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Drug Policy Proposal Paper

Executive Summary

The significant US population consumes psychoactive substances, with about 86% of adults having tried alcohol at a point in life and more than 9% of young Americans being illegal drug users. As a result, the US government advocated for the War on Drugs policy approach as drug abuse put more people at risk of harm. The adoption and implementation of this policy approach led to an increase in penalties, enforcement, and incarceration for drug offenders. Even with the need and the public support for harm reduction, this war on drugs did not provide an effective solution to the problem of drug sale and abuse. Though, to a great extent, the drug war led to reduced accessibility of drugs and lowered the potential drug abuse levels, there was still an escalation of police efforts and global military against drugs. The current approach has exhibited various shortcomings, including prevailing spending priorities that have seen the government spend millions of dollars, though the outcome is not worth it. Therefore, a preventive and treatment-based approach would be a more effective alternative solution. The approach extends to favoring many drug users, especially those that meet the diagnostic criteria for dependence on the substance.

Context and the Importance of the Problem

The United States is among the leading countries with the highest population consuming psychoactive substances. From the National Institute on Alcohol Abuse and Alcoholism report, about 86% of adults have tried alcohol at a point in life (Earp et al., 2021). The report also indicates that more than 9% of Americans above 12 years abuse illegal drugs annually, with 6% having been diagnosed and undergoing treatment for alcohol-use disorder as shown in figure 1. As a result of the prevalent issue of substances abuse in America, the country’s authority adopted an effort to combat illegal drug use leading to a “war on drugs” (Caulkins et al., 2018). This followed the public support for strategies to reduce harm, considering that the white Americans became victims of the opioid epidemic while black communities were increasingly hit by the effects. The war on drugs which was formally launched by President Richard Nixon in the 1970s, saw a great increase in penalties, enforcement, and incarceration for drug offenders (Jelsma, 2019). The official implementation of the War on Drugs came following the declaration of drug abuse number one enemy of the public. At the same time, the government increased the federal funding for agencies controlling drugs. New developments came up, including the creation of the Drug Enforcement Administration as a result of the merger of various agencies to make a stronger one.

Figure 1: Drug use among young people

Drug use among young people

However, the modern war on drugs as launched by Nixon did not provide the alternatives for harm reduction, especially among the black American addicts. Instead, there was a steady escalation of police efforts and the global military against drugs. The situation was followed by the criminalization and strict regulation of drug use leading to unintended consequences (Earp et al., 2021). Even though the drug war reduced the accessibility of drugs and lowered the potential drug abuse levels, it led to proliferated violence around the world and mass incarceration in the US, especially among black Americans (Payan et al., 2013). Two-thirds of those jailed report regular alcohol use, while 69% include the illicit drugs users either found drinking or under the influence of drugs. Almost five decades later, the number of Americans behind bars has increased by 350%, with more than 2.2 million Americans in jail or prison by 2017, as shown in figure 2 (Earp et al., 2021). The majority of those incarcerated, at least 60%, were black or Latino, with 1 in 9 black and 1 in 28 Latino children having their parent incarcerated (Earp et al., 2021). Thus, the war on drugs disproportionately impacted communities of color.

Figure 2: US prison population

US prison population

For over decades now, the US has continued to fight a global war on drugs with limited positive outcomes. Instead, there has been an increase in financial costs and prison populations as well as the global drug-related violence (Brownstein et al., 2015). The War on Drugs policy held all government levels, which led to exponential incarceration growth with no discernible safety or health benefits. The impact of it all is that even with the increased incarceration, there is essentially no reduction in violent crime rates but only a marginal decrease in property crime (Rosino & Hughey, 2017). The criminalization of substance misuse has not been able to improve health outcomes. Additionally, a comparison between states showed that there were no reductions in the misuse of substances, fatalities due to overdose, or even drug arrests even as the incarceration for drug offenses increased.

Despite the fact that the US has spent over $1 trillion to fight the war on drugs, this policy has failed to produce the desired outcomes. Much of these resources were allocated to police to enforce the war on drugs considering that it targeted dealers. It was assumed that the domestic drug trade was exclusively an urban phenomenon hence committing resources towards street-level enforcement in inner-city neighborhoods (Rosino & Hughey, 2017). This led to many arrests that gradually saw the prison population balloon with longer prison sentences. Soon, as more people continued to be sent to prison, the construction could no longer keep pace leading to disorder and violence.

The conditions of confinement were also not good and became decrepit in violation of the Eighth Amendment, which prohibited cruel and unusual punishment. The American criminal justice system has significantly been strained that saw the emergence and rapid expansion of drug courts without considering their effectiveness (Jelsma, 2019). Even as drug courts became significant players in the fight against drugs, enforcement remains the focal point of policy efforts. Despite these efforts, the problem of drug use continues to affect the country, even with the lowered substance accessibility (Earp et al., 2021). This shows that the war in drugs policy agenda that fronts enforcement-based strategies is not effective. Drug courts have instead come out to emphasize the need for rehabilitation and problem-solving in the process of combating drug addiction.

Therefore, the overall effectiveness of the enforcement-based strategies embedded in the war on drugs policy is limited. Concerns have continued to be raised, especially regarding the effectiveness of this policy and the increased situation of racial disparity of the punishments meted out (McBride et al., 2013). Drug policy experts believe that the drug war does not entirely prevent the abuse of the drug. This is because the policy intends to reduce drug use by destroying and inhibiting the international drug trade. The ultimate outcome is to increase the cost of drugs and make it scarcer, hence unaffordable drug habits in the US (Brownstein et al., 2015). Instead, the prices of most drugs have continued to fall, with heroin dropping by about 93%, powder cocaine by about 87%, and crack cocaine by 54% (Earp et al., 2021). However, the prices of meth and Marijuana have remained stable over the period; it is all evidence that the policy of war on drugs has failed to achieve its goal of reducing the use of the drug. This follows the continued trend of drugs prices fall making it easier for drug users to access and abuse them.

In situations where prohibition has led to price increases for some hard drugs such as cocaine, it has only reduced their accessibility but not necessarily brought their abuse to an end. The trend can be explained by the balloon effect that cracking down on drugs in an area does not reduce the overall drugs supply (Rosino & Hughey, 2017); instead, once an area is cracked off, the drugs, the production, and trafficking shifts to another place. This is because the drug trade is such a lucrative business that dealers would always want to take part, especially in countries with drug trade as a major or only economic chance, and the governments may not be able to suppress such trade (Caulkins et al., 2018). Even with the war on drugs adopted as early as the 1970s, there have been many cases exhibiting the balloon effect.

Similarly, in many cases, the drug war has not been able to push production down. An example is told of the effort by the United States to crack down on opium in Afghanistan between 2002 and 2014. Afghanistan supplies heroin to the world in bulk, and attempts by the US were to suppress the production. However, despite the efforts and US spending of over $7.6 billion in the program, opium poppy crop cultivation in Afghanistan reached record levels in 2013 (Earp et al., 2021). A significantly essential problem with the enforcement-based strategies is that drug war is more punitive and has often increased the level of incarceration in the country.

Research shows over 2.2 million people having been incarcerated because of drug abuse is evident enough that the policy is only meant to punish the offenders rather than find a solution to the problem. Policy experts have found limited or no substantial evidence that having tougher punishments or harsher efforts such as incarcerating offenders can be a better way of reducing access to substance and drug abuse as compared to lighter measures. Instead, such punitive measures may only slow the flow of drugs (Jelsma, 2019). Additional, significant racial disparities in prison populations have been attributed to the war on drugs and accompanying determinant sentencing structures. The country also continued to spend more resources in the war on drugs, with over $1 trillion having been spent in the last five decades (Earp et al., 2021). Therefore, this proves that the war on drugs policy has significantly failed in addressing the problem of drug abuse in the US, and there is the need to develop more alternatives to solve the issue that continues to affect the country.

Pre-Exiting Policies, Policy Alternatives, and Research

Despite the US having fought a global war on drugs for decades, the policy fostering enforcement-based strategies has not proved a success in ending drug abuse in the country. Though the proponent of the war on drugs claim that the policy has helped reduce the crime related to drugs, lower the disease and overdose of drugs, and disrupted and dismantled organized criminal groups, it has proved ineffective in addressing the entire problem (Brownstein et al., 2015). Instead, the country has spent costly, crowded its prisons or jails, and seen a continuous increase in drug-related violence around the world.

Lawmakers and experts need to reconsider replacing the drug war policy as its potential benefits are really not worth its many drawbacks. A large focus being advocated for by many drug policy experts and historians is moving from enforcement-based efforts towards more prevention and treatment-based efforts (Earp et al., 2021). The newly advocated policy agenda entails the rehabilitation of the drug abusers, decriminalization of currently illicit substances, and to the extent of legalizing all drugs.

The need for alternatives for drug policy is because the current war on drugs that is based on enforcement strategies has proved incapable and failed to address the drug problem. The enforcement approach has exhibited various shortcomings to warrant the need for change. Critics of the current policy approach have emphasized its prevailing spending priorities (Caulkins et al., 2018). The increased spending has amounted to overfunding of the activities related to enforcing the war on drugs compared to other approaches. The enforcement policy approach has been unable to produce greater progress in achieving the drug policy goals for every dollar that is spent on it. For instance, in 1997, additional million dollars were estimated to have been spent on federal enforcement activities in the US (Csete et al., 2016). However, despite the million dollars spent earlier, the enforcement approach could not reduce total cocaine consumption by 53 to 98 kilograms as it was intended. Therefore, in terms of cost, enforcement is not effective as millions are spent yearly arresting, prosecuting, and sending people to prisons, especially the typical dealers. Large amounts of money are also used in rewards to help confiscate drugs loaded on ships that are worth billions of dollars.

The enforcement policy approach is limited by a varied collection of activities and significantly directed at the stages of drug production. These stages include control at the source country, interdiction when moving to the US, and enforcement domestically (Earp et al., 2021). However, the enforcement process faces challenges at every stage meant to prohibit drug production. The use of an enforcement approach disrupts the supply network where new tactics are introduced and new efforts intensified. The disruption has always resulted in increased use of resources and making the whole process of dealing with drug supply hard to achieve. The application of the enforcement policy approach has also proved ineffective since it affects the severity of consequences related to drug abuse for every consumed kilogram (Jelsma, 2019). When enforcement is selectively done against those dealers who are corrupt or violent, it reduces the consequences.

Similarly, the enforcement-based approach has failed to achieve the intended deterrence and incapacitation. The war on drugs was purposed to gain the positive impacts of deterrence, though little has been achieved considering that the approach gives no economic option to the people involved in the drugs (McBride et al., 2013). As a result, one opts to sell or make drugs for economic purposes, and they find it the best alternative and maybe the only means for survival. For instance, opium production in Afghanistan does well compared to other forms of farming, and many farmers would do opium in Afghanistan and send it to the US as a means to earn a living (Csete et al., 2016). Similarly, the sale of the drug in the street is fueled by poverty and a lack of employment opportunities. This, therefore, explains the failure by enforcement policy approach to offer alternative socioeconomic empowerment to facilitate reduced abuse and trade in drugs.

Similarly, the approach has not been able to incapacitate the supply of drugs even with massive arrests and long-term imprisonment of those perceived to be dealers of drugs in the streets. Even though markets were disrupted, the drug enforcement approach undermines the effort because the activities to enforce against drug sellers happen on the streets (Joint United Nations Programme on HIV/AIDS, 2019). The dealers and sellers on the streets are only a smaller part of the drug trade despite being easily identified and captured. So, the approach is only effective at managing minor dealers, leaving out the real traffickers. This makes the whole idea of enforcement-based strategies ineffective in handling drug issues in America.

The implementation of the enforcement approach has seen more illnesses and deaths related to drug overdose in the US. The reason is that the continued use leads to poor information quality and the potency effects on the market part. For instance, there was an increase in the number of deaths related to drug overdose in the US from 1 to 3.4 deaths in every 100,000 people (Berryessa, 2021). As late as 2008, the country reported 12 deaths from a drug overdose in every 100,000 people. Over the years, these numbers continue to increase, with 2014 alone recording over 47,000 deaths due to overdose. All these deaths occurred despite the presence and application of the enforcement-based policy against the sale and abuse of the drug. Similarly, the country experienced drug-related violence despite the war on drugs, with researchers reporting that about 7.5% of murder crimes were associated with physical drug effects while 40% related to the illicit market system (Berryessa, 2021). The happenings related to drugs show that the enforcement policy approach is not effective and exhibits significant shortcomings that prevent its optimal.

Further, instead of ending the drug menace in the country, enforcing the war on drugs has seen the drug industry being cartelized. The prohibition of alcohol led to the American Mafia emerging, while Chinese drug gangs emerged when opium and other drugs were prohibited (Bretteville-Jensen et al., 2017). In the modern days, the war on drugs has promoted many violent cartels to be created and grow stronger. For instance, as drug sellers are frequently being cracked down in the US, the drug cartels in Mexico have gotten an opportunity to export hard drugs, including cocaine and heroin. Besides cartelization, the approach has led to the corruption level increase in the US, especially among law officers working on the border (Jelsma, 2019). Most of them have faced charges related to criminal corruption of aiding drug smugglers and immigrants smuggling drugs into the country. The war on drugs has also given rise to the racial biasness in the US as the majority of those groups affected are blacks and Latino who face incarceration. Black Americans have been unfairly targeted, and this has created racial tensions.

Therefore, since the enforcement policy approach has proved ineffective, prevention and treatment-based efforts would do well in holistically addressing the problem of the drug in the country. The prevention involves advancing more drug-prevention programs such as the Drug Abuse Resistance Education (DARE) that is commonly known that is offered mostly in schools as a curriculum. The curriculum, which has gone beyond the prohibition of drug use, includes an appeal against bullying and violence, among other antisocial behaviors (Berryessa, 2021). The prevention is purposed to keep people away from destructive or addictive substances to limit their risk of facing arrest or being incarcerated or subjected to treatment because of addiction. The approach of prevention presents social value utility that entails stopping people not to ever consuming drugs, thus reducing drug use in society (Bretteville-Jensen et al., 2017). Though it is not such a simple process, this makes drug-prevention programs have limited power in influencing youths that have been raised in an environment dominated by the use of drugs.

On the other hand, treatment-based efforts proposed by drug policy experts and other key stakeholders would be effective in managing the drug problem in the country. The treatment approach has provided a guiding rationale for the war on the drug since it began. Even as policymakers advocate for the harsh penalties for sellers, they have equally called for treating people suffering due to dependence on substances (McBride et al., 2013). The same perception has accorded with public opinion, with the majority proposing heroin and cocaine addicts to attend treatment programs instead of being subjected to prison or jail terms.

The lowest percentage only believes that the current enforcement-based approach is helping the government to win the drug war. However, this policy has been in existence over a lengthy period, and it is difficult to believe that it has helped win the war on the drug (Bretteville-Jensen et al., 2017). After the violation of the Eighth Amendment that prohibits cruel and unusual punishment, the court orders prisons to find a solution to the problem. Even the drug courts have proposed to exhibit rehabilitation and seek for solution to the problem when combating drug addiction.

The treatment-based approach favors many drug users, though it is not well utilized, considering that many of these users fail to meet the diagnostic criteria for dependence on the substance. As a result, those who do not meet the formal diagnosis end up abusing drugs in a worrying manner which includes causing disruption to families and even being unable to work well or attend schools (Jelsma, 2019). Though, treatment is not sensical for those people using drugs occasionally and for recreational purposes. Therefore, treatment as an alternative for drug abuse needs to be reserved for the people who demonstrate to be in need.

The treatment-based efforts are less costly as compared to enforcement which could see limited spending on reducing the consumption of drugs. The advantage that is attached to the treatment option is that it attacks demand directly, unlike the case for enforcement which would lead to an increase in the cost of resources spent (McBride et al., 2013). Therefore, when used, treatment reduces the dollar value of the black market; hence its effects on black market revenue are likely to be greater compared to the use of the enforcement policy approach.

Ultimately, the effects of treatment on drug-related crime are greater than it is for enforcement options. Treatment would be more effective in the situation where enforcement is big enough that it acts as a deterrent (Minhee & Calandrillo, 2019). It is cheaper to treat heavy drug users compared to incarcerating the dealers for a longer period if at all the goal is to reduce the consumption of alcohol in totality by some amount. It is evident that the incarceration option through an enforcement-based approach wastes more money.

In 2016, the National Drug Control Policy Office in the White House embraced the treatment approach through rehabilitation. The agency planned to increase the rehabilitation funding programs in the future. Under the Obama administration, there were legal and regulatory reforms such as Obamacare that were approved to increase access to addiction treatment by offering drug users health insurance to access the service (Minhee & Calandrillo, 2019). The drug courts supported the rehabilitation-based approach instead of imprisoning the drug offenders. The courts have since stopped sending the abusers to jail but instead to rehabilitation programs that focus majorly on addiction treatment as a medical issue, not criminal.

The treatment approach is advantageous in the sense that it limits the number of deaths caused by drug addicts using an overdose of substances. This is because; medical attendants prescribe and administer heroin to some addicts under strict supervision, especially when they become resistant to other forms of treatments (Berryessa, 2021). The addicts are then able to achieve the satisfaction of depending on the drug without the risk of overdoing the use or committing other crimes that result in violence, such as robbery (Caulkins et al., 2018). Unlike it is in the case of enforcement that has led to many deaths due to overdose, the treatment-based approach monitors the intake of drugs if need be within the recovery process, which limits the deaths occurring from the usage (Jelsma, 2019).

Research has found that a heroin-assisted treatment program is effective in reducing crimes related to drugs and improve on social functioning, including stabilizing housing and employment. However, advocates of the war on drugs, including the International Task Force on Strategic Drug Policy, have argued against the treatment approach, indicating that it does not give a true picture of the drug habits but instead falsely implies the safe management of drug addiction (Berryessa, 2021). This leads to the weakening of the social stigma around the use of drugs and may influence more people to abuse even some of the most dangerous substances, especially if the patients fail to meet the criteria for diagnosis.

Conclusion

The US government advanced for War on Drugs policy approach following the risk of harm that drug abuse caused to the American people, including both adults and children. The policy approach saw an increase in penalties, enforcement under the DEA, and incarceration for drug offenders. The government’s decision was influenced by the need and the public support for harm reduction. The drug war, to a great extent, led to reduced accessibility of drugs and lowered the potential drug abuse levels. However, this war on drugs did not provide an effective solution to the problem of drug sale and abuse but instead saw an escalation of police efforts and the global military against drugs. It led to proliferated violence around the world and mass incarceration in the US, especially among the black Americans raising the racial notion conflict. The US has spent over $1 trillion to fight the war on drugs over almost the past five decades. Despite these efforts, including incarceration and financial resource commitment, the problem of drug use continues to affect the country fronting the war on drugs as an ineffective policy approach. This current approach has exhibited various shortcomings, including prevailing spending priorities that have seen the government spend millions of dollars, though the outcome is not worth it. The approach does not give the economical option to the people involved in the drugs who view it as the only source of living. More illness and deaths, violence related to drugs, and cartelization of the industry continued to be recorded due to this approach.

A preventive and treatment-based approach is considered an effective alternative solution to the problem of drug abuse in the country. Prevention extends to appeal against bullying and violence and is purposed to keep people away from destructive or addictive substances to limit their risk of arrest or being incarcerated. Treatment-based efforts focused on treating people suffering due to dependence on substances. This approach favors many drug users, especially those that meet the diagnostic criteria for dependence on the substance. When applied, a treatment-based approach reduces the cost of resources to be used, lowers the deaths and violence, and increases the health and wellbeing of victims. Therefore, treatment-based efforts should be prioritized over an enforcement-based approach to finding a suitable and cost-effective solution to the problem of drug sale and abuse.

Policy Recommendations

Research has established that the current enforcement-based policy approach has continued to experience failings that have rendered it almost ineffective in the fight against the drug problem in the US. However, the following recommendations would be helpful in improving the policy aspects to enhance its effects and the solution towards the problem:

Prior steps by some states to actively lessen the sharp sting of the drug policy have proved workable though these are but only a few successes. Therefore, the focus should be given to facilitating effective reforms requiring significant changes at the state level that will ultimately necessitate federal policies to shift domestically and internationally to improve on the effects of the policy approach to the drug problem in the country.

There is a need to reduce the level of violence and discrimination witnessed in policing, which extends to phasing the military forces in the process of drug policing, allowing syringes possession, and lowering the targeting of services based on harm reduction to lower the rate of arrests. Violence reduction will also see setting better targets of policing, especially on armed criminals that are most violent.

The positive effects of the policy can best be realized when minor and non-violent offenses are decriminalized, which include merely using, found in possession, or even petty sale. At the same time, resources should be committed to strengthening alternatives that support the health and social sector instead of only focusing on criminal sanctions.

The focus needs to shift towards facilitating easier access to harm reduction services by all those in need of them as a way to respond to drugs while scaling up and sustaining the involved services to ensure that cost-effectiveness is achieved. This means that services such as naloxone access and injection sites should be scaled up to reduce their demand.

References

Berryessa, C. M. (2021). “Second Chance” Mechanisms as a First Step to Ending the War on Drugs. The American Journal of Bioethics21(4), 54-56.

Bretteville-Jensen, A. L., Mikulic, S., Bem, P., Papamalis, F., Harel-Fisch, Y., Sieroslawski, J., & Costa Storti, C. (2017). Costs and unintended consequences of drug control policies. Report by the expert group on possible adverse effects and associated costs of drug control policies. Council of Europe.

Brownstein, H. H., Crossland, C., Anthony, J. C., Forman, V., MacCoun, R., Kilmer, B., … & Terry-McElrath, Y. M. (2015). Toward a drugs and crime research agenda for the 21st century. Washington, DC: National Institute of Justice, US Department of Justice.

Caulkins, J. P., Reuter, P., Chiesa, J., & Iguchi, M. (2018). How goes the” war on drugs”?: An assessment of US drug problems and policy (Vol. 121). Minnesota Historical Society.

Csete, J., Kamarulzaman, A., Kazatchkine, M., Altice, F., Balicki, M., Buxton, J., … & Beyrer, C. (2016). Public health and international drug policy. The Lancet387(10026), 1427-1480.

Earp, B. D., Lewis, J., Hart, C. L., & with Bioethicists and Allied Professionals for Drug Policy Reform. (2021). Racial justice requires ending the war on drugs. The American Journal of Bioethics21(4), 4-19.

Jelsma, M. (2019). UN Common Position on drug policy–Consolidating system-wide coherence. London: International Drug Policy Consortium, 1-36.

Joint United Nations Programme on HIV/AIDS. (2019). Health, Rights and Drugs—Harm Reduction, Decriminalization and Zero Discrimination for People Who Use Drugs.

McBride, D. C., VanderWaal, C. J., & Terry-McElrath, Y. M. (2013). The drugs-crime wars: Past, present, and future directions in theory, policy, and program interventions. Toward a drugs and crime research agenda for the 21st century, 97-162.

Minhee, C., & Calandrillo, S. (2019). The Cure for America’s Opioid Crisis: End the War on Drugs. Harv. JL & Pub. Pol’y42, 547.

Payan, T., Staudt, K., & Kruszewski, Z. A. (Eds.). (2013). A war that can’t be won: Binational perspectives on the war on drugs. University of Arizona Press.

Rosino, M. L., & Hughey, M. W. (2017). Speaking through Silence: Racial discourse and identity construction in mass-mediated debates on the “War on Drugs”. Social Currents4(3), 246-264.

 

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