A New Approach to Substance Abuse

Let us tell the truth – a truth that for far too long has been neglected by public-policy makers throughout our country: America’s “War On Drugs” is a failure. For many years, our Nation’s so-called “war on drugs” has not only been ineffective; it has resulted in tremendous harm to substance abusers, hundreds of thousands of American families, and taxpayers.

Instead of reducing and preventing drug abuse, our war on drugs has cost many American citizens their fundamental freedoms; it has destroyed families and individual lives through the incarceration of drug offenders for outrageously excessive periods; and it has fleeced the U.S. taxpayers of hundreds of billions of dollars for source-control and interdiction efforts, as well as the astronomical costs of unnecessary incarceration.

This war is devastating in terms of dollars, lives, and civil liberties; it is racially motivated and conducted in a racist manner; and it is completely ineffective in accomplishing the stated goals of its proponents.

Rather than continuing to spend billions of taxpayer dollars on ineffective interdiction and source-control efforts; rather than supporting a campaign that was conceived and expanded primarily for political gain; and rather than compounding and perpetuating the horrors faced by our citizens suffering from drug addictions; we should finally – working together – define our real goals and objectives, and then take measures that will actually help us achieve them.

If our real goal is to funnel billions of dollars and military equipment into Latin American countries to aid one side in an internal conflict under the auspices of drug interdiction – while not impacting the supply of cocaine or any other illegal substance on our Nation’s streets by one ounce – then we’re moving in the right direction. If our objective is to imprison a greater portion of our own citizens than any other country in the world, paying hundreds of millions of dollars to house non-violent offenders in an ever-growing national internment campaign, then we’re doing just fine. But if we truly seek to reduce drug use and abuse, and to reduce the harmful effects of drugs on our society, then we must reject the failed policies of the past and adopt practices that will constructively aid in attaining our common goals.

I submit that we should be very clear about stating our common goals – and then reach an agreement about what measures will help us attain those goals. I propose that our common goals be (1) the prevention of drug abuse to the extent possible; (2) effective treatment for people who have substance abuse problems; and (3) the reduction of harm in the best interests of all, including substance abusers, families, and taxpayers. If, as a nation, we can agree upon these goals, then we certainly ought to be able to determine what measures we can take to accomplish them.

But first, we must understand how we got into the present mess and what has prevented us so far from extracting ourselves from it. The answers to these questions begin with an examination of our recent history when, in the late 1960s, Richard Nixon was desperately searching for a chink in the armor of Johnson’s Great Society. He felt his best hope was to “convince Americans that people are poor and violent not because of grand social pressures, . . . but because they are bad individuals deserving only of discipline and punishment.”

This urge to punish was aimed at two targets: urban African-Americans, and the protesting American youth, who were challenging every social and moral norm through “aberrant” behavior. The common thread Nixon strung to connect these two groups was illegal drug use. The urban African-American population was portrayed as having a serious heroin addiction, and the college-aged hippies were, of course, smoking marijuana.

Nixon’s approach was also racially motivated. The covert divisiveness of this strategy was described in a 1969 H.R. Haldeman diary entry, which reads: “[Nixon] emphasized that you have to face the fact that the whole problem is really the blacks. The key is to devise a system that recognizes this while not appearing to.”

It was in that context that the “war on drugs” was declared. The effort began by federalizing drug trafficking under the auspices of regulating interstate commerce, and prosecuting crimes that had previously been prosecuted in state courts under state criminal laws. Since then, every president has expanded the government?s authority to wiretap, issue broad search warrants, seize personal property without any semblance of due process, incarcerate non-violent offenders for excessive periods of time, and spend huge sums on ineffective interdiction efforts.

Between 1980 and 1986, Ronald Reagan cut support for drug treatment programs by more than 60% and shifted those funds to interdiction and eradication efforts in foreign countries. Federal spending on so-called drug control programs has increased from $1.5 billion in 1981 to $18.5 billion in 2000. During George Bush’s tenure, local, state, and federal governments spent more than $120 billion on the war on drugs. During the Clinton Administration, the war on drugs has consumed more federal dollars than the Commerce, Interior, and State Departments combined.

A few months ago, President Clinton gave over $1.3 billion to the Columbian military under the aegis of funding counter-drug operations. Yet, from all indications, much of this aid is actually going to the Columbian government’s fight against leftist rebels and political uprisings instead. If history is any indication, the supply of cocaine on the streets of our country will not be affected by the expenditure of the $1.3 billion – money that could be utilized in prevention and treatment programs to actually make a difference. Of all the money we spend on the drug war, only one-fifth goes to fund treatment or prevention programs.

The history of the war on drugs reveals a mindless resort to a retributive and punitive model for dealing with our problem. Why have we not focused on rehabilitating and restoring individuals who have made poor decisions? Why have we not sought cost-effective measures that will actually help us accomplish our goals? Part of the answer lies in the shameful political exploitation of the issue. Part of the answer lies in the disingenuousness of public policy makers who will not admit failure and move on to an effective, constructive approach. And part of the answer lies in the desire of so many people in our nation to pass judgment against and punish others, while failing to understand that such an approach only undermines the interests of us all.

Regardless of who prevails in Florida, our new President is unlikely to offer any relief from the drug war rhetoric. Vice President Al Gore has promised tougher drug penalties and enforcement, increased interdiction, and continued military aid to Columbia to fight the supply of drugs. Similarly, during his presidential campaign, Governor George W. Bush promised to renew America’s commitment to the war on drugs by proposing nearly three billion dollars in new spending. Vice-president Gore and Governor Bush both endorse the failed policies of the past, while our Nation’s ordeal with drugs continues to worsen.

After more than a quarter century, the war on drugs has failed to solve our drug problem, it has led to increased availability and purity of illegal drugs, and it has flooded our prisons and bogged down our criminal justice system. The United States has the highest incarceration rate in the world – one out of every 147 American citizens is now serving time. In 1980, the number of Americans in prison for drug offenses was 41,000; today that number has increased more than tenfold, to 458,000. When mandatory sentencing laws were passed in 1986, drug offenders comprised 38 % of the federal prison population; today they comprise almost 60%. The average sentence for a first time, non-violent drug offender is longer than the average sentence for rape, child molestation, bank robbery, or manslaughter. As of 1996, one-third of all black males in their twenties were under some form of correctional control.

With 458,000 drug offenders off the streets, one would think that drug use would be declining. In fact, it is still on the rise. By the time they graduate from high school, half of American teenagers will have used illegal drugs. Between 1979 and 1998, the number of persons 12 and older reporting some illicit drug use during their lifetimes increased from 31% to 36%.

Just as the huge number of drug offenders in prison has not reduced drug use, the billions of dollars we spend for foreign drug interdiction efforts have not decreased the drug supply. In fact, nearly 90% of high school seniors interviewed in 1999 reported that marijuana was “very easy” or “fairly easy” to obtain. Nearly 50% of them felt the same way about cocaine, and 32% said the same about heroin. Between 1981 and 1998, while we were spending billions on interdiction and source control efforts, the cost of cocaine actually declined from $190 per gram to $44 per gram, and the purity increased from 60% to 66%. The cost of heroin also declined, from $1200 per gram to $318 per gram, and its purity more than doubled, from 19% to 51%.

Despite the billions we are spending to stop drugs, prices are going down and the availability and purity are increasing. And despite the huge portion of our population we have incarcerated, the demand for illegal drugs has not declined. The drug war, as we have known it for some thirty years, is an unmitigated failure. We must acknowledge this failure now, and devote our resources to programs that work.

We know what works and we know which programs are most effective for different segments of our population. We have volumes of scientifically based, peer-reviewed research demonstrating the effectiveness of a wide variety of drug abuse treatment programs. And we have empirical data demonstrating the severe shortage of substance abuse treatment programs for those seeking help. In Salt Lake City, for example, there is currently a waiting list for our County-run detox program. We have a shortage of transitional and group home facilities for people waging their own personal, painful, and often courageous wars on drugs so they can once again be productive members of our community. Nationally, we lack adequate treatment facilities, yet, as a nation, we seem eager to build more prison cells.

Although treatment for drug addiction can be very expensive, our investment in such programs frequently produces a person who has healed, who is working, who is able to participate in the life of his or her family and community. Imprisoning drug abusers costs $30,000 per inmate each year. At the end of the offender’s sentence, our huge financial investment results in a person who has become a social pariah, possibly unemployable and almost certainly underemployed, frequently subjected to unspeakable horror, leaving him or her bitter, broken and all too likely to return to the old ways of numbing oneself through substance abuse.

We can and must do better. We have spent billions of dollars perpetuating pain and destroying families through a “war;” now it is time to make the same investment in healing. We must reduce dangerous drug abuse, we must remove the social factors that lead people to use and sell drugs, we must make our streets and schools safe for our children, and we must ensure our tax dollars are spent effectively.

Currently, we are fighting against our own best interests and gaining nothing but more pain. We can turn the tide by first describing our efforts to reduce substance abuse in our communities in the productive, goal-oriented language of treatment, healing, and community building. And we can utilize the scientific research to evaluate our progress and to make prudent decisions regarding the allocation of resources.

In pursuit of this different approach, two principles should guide our efforts: First, we must develop and implement the most effective programs available to educate our children and prevent drug use before it starts. Second, for those who do not entirely abstain from the abuse of drugs, we must provide adequate treatment and other harm-reduction programs, all of which are less expensive and far more effective than punishment and incarceration.

Effective prevention programs allow us to avoid all of the enforcement, prosecution, and incarceration costs associated with the punitive approach. Such prevention programs will reduce the number of children who start using drugs, and keep those children from becoming the future drug offenders who will be sent to prison. Effective prevention programs will also reduce the number of people imprisoned for other crimes, because many inmates who are incarcerated for non-drug-related offenses committed those offenses either while under the influence of drugs, or to support their drug habits.

Making wise decisions requires experience, good judgment, and responsibility. If we want our children to exercise good judgment and act responsibly, we must entrust them with responsibility and give them the tools and honest information to make sound decisions.

Our approach to drug prevention too often has been to demonize bad behavior, and insist that abstinence is the only acceptable path. Having made this moral pronouncement, we then refuse to provide any information that might help children evaluate the choices on their own terms and make responsible decisions. We have staked out a moral high ground that leaves no room for questions, special circumstances, or supplemental information. Our teaching to children completely short-circuits any rational decision-making process. And it is posed in an all-or-nothing context. Total abstinence is the only possibility. We tell them to “JUST SAY NO.” Period. End of discussion.

This approach has proven to be ineffective in drug prevention programs. The Drug Abuse Resistance Education Program (DARE) is currently the most popular program offered in our nation’s classrooms, at a cost of $700 million a year. Extensive peer-reviewed research has shown DARE to be completely ineffective at curbing drug use. One study even showed that suburban children who participated in the DARE program actually engaged in significantly higher levels of drug use than suburban students who did not participate in DARE.

We must abandon the unrealistic and naïve approach of “just say no.” We all would like to see our children resist the pressures to use drugs, but we must ensure that all children have accurate information. Our strategy to provide the best drug prevention programs for our children must involve an honest assessment of the drug problem. Fear-based tactics and oversimplified slogans have not prepared our young people for deciding whether to use illegal drugs.

For these reasons, in Salt Lake City, I have discontinued our support for ineffective programs such as DARE. Rather, I am committed to utilizing our resources for programs that are proven effective and have asked our school district to implement a comprehensive, proven curriculum for drug education.

One program we are pursuing in Salt Lake City is called Athletes Training and Learning to Avoid Steroids – the ATLAS program. This system has proven successful among male high school athletes by teaching them drug prevention and general health promotion. Youth who have been trained in the ATLAS program showed a 50% reduction in new use of anabolic steroids, as well as significantly lower use of alcohol, illicit drugs, and other sport supplements. One year after the program, ATLAS students also had reduced drinking and driving occurrences. Under the direction of Dr. Linn Goldberg, we have been awarded a federal grant to implement and test the ATLAS program in Salt Lake City’s schools. We have already conducted the training sessions for our coaches, and will launch the program in January.

I have also urged the Salt Lake City School Board to implement a comprehensive 5th-through-12th grade prevention program that has proven to be effective. Students Taught Awareness and Resistance – the STAR program – is one of those programs. A five-year follow-up study showed that STAR had reduced the rates of tobacco, marijuana, and alcohol use among youth by 20 to 40%. Ninth and tenth graders who had graduated from the STAR program had half the rate of cocaine use compared to non-STAR participants.

Another effective prevention program I have asked our School Board to consider is LST, Life Skills Training. LST trains youth in social resistance skills, personal self-management skills, and general social skills. Research has shown that students who develop skills in these domains are far less likely to engage in a wide range of high-risk behaviors. The Life Skills Training program has been extensively studied for nearly 20 years. Results indicate that this prevention approach can produce 59- to 75-percent lower levels of tobacco, alcohol, and marijuana use.

These programs are just a few examples of the sorts of alternatives to ineffective programs such as DARE that should be implemented if we are to protect, to the extent possible, our youth and our culture from drugs. However, we must realize that even the most effective drug prevention programs will not achieve total abstinence for all participants. We must abandon the unrealistic approach of “just say no,” because we know that there will always be those who will just say “yes” In those instances, the drug user should have good information in order that potential harm can be reduced for everyone involved.

In our efforts to prevent drug abuse before it starts, we must focus our attention away from punitive, inhumane solutions and turn toward our communities. We must do our best to eliminate the social injustices and pressures that encourage our citizens to turn to drugs in the first place. To this end, we must help our citizens with housing and employment issues. We need to desegregate our communities and help low income communities develop.