In Midst of Opioid Drug Crisis, No Real Drug Reform

Man using drugs
Man using drugs

We learn of a new tragic data point in the country's struggle to confront opioid addiction on a weekly basis. As the Centers for Disease Control recently acknowledged, the U.S. in in the midst of an "an epidemic of drug overdose (poisoning) deaths." In receipt of this information, a number of politicians have shared their own family narratives of struggles with addiction, and even more have stepped forward with new plans to expand access to treatment and increase criminal penalties for trafficking in illicit drugs.

Yet no one has made the case for meaningful drug reform.

As should be clear at this point, it is not for want of resources, conviction or additional penalties that the nation's war on drugs has failed. It is doomed to failure because of its own flawed premise, yet those in support of the drug war's logic remain as undisturbed by this latest "reform" wave as the prodigious illicit drug production of criminal syndicates unperturbed by law enforcement.

On this point, we have sadly too much evidence. After all, this is is not America's first drug crisis. In the past, a variety of people have put forward an appealing combination of both punishment and treatment that only further entrenches the logic and failures of the drug war, in spite of sincere promises to treat addiction more humanely. And as we should all be aware at this point, a militant and ruthless drug war has succeeded in producing only militant and ruthless drug dealers. When it comes to the ostensible targets of drug enforcement -- the price, availability and purity of illicit drugs -- the drug war has driven these measurements in the exact wrong direction.

The drug war is the U.S.' most failed social policy intervention in modern history -- yet the call to rethink its assumptions, and revise our approach to regulation of illicit drugs, has been issued and seriously engaged only by reformers in Europe and Latin America.

True, this country has undertaken a dramatic -- and I think laudable -- effort to rethink the standing of marijuana--but, as I point out here, this has been done often at the expense of making progress on how we approach other illicit drugs.

How many times have we heard activists depict marijuana as benign while demonizing heroin? Yet, as I am only one historian to recount, heroin was once the Oxycontin of its day, a painkiller dispensed to treat a number of ailments, and one that fell into disrepute as recreational use of it spread. Rather than deal with the thorny problem of the diversion of heroin somewhere along the licit chain of production, prescription, and consumption, the United States elected to prohibit the drug in 1956, asking doctors and pharmacies to relinquish to the government for destruction the small amounts of the drug remaining in their possession.

As a result and since that time, the country has confronted the far more violent and vexing problem of subversion, the knowing illicit production, distribution and use of the drug. In other words -- and this is a woefully neglected point -- one of the reasons heroin is such a dangerous drug today is precisely because the United States prohibited it. It is at least possible to regulate otherwise legal actors like pharmaceutical companies and doctors when they misbehave, but unfortunately violent criminal enterprises don't file applications before the Food and Drug Administration or appear before professional boards to gain a license to practice.

It is not my personal opinion that heroin ought to be legal -- and in this regard, I disagree with respected authorities on the subject. I spell out my reasons in favor of my own preference for decriminalization rather than legalization, as well as my own thoughts on what would constitute meaningful drug reform at the end of my book, and it is not surprising that my ideas borrow heavily from the United States' once substantially effective regime of regulating illicit drugs in the era prior to criminal prohibition.

It would not be upsetting to me if people were to disagree with my plan; I have no special monopoly on policy prescriptions. It is, however, extremely distressing that there is no conversation on these or any similarly fundamental -- and urgently needed -- attempts to reprogram a militant drug war into something that would actually affect the price, potency, and availability of illicit drugs. This failure is more unforgivable in the midst of the opioid epidemic, and more pronounced given that the United Nations is set to convene a special session on drug treaties governing prohibition in April 2016.

In the place of reform, a small of army of elected officials appear before us regularly with promises to punish illicit markets out of existence. Maine's Governor LePage currently occupies the farcical end of the spectrum (as he often does) by suggesting that concealed weapon carriers undertake their own vengeance on drug traffickers.

As I have written in this forum before, even when such strident proposals are coupled with treatment options, history returns a sad verdict on their efficacy. Prohibition necessarily entails policing an underground market, and this in turn means that addicts will be pressured via criminal punishment; this reality punctures the myth of "treatment" offered in a criminal justice context, instead of via the healthcare setting where it belongs. (Those seduced by enlightened-sounding "drug courts" would do well to review research on their actual effectiveness.)

Even more to the point, in a regime of prohibition, it will never be possible to prosecute traffickers such that the underground market is substantially impaired for a meaningful length of time. Governors who put forward plans to punish should be asked just how and why previous criminal sanctions fell short: were the mandatory minimums too trivial, were the jails and prisons too small? What new incremental investment would vindicate what has up till now been a failure? How many more platoons should we send to South Vietnam?

Yet such questions are never asked -- and the drug war churns away, totally unaccountable to its failures. Undoubtedly this is related to the many interests who profit from its existence. But these shortcomings and political limitations should not deter drug reformers from boldly claiming a case for reform. Up until this point and as of right now, Americans need a passport in order to hear a case in favor of effective drug policy discussed in a public venue. As the United States is the country responsible for the drug war's many ruinous consequences, this is more than an embarrassment; it's a disgrace.

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