Toward a New Foreign Policy.

A more enlightened U.S. foreign policy on drug control will necessarily mean major changes in U.S. domestic drug policy. Current consideration of alternative drug strategies is dominated by political cowardice and hot-button rhetoric. When Gov. Gary Johnson (R-NM) bravely suggested drug legalization, no politicians publicly joined him. Instead, President Clinton's drug czar, Gen. Barry McCaffrey, led a political attack, calling Johnson "irresponsible." And Rep. Bob Barr (R-GA) suggested that global philanthropist George Soros be investigated for racketeering offenses, just because he funded criticism of national drug policy.

The public, however, has lost faith in the U.S. drug strategy. According to a March 2001 survey by the Pew Research Center, 74% of the public agrees that America is losing the war on drugs. Public dissatisfaction with the antidrug strategy will not disappear by suppressing discussion of alternative strategies. Independent blue-ribbon commissions, faith communities, civic organizations, professional societies, and service clubs must undertake rational, cost-benefit, top-to-bottom reviews of drug strategies.

In the short term, increasing the availability of drug treatment on request would be the most important and effective policy initiative. Drug treatment is not perfect--many addicts relapse. But relapse rates are comparable to the rates of those who fail to change their behavior in dealing with chronic diseases such as diabetes or hypertension. Over time, many addicts are successful in quitting. A leading California study found treatment to be seven times more cost-effective than imprisonment. A RAND Corporation analysis suggested that cocaine consumption could be reduced by 1% by spending either $783 million in source countries, or $366 million on international interdiction, or $246 million on domestic enforcement, or just $34 million on treatment.

About 2.1 million addicts were treated in 1998, but 2.9 million were unable to get treatment. The percentage of prisoners receiving drug treatment in prison decreased during the 1990s. For the poor and uninsured, publicly funded treatment is scarce.

Evaluations have found current youth drug-prevention-through-abstinence programs to be almost totally ineffective. Given that 50% of U.S. youth end up experimenting with drugs, a safety-first message needs to be adopted instead of focusing on total abstinence. Promoting responsible use is the current policy with alcohol, i.e., promoting the use of designated drivers. A responsible-use approach to drugs would be honest, acknowledging that most youths stop with drug experimentation and never become addicts. Often programs that have nothing to do with drugs directly, such as Head Start and Big Brother/Big Sister, have dramatic effects in reducing youth drug use.

Drug abuse by women has been increasing more rapidly in the U.S. than has male drug abuse. Further research regarding female drug abusers and more treatment programs for women are vitally needed. In addition, discriminatory policies toward women should be stopped. Recently the U.S. Supreme Court (Ferguson v. City of Charleston) struck down warrantless South Carolina Police drug searches of poor, black, pregnant women at Charleston's principal hospital for indigent persons. Women should not be forced to give up their children to enter drug treatment programs.

Ninety percent of new AIDS cases among children under 13 are due to the sharing of wed injection equipment by their mothers or fathers. All of these cases could be prevented if the federal government approved and funded syringe exchange, the nearly universal recommendation of public health authorities.

Drug offense sentences need to be reduced dramatically. Sixty percent of federal prisoners are drug offenders, and federal drug sentences are longer than those imposed for many violent crimes. Drug offenders should not be singled out for additional penalties, such as eviction from housing or denial of aid for higher education-especially when persons convicted of violent crimes are not subject to such penalties.

Physicians should be permitted to prescribe marijuana and other appropriate pain relief. Studies show that doctors undertreat pain for 40-80% of their terminally ill patients.

It is likely that licensed and taxed drug distribution systems would be substantially less violent, less expensive, and more effective in reducing total harms than prohibition. Drug users would not need to be imprisoned, thus liberating substantial resources to pay for treatment. And a regulated drug industry would generate tens of billions of dollars in taxes.

An enlightened drug policy would recognize that drug use and drug abuse are two different matters, and it would focus on reducing drug abuse. America has a genius for regulation, but that genius has not yet been applied to the trade in and use of drugs.

Key Recommendations

* Emotionally charged political discussion of drug policy must be replaced by honest study and rational discussion in the private sector.

* Reducing harm both from drugs and from antidrug policies is key to achieving a healthier, safer, more sober society.

* A comprehensive control structure including the licensing, taxing, and regulating of the drug trade and drug use should be considered.

Eric E. Sterling <[e-mail]> is president of the Criminal Justice Policy Foundation.