Still a war worth fight­ing

New anti-drug pol­icy is right to fo­cus on the pub­lic-health is­sue, but ...

Modern Healthcare - - Opinions Editorials - DAVID MAY As­sis­tant Man­ag­ing Edi­tor/Fea­tures

So the “war” is over. We’re talk­ing specif­i­cally about the long-run­ning war on il­le­gal drugs, first de­clared by Pres­i­dent Richard Nixon in 1971.

In a talk this month an­nounc­ing a fun­da­men­tal shift in drug pol­icy un­der the Obama ad­min­is­tra­tion, the nation’s new drug czar, Gil Ker­likowske, said that in­stead of an in­tense fo­cus on in­car­cer­a­tion and crim­i­nal­iza­tion—he would pre­fer we drop the phrase “war on drugs”—il­le­gal drug use will be treated more as a pub­lichealth is­sue. That means a re­newed em­pha­sis on pre­ven­tion, in­ter­ven­tion and treat­ment.

“Call­ing it a war re­ally lim­its your re­sources,” Ker­likowske said. “And, es­sen­tially, the great­est re­source in a war is some type of force. Look­ing at this as both a public­safety prob­lem and a pub­lic-health prob­lem seems to make a lot more sense.”

Heaven knows the crim­i­nal-jus­tice sys­tem has be­come choked with drug-re­lated cases—many that cer­tainly raise the ques­tion of whether the pun­ish­ment truly fits the crime.

At the same time, part of the pol­icy must in­clude con­tin­u­ing to take the fight to those who aren’t vic­tims of the pub­lic-health cri­sis. When it comes to the per­pe­tra­tors of the prob­lem, the pro­duc­ers, the traf­fick­ers, the gang­bangers, does any­body re­ally have a prob­lem with us­ing all the law-en­force­ment re­sources avail­able—“wag­ing war” if you will—in an ef­fort to save thou­sands of lives from the tragedy of ad­dic­tion and all the so­cial ills as­so­ci­ated with it?

We know that four decades of this war haven’t ex­actly pro­duced stun­ning re­sults for the nu­mer­ous pro­grams and ini­tia­tives that all the ad­min­is­tra­tions since Nixon have thrown at the prob­lem—to the tune of about $1 tril­lion and count­ing.

“In the grand scheme, it has not been suc­cess­ful,” Ker­likowske told the As­so­ci­ated Press in talk­ing about pre­vi­ous pol­icy. “Forty years later, the con­cern about drugs and drug prob­lems is, if any­thing, mag­ni­fied, in­ten­si­fied.”

Statis­tics sup­port that state­ment. We re­main a nation hooked on drugs, even though con­sump­tion is grad­u­ally trend­ing lower. Still, ac­cord­ing to the Of­fice of Na­tional Drug Con­trol Pol­icy, some 330 tons of co­caine, 110 tons of metham­phetamine and 20 tons of heroin are sold in the U.S. an­nu­ally, much of it smug­gled in. Es­ti­mates of mar­i­juana vol­ume, both smug­gled and do­mes­tic pro­duc­tion, are in the thou­sands of tons. And about 15 mil­lion Amer­i­cans are con­sumers of mar­i­juana, ac­cord­ing to a 2008 govern­ment re­port.

Mean­while, a 2002 es­ti­mate of the over­all eco­nomic cost of drug abuse was set at more than $180 bil­lion. Does any­body think that in 2010 that to­tal has done any­thing other than rise like smoke es­cap­ing from a crack pipe?

Given all those neg­a­tive num­bers, has the “war on drugs” been in vain? Of course not. No­body knows where this nation might be in the strug­gle over drug abuse if not for the many “sol­diers” who have been fight­ing in the trenches all these years—po­lice, clergy, civic lead­ers, health­care providers, to name just a few. The sit­u­a­tion could be far worse.

While it’s prob­a­bly cor­rect to say by all quan­ti­ta­tive mea­sures that lit­tle progress has been made in ac­tu­ally loos­en­ing the hold drugs have on this nation, what about those who were saved? What about those who did hear the re­lent­less anti-drug mes­sages and chose to “just say no”?

The bot­tom line here is that as long as de­mand for drugs stays strong, there will al­ways be the need for sup­ply and peo­ple will­ing to take great risks to de­liver the goods. Re­duce the num­ber of will­ful users and you chip away at the cri­sis. The Obama ad­min­is­tra­tion’s new pol­icy tar­gets this side of the equa­tion, which we ap­plaud.

It will al­ways be a bat­tle worth fight­ing.

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