the law enforcement side of this policy claiming that the nation's policy choice is either "law enforcement" or "treatment." Nothing could be farther from the truth. Half of all people in drug abuse treatment in the US today are in treatment BECAUSE law enforcement requires them to be in treatment. Cutting out the long arm of the law would, in one blow, reduce drug treatment by 50%. What is needed for the future is not a choice of law enforcement OR treatment, but rather new polices that unite law enforcement AND treatment to work together more effectively over long periods of time. The impressive spread of drug courts, now numbering more than 2,000, is an excellent example of the new programs needed to link law enforcement and treatment for better results. While a program based purely upon demand reduction could not succeed, neither could a program based purely on supply reduction. If the drug supply were cut without curbing demand, the incentive for drug suppliers would rise. The only way to reduce the incentive for drug supply is to reduce the demand for drugs along with reducing the supply of drugs. That is why demand reduction was added to the traditional supply reduction strategy of this country in 1971. The truth is that the balanced, bipartisan war on drugs has accomplished a great deal, and Americans are safer and healthier because of it. It is also true that illegal drug use can be reduced far below the current levels. There is great potential to make even greater progress, but we are winning the war on drugs. How Do We Know We are Winning? The nation has a great deal to be proud of in its 35-year effort to cope with the unprecedented modern drug abuse epidemic. The epidemic of illegal drug is as new as the computer. Never before the past 40 years in world history has any entire population been exposed to an almost limitless variety of dependence-producing drugs in high potency and by intensely rewarding routes of administration (particularly snorting, smoking and shooting). This epidemic has become not only an American problem but a global burden. Responding to this threat has become a serious public policy challenge one that the US has met by a remarkable investment in a new strategy that balances more traditional law enforcement with a new and very large investment in treatment, prevention and research. This bipartisan strategy, in place now for more than three decades, has produced real but modest gains including a dramatic turndown in the overall level of illegal drug use from the peak of the epidemic in 1979. One of the most significant factors in the decision by youth to use or not to use drugs is their perception of the harm that could come from using drugs. The perceived risk of using marijuana -- the gateway illegal drug - is a pivotal factor, as shown in the graph below:
While the rate of marijuana use among high school seniors (a bell-weather indicator) fell 61% between 1978 and 1992 only to begin gradually increase in the time since, the use of drugs other than marijuana fell 71% in that time span.
It was not just the effects of successful efforts by law enforcement that produced this hopeful trend over the course of 14 years. The Parents' Movement was a major factor in the dramatic decline in illegal drug use from 1978 to 1992. This grass-roots movement exposed the real The uptick in drug use rates from 1992 to 1997 was the direct result of well-funded efforts to turn around the public's negative attitudes toward illicit drug use. Marijuana use has been promoted in particular, using a campaign in support of the "compassionate" and "humanitarian" use of "medical marijuana". In the last few years there has been a newly energized national response at the grassroots and federal policy levels that seeks to regain the momentum of the Parents' Movement by protecting youth from the use of the marijuana by showing that Illegal drug use, particularly marijuana use, is not a harmless, casual lifestyle choice.
Supply reduction is an effective tool for demand reduction because when drugs cost more and are more difficult to obtain there are fewer drug users and less demand for illegal drugs. Demand reduction is also an effective tool in supply reduction because when the number of drug users falls, drug supply falls correspondingly as the market for illegal drugs shrinks. Linking these complementary approaches maximizes the impact of the national strategy on illegal drug use by attacking the drug economy from both sides: While this "one-two" punch has worked well in the past, the best hope for future reductions lies in improved and more cost-effective demand reduction. If the demand for illegal drugs remains high, then the money spent by would-be drug users would sustain a large supply of illegal drugs no matter how effective the supply reduction becomes. The search for what can be called "real demand reduction" is the heart of tomorrow's drug prevention policy.
However, in a bizarre and purposefully deceptive twist of rhetoric, the term Harm Reduction has been hijacked in the drug policy world by a heterogeneous group of advocates who think that the only harm worth talking about in drug abuse policy is the "harm" caused by anti-drug efforts such as the arrest and imprisonment of the distributors of illegal drugs. Their Harm Reduction proposals range from legalizing drugs (so sellers would not face legal "harm"), to teaching heroin users how to treat overdoses, to providing clean needles to intravenous drug users. The problem with these proposals is that they normalize illegal drug use and inevitably lead to more use of drugs such as marijuana, cocaine, heroin, and ecstasy which, just as inevitably, will lead to more drug-caused harm. Successful Harm Reduction is not achieved by making illegal drug use easier, cheaper or safer. It is achieved by rejecting illegal drug use and calling it unwise, unhealthy and unacceptable. It is easy to identify modern Harm Reduction initiatives because they all permit, if not encourage, the use of the drugs that are now illegal. The Harm Reduction movement seeks to reduce the pain that restrictive drug policies cause to individuals who choose to use illegal drugs. Proponents of Harm Reduction do not want to reduce drug use; they want to offer seemingly reasonable modifications of current drug policies that are designed to reduce actual harm to the users of illegal drugs. Today's Harm Reduction movement is the reincarnation of the discredited Responsible Drug Use movement of the 1970s that resulted in the greatest use of illegal drugs in our nation's history. For the past decade, Harm Reduction programs have been lavishly funded and widely supported by many well-meaning, but often poorly informed people. The significant fall in illegal drug use in the US between 1979 and 1992 can be traced to many factors, but the primary reason for the decline in drug use at that time was the strong influence of the Zero Tolerance movement, the antithesis of what is now called "harm reduction." Zero Tolerance, which rejected illegal drug use, was promoted by parents in the late 1970's, who organized into a national coalition known as the Parents' Movement. Nancy Regan embraced the message of the Parents' Movement, and from 1980 to 1988 Zero Tolerance emerged in her "Just Say No" campaign. During the George H.W. Bush administration, this strong anti-drug leadership was strongly supported. While this effective effort to de-normalize illegal drug use has often been seen as politically partisan, it was never a partisan movement. The manifesto of the Parents' Movement was written by Marsha Manatt, the sister of the then-National Chairman of the Democratic Party. The Parents' Movement received White House support when Jimmy Carter's second Drug Czar, Lee Dogoloff took up the cause. General Barry McCaffrey, Bill Clinton's White House Drug Czar was also a strong supporter of the Parents' Movement and an opponent of the core ideas of the Harm Reduction movement. Many Democrats as well as many Republicans have supported the premise of Zero Tolerance in current drug prevention policies.
In recent years, after some successes in the early 1990s, most of the pro-drug state and local initiatives failed at ballot boxes across the country. More recently, with significant financial support to proponents of medical marijuana, the number of ballot initiatives has increased, with some limited success. It is of particular concern that the hidden agenda for "compassionate medical use" is the legalization of marijuana and other currently illegal drugs. See below for more information on "medical marijuana."
The idea of using marijuana in the treatment of illness, such as AIDS or multiple sclerosis, is not new. Much of the allure of this concept comes from marijuana's historic use as a folk medicine. But in the twenty-first century, medical practice requires that medicines meet a variety of well-established standards to establish that they are safe and effective before they are approved for sick patients. This system includes the requirement that medicines be approved by the US Food and Drug Administration. Smoked marijuana fails to meet these commonly accepted standards for many reasons. IBH supports the study of the therapeutic use of the specific chemicals in marijuana delivered just as are all other medicines, in purified forms, in controlled doses, for specific disorders, and by nontoxic routes of administration.
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These facts speak to the measurable, yet uneven success of this effort:
Those advocating for the normalization or legalization of marijuana claim that this illegal drug is harmless. They discount the growing body of research that indicates that serious mental and physical damage is caused by the use of marijuana. The current federal government interagency campaign cautions about the dangers of smoking marijuana, especially for youth. This information is vital to the country's efforts to reduce illegal drug use.
dangers of marijuana use and promoted the responsibility of individuals, families and social institutions to actively resist illegal drug use; and to reject the normalization of illegal drugs that has fueled the modern illegal drug epidemic.
Demand reduction efforts reduce the demand for illegal drugs using prevention, treatment, and research. Supply reduction makes drugs scarcer, more expensive, and less socially tolerated.
IBH supports the concept of harm reduction when the term means reducing the use of the illegal drugs that cause harm including mental and physical disease, death, crime, decreases in productivity and family suffering.
In the early 1990s there was a renewed, sharp rise in illegal drug use in all age groups although illegal drug use in this period never reached the levels it did in the 1970s. While it was not easy to explain this sudden increase, the best explanation was the revival of the pro-drug movement, which for the first time was Harm Reduction. The central thrust of this movement was the claim that smoked marijuana was "medicine." This movement was well-funded by wealthy supporters who refashioned the early pro-pot movement, which had all but vanished from the scene in the wake of the Parents' Movement, transforming it into a more politically-palatable movement that portrayed the central drug policy choice facing America as "jail vs. treatment." These activists had some success in state ballot initiatives around the country, especially when it came to "medical marijuana", a hoax they sold as "compassion." It was easy to see that these activists were not serious about medical treatment because they supported only smoked marijuana and not the purified chemicals that are found in marijuana. In fact, a properly manufactured synthetic form of marijuana's active ingredient, THC (tetrahydrocannabinol), has been available by prescription from any physician since 1985. This movement, which continues today, is not about medical treatment, it is about symbolism. Their message is that smoked marijuana is "medicine."
Advocates of drug legalization believe that making high-quality drugs cheaply and widely-available will eliminate the underworld's illegal drug market, regulate quality and price, and decrease law enforcement demands. They predict that governments will spend less money on law enforcement, benefit from a new source of tax revenue and that drug-related crime will fall if drugs from marijuana to heroin become routinely accessible, more or less like alcohol and tobacco.
International efforts to reduce illegal drug use are succeeding in containing the global threat posed by drug use and drug trafficking. These efforts have evolved over the past century to include a balance of supply reduction and demand reduction. The future of drug policy builds on this foundation, using new ideas to make tomorrow's drug abuse prevention strategies even better than today's.
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