Engaging the debate: reform vs. more of the same.

• Author: Zeese, Kevin B.
• Position: Drug laws

INTRODUCTION

This Essay dispels common myths put forward by drug war advocates and describes more effective alternatives available than present policy contemplates.

Drug Enforcement Administration ("DEA") Administrator Asa Hutchison deserves credit for engaging in a dialogue between those favoring the status quo and those favoring reform. For too long discussion has been absent between us. The seemingly intractable drug problem can be solved if we listen and understand each other. More and more people are looking for a new approach to drug control. A recent poll from the Pew Research Center for the People and the Press found only fifteen percent of the public still thinks the drug war is winnable. (1) A Zogby International poll found that sixty-one percent of the American public opposes arresting and jailing nonviolent marijuana smokers. (2) Since 1996, the public has voted for statewide reform initiatives seventeen times. (3) Thus, this is a good time for us to engage in a dialogue. The public is ready and the failure of the drug war has become evident to most.

Before reviewing some of the common claims made by Administrator Hutchison, myths that are common among many who advocate for more of the "War on Drugs," it is important to note that reformers share many of the same goals as those advocating drug war. We all want to prevent adolescent drug abuse, protect the health and safety of the community, deny drug profits to terrorists and other criminals, and develop a drug policy that works and is based on our common humanity, as well as on research and reality, rather than myth and rhetoric.

1. ARE WE WINNING THE WAR ON DRUGS?

   A critical place to start is to answer the question: Is the drug war working? (4) Administrator Hutchison claims the drug war has been successful. He claims that the failure of the drug war is a myth:

   Some say our fight against drugs has been a failure, and we have not made any progress. But when we look at measurements there, we see a different story. First, on the demand side, we've reduced casual use, chronic use, and prevented others from even starting. Overall drug use in the United States is down fifty percent since the late 1970s. That's 9.3 million people fewer using illegal drugs. We've reduced cocaine use by an astounding seventy five percent during the last fifteen years. That's four million people fewer using cocaine on a regular basis. The crack cocaine epidemic of the 1980s and early 1990s has long passed. We've also reduced the number of chronic heroin users over the last decade. And the number of new marijuana users and cocaine users continues to steadily decrease. This is not to say we have reached our optimal level of drug abuse. We still have much progress to make, particularly with drugs like Ecstasy and methamphetamine. But the bottom line is that our current policies have kept drugs away from most Americans. (5) Administrator Hutchison's claim that we are wining the drug war is mistaken on three grounds. First, measuring the use of drugs is not the best determination of success. Rather, we should be looking at whether problems related to drugs are decreasing, for example, is there less crime, disease, dysfunction, health, and community problems related to drug use. Second, Administrator Hutchinson draws the line for comparison in places that most suits his argument, for example, in the late-1970s, when drug use was at an all-time high and in the mid-1980s, when we were in the midst of a cocaine epidemic. If more typical points in time are chosen, the failure of the drug war becomes evident. Finally, his claim of reduced drug use is not credible when the survey on which it is based on is examined.

   Regarding the final point, Administrator Hutchison's belief that the drug war is working is primarily based on one survey--the National Household Survey on Drug Abuse conducted by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration in the United States Department of Health and Human Services. (6) Based on this survey, Administrator Hutchinson claims dramatic drops in cocaine and heroin use over the last two decades. When the shortcomings of this survey are realized, however, substantive reliance on the survey is untenable.

   There are two major problems with the survey:

   First, it only counts "households," it does not count some heavy-drug using communities--such as the homeless population (surveys show that half of the homeless population in the United States may be addicts), (7) the institutionalized mentally ill (surveys show that half may self-medicate with illegal drugs), (8) and, perhaps most importantly, prisons (important because there are so many incarcerated).

   For example, the 2001 National Household Survey on Drug Abuse estimates that there are three to four million cocaine users and under one million-heroin users in the United States. (9) At the same time, surveys of inmates indicate that over one million have underlying substance abuse problems, and over 400,000 have committed a drug offense or use drugs regularly. (10) This does not even count people in county jails, where probation revocation for positive drug tests are common. Thus, if you add those million plus drug-using prisoners to the Household Survey, it becomes evident that the results do not accurately describe the level of drug use. Indeed, the more drug users are incarcerated, the more it will look like there are less drug users in the Household Survey, but in fact, there may be more drug use in the United States.

   Second, comparisons between people's admitted drug use to surveyors and their actual drug use based on drug testing shows that there is as a much as twenty-five percent underreporting of drug use. (11) As sentencing and drug arrests increase, the less likely it is that people will report their drug use without being questioned. Surveys have shown that the rate of drug use of those who refuse to respond to the survey is higher than for those that do respond to the survey. (12)

   Therefore, it is important to note that the Household Survey is a voluntary survey where an agent of the government actually comes to the house and interviews people about their drug use. Over twenty percent of the people asked to participate refuse. (13) This makes for a large margin of error, too large to claim progress in the drug war, especially when indicators of drug related harm are at record levels.

   This returns to the first point. It is more important to look at the harms done by drugs--are they increasing or decreasing--in order to determine whether current drug policy is working. If we look at the harmful effects of drug abuse and other more indicative numbers, we get a better idea whether we are making progress.

   Perhaps the most reliable number is overdose deaths. This number is imperfect because the reporting of these deaths is less standardized than it should be, and the figures include intentional suicides. Undoubtedly, however, overdose deaths are at record or near record highs, and are a clear example of failure.

   In 1998 a total of 16,926 persons died of drug-induced causes in the United States. The category "drug-induced causes" includes not only deaths from dependent and nondependent use of drugs (legal and illegal use), but also poisoning from medically prescribed and other drugs. It excludes accidents, homicides, and other causes indirectly related to drug use. Also excluded are newborn deaths due to mother's drug use. (14) Similarly, mentions of drugs in hospital emergency rooms are another source of more reliable information. Again, this is an imperfect source of information as hospitals are encouraged to report emergency room mentions. In addition, a mention does not mean the person came to the hospital for a drug-related emergency, just that when they came and were asked about drug use, they mentioned various drugs. Up to four drugs are counted if they are mentioned. The United States is at record or near-record highs in emergency room mentions. (16)

   From 1990 to 2000, total drug-related episodes increased 62 percent, from 371,208 to 601,776 (Figure 1). Mentions of the four major illicit drugs increased from 1990 to 2000 as follows: marijuana/hashish (514%, from 15,706 to 96,446), heroin/morphine (187%, from 33,884 to 97,287), methamphetamine/speed (158%, from 5,236 to 13,513), and cocaine (118%, from 80,355 to 174,896) (Figure 2). (17) [FIGURES 1-2 OMITTED]

   Another example that problems relating to drugs are increasing is data on the spread of HIV/AIDS. The sharing of contaminated syringes is the major source of new AIDS cases, especially among women and children. According to the Centers for Disease Control and Prevention ("CDC"), by the end of the year 1999 there were 733,374 reported cases of AIDS in the United States. (19) Of these, 263,789, or thirty-five percent, are linked to injection drug use. (20)

   Adolescent drug use is another area where the failure of the drug war is evident. There are multiple sources here: the Household Survey (which is less impacted by incarceration and other non-home-based population issues when dealing with youth), (21) and the Monitoring the Future Survey conducted by the University of Michigan. (22) While there are shortcomings in both surveys, they both show a relatively consistent increase in adolescent drug use since the last two years of the first Bush Administration. (23)

   Data from the [Monitoring the Future Survey] imply that annual prevalence rates for students in 12th grade increased from 29 percent in 1991 to 42 percent in 1997. (24) Data from the [Household Survey] indicate that the annual prevalence rates of use for adolescents ages 12 to 17 increased from 13 percent in 1991 to 19 percent in 1997. Both series suggest that from 1991 to 1997, the fraction of teenagers using drugs increased by nearly 50 percent. (25)

   Related to adolescent drug use is the availability of drugs for adolescents...