A drug policy is the policy, usually of a government, regarding the control and regulation of drugs considered dangerous, particularly those that are addictive. Drug policy reform, also known as drug law reform, is any proposed changes to the way governments respond to the socio-cultural influence on perception of. Our mission is to formulate policy on anti-drug matters and to co-ordinate anti- drug efforts in law enforcement, preventive education, research, international.
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Yet hard drug prices are currently near their all-time lows. The most widely debated example is needle exchange, which aims to reduce the transmission of HIV and other infectious organisms that can occur when intravenous drug users share needles. The question always is whether and to what extent such reductions in risk would be offset or more than offset by increases in the extent of illicit drug taking.
Reducing the risk of harm associated with any given pattern of drug-taking is not the same thing as reducing the aggregate level of harm. Thus, whether a given harm reduction policy increases or decreases total damage depends on the details of the program and the circumstances.
So far, the advocates of use reduction have had very much the better of the political confrontation. And legalization remains the great bogeyman of the drug policy debate. The dominance of the use-reduction viewpoint is illustrated and reinforced by the extent to which measures of prevalence-the total number of drug users-dominate public discussion of the effectiveness of current drug policies. The two big national surveys paid for the federal government, the Monitoring the Future study of high school students done by the University of Michigan and the National Household Survey on Drug Abuse done by the Research Triangle Institute, each ask people to volunteer information about their own drug use.
But prevalence is only one measure, and probably not even a very important one, of the size of the problem or the success of our control efforts. Prevalence in the use of any drug is a poor proxy measure for aggregate damage. Most users of most drugs cigarettes and heroin are the prominent exceptions are occasional users, suffering little damage, doing little damage to others, and contributing little-even in the aggregate-to the revenues of the illicit markets.
Moreover, no one would argue that an occasional marijuana smoker by far the most common variety of illicit drug user faces personal risks or creates problems for others that are comparable to the personal risks and social problems created by frequent high-dose crack use. But by taking the total user count as the measure of success, we implicitly give the two cases equal weight. Although public opinion is strongly on the drug warrior side of the debate, public concern about drug abuse does not in fact track data about drug use prevalence.
In the late s, when the total number of illicit drug users reached its peak, drug abuse was barely on the national radar screen. The goal of drug policy ought to be to minimize the aggregate damage created by drug taking, drug trafficking, and the enforcement effort. That is, we ought to judge drug control efforts as we judge other public policies: The major barrier to more effective drug-control policies is that effectiveness, measured in terms of damage control, has not been at the center of policymaking in this arena.
First, applying a damage standard would expand our focus to include licit drugs such as alcohol and tobacco, which, precisely because they are more widely used, cause much more aggregate damage than any illicit drug.
Second, within the realm of the illicit drugs, a damage standard would prompt us to concentrate our efforts on frequent high-dose users, especially those whose addiction to expensive drugs leads them into criminal activity, rather than occasional marijuana smokers and other casual users. A damage standard would also require us to pay as much attention to the side effects of drug trafficking, especially violence and the enticement of juveniles into illicit activity, as to the damage done by the actual consumption of illegal drugs, and to count the financial and social costs of enforcement and imprisonment.
Thinking about juvenile drug abuse while ignoring alcohol and nicotine is like studying oceans while ignoring the Atlantic and the Pacific. If our goal is to protect children from the damage they can do to themselves by abusing psychoactive chemicals, we need to concentrate on the licit drugs, which are by far the greatest threats.
Relatively few adolescents are heavy smokers; the habit takes time to develop. But about a quarter of high-school seniors do smoke, and most of them will go on to months, if not years, of heavy daily smoking.
Heavy smoking, in turn, roughly doubles the mortality rate at any given age. As for alcohol, its prevalence among high-school seniors approaches universality 87 percent. According to the most recent Monitoring the Future study, more high school seniors had gone on a drinking binge defined as more than five drinks at a sitting in the previous two weeks 31 percent than had used any illicit drug in the previous month 23 percent.
In this context, the political fixation on marijuana use among children seems bizarre. Of course, marijuana can pose a significant threat to children but not primarily because it leads to hard drugs, as the so-called gateway hypothesis holds.
The vast majority of juveniles who use marijuana do not go on to use other illicit drugs, as both national surveys demonstrate, and the causal significance, if any, of the statistical association between early marijuana use and subsequent use of cocaine and heroin remains open to debate. Instead, the major risk is that marijuana use itself will turn into a hard-to-break habit.
This happens far more often than many people believe. Nearly 40 million Americans are addicted to tobacco and about 22 million people suffer from either alcohol dependency or its less severe form, alcohol abuse.
Drinking and drunken behavior exact a terrible toll. Surveys of offenders under criminal justice supervision show that 40 percent of them had been drinking at the time they committed the offense that led to their convictions; and alcohol involvement in some categories of violent offenses, including murder and, especially domestic violence and hate crime, is even higher. Alcohol is also a substantial risk factor for being a victim of a violent crime. Alcohol also contributes to risky sexual behavior.
In the furor over the use of the drug flunitrazepam Rohypnol in date rapes, almost no one mentioned the much larger role of alcohol in creating the conditions not only for date rape but for unplanned and unprotected intercourse and the unwanted pregnancy and sexually transmitted disease that results from it. Although there is no careful scientific backup for the assertion that alcohol has been associated with more cases of HIV transmission than has heroin, it is almost certainly true.
The death toll from tobacco consumption is about , per year; from alcohol consumption, about , per year. Whether alcohol or tobacco should be considered the bigger threat depends on how one weighs chronic health damage against accidents, crimes, suicides, and irresponsible sexual behavior. Fortunately, we know exactly how to reduce smoking and drinking among juveniles: Make them more expensive.
Among feasible public actions to reduce adolescent substance abuse, only a similarly massive increase in alcohol taxation could conceivably create comparable benefits. The path to reducing illicit drug use among schoolchildren is less clear. We know a lot more than we used to about education to prevent drug abuse, and most of it is discouraging.
Most programs do much worse than that, and so far there is only scanty evidence that the most popular one of all, Drug Abuse Resistance Education DARE , has had any measurable effect whatsoever on drug use.
Its benefits in terms of police-community relations are a separate issue. Media-based prevention campaigns, such as the one recently launched with great fanfare by the federal government and the Partnership for a Drug-Free America, have proven much more successful at hardening antidrug attitudes among those uninterested in drugs in the first place than at changing the behavior of those actually at risk. A case could be made for replacing much of the explicit antidrug persuasion effort with a truly educational effort aimed more broadly at achieving self-control and at recognizing and avoiding health risk behaviors, if only we knew how.
According to the National Household Survey, fewer than 6 million people in the United States use illicit drugs other than marijuana. Because this survey does not include the homeless and prisoners and because illicit drug users are probably undercounted because of sample bias and response bias, the actual number is probably substantially higher, though there is no carefully developed published estimate.
Moreover, even for the hardest drugs-heroin, cocaine, and methamphetamine-long-term addiction is far from universal among users. Estimates combining survey results with the drug tests performed on a sampling of arrestees under the National Institute of Justice Arrestee Drug Abuse Monitoring program put the total number of hard drug addicts at any one time at fewer than 4 million.
This small group of hard-core hard-drug users, which accounts for about 80 percent of total consumption, creates a set of problems out of any proportion to their numbers. They suffer enormously and cause suffering around themselves. Their health problems are extensive, their behavior frequently obnoxious. Few of them can hold down steady jobs, though many work off and on. In addition to legal work, which is rarely the major source, this money comes from drug dealing, from theft, from prostitution, from relatives or lovers, and from income-support payments of various kinds.
Compared to addicts in Europe, where income-support payments are much more generous, U. Of the conventional tools of drug policy-prevention, enforcement, and treatment-only treatment has much relevance to controlling the problems of this group. Prevention is obviously too late for those who are already addicted.
Enforcement also appears to have little to offer. Policymakers have long believed that the demand for hard drugs is inelastic; that is, it is not sensitive to changes in price. Recent research as well as common sense contradicts this notion, suggesting that enforcement could curtail drug use if it succeeded in driving up prices. This encouraging finding, however, is offset by the discouraging fact that hard drug prices have proven remarkably insensitive to the massive increase in enforcement and punishment directed at drug dealing over the past two decades.
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The war on drugs is harming millions of us. Let's work together to end it. It's time for a new approach grounded in science, compassion, health and human rights. Current drug policies are failing. Worse, they're causing enormous harm to individuals and communities. Around the world, poorly designed drug laws that seek. Since , the RAND Drug Policy Research Center has conducted research to help decisionmakers in the United States and throughout the world address.