Drug use is down over the last 25 years, but a half million Americans are in prison for drug offenses. How should success be measured?

America is either winning the war on drugs or losing it badly, depending on whom you ask.

The fact that the answers vary so widely raises the question, How should success or failure be measured? As part of its focus on crime and punishment, the Bulletin put that query to several HLS alumni who figure prominently in the national debate over drug policy, across the political spectrum.

Ethan Nadelmann '84

Credit: John Goodman Ethan Nadelmann ’84 of the Drug
Policy Alliance

For Ethan Nadelmann ’84, head of the Drug Policy Alliance, a New York City-based policy and lobbying group dedicated to a less punitive approach to drug policy, the answer lies in the social and economic costs of a strategy that he believes has put too many in jail or prison and done little to reduce the availability of drugs. Of the approximately 2 million people behind bars in the U.S., he notes, about 500,000 are there for drug-law violations–more than the total number of people jailed for all criminal offenses in Western Europe, although the U.S. has 100 million fewer people.

“If we’re lucky, our grandchildren will recall the global war on drugs of the late 20th and early 21st centuries as some bizarre mania,” says Nadelmann. “The true challenge is learning to live with drugs so that they cause the least harm. An effective strategy needs to establish realistic objectives and criteria for evaluating success or failure, and must focus on reducing the death, disease, crime and suffering associated with both drug use and drug policies.”

Nadelmann and the DPA favor legalizing marijuana and treating it like alcohol–a commodity, he says, that’s taxed and regulated with prescribed minimum legal ages for use. Working primarily at the state level, Nadelmann and his group have been successful in a variety of ballot initiatives dealing with medical use of marijuana and treatment instead of incarceration (for nonviolent offenders charged with possession). The DPA’s single biggest victory, he says, has been the passage of California’s Proposition 36, in 2000, which requires treatment in place of incarceration for many drug possession offenders and has already kept close to 100,000 people from going to jail or prison. “We doubled money for drug treatment while simultaneously saving taxpayers money by reducing prison populations,” he notes. “We’re now taking that model around the rest of the country.”

Nadelmann has also been successful in pushing for needle-exchange programs, which now exist in nearly half the states. Neither Congress nor any presidential administration has taken federal action promoting such programs even though the public health world is nearly unanimous in its assessment that they significantly reduce the spread of HIV.

“At the state level, people have to deal with the fact that HIV and hepatitis are spreading; it’s going to add to hospital costs,” Nadelmann says. “They have to deal with the fact that building new prisons and new jails is a major cost. When you get to the national level in Washington, that’s where you see a lot more of the rhetoric, a lot more of the disregard for both the human cost and the fiscal cost of the policy.”

William Bennett '71

Credit: Kim Kulish/Corbis William Bennett ’71, drug czar under President George H.W. Bush

William Bennett ’71, drug czar under President George H.W. Bush, and secretary of education under President Reagan, takes a very different approach to measuring the success of national drug policy. “You measure [success] by overall, current drug use,” he argues. “Other good measures include city-by-city emergency room admission rates and [looking] to the culture–how is drug use depicted in the movies and in television?” By all of these yardsticks, he believes, the war on drugs declared by President Nixon more than 30 years ago is succeeding.

He points to a study sponsored by the U.S. Department of Health and Human Services, which shows that in 1999, 14.8 million Americans were drug users, down from the 1979 peak of 25 million users.

As drug czar, Bennett was a vehement advocate of the punitive approach, and he continues to support it today. He is untroubled by the number of people in prison for drug offenses. “Most people are in prison for multiple offenses, including illegal drug use,” he contends. “Some people plead down to a drug use conviction when a lot of other charges brought them to the prosecution in the first place. Very few people are in prison for drug use alone.”

Nevertheless, even Bennett believes that, for some offenders, penalties besides prison should be explored: “[We should] consider revoking privileges and licenses–drivers’ licenses, realty licenses–bar memberships and so on.”

Asked about proposals for decriminalizing marijuana use, Bennett answers emphatically: “No. Marijuana is the most abused drug because it is the most used drug. More children are in treatment for marijuana than for all other drugs.”

View More

Rx for a public health problem

A public-private partnership at HLS looks to limit illegal Internet drug sales

Recent studies show an alarming spike in illegal Internet sales of Vicodin, OxyContin and other highly addictive or dangerous drugs to teenagers who don’t have prescriptions.

Read more.

Somewhere between Nadelmann and Bennett is Joseph A. Califano Jr. ’55, President Carter’s secretary of health, education and welfare and currently the chairman and president of the National Center on Addiction and Substance Abuse at Columbia University. Like Bennett, Califano believes that decriminalization of drugs is a dangerous idea and that the criminal justice system must continue to handle drug users with a firm hand. But he has opposed some of the tough mandatory minimum sentences for drug offenses and says we can do much better in prevention through education.

Legalization or decriminalization, he believes, would make drugs more available to children, and overall use would increase.

“Marijuana is particularly harmful to children and young teens,” Califano said in a written statement to the Bulletin. “It can impair short-term memory and ability to maintain attention span; it inhibits intellectual, social and emotional development, just when young people are learning in school. [There is] a powerful statistical correlation between using marijuana and use of other drugs such as heroin and cocaine.” Twelve- to 17-year-0lds who smoke marijuana are 85 times more likely to use cocaine than those who do not, he says.

“Legalizing drugs not only is playing Russian roulette with children,” Califano said. “It is slipping a couple of extra bullets into the chamber.”

Drug policy, he believes, should focus on initiatives such as neighborhood- and school-based programs aimed at high-risk 8- to 13-year-olds. He also favors outreach programs specifically tailored to particular categories of people who may abuse substances for very different reasons and in very different patterns, such as mothers on welfare, families torn by domestic abuse, families living in public housing, college students and people with HIV.

He sees the medical marijuana initiatives, the push for reduced sentences and the needle-exchange programs as vehicles to pave the way for the reformers’ true goal: broad drug legalization.

But Nadelmann rejects the claim that decriminalization of marijuana is a Trojan horse for a broader legalization agenda. With regard to decriminalizing other drugs, such as heroin, cocaine and methamphetamines, he says, “A majority of my organization and my board and the drug-policy reform movement as a whole are basically very cautious. We basically don’t support that.” But, he adds, he and his group support an elimination of prison time or severe punishment for possession of small quantities for personal use.

He also believes that opinion polls are “trending our way.” Majorities of Americans now favor decriminalization of marijuana, treatment instead of incarceration for many drug offenses, elimination of police asset-forfeiture powers and needle-exchange programs, he says.

Maybe so, but few national politicians have jumped on the bandwagon. One who has is Kurt Schmoke ’76, who, as mayor of Baltimore from 1987 to 1999, argued for decriminalization of marijuana and for a radical rethinking of national drug policy. The war on drugs, Schmoke has said, is America’s “domestic Vietnam.”

“The problem of substance abuse is more a public health problem than a criminal justice problem,” he says. “The drug traffickers can be beaten and the public health of the United States can be improved if we are willing to substitute common sense for rhetoric, myth and blind persistence,” he wrote. Schmoke worked with Nadelmann in developing a needle-exchange program in Baltimore when he was mayor. Are such programs making a difference?

“I think they are,” Schmoke says. “But it’s simply a long and difficult process because there are some people who believe that it’s just morally wrong. Forget whether the war on drugs is actually effective or not; they would say that it’s morally wrong to legalize drugs that are currently illegal.”

Perhaps the best-known spokesman for that view is Bennett, who is buoyed by a recent study showing a slight dip in drug use among high school students. “People should associate drug use with a penalty,” he maintains. “We need an unambiguous message.”

Dick Dahl contributed to this story.