Reflections on Drug Policy

• Date: 01 January 2009
• Published date: 01 January 2009
• Author: Henrick Harwood,Carl Leukefeld,James A. Inciardi,Yvonne Terry-McElrath,Duane C. McBride
• DOI: 10.1177/002204260903900107
• Subject Matter: Article

© 2009 BY THE JOURNAL OF DRUG ISSUES

JOURNAL OF DRUG ISSUES 0022-0426/09/01 71-88

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Duane C. McBride is Research Professor of Sociology at Andrews University and Director of the

University’s Institute for Prevention of Addictions. He has published approximately 100 articles, chapters,

books, and monographs in drug abuse research. For the past ten years, he has led policy research

projects supported by the Robert Wood Johnson Foundation and the National Institute of Justice. Yvonne

Terry-McElrath is a Research Associate at the Institute for Social Research at the University of Michigan.

She has published over 40 articles, chapters, and monographs in the areas of tobacco, alcohol, and illicit

drug policy-related research. Henrick Harwood is Director of Research with the National Association of

State Alcohol and Drug Abuse Directors (NASADAD). His work has focused on the economic impacts of

substance abuse and mental illness on the economy, and on public and private f‌i nancing of substance

abuse and mental health services. Previously he worked at ONDCP, the IOM, RTI, International and

The Lewin Group. James A. Inciardi, Ph.D., is Director of the Center for Drug and Alcohol Studies at

the University of Delaware; Professor in the Department of Sociology and Criminal Justice at Delaware;

Adjunct Professor in the Department of Epidemiology and Public Health at the University of Miami

School of Medicine; and a Guest Professor in the Department of Psychiatry at the Federal University of

Rio Grande do Sul in Porto Alegre, Brazil. Dr. Inciardi is the author of more than 450 articles, chapters,

and books in the areas of substance abuse, criminology, criminal justice, history, folklore, public policy,

HIV/AIDS, medicine, and law. Carl Leukefeld is Professor and Chair of the Department of Behavioral

Science and Bell Alcohol and Addictions Chair at the University of Kentucky. His research interests and

publications include treatment outcomes, HIV, criminal justice, health services, and rural populations.

REFLECTIONS ON DRUG POLICY

DUANE C. MCBRIDE, YVONNE TERRY-MCELRATH, HENRICK HARWOOD, JAMES A.

INCIARDI, CARL LEUKEFELD

The history of United States drug policy is complex, ranging from laissez-faire to

strict prohibition. In recent years, there has been little federal interest in drug policy

reform and a continuing focus on a prohibitionist deterrence approach. During this

period, state initiatives have been in the forefront of drug policy experimentation via

ballot initiatives, legislative actions, or judicial and administrative policy decisions.

The resulting state-level drug policy landscape includes continued prohibition as

well as harm reduction, medicalization, and decriminalization. In addition, there has

been considerable state-level policy focus on substance abuse treatment quality.

With a new presidential administration, there is some indication that drug policy

reform may be a national issue as part of the federal health reform agenda. The

authors hope that the results of state policy experiments that provide evidence for

the viability of harm reduction, quality treatment, and related approaches can be a

viable part of the national policy discussion.

72 JOURNAL OF DRUG ISSUES

MCBRIDE, TERRY-MCELRATH, HARWOOD, INCIARDI, LEUKEFELD

THE ORIGINS OF DRUG POLICY

In any era people tend to believe that they encounter issues unique in human

history. Those involved in today’s drug policy debate are no different. However,

scholars such as Musto (1999) and Inciardi (2008) have documented that drug polices

in the United States have historically varied dramatically and have sparked public

discourse, debate, and hysteria in each era. From the colonial era through the late

1800s, drug policy focused on light regulation and has been characterized as laissez

faire (McBride, VanderWaal, & Terry-McElrath, 2003). Addictive substances were

a major part of global trade in this highly entrepreneurial era (Musto, 1999), and

many powerful drugs were sold over-the-counter, through itinerant medicine shows

and major store catalogs (Inciardi, 2008). The Sears Catalog of 1897 advertised

Peruvian Wine of Coca, guaranteeing that the product would provide energy, reduce

fatigue, and enable workers to be productive under any conditions. Social reformers

increasingly recognized the broad consequences of addiction. During the early

twentieth century, drug policy was debated vigorously, mirroring in many ways

our own current debate (see Cherrington, 1920; Dai, 1937; Lichtenstein, 1914;

O’Donnell, 1969; Wood & Bache, 1883).

THE REACTION TO A LAISSEZ FAIRE DRUG POLICY

Drug policy changes in the twentieth century should be viewed within the context

of major social reforms. Society began to realize individuals were consuming

highly addictive substances they did not realize were in over-the-counter medicines

(Inciardi, 2008; Whitebread, 1995). The broad social reforms of the period included

safe foods and drugs, and two major drug policies resulted from these reforms: (a)

the Pure Food and Drug Act of 1906, which introduced labeling of ingredients and

prescription requirements for many drugs, and (b) the Harrison Act of 1914. Although

the Harrison Act only regulated and taxed production, importation, distribution,

and use of drugs such as opium and coca leaf derivatives, it was interpreted as de

facto prohibition. From a policy development perspective, it is important to note

that these federal acts followed years of state policy development that served as a

model for federal action. (Inciardi, 2008).

America went from a relatively open market approach to drugs to one that was

strongly moralistically prohibitionist. Those who previously had access to cocaine,

opium, and injection paraphernalia suddenly found themselves experiencing the

pain of withdrawal or engaging in illegal behavior to access the drugs on which

they were now dependent (O’Donnell, 1969). From the 1930s on, largely through

Harry Anslinger, Commissioner of the U.S. Bureau of Narcotics from 1930 to

1962 (see Anslinger & Thompkins, 1953), illicit drug use was def‌i ned as a foreign

threat destroying America’s soul. The media focused on drug-maddened foreign or

minority-group rapists. Classic examples of these efforts were the movies Reefer