The Obama Administration's Public Health Approach to Drug Policy

I understand, from firsthand experience, that we cannot arrest or incarcerate our way out of a problem as complex as drug use, and that a "War on Drugs" mentality is too simplistic an approach to be effective.
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President Obama's comments during last week's live YouTube interview about the need to approach our national drug problem from a public health perspective were timely, thoughtful, and well-grounded in what science tells us about drug use and its consequences. Like the president, I am opposed to the legalization of illegal drugs. At the same time, I understand, from firsthand experience as a police officer and police chief, that we cannot arrest or incarcerate our way out of a problem this complex, and that a "War on Drugs" mentality is too simplistic an approach to be effective.

Before my confirmation as President Obama's drug policy advisor, I'd spent thirty-seven years −- my entire professional career -− in law enforcement or working on law enforcement issues. Just one year before my career began, in 1971, President Nixon held a press conference declaring illicit drugs "public enemy number one." It was a powerful metaphor -- characterizing the Nation's drug problem as fundamentally a criminal justice issue, and marking the beginning of a so-called "War on Drugs" that would last for most of the next four decades.

While drug use was spreading across the country, especially after support for legalization reached a high point in the late 1970's and the introduction of crack cocaine in the 1980's, this era came to be defined with a heavily punitive emphasis, from mandatory minimum sentences to enhanced penalties for crack cocaine possession. Our Nation's courageous law enforcement officers, prosecutors, courts and prisons system were asked to shoulder an ever-growing load, and to use the effective -- but limited -- tools at their disposal to arrest and prosecute dangerous drug traffickers that deserved severe sentences in addition to non-violent drug addicts.

Drug use fell throughout the 1980's, to some of the lowest levels we've ever seen - but spending on overcrowded prisons spiked to unsustainable levels, the criminal justice system came to resemble a revolving door, and the relationship between police and the communities they serve was frequently strained to the breaking point. Eventually, progress stalled and use began to rise again as it became clear that our mostly one-sided response needed retooling. Many Americans were also forced to confront a difficult truth -- that the face of the drug problem was too often that of a son, an aunt, a wife, or a father.

So when President Obama asked me to serve as Director of National Drug Control Policy, he explained that one of my first duties would be to travel the country and sit down with people working on all aspects of this issue. With those as my marching orders, I went out and sought as much input, from as many informed sources as I could. I've met with hundreds of teachers, drug prevention and treatment experts, local officials, law enforcement practitioners, parents, teachers, community group members, addicts in recovery, academics, and young people.

These consultations, across the country and across government, helped highlight an important truth -- that public safety isn't the only thing threatened by drug use; drugs also pose an extremely complex and dynamic challenge to public health. And the public safety community cannot bear the full weight of addressing drug use and its consequences. The result of our engagement with the American people is the Obama Administration's National Drug Control Strategy -- a shift in how we address drug control, by restoring balance in our efforts and treating drug addiction as a brain disease rather than a moral failing.

We have no choice but to meet these challenges. They strain our economy, our health care and criminal justice systems, and harm the well-being of young people, service members, and our Nation's veterans.

But we also know we can make progress by employing evidence-based strategies. Despite recent increases in drug use, it is half of what it was 30 years ago, cocaine production in Colombia has dropped by almost two-thirds, and we're already successfully diverting thousands of non-violent offenders into treatment instead of jail by supporting alternatives to incarceration.

Last year, President Obama also signed into law the Fair Sentencing Act, which dramatically reduced a 100-to-1 disparity between trafficking offenses for crack and powder cocaine. We're also providing communities with the capacity to prevent drug use and drug-related crime, increasing funding for drug courts and other alternatives to incarceration by millions of dollars, and using community corrections programs involving swift, certain, yet modest sanctions to monitor and support drug-involved offenders.

We're also placing more emphasis on education -- preventing drug use (and the many negative consequences that follow) before it ever starts, and expanding Americans' access to treatment for the disease of addiction. In fact, the President's budget request for this fiscal year asks for a $203 million increase in prevention funding and a $137 million increase in treatment funding.

Despite recent calls to do so, legalizing drugs is not the answer. Our opposition to legalization is not born out of a culture-war or drug-war mentality. It is born out of the recognition that our drug problem is a major public health threat, and that drug addiction is a preventable and treatable disease. Already drug use -- legal and illegal -- is the source of too many of our Nation's problems. Why would we implement policies that would make these problems worse?

As President Obama said -- we've made huge strides in reducing smoking, drunk driving, and other public health problems through a policy approach that stresses prevention and changing public attitudes about dangerous behavior. There's no reason we can't build on those successes and achieve the same results with drug use and its consequences. The Administration's National Drug Strategy provides the roadmap. Now we just need to do the hard work to follow it.

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