Imagining Rational Drug Policy: If You Build It, It Will Come

Lately we have been hearing a lot about this "tipping point" we have reached in the War on Drugs. A time when public opinion is shifting and leaders, legislators and others are changing the way the conversation is had. This began when newly appointed Drug Czar Gil Kerlikowskestated in 2009 that, "Regardless of how you try to explain to people it's a 'war on drugs' or a 'war on a product,' people see a war as a war on them," he said. "We're not at war with people in this country." Even though the Obama administration has hardly called a truce with drug users, Kerlikowske's comments still signified a shift in beliefs about how people who use drugs should be viewed and dealt with in the U.S. Furthermore, public support for marijuana legalization is at a historic high of 52 percent, and, according to a 2013 poll by The Huffington Post, 53 percent of those surveyed believe that the War on Drugs has not been worth the cost. Indeed, with the U.S. housing a larger percentage of its population in prison than any other country on the planet, the American public is poised to embrace a new landscape in the regulation of drugs and the treatment of drug users. However, it was just announced that Kerlikowske will not be continuing on as drug czar, and Attorney General Eric Holder recently stated that, "The war on drugs is now 30, 40 years old. There have been a lot of unintended consequences. There's been a decimation of certain communities, in particular communities of color."

The question now becomes what would a rational drug policy look like? In a post Drug War world, how should policies address substance use, treatment, addiction and incarceration? The goal of drug policy is a balance between personal freedom and public safety, so a rational drug policy would lessen the role of the criminal justice system while still ensuring the health and safety of the user and those in their environment. It's a model the public supports, but visualizing what that means in terms of policies and programs can be difficult. This is not something that will be figured out overnight, but I offer the five aspects below as a place to start, and something concrete to move towards.

1. De-schedule, tax and regulate marijuana

As many people now know, marijuana is located in the Schedule I category of illicit drugs after being "temporarily" placed there by Nixon until further research could be completed. By definition, these drugs have no accepted medical use, a high potential for abuse and are deemed too dangerous to use even under the care of a physician. If we are to have rational conversations about how to best regulate marijuana in the U.S., a necessary step is removing it from this category. Until this happens, the conflict between state and Federal law will continue to impede the tax and regulate reality that a majority of Americans favor. Bringing marijuana out of an illicit market and into a tax and regulate regime not only saves taxpayers millions, it prevents the devastation associated with arresting 750,000 people per year for marijuana related offenses.

2. Decriminalize the possession of small amounts of drugs

Of the inmates residing in federal prisons as of September 2011, more than half (50.4 percent) were serving sentences for federal drug offenses, including simple possession. At the same time, a large treatment gap exists in the U.S. with an estimated 90 percent of people who need drug treatment not receiving it. According to a 2010 report from the Justice Policy Institute, "Treatment delivered in the community is one of the most cost-effective ways to prevent crimes and costs approximately $20,000 less than incarceration per person per year."

3. Reduce the presence of the illicit market

Much of the violence associated with drugs is not because of the drug user, but rather the illicit market that has built up around the drug trade. While the U.S. might not be ready for a licit cocaine or heroin market, there are ways to reduce the presence of the illicit market while still exerting control over use. For example, Canada, Switzerland, the Netherlands and the UK have all piloted heroin assisted treatment (HAT) programs in which those dependent on opiates are administered heroin by a physician. A 2007 evaluation of these programs published in the Journal of Urban Health concluded that, "studies above have demonstrated in several different contexts that the implementation of HAT is feasible, effective, and safe as a therapeutic intervention". Recently New Zealand has come on board with their own plan to reduce the illicit market and safety hazards associated with newly developed recreational drugs by allowing the substances to be tested, licensed and brought to market in a legitimate way.

4. Eliminate the collateral sanctions associated with drug offenses

No criminal conviction holds quite the long term effects on success in life as a drug conviction. Education, housing, employment, parenting and the ability to vote all hang in the balance after a person is convicted of a drug offense. In some cases, minor youthful indiscretions result in a lifetime of barriers. And these sanctions are not handed down equally, as our own President would likely not have reached the White House had these sanctions been placed upon him during his Choom Gang college days. Creating barriers to employment and housing in no way promote sustainable economic success, and since most of the people convicted of drug offenses are poor, this is an especially dangerous blow to the success of the U.S. economy.

5. Protect public health with evidence-informed programs that work

The public health issues associated with drug use do not usually involve a drug crazed person wreaking havoc on innocent bystanders. Most concerns arise from unsafe drug using practices, such as sharing needles, and the consumption of tainted substances. Luckily, research supports that programs such as syringe exchange, supervised injection facilities and drug purity testing can greatly reduce these harms. A 2008 evaluation of supervised injection facilities in Vancouver found that "...when we considered all 3 health benefits: the incremental net savings was more than $18 million and the number of life-years gained 1175."

It's easy to think that the current War on Drugs is costly and ineffective. It can be difficult to visualize exactly what a cost effective and productive drug policy might look like, especially in the face of deep rooted biases against those who use illicit drugs. However, to truly move into a new era of drug policy, we must do more than simply wish for it, we must be the change we want to see and support policies and programs that bring that change to light.