Toward a Policy on Drugs

...and no one seriously doubts that legalization would indeed increase availability, and probably lower prices for many drugs...

...Other studies have found that for many addicts, drug use and crime seem to have begun more or less independently without one clearly causing the other...

...they're the author's responsibility...

...And it would not solve the drug problem...

...Most of the street addicts in this study were "primarily thieves and small-scale drug distributors who avoided serious crimes, like robbery, burglary, assault...

...If we take the harms of drug abuse seriously, and I think we must, we cannot avoid being deeply concerned about anything that would significantly increase the availability of hard drugs within the American social context...

...That is the social reality that the rather abstract calls for the legalization of hard-drug sales tend to ignore...

...We would expect, therefore, that a free-market policy applied to hard drugs would produce the same results it has created with the legal killer drugs, tobacco and alcohol—namely, a widening disparity in use between the better-off and the disadvantaged...

...Higher levels of drug use do go hand in hand with increased crime, especially property crime...

...But even before they were addicted, they averaged 573 crime days, and 491 after their addiction had ended...

...Even if we exclude the more than 20 million people who used marijuana in the past year, the number of hard-drug users is enormous: the survey estimates over six million cocaine users in 1991 (including over a million who used crack), about 700,000 heroin users, and 5.7 million users of hallucinogens and inhalants...

...What makes the drug problem so resistant to even very heavy doses of criminalization is that neither mechanism works effectively for most drug offenders—particularly those most heavily involved in the drug subcultures of the street...

...Please use inclusive language so that we don't have to make adjustments during editing...

...This pattern has been best illuminated in the study of Harlem heroin addicts by Bruce Johnson and his co-workers...

...A small-scale experiment in cocaine prescription is presently being tried in the city of Liverpool...

...It is not only that crime may precede drug use, especially heavy or addictive use, or that both may emerge more or less independently...

...In this view it is precisely the illegality of drug use that is responsible for drug-related crime — which, in turn, is seen as by far the largest part of the overall problem of urban violence...

...It is among the poor and near-poor that offsetting measures like education and drug treatment are least effective and where the countervailing social supports and opportunities are least strong...

...Their experience suggests that a different and more humane criminal-justice response to drugs is both possible and practical...

...Look at our last few issues to see if your idea fits in...

...If there's a delay, it's because a few editors are reading your article...

...While alcoholics seemed to become involved in crime as a result of their abuse of alcohol, more than half of the heroin addicts (versus just 5 percent of the alcoholics) "were known to have been delinquent before drug abuse...

...Much more of this would alter the character of American society beyond recognition...

...Much of that clash is about philosophical principles, and addressing those issues in detail would take more space than we have...

...Copyright © 1993 by Elliott Currie...

...And they continued to commit crimes —often violent ones—long after they had ceased to be addicted to narcotics...

...At a conservative estimate of about $100,000 per cell, that means a $30 billion investment in construction alone...

...For if the goal is to prevent the drug dealing and other crimes that addicts commit, the remedy may literally cost more than the disease...

...Today the criminal-justice system does very little of the first and not enough of the second...

...As we're not an academic journal, we prefer that they, wherever possible, be dropped altogether or worked into the text...

...The average income per nondrug crime among these addicts was $35...

...But there is more technical evidence as well...

...And that disparity is already stunning...

...As we've seen, however, a key finding of most of the research into the meaning of drug use and the growth of drug subcultures since the 1950s has been that the purely pharmacological craving for drugs is by no means the most important motive for drug use...

...One response to the failure of the drug war has been to call for more of what we've already done—even harsher sentences, still more money for jails and prisons—on the grounds that we have simply not provided enough resources to fight the war effectively...

...Consider the estimates of the number of people who have used drugs during the previous year provided annually by the NIDA (National Institute on Drug Abuse) Household Survey —which substantially understates the extent of hard-drug use...

...But these are seen as necessary, if sometimes grudging, exceptions to the general rule that private drug transactions should not be the province of government intervention...

...This is a tall order, but, as we shall see, something similar is being practiced in many countries that suffer far less convulsing drug problems than we do...

...4) Notes and footnotes should also be typed double-spaced, on a separate sheet...

...Yet this would leave the majority of drug dealers and hard-core addicts still on the streets and, of course, would do nothing to prevent new ones from emerging in otherwise unchanged communities to take the place of those behind bars...

...That shouldn't surprise us in the 1990s...

...To be sure, these figures obscure the fact that many prisoners behind bars for nondrug offenses are also hard-core drug users...

...And where drug addiction is truly endemic, the disparity is greater...

...The point is that—as the early drug researchers discovered in the 1950s—both crime and drug abuse tend to be spawned by the same set of unfavorable social circumstances, and they inter70 • DISSENT act with one another in much more complex ways than the simple addiction-leads-to-crime view proposes...

...First, however, we need to step back in order to sort out exactly what we mean by "legalization" —a frustratingly vague and often confused term that means very different things to different interpreters...

...Why wouldn't more of the same do the job...

...The most troubling group of addicts—what the researchers called "violent generalists" — were only about 7 percent of the total sample, but they were extremely active—and very dangerous...

...Even among the most criminally active group—what these researchers called "robberdealers" —the annual income from crime amounted on average to only about $21,000, and for the great majority—about 70 percent —of less active addict-criminals, it ranged from $5,000 to $13,000...

...We will not consider manuscripts submitted simultaneously to several publications...

...Though drug use remains technically illegal, Dutch policy is to focus most law-enforcement resources on sales, especially on larger traffickers, while dealing with users mainly through treatment programs and other social services, rather than the police and courts...

...they accounted for over half of all the violent crimes committed by the entire sample...

...Here the free-market view fails to convince...

...Yet no other country has anything resembling the American drug problem...

...It is difficult to imagine why a similar rise in consumption—and in the associated public-health problems—would not follow the full-scale legalization of cocaine, heroin, methamphetamine, and PCP (not to mention the array of as yet undiscovered "designer" drugs that a legalized corporate drug industry would be certain to develop...

...Advocates of this position run the gamut from right-wing economists to some staunch liberals, united behind the principle that government has no business interfering in individuals' choice to ingest whatever substances they desire...

...For all of these reasons, it is argued, outlawing drugs has the unintended, but inevitable, effect of causing a flood of crime and urban violence that would not exist otherwise and sucking young people, especially, into a bloody drug trade...

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...If we cannot expect much from intensified criminalization, would the legalization of hard drugs solve the drug crisis...

...Still another meaning sometimes given to legalization is what is more accurately called the "decriminalization" of drug use...

...Although drug addicts do commit a great deal of crime, most of them are very minor ones, mainly petty theft and small-time drug dealing...

...But doing these things well will require far-reaching changes in our priorities...

...Methadone prescription, of course, does not "legalize" heroin, and the possession or sale of methadone itself is highly illegal outside of the strictly controlled medical relationship...

...According to a recent study by Colin McCord and Howard Freeman of Harlem Hospital, between 1979 and 1981—that is, before the crack epidemic of the eighties—Harlem blacks were 283 times as likely to die of drug dependency as whites in the general population...

...My aim here is simply to examine the empirical claims of the free-market perspective in the light of what we know about the social context of drug abuse...

...Some variant of that approach is more prominent in drug-policy debates in the United States than in other developed societies, probably because it meshes with a strongly individualistic and antigovernment political culture...

...A growing body of research, for example, shows that most alcoholrelated health problems, including deaths from cirrhosis and other diseases, were far lower during Prohibition than afterward, when per capita alcohol consumption rose dramatically (by about 75 percent, for example, between 1950 and 1980...

...it is also likely that there are several different kinds of drugs-crime connections among different types of drug users...

...Just as we cannot punish our way out of the drug crisis, neither will we escape its grim toll by deregulating the drug market...

...as the researchers put it, they tended to be either "dealers or stealers," but rarely both...

...Something close to this is the practice in Holland, which is often wrongly perceived as a country that has legalized drugs...

...The practice of dispensing methadone to heroin addicts came into wide use in the United States in the 1960s and remains a major form of treatment...

...A German court has recently ruled that possession of small amounts of hashish and marijuana is not a crime, and, indeed, marijuana possession has largely been decriminalized in some American states, though usually as a matter of practical policy rather than legislation...

...If consumption increased, it would almost certainly increase most among the strata already most vulnerable to hard-drug use—thus exacerbating the social stratification of the drug crisis...

...To triple the number of users and low-level dealers behind bars, even putting two 66 • DISSENT drug offenders to a cell, would require about 300,000 new cells...

...Criminal sanctions against drugs, as one observer insists, "cause the bulk of murders and property crime in major urban areas...

...But the evidence suggests that although this view contains an element of truth, it is far too simplistic—and that it relies on stereotypical assumptions about the relationship between drugs and crime that have been called into serious question since the classic drug research of the 1950s...

...I do not think that either approach takes sufficient account of the social realities of drug abuse...

...Others were involved in illegal gambling and what the researchers called "deception crimes" —including forgery and con games—and a relatively small percentage had engaged in violent crime...

...On the whole, addicts heavily involved in one type of crime were not likely to be involved in others...

...But a closer look shows that things are considerably more complicated...

...We will never, for reasons that will shortly become clear, punish our way out of the drug crisis...

...Simply providing drugs more easily to people enmeshed in the drug cultures of the cities is not likely to cut the deep social roots of addict crime...

...It confirms that much (though, of course, not all) of the harm caused by endemic drug abuse is intrinsic to the impact of hard drugs themselves (and the street cultures in which drug abuse is 68 • DISSENT embedded) within the context of a glaringly unequal, depriving, and deteriorating society...

...And please remember that we can't return articles unless they're accompanied by a stamped, self-addressed envelope...

...Under the so-called British system, addicts could receive heroin from physicians or clinics—but the private production and distribution of heroin was always subject to strong penalties, as was the use of the drug except in its medical or "pharmaceutical" form...

...Like earlier researchers, they found that most addicts committed large numbers of crimes—mainly drug dealing and small-scale property crime, notably shoplifting, burglary, and fencing...

...The most important argument for a freemarket approach has traditionally been that it would reduce or eliminate the crime and violence now inextricably entwined with addiction to drugs and with the drug trade...

...The free-market approach, on the other hand, is another matter entirely...

...Nurco and his colleagues measured the addicts' criminal activity by what they called "crime days" per year...

...Check all your figures, dates, names, etc...

...3) Type your ms double-spaced, with wide margins...

...The main reason why incapacitation is unworkable as a strategy against drug offenders is that there are so many of them that a serious attempt to put them all—or even just the "hard core" —behind bars is unrealistic, even in the barest fiscal terms...

...Drugs will always be a "law-enforcement problem" in part, and the real job is to define what we want the police and the courts to accomplish...

...This is obvious if we pause to recall the sheer number of people who use hard drugs in the United States...

...That position is shared by the Bush administration and many Democrats in Congress as well...

...Nor is it clear that those cravings are typically so uncontrollable that addicts are in any meaningful sense "driven" to crime to satisfy them...

...In particular, the widely held notion that most of the crime committed by addicts can be explained by their need for money to buy illegal drugs does not fit well with the evidence...

...Drug deaths, combined with deaths from cirrhosis, alcoholism, cardiovascular disease, and homicide, helped to give black men in Harlem a shorter life expectancy than men in Bangladesh...

...To understand why, we need to consider the claims for legalization's effects in the light of what we know about the roots and meanings of endemic drug abuse...

...Or take a chance and send us your article...

...Indeed, the most active group of violent generalists engaged in more crime prior to addiction than any other group did while addicted...

...6) Please bear with us—we have accumulated quite a backlog of material, and you may have to wait for a few issues before you see your article in print...

...If we take as a rough approximation that about 25 percent of America's prisoners are behind bars for drug offenses, that gives us roughly 300,000 drug offenders in prison at any given point—and this after several years of a hugely implemented war mainly directed at lower-level dealers and street drug users...

...Thus, though we cannot quantify these proportions with any precision, the basic point should be clear: the pool of serious addicts and active dealers is far, far larger than the numbers we now hold in prison—even in the midst of an unprecedented incarceration binge that has made us far and away the world's leader in imprisonment rates...

...since on any given day they might have committed more than one type of crime, the resulting figure could add up to more than the number of days in the year...

...In between, there is a range of more promising strategies— what some Europeans call a "third way" —that is more attuned to those realities and more compatible with our democratic values...

...But proponents of full-scale deregulation of hard drugs also tend to gloss over the very real primary costs of drug abuse—particularly on the American level—and to exaggerate the degree to which the multiple pathologies surrounding drug use in America are simply an unintended result of a "prohibitionist" regulatory policy...

...Certainly, many addicts mug, steal, or sell their bodies for drugs...

...For reasons that will become clear, decriminalization is not a panacea...

...If we legalize the sale and use of hard drugs, the roots of drug-related violence would be severed, and much of the larger crisis of criminal violence in the cities would disappear...

...In turn, increased availability—as we know from the experience with alcohol—typically leads to increased consumption, and with it increased social and public-health costs...

...But those are not the only alternatives...

...Putting these numbers together, Johnson and his co-workers came to the startling conclusion that it would cost considerably more to lock up all of Harlem's street addicts than to simply let them continue to "take care of business" on the street...

...and both, consequently, exaggerate the role of regulatory policies in determining the shape and seriousness of the problem...

...David Nurco of the University of Maryland and his colleagues, for example, studying heroin addicts in Baltimore and New York City, found that nine different kinds of addicts could be distinguished by the type and severity of their crimes...

...What would it mean to expand our prison capacity enough to put the majority of hard-core users and dealers behind bars for long terms...

...Many, indeed, who argue most vehemently one way or the other about the merits of legalization are not really clear just what it is they are arguing about...

...Nor is there much question that this argues for a root-and-branch rethinking of our current punitive strategy —to which we'll return later in this essay—especially our approach to drug users...

...This was the finding, for example, in Charles Faupel and Carl Klockars's study of hard-core heroin addicts in Wilmington, Delaware...

...it has, after all, been a central argument of drug research since the 1950s...

...We have seen what this flood of offenders has done to the nation's courts and prisons, but what is utterly sobering is that even this massive effort at repression has barely scratched the surface: according to the most optimistic estimate, we may at any point be incarcerating on drugrelated charges about one-eighth of the country's hard-core cocaine and heroin abusers...

...principles: the reintegration of drug abusers into productive life, the reduction of harm, and the promotion of community safety...

...Criminologists distinguish between two mechanisms by which punishment may decrease illegal behavior...

...Above all, we will have to shift from an approach in which discouraging drug use through punishment and fear takes central place to one that emphasizes three very different Excerpted from RECKONING: Drugs, the Cities, and the American Future, by Elliott Currie, published this month by Hill & Wang, a division of Farrar, Straus & Giroux, Inc...

...But the strategy of upping the ante cannot work...

...All of our respondents," they note, "reported some criminal activity prior to their first use of heroin...

...Addicts were asked how many days they had committed each of several types of crime...

...Thus, for example, heroin addicts in Ball's study in Baltimore had an average of 255 "crime days" per year when they were actively addicted, versus about 65 when they were not...

...Most who subscribe to that general view would add several qualifiers: for example, that drugs (like alcohol) should not be sold to minors, or that drug advertising should be regulated or prohibited, or (less often) that drugs should be sold only in government-run stores, as alcohol is in some states...

...There is no question that the criminalization of drugs produces negative secondary consequences — especially in the unusually punitive form that criminalization has taken in the United States...

...About 6 percent of the addicts, moreover, were "uninvolved" —they did not commit crimes either while addicted or before, or during periods of nonaddiction interspersed in the course of their longer addiction careers...

...In general, the level of property crime appears in these studies to go up simultaneously with increasing intensity of drug use...

...Moreover, they are forced to seek out actively criminal people in order to obtain their drugs, which exposes them to even more destructive criminal influences...

...Moreover, "perhaps most importantly, virtually all of our respondents reported that they believed that their criminal and drug careers began independently of one another, although both careers became intimately interconnected as each evolved...

...none of this is to deny that serious addiction to heroin or other illegal drugs can accelerate the level of crime among participants in the drug culture, or stimulate crime even in some users who are otherwise not criminal...

...For present purposes, I will call this the "free-market" approach to drug control, and describe its central aim as the "deregulation" of the drug market...

...but the figures are skewed in the other direction by the large (if unknown) number of active drug dealers who are not themselves addicted...

...At one end of the spectrum are those who mean by legalization the total deregulation of the production, sale, and use of all drugs—hard and soft...

...Let me make my own view clear...

...Because criminalization makes drugs far more costly than they would otherwise be, addicts are forced to commit crimes in order to gain enough income to afford their habits...

...Moreover, revealingly, the violent generalists were very active in serious crime before they became addicted to narcotics as well as during periods of nonaddiction thereafter —again demonstrating that the violence was not dependent on their addiction itself...

...No: it would not...

...And we can use law enforcement, in small but significant ways, to help strengthen the ability of drug-ridden communities to defend themselves against violence, fear, and demoralization...

...George Vaillant's follow-up study of addicts and alcoholics found, for example, that, unlike alcoholics, heroin addicts had typically been involved in delinquency and WINTER • 1993 • 69 crime well before they began their career of substance abuse...

...One explanation, and perhaps the most common one, is that the increased need for money to buy drugs drives addicts into more crime...

...The rates were highest during periods when they were heavily addicted to drugs...

...All rights reserved...

...We can, however, use the criminaljustice system, in small but significant ways, to improve the prospects of drug users who are now caught in an endless loop of court, jail, and street...

...Another aspect of Dutch policy illustrates a further possible meaning of legalization: we may selectively decriminalize some drugs, in some amounts, and not others...

...I think much would be gained if we followed the example of some European countries and moved toward decriminalization of the drug user...

...I also think there is a strong argument for treating marijuana differently from the harder drugs, and that there is room for careful experiment with strictly controlled medical prescription for some addicts...

...2) Please don't write to ask whether we're interested in such and such an article—it makes for useless correspondence...

...But that does not mean that the justice system has no role to play in a more effective strategy against drugs...

...A federal survey of drug use among prison inmates in 1986, similarly, found that three-fifths of those who had ever used a "major drug" regularly —that is, heroin, cocaine, methadone, PCP, or LSD—had not done so until after their first arrest...

...On the surface, there is much to suggest a strong link between crime and the imperatives of addiction...

...We've seen that the effort to contain the drug problem through force and fear has already distorted our justice system in fundamental ways and caused a rippling of secondary costs throughout the society as a whole...

...By 1989 there were roughly 20,000 drug offenders on any given day in New York State's prisons, but there were an estimated 200,000 to 250,000 heroin addicts in New York City alone...

...The other is "deterrence," by which we mean either that people tempted to engage in the behavior will be persuaded otherwise by the threat of punishment ("general deterrence"), or that individuals, once punished, will be less likely to engage in the behavior again ("specific deterrence...

...The Dutch, in practice— though not in law —have tolerated both sale and use of small amounts of marijuana and hashish, but not heroin or cocaine...

...Something like this "medical model," in varying forms, guided British policy toward heroin after the 1920s...

...In its popular form, the drugs-cause-crime argument is implicitly based on the assumption that addict crime is caused by pharmacological compulsion —as a recent British study puts it, on a kind of "enslavement" model in which the uncontrollable craving for drugs forces an otherwise law-abiding citizen to engage in crime for gain...

...At the same time, the fact that the drug trade is illegal means both that it is hugely profitable and that the inevitable conflicts and disputes over "turf " or between dealers and users cannot be resolved or moderated by legal mechanisms, and hence are usually resolved by violence...

...and even to attempt it on a large scale would WINTER • 1993 • 65 dramatically increase the social costs that an overreliance on punishment has already brought...

...If we then assume an equally conservative estimate of about $25,000 in yearly operating costs per inmate, we add roughly $15 billion a year to our current costs...

...It is not entirely clear, moreover, what that huge expenditure would, in fact, accomplish...

...A few suggestions: (1) Be sure to keep a copy of your manuscript—the mails aren't always reliable...

...Today, as the drug problem has worsened, the limits of the law are if anything even clearer...

...Another approach would not 47,o so far as to deregulate the drug trade, but would opt for the controlled dispensation of drugs to addicts who have been certified by a physician, under strict guidelines as to amounts and conditions of use...

...That alone should tell us that more than prohibition is involved in shaping the magnitude and severity of our drug crisis...

...It greatly exaggerates the benefits of deregulation while simultaneously underestimating the potential costs...

...Today, there is much debate about the role of the justice system in a rational drug policy—but for the most part, the debate is between those who would intensify the effort to control drugs through the courts and prisons and those who want to take drugs out of the orbit of the justice system altogether...

...At the same time, the researchers estimated that the average cost per day of confining one addict in a New York City jail cell was roughly $100, or $37,000 a year...

...Since the seventies, the British have largely abandoned WINTER • 1993 • 67 prescribing heroin in favor of methadone—a synthetic opiate that blocks the body's craving for heroin but, among other things, produces less of a pleasurable "high" and lasts considerably longer...

...Even if we abandon the aim of imprisoning less serious hard-drug users, thus allowing the most conservative accounting of the costs of incapacitation, the problem remains staggering: by the lowest estimates, there are no fewer than two million hard-core abusers of cocaine and heroin alone...

...To understand why escalating the war on drugs would be unlikely to make much difference— short of efforts on a scale that would cause unprecedented social damage—we need to consider how the criminal-justice system is, in theory, supposed to work to reduce drug abuse and drug-related crime...

...One is "incapacitation," an unlovely term that simply means that locking people up will keep them—as long as they are behind bars —from engaging in the behavior we wish to suppress...

...The studies of addict crime by John Ball and Douglas Anglin and their colleagues show not only that the most heavily addicted commit huge numbers of crimes, but also that their crime rates seem to increase when their heroin use increases and to fall when it declines...

...We may continue to define the production and sale of certain drugs as crimes and subject them to heavy penalties, but not punish those who only use the drugs (or have small amounts in their possession), or punish them very lightly—with small fines, for example, rather than jail...

...No dot matrix submissions, please...

...Indeed, the degree to which the debate over drug policy has been dominated by the clash between fervent drug "warriors" and equally ardent free-market advocates is a peculiarly American phenomenon...

...5) We're usually quick in giving editorial decisions...

...More recent research shows that the drugscrime relationship may be even more complex than this suggests...

...To begin with, it is a recurrent finding that most people who both abuse drugs and commit crimes began committing the crimes before they began using drugs—meaning that their need for drugs cannot have caused their initial criminal involvement (though it may have accelerated it later...

...The violent generalists averaged an astonishing 900 crime days a year over the course of their careers...

...And it affirms that we will not substantially reduce that harm without attacking the social roots of the extraordinary demand for hard drugs in the United States...

...it will not end the drug crisis, but it could substantially decrease the irrationality and inhumanity of our present punitive war on drugs...

...No country now legalizes the sale of hard drugs...

...THE EDITORS WINTER • 1993 • 71...