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Race, Mass Incarceration, and the Disastrous War on Drugs

Unravelling decades of racially biased anti-drug policies is a monumental project.

• Nkechi Taifa
• Cutting Jail & Prison Populations
• Social & Economic Harm

This essay is part of the  Brennan Center’s series  examining  the punitive excess that has come to define America’s criminal legal system .

I have a long view of the criminal punishment system, having been in the trenches for nearly 40 years as an activist, lobbyist, legislative counsel, legal scholar, and policy analyst. So I was hardly surprised when Richard Nixon’s domestic policy advisor  John Ehrlichman  revealed in a 1994 interview that the “War on Drugs” had begun as a racially motivated crusade to criminalize Blacks and the anti-war left.

“We knew we couldn’t make it illegal to be either against the war or blacks, but by getting the public to associate the hippies with marijuana and blacks with heroin and then criminalizing them both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night in the evening news. Did we know we were lying about the drugs? Of course we did,” Ehrlichman said.

Before the War on Drugs, explicit discrimination — and for decades, overtly racist lynching — were the primary weapons in the subjugation of Black people. Then mass incarceration, the gradual progeny of a number of congressional bills, made it so much easier. Most notably, the 1984  Comprehensive Crime Control and Safe Streets Act  eliminated parole in the federal system, resulting in an upsurge of  geriatric prisoners . Then the 1986  Anti-Drug Abuse Act  established mandatory minimum sentencing schemes, including the infamous 100-to-1 ratio between crack and powder cocaine sentences.  Its expansion  in 1988 added an overly broad definition of conspiracy to the mix. These laws flooded the federal system with people convicted of low-level and nonviolent drug offenses.

During the early 1990s, I walked the halls of Congress lobbying against various omnibus crime bills, which culminated in the granddaddy of them all — the  Violent Crime Control and Safe Streets Act  of 1994. This bill featured the largest expansion of the federal death penalty in modern times, the gutting of habeas corpus, the evisceration of the exclusionary rule, the trying of 13-year-olds as adults, and 100,000 new cops on the streets, which led to an explosion in racial profiling. It also included the elimination of Pell educational grants for prisoners, the implementation of the federal three strikes law, and monetary incentives to states to enact “truth-in-sentencing” laws, which subsidized an astronomical rise in prison construction across the country, lengthened the amount of time to be served, and solidified a mentality of meanness.

The prevailing narrative at the time was “tough on crime.” It was a narrative that caused then-candidate Bill Clinton to leave his presidential campaign trail to oversee the execution of a mentally challenged man in Arkansas. It was the same narrative that brought about the crack–powder cocaine disparity, supported the transfer of youth to adult courts, and popularized the myth of the Black child as “superpredator.”

With the proliferation of mandatory minimum sentences during the height of the War on Drugs, unnecessarily lengthy prison terms were robotically meted out with callous abandon. Shockingly severe sentences for drug offenses — 10, 20, 30 years, even life imprisonment — hardly raised an eyebrow. Traumatizing sentences that snatched parents from children and loved ones, destabilizing families and communities, became commonplace.

Such punishments should offend our society’s standard of decency. Why haven’t they? Most flabbergasting to me was the Supreme Court’s 1991  decision  asserting that mandatory life imprisonment for a first-time drug offense was not cruel and unusual punishment. The rationale was ludicrous. The Court actually held that although the punishment was cruel, it was not unusual.

The twisted logic reminded me of another Supreme Court  case  that had been decided a few years earlier. There, the Court allowed the execution of a man — despite overwhelming evidence of racial bias — because of fear that the floodgates would be opened to racial challenges in other aspects of criminal sentencing as well. Essentially, this ruling found that lengthy sentences in such cases are cruel, but they are usual. In other words, systemic racism exists, but because that is the norm, it is therefore constitutional.

In many instances, laws today are facially neutral and do not appear to discriminate intentionally. But the disparate treatment often built into our legal institutions allows discrimination to occur without the need of overt action. These laws look fair but nevertheless have a racially discriminatory impact that is structurally embedded in many police departments, prosecutor’s offices, and courtrooms.

Since the late 1980s, a combination of federal law enforcement policies, prosecutorial practices, and legislation resulted in Black people being disproportionately arrested, convicted, and imprisoned for possession and distribution of crack cocaine. Five grams of crack cocaine — the weight of a couple packs of sugar — was, for sentencing purposes, deemed the equivalent of 500 grams of powder cocaine; both resulted in the same five-year sentence. Although household surveys from the National Institute for Drug Abuse have revealed larger numbers of documented white crack cocaine users, the overwhelming number of arrests nonetheless came from Black communities who were disproportionately impacted by the facially neutral, yet illogically harsh, crack penalties.

For the system to be just, the public must be confident that at every stage of the process — from the initial investigation of crimes by police to the prosecution and punishment of those crimes — people in like circumstances are treated the same. Today, however, as yesterday, the criminal legal system strays far from that ideal, causing African Americans to often question, is it justice or “just-us?”

Fortunately, the tough-on-crime chorus that arose from the War on Drugs is disappearing and a new narrative is developing. I sensed the beginning of this with the 2008  Second Chance Reentry  bill and 2010  Fair Sentencing Act , which reduced the disparity between crack and powder cocaine. I smiled when the 2012 Supreme Court ruling in  Miller v. Alabama  came out, which held that mandatory life sentences without parole for children violated the Eighth Amendment’s prohibition against cruel and unusual punishment. In 2013, I was delighted when Attorney General Eric Holder announced his  Smart on Crime  policies, focusing federal prosecutions on large-scale drug traffickers rather than bit players. The following year, I applauded President Obama’s executive  clemency initiative  to provide relief for many people serving inordinately lengthy mandatory-minimum sentences. Despite its failure to become law, I celebrated the  Sentencing Reform and Corrections Act  of 2015, a carefully negotiated bipartisan bill passed out of the Senate Judiciary Committee in 2015; a few years later some of its provisions were incorporated as part of the 2018  First Step Act . All of these reforms would have been unthinkable when I first embarked on criminal legal system reform.

But all of this is not enough. We have experienced nearly five decades of destructive mass incarceration. There must be an end to the racist policies and severe sentences the War on Drugs brought us. We must not be content with piecemeal reform and baby-step progress.

Indeed, rather than steps, it is time for leaps and bounds. End all mandatory minimum sentences and invest in a health-centered approach to substance use disorders. Demand a second-look process with the presumption of release for those serving life-without-parole drug sentences. Make sentences retroactive where laws have changed. Support categorical clemencies to rectify past injustices.

It is time for bold action. We must not be satisfied with the norm, but work toward institutionalizing the demand for a standard of decency that values transformative change.

Nkechi Taifa is president of The Taifa Group LLC, convener of the Justice Roundtable, and author of the memoir,  Black Power, Black Lawyer: My Audacious Quest for Justice.

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America’s War on Drugs Was Designed to Fail. So Why Is It Being Revived Now?

By: Nick Schou

Updated: September 1, 2018 | Original: June 16, 2017

While much of the media is focused on Trump’s Russian skullduggery, America has quietly found itself enmeshed in the worst drug epidemic in our history. Drug overdoses, mostly from increasingly lethal opioids , now kill more people than guns and traffic accidents. A recent investigation by The New York Times of local and state authorities across the country came to a staggering conclusion—that somewhere between 59,000 and 65,000 people died of drug overdoses in 2016, a nearly 20% spike in a single year, the paper estimates.

2017 is gearing up to be just as bad, or worse.

In the face of this crisis, Attorney General Jeff Sessions has re-declared the War on Drugs , a five-decade old boondoggle that civil-rights organizations, economists and even some law-enforcement groups believe to be discredited by years of failure. While it’s unclear exactly what Sessions is planning, so far he’s called for a crackdown on marijuana and longer mandatory sentences for drug dealers, seemingly intent on a return to policies that historically have ravaged entire communities, corrupted police forces and destroyed trust in authority—all in the name of fighting a war that opinion polls show the majority of the public doesn’t want.

But what most Americans don’t know is that our War on Drugs isn’t just a failed war; it’s one that was never designed to be won. To understand the true story of the origins of the War on Drugs is to understand why Trump’s return to some of its most controversial policies is doomed to fail.

President Nixon kickstarted America’s war on drugs in 1971 (he called it an “offensive”) and created the U.S. Drug Enforcement Administration (DEA) two years later. Ironically, or perhaps not, the war on drugs was conceived by criminals. Four of the main architects of Nixon’s drug policy—Attorney General John Mitchell, White House aide John Erlichman (who later allegedly admitted the war on drugs was really a war on hippies and black people), Egil Bud Krogh (who famously arranged for a drug-addled Elvis Presley to receive an honorary DEA badge) as well as Watergate break-in conspirator G. Gordon Liddy—were all imprisoned over Watergate.

But by the time Nixon declared a war on drugs, the real fighting had begun a decade earlier during America’s effort to overthrow Fidel Castro. In 1961, the CIA conspired with mobsters in Miami to assassinate Castro, whose revolution had put an end to the lucrative drug and vice networks operating on the island. Although the CIA-planned Bay of Pigs invasion failed, many of the agency’s Cuban assets survived; and after making their way back to Miami, they turned Southern Florida into an early epicenter of drug smuggling and drug-related violence.

Meanwhile, the CIA had simultaneously helped introduce LSD to the American populace via clandestine programs that dosed countless citizens—all part of a Cold War mind-control operation titled MK-Ultra. In Southeast Asia, the CIA teamed up with Laotian general Vang Pao to help make Laos the world’s top exporter of heroin. By the time Nixon began ratcheting down U.S. troop presence in Vietnam to focus on the war against drugs, more troops were dying of heroin overdoses than actual combat, an epidemic that quickly found its way to the streets of urban America.

A decade later, as a result of turning a blind eye to cocaine smugglers funding the CIA’s illegal war against the communist Sandinistas in Nicaragua, the CIA unwittingly helped unleash a nationwide crack-cocaine epidemic. Most notably, cocaine kingpin “Freeway” Ricky Ross was able to take his South Central L.A.-based crack businesses nationwide thanks to his access to a cheap supply of coke from politically connected Nicaraguan suppliers.

“Dark Alliance,” Gary Webb’s landmark 1996 newspaper series alleging CIA involvement in the crack-cocaine epidemic, created a firestorm of controversy that ultimately drove Webb out of journalism and into a spiral of depression that led him to take his own life. Although there were problems with Webb’s reporting and the editing of his story that allowed it to be discredited by rival news organizations, it forced the CIA to reveal that for more than a decade it had protected its Nicaraguan allies from being prosecuted for smuggling cocaine into the U.S.

Veteran drug agents, including Phil Jordan, former director of the DEA’s El Paso Intelligence Center (EPIC), say they were repeatedly called off cases involving CIA-tied drug rings.

“We had three or four cases where we arrested CIA contract workers with cocaine, and I get a phone call that the charges have been dismissed,” Jordan recalls in a new HISTORY series, America’s War on Drugs . “You know, we are risking our lives, making cases against significant drug traffickers, then on the other hand you got another government agency allowing the drugs to come in . . . And we’re not talking about 100 pounds, we’re talking about tons. That introduction of white powder was killing black people.”

The CIA’s collusion with anti-communist drug smugglers beginning in the 1960s played a direct role in the drug epidemic of the 1980s that was used to justify President Reagan ‘s 1986 crime bill. The law introduced harsh mandatory sentencing for non-violent drug offenders, the legacy of which we are still dealing with today.

President Bill Clinton expanded on Reagan’s drug war by militarizing the nation’s police forces and introducing mandatory minimum sentencing. Although President Obama tried to revise this policy shortly before leaving office, President Trump seems intent on doubling down on the war on drugs. When Trump recently invited Philippine President Rodrigo Duterte to the White House, he congratulated him for sending police death squads into the streets to kill drug dealers and addicts. “Many countries have the problem, we have a problem, but what a great job you are doing and I just wanted to call and tell you that,” Trump reportedly said .

National polls in recent years have consistently shown that the overwhelming majority of Americans believe the war on drugs cannot be won. Given the fact that more than half of the United States have legalized medical marijuana, with several others set to join Colorado, Washington and California in approving recreational marijuana use, there has never been a stronger mandate for drug reform than now.

As a nation, we are tired of the drug war’s endless cycle of crime, political corruption, mass incarceration and mayhem—particularly in Mexico, much of which is a war zone, while north of the border, we are mired in a highly politicized hysteria over immigration and border security. The war on drugs has already cost U.S. taxpayers more than $1 trillion and our nation’s jails, prisons and hospitals now overflow with the ranks of its combatants and victims. The stakes couldn’t be higher, nor the timing better, for America to end this war, not expand it.

Nick Schou is author of Kill the Messenger: How the CIA’s Crack Cocaine Controversy Destroyed Journalist Gary Webb (Nation Books, 2006) and also appears in the upcoming HISTORY limited series America’s War on Drugs , premiering June 18 at 9/8c.

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The War On Drugs: 50 Years Later

After 50 years of the war on drugs, 'what good is it doing for us'.

During the War on Drugs, the Brownsville neighborhood in New York City saw some of the highest rates of incarceration in the U.S., as Black and Hispanic men were sent to prison for lengthy prison sentences, often for low-level, nonviolent drug crimes. Spencer Platt/Getty Images hide caption

During the War on Drugs, the Brownsville neighborhood in New York City saw some of the highest rates of incarceration in the U.S., as Black and Hispanic men were sent to prison for lengthy prison sentences, often for low-level, nonviolent drug crimes.

When Aaron Hinton walked through the housing project in Brownsville on a recent summer afternoon, he voiced love and pride for this tightknit, but troubled working-class neighborhood in New York City where he grew up.

He pointed to a community garden, the lush plots of vegetables and flowers tended by volunteers, and to the library where he has led after-school programs for kids.

But he also expressed deep rage and sorrow over the scars left by the nation's 50-year-long War on Drugs. "What good is it doing for us?" Hinton asked.

Revisiting Two Cities At The Front Line Of The War On Drugs

Critics Say Chauvin Defense 'Weaponized' Stigma For Black Americans With Addiction

As the United States' harsh approach to drug use and addiction hits the half-century milestone, this question is being asked by a growing number of lawmakers, public health experts and community leaders.

In many parts of the U.S., some of the most severe policies implemented during the drug war are being scaled back or scrapped altogether.

Hinton, a 37-year-old community organizer and activist, said the reckoning is long overdue. He described watching Black men like himself get caught up in drugs year after year and swept into the nation's burgeoning prison system.

"They're spending so much money on these prisons to keep kids locked up," Hinton said, shaking his head. "They don't even spend a fraction of that money sending them to college or some kind of school."

Aaron Hinton, a 37-year-old veteran activist and community organizer, said it's clear Brownsville needed help coping with the cocaine, heroin and other drug-related crime that took root here in the 1970s and 1980s. His own family was devastated by addiction. Brian Mann hide caption

Aaron Hinton, a 37-year-old veteran activist and community organizer, said it's clear Brownsville needed help coping with the cocaine, heroin and other drug-related crime that took root here in the 1970s and 1980s. His own family was devastated by addiction.

Hinton has lived his whole life under the drug war. He said Brownsville needed help coping with cocaine, heroin and drug-related crime that took root here in the 1970s and 1980s.

His own family was scarred by addiction.

"I've known my mom to be a drug user my whole entire life," Hinton said. "She chose to run the streets and left me with my great-grandmother."

Four years ago, his mom overdosed and died after taking prescription painkillers, part of the opioid epidemic that has killed hundreds of thousands of Americans.

Hinton said her death sealed his belief that tough drug war policies and aggressive police tactics would never make his family or his community safer.

The nation pivots (slowly) as evidence mounts against the drug war

During months of interviews for this project, NPR found a growing consensus across the political spectrum — including among some in law enforcement — that the drug war simply didn't work.

"We have been involved in the failed War on Drugs for so very long," said retired Maj. Neill Franklin, a veteran with the Baltimore City Police and the Maryland State Police who led drug task forces for years.

He now believes the response to drugs should be handled by doctors and therapists, not cops and prison guards. "It does not belong in our wheelhouse," Franklin said during a press conference this week.

Aaron Hinton has lived his whole life under the drug war. He has watched many Black men like himself get caught up in drugs year after year, swept into the nation's criminal justice system. Brian Mann/NPR hide caption

Aaron Hinton has lived his whole life under the drug war. He has watched many Black men like himself get caught up in drugs year after year, swept into the nation's criminal justice system.

Some prosecutors have also condemned the drug war model, describing it as ineffective and racially biased.

"Over the last 50 years, we've unfortunately seen the 'War on Drugs' be used as an excuse to declare war on people of color, on poor Americans and so many other marginalized groups," said New York Attorney General Letitia James in a statement sent to NPR.

On Tuesday, two House Democrats introduced legislation that would decriminalize all drugs in the U.S., shifting the national response to a public health model. The measure appears to have zero chance of passage.

But in much of the country, disillusionment with the drug war has already led to repeal of some of the most punitive policies, including mandatory lengthy prison sentences for nonviolent drug users.

In recent years, voters and politicians in 17 states — including red-leaning Alaska and Montana — and the District of Columbia have backed the legalization of recreational marijuana , the most popular illicit drug, a trend that once seemed impossible.

Last November, Oregon became the first state to decriminalize small quantities of all drugs , including heroin and methamphetamines.

Many critics say the course correction is too modest and too slow.

"The war on drugs was an absolute miscalculation of human behavior," said Kassandra Frederique, who heads the Drug Policy Alliance, a national group that advocates for total drug decriminalization.

She said the criminal justice model failed to address the underlying need for jobs, health care and safe housing that spur addiction.

Indeed, much of the drug war's architecture remains intact. Federal spending on drugs — much of it devoted to interdiction — is expected to top $37 billion this year.

The Coronavirus Crisis

Drug overdose deaths spiked to 88,000 during the pandemic, white house says.

The U.S. still incarcerates more people than any other nation, with nearly half of the inmates in federal prison held on drug charges .

But the nation has seen a significant decline in state and federal inmate populations, down by a quarter from the peak of 1.6 million in 2009 to roughly 1.2 million last year .

There has also been substantial growth in public funding for health care and treatment for people who use drugs, due in large part to passage of the Affordable Care Act .

"The best outcomes come when you treat the substance use disorder [as a medical condition] as opposed to criminalizing that person and putting them in jail or prison," said Dr. Nora Volkow, who has been head of the National Institute of Drug Abuse since 2003.

Volkow said data shows clearly that the decision half a century ago to punish Americans who struggle with addiction was "devastating ... not just to them but actually to their families."

From a bipartisan War on Drugs to Black Lives Matter

Wounds left by the drug war go far beyond the roughly 20.3 million people who have a substance use disorder .

The campaign — which by some estimates cost more than $1 trillion — also exacerbated racial divisions and infringed on civil liberties in ways that transformed American society.

Frederique, with the Drug Policy Alliance, said the Black Lives Matter movement was inspired in part by cases that revealed a dangerous attitude toward drugs among police.

In Derek Chauvin's murder trial, the former officer's defense claimed aggressive police tactics were justified because of small amounts of fentanyl in George Floyd's body. Critics described the argument as an attempt to "weaponize" Floyd's substance use disorder and jurors found Chauvin guilty.

Breonna Taylor, meanwhile, was shot and killed by police in her home during a drug raid . She wasn't a suspect in the case.

"We need to end the drug war not just for our loved ones that are struggling with addiction, but we need to remove the excuse that that is why law enforcement gets to invade our space ... or kill us," Frederique said.

The United States has waged aggressive campaigns against substance use before, most notably during alcohol Prohibition in the 1920s and 1930s.

The modern drug war began with a symbolic address to the nation by President Richard Nixon on June 17, 1971.

Speaking from the White House, Nixon declared the federal government would now treat drug addiction as "public enemy No. 1," suggesting substance use might be vanquished once and for all.

"In order to fight and defeat this enemy," Nixon said, "it is necessary to wage a new all-out offensive."

President Richard Nixon's speech on June 17, 1971, marked the symbolic start of the modern drug war. In the decades that followed Democrats and Republicans embraced ever-tougher laws penalizing people with addiction.

Studies show from the outset drug laws were implemented with a stark racial bias , leading to unprecedented levels of mass incarceration for Black and brown men .

As recently as 2018, Black men were nearly six times more likely than white men to be locked up in state or federal correctional facilities, according to the U.S. Justice Department .

Researchers have long concluded the pattern has far-reaching impacts on Black families, making it harder to find employment and housing, while also preventing many people of color with drug records from voting .

In a 1994 interview published in Harper's Magazine , Nixon adviser John Ehrlichman suggested racial animus was among the motives shaping the drug war.

"We knew we couldn't make it illegal to be either against the [Vietnam] War or Black," Ehrlichman said. "But by getting the public to associate the hippies with marijuana and Blacks with heroin, and then criminalizing both heavily, we could disrupt those communities."

Despite those concerns, Democrats and Republicans partnered on the drug war decade after decade, approving ever-more-severe laws, creating new state and federal bureaucracies to interdict drugs, and funding new armies of police and federal agents.

At times, the fight on America's streets resembled an actual war, especially in poor communities and communities of color.

Police units carried out drug raids with military-style hardware that included body armor, assault weapons and tanks equipped with battering rams.

President Richard Nixon explaining aspects of the special message sent to the Congress on June 17, 1971, asking for an extra $155 million for a new program to combat the use of drugs. He labeled drug abuse "a national emergency." Harvey Georges/AP hide caption

President Richard Nixon explaining aspects of the special message sent to the Congress on June 17, 1971, asking for an extra $155 million for a new program to combat the use of drugs. He labeled drug abuse "a national emergency."

"What we need is another D-Day, not another Vietnam, not another limited war fought on the cheap," declared then-Sen. Joe Biden, D-Del., in 1989.

Biden, who chaired the influential Senate Judiciary Committee, later co-authored the controversial 1994 crime bill that helped fund a vast new complex of state and federal prisons, which remains the largest in the world.

On the campaign trail in 2020, Biden stopped short of repudiating his past drug policy ideas but said he now believes no American should be incarcerated for addiction. He also endorsed national decriminalization of marijuana.

While few policy experts believe the drug war will come to a conclusive end any time soon, the end of bipartisan backing for punitive drug laws is a significant development.

More drugs bring more deaths and more doubts

Adding to pressure for change is the fact that despite a half-century of interdiction, America's streets are flooded with more potent and dangerous drugs than ever before — primarily methamphetamines and the synthetic opioid fentanyl.

"Back in the day, when we would see 5, 10 kilograms of meth, that would make you a hero if you made a seizure like that," said Matthew Donahue, the head of operations at the Drug Enforcement Administration.

As U.S. Corporations Face Reckoning Over Prescription Opioids, CEOs Keep Cashing In

"Now it's common for us to see 100-, 200- and 300-kilogram seizures of meth," he added. "It doesn't make a dent to the price."

Efforts to disrupt illegal drug supplies suffered yet another major blow last year after Mexican officials repudiated drug war tactics and began blocking most interdiction efforts south of the U.S.-Mexico border.

"It's a national health threat, it's a national safety threat," Donahue told NPR.

Last year, drug overdoses hit a devastating new record of 90,000 deaths , according to preliminary data from the Centers for Disease Control and Prevention.

The drug war failed to stop the opioid epidemic

Critics say the effectiveness of the drug war model has been called into question for another reason: the nation's prescription opioid epidemic.

Beginning in the late 1990s, some of the nation's largest drug companies and pharmacy chains invested heavily in the opioid business.

State and federal regulators and law enforcement failed to intervene as communities were flooded with legally manufactured painkillers, including Oxycontin.

"They were utterly failing to take into account diversion," said West Virginia Republican Attorney General Patrick Morrisey, who sued the DEA for not curbing opioid production quotas sooner.

"It's as close to a criminal act as you can find," Morrisey said.

Courtney Hessler, a reporter for The (Huntington) Herald-Dispatch in West Virgina, has covered the opioid epidemic. As a child she wound up in foster care after her mother became addicted to opioids. "You know there's thousands of children that grew up the way that I did. These people want answers," Hessler told NPR. Brian Mann/NPR hide caption

Courtney Hessler, a reporter for The (Huntington) Herald-Dispatch in West Virgina, has covered the opioid epidemic. As a child she wound up in foster care after her mother became addicted to opioids. "You know there's thousands of children that grew up the way that I did. These people want answers," Hessler told NPR.

One of the epicenters of the prescription opioid epidemic was Huntington, a small city in West Virginia along the Ohio River hit hard by the loss of factory and coal jobs.

"It was pretty bad. Eighty-one million opioid pills over an eight-year period came into this area," said Courtney Hessler, a reporter with The (Huntington) Herald-Dispatch.

Public health officials say 1 in 10 residents in the area still battle addiction. Hessler herself wound up in foster care after her mother struggled with opioids.

In recent months, she has reported on a landmark opioid trial that will test who — if anyone — will be held accountable for drug policies that failed to keep families and communities safe.

"I think it's important. You know there's thousands of children that grew up the way that I did," Hessler said. "These people want answers."

A needle disposal box at the Cabell-Huntington Health Department sits in the front parking lot in 2019 in Huntington, W.Va. The city is experiencing a surge in HIV cases related to intravenous drug use following a recent opioid crisis in the state. Ricky Carioti/The Washington Post via Getty Images hide caption

A needle disposal box at the Cabell-Huntington Health Department sits in the front parking lot in 2019 in Huntington, W.Va. The city is experiencing a surge in HIV cases related to intravenous drug use following a recent opioid crisis in the state.

During dozens of interviews, community leaders told NPR that places like Huntington, W.Va., and Brownsville, N.Y., will recover from the drug war and rebuild.

They predicted many parts of the country will accelerate the shift toward a public health model for addiction: treating drug users more often like patients with a chronic illness and less often as criminals.

But ending wars is hard and stigma surrounding drug use, heightened by a half-century of punitive policies, remains deeply entrenched. Aaron Hinton, the activist in Brownsville, said it may take decades to unwind the harm done to his neighborhood.

"It's one step forward, two steps back," Hinton said. "But I remain hopeful. Why? Because what else am I going to do?"

• drug policy
• war on drugs
• public health
• opioid epidemic

clock This article was published more than  2 years ago

The War on Drugs turns 50 today. It’s time to make peace.

America’s longest war has been a failure.

As declarations of war go, it was pretty low key. On June 17, 1971, President Richard M. Nixon held a news briefing in the West Wing of the White House. In his usual dark suit and striped tie, speaking comfortably from notes, the president branded Americans’ rising tide of drug abuse “public enemy number one.” He continued: “In order to fight and defeat this enemy, it is necessary to wage a new, all-out offensive. … This will be a worldwide offensive. … It will be government-wide … and it will be nationwide.” To fund this new war, Nixon declared, he would ask Congress to appropriate a minimum of $350 million. (In 1969, when Nixon first took the oath of office, the nation’s entire federal drug budget was just $81 million .) Fifty years later, the United States has expended approximately one trillion dollars waging war on illegal drugs.

That money has bought some 30 million arrests and millions of imprisonments. Today, nearly 500,000 Americans are incarcerated for drug offenses; the federal government expends well over $9 million every day, more than $3 billion a year, just to lock up drug offenders. States and localities, combined, pay far more . Black Americans are almost six times as likely as White Americans to have been incarcerated on drug charges, even as White and Black Americans use illegal drugs at around the same rate. The War on Drugs — a civil war waged by U.S. authorities against the tens of millions of Americans — is another of America’s “longest wars,” in which the light at the end of the tunnel remains dim.

It would fit conventional wisdom to fault Nixon for the grotesque policy mistakes of the ongoing war on drugs. But we can’t blame Nixon for this one. His war was targeted primarily at the scourge of heroin addiction that was ravaging New York City and affecting U.S. troops in Vietnam, who had easy access to the drug in Southeast Asia. Nixon-the-pragmatist appointed drug rehabilitation experts, not anti-drug moralists, to lead his fight.

Elected officials, however, quickly realized the War on Drugs was good politics. New York Gov. Nelson Rockefeller, known as a moderate Republican, was among the first to successfully push for draconian drug laws, in 1973, as a way to demonstrate his law-and-order credentials in hopes of finally attaining the presidency. Others followed suit.

Those politicians had good instincts. America’s parents had watched in horror as their children embraced illegal drugs, especially marijuana and hallucinogens, such as LSD. Already in 1969, 84 percent of Americans said anyone caught with even the smallest amount of marijuana should go to prison. Congress was fully onboard. In 1970, Congress passed “The Federal Comprehensive Drug Abuse Prevention and Control Act” that made LSD, peyote, psilocybin (“magic mushrooms”) and other hallucinogens Schedule One drugs, meaning they were illegal to use for any and all purposes, including scientific research.

The war only intensified in the 1980s, as it became a critical aspect of the culture wars that permeated the era. Millions of Americans embraced recreational pharmaceuticals, including the new party drug, cocaine. While Time magazine and the mass media made light of Yuppies’ use of the “Bolivian marching powder,” public health officials issued warnings, and friends and families feared for their loved ones. The introduction of cheap, highly potent rock cocaine — crack — intensified those fears, as this new drug ravaged poor inner-city communities. White, middle-class suburban parents were terrified that their children would move from cannabis to crack and would be lost to the ravages of addiction. While such fears were largely unfounded, a moral panic ensued. Once again, elected officials saw opportunity.

These fears and furies drove the Anti-Drug Abuse Act of 1986, which targeted petty African American drug dealers — perceived as the source of the “deadly” drug — with draconian prison sentences . President Ronald Reagan had made a punitive war on drugs central to his administration’s domestic policy agenda. In 1987, at the height of the crack cocaine crisis, some 38 percent of Americans surveyed told pollsters that convicted “drug dealers,” guilty of no other crime and with the quantity and kind of drug being dealt unspecified, should be executed.

Two years later, then-Sen. Joe Biden (D-Del.) tore into the George H.W. Bush administration, declaring, “We need another D-Day. Instead, you’re giving us another Vietnam: a limited war, fought on the cheap, financed on the sly, with no clear objectives, and ultimately destined for stalemate and human tragedy.” Mainstream politicians vied with one another to be seen as the toughest of the drug warriors. Harsh drug laws did not end with Reagan. Both Bush and Bill Clinton further escalated the War on Drugs, passing federal laws that increased imprisonment and provided massive resources for local and state enforcement.

Yet, even as the war escalated, opponents began to speak out. Among the most prominent elected officials was Rep. Ron Dellums, a Democratic congressman from Oakland, Calif. Dellums believed, as did increasing numbers of other Black elected officials and activists, that the War on Drugs had become far more harmful than helpful in protecting their constituents from the dangers of drug addiction and abuse. Young Black men were being sent to prison as drug criminals in massive numbers not seen before in U.S. history. Dellums, ironically, sought a return to Nixon’s original vision, focused not on punishment but rehabilitation, not prison but treatment centers. Black reformers were joined by public health officials, opponents of the “carceral state” and even police officials and prosecutors. They saw a war with no end, a merciless and destructive juggernaut that was upending communities, families and individual lives — to little purpose. The War on Drugs had become a civil war.

The War on Drugs has only continued to lose public support in the decades since. At least one recent survey indicates decriminalization has become a majoritarian position in the United States — 55 percent of those surveyed said all drug offenses should be treated not as felonies but as civil offenses, “like minor traffic violations rather than crimes,” in the words of the survey .

As president, Biden has acknowledged the harm the merciless War on Drugs has caused, especially on low-income African Americans. His understanding of the issue has fundamentally changed. On the 2020 campaign trail, he insisted that education, prevention and redemption — not incarceration — should govern American drug policy. “No one should be incarcerated for drug use,” he said .

Following the success of medical marijuana legalization campaigns in 17 states between 1996 and 2011, Colorado and Washington in 2012 made cannabis legal for recreational users. Other states have followed — though many still only allow the drug for “medical” use. Even so, the federal government has refused to budge on its statutory prohibition of marijuana, creating a legal conundrum that has yet to be resolved.

Likewise, a growing movement, given legitimacy by scientists and members of the medical and therapeutic community, has emerged to challenge the total criminal sanctioning of LSD and other hallucinogens. Researchers insist such drugs can alleviate and even cure a range of illnesses, including PTSD, depression and addiction. A few localities, including Denver, Oakland and Santa Cruz, Calif., have gone further, completely decriminalizing the use of psilocybin for any purpose, including recreation. Yet, on this issue as well, the federal government has continued to classify hallucinogens as Schedule One drugs, making it extremely difficult for research scientists to legally access and study them in clinical settings.

No opponents of the current War on Drugs believe we should simply replace a punitive “Just say No” approach to illegal drugs with a simplistic “Just say Yes” version. Some compellingly argue for a public health approach, in which “harm reduction” replaces incarceration. Many activists and researchers propose that the federal regulatory system we use to manage “white market” drugs, including powerful depressants and stimulants, can be applied to a range of “black market” drugs, including heroin, that we now criminalize. (A number of European nations, including Switzerland, the Netherlands and Germany, have moved in that direction.) Of course, as the American experience with the prescription drug OxyContin has shown, regulatory solutions to addictive drugs are far from perfect.

Nonetheless, most Americans now agree: The 50-year-long War on Drugs has failed. We have begun to negotiate an end to this tragic and destructive war. We must demand that our elected officials find the political courage they will need to win the peace.

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Drugs and Thugs: The History and Future of America's War on Drugs

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How can the United States chart a path forward in the war on drugs? This book uncovers the full history of this war that has lasted more than a century. The book provides an essential view of the economic, political, and human impacts of U.S. drug policies. It takes readers from Afghanistan to Colombia, to Peru and Mexico, to Miami International Airport and the border crossing between El Paso and Juarez to trace the complex social networks that make up the drug trade and drug consumption. Through historically driven stories, the book reveals how the war on drugs has evolved to address mass incarceration, the opioid epidemic, the legalization and medical use of marijuana, and America's shifting foreign policy.

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The war on drugs, explained

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The US has been fighting a global war on drugs for decades. But as prison populations and financial costs increase and drug-related violence around the world continues, lawmakers and experts are reconsidering if the drug war's potential benefits are really worth its many drawbacks.

What is the war on drugs?

In the 1970s, President Richard Nixon formally launched the war on drugs to eradicate illicit drug use in the US. "If we cannot destroy the drug menace in America, then it will surely in time destroy us," Nixon told Congress in 1971. "I am not prepared to accept this alternative."

Over the next couple decades, particularly under the Reagan administration, what followed was the escalation of global military and police efforts against drugs. But in that process, the drug war led to unintended consequences that have proliferated violence around the world and contributed to mass incarceration in the US, even if it has made drugs less accessible and reduced potential levels of drug abuse.

Hulton Archive via Getty Images

Nixon inaugurated the war on drugs at a time when America was in hysterics over widespread drug use. Drug use had become more public and prevalent during the 1960s due in part to the counterculture movement, and many Americans felt that drug use had become a serious threat to the country and its moral standing.

Over the past four decades, the US has committed more than $1 trillion to the war on drugs. But the crackdown has in some ways failed to produce the desired results: Drug use remains a very serious problem in the US, even though the drug war has made these substances less accessible. The drug war also led to several — some unintended — negative consequences, including a big strain on America's criminal justice system and the proliferation of drug-related violence around the world.

While Nixon began the modern war on drugs, America has a long history of trying to control the use of certain drugs. Laws passed in the early 20th century attempted to restrict drug production and sales. Some of this history is racially tinged , and, perhaps as a result, the war on drugs has long hit minority communities the hardest.

In response to the failures and unintended consequences, many drug policy experts and historians have called for reforms: a larger focus on rehabilitation , the decriminalization of currently illicit substances, and even the legalization of all drugs.

The question with these policies, as with the drug war more broadly, is whether the risks and costs are worth the benefits. Drug policy is often described as choosing between a bunch of bad or mediocre options, rather than finding the perfect solution. In the case of the war on drugs, the question is whether the very real drawbacks of prohibition — more racially skewed arrests, drug-related violence around the world, and financial costs — are worth the potential gains from outlawing and hopefully depressing drug abuse in the US.

Is the war on drugs succeeding?

The goal of the war on drugs is to reduce drug use. The specific aim is to destroy and inhibit the international drug trade — making drugs scarcer and costlier, and therefore making drug habits in the US unaffordable. And although some of the data shows drugs getting cheaper, drug policy experts generally believe that the drug war is nonetheless preventing some drug abuse by making the substances less accessible.

The prices of most drugs, as tracked by the Office of National Drug Control Policy , have plummeted. Between 1981 and 2007, the median bulk price of heroin is down by roughly 93 percent, and the median bulk price of powder cocaine is down by about 87 percent. Between 1986 and 2007, the median bulk price of crack cocaine fell by around 54 percent. The prices of meth and marijuana, meanwhile, have remained largely stable since the 1980s.

Much of this is explained by what's known as the balloon effect : Cracking down on drugs in one area doesn't necessarily reduce the overall supply of drugs. Instead, drug production and trafficking shift elsewhere, because the drug trade is so lucrative that someone will always want to take it up — particularly in countries where the drug trade might be one of the only economic opportunities and governments won't be strong enough to suppress the drug trade.

The balloon effect has been documented in multiple instances, including Peru and Bolivia to Colombia in the 1990s, the Netherlands Antilles to West Africa in the early 2000s, and Colombia and Mexico to El Salvador, Honduras, and Guatemala in the 2000s and 2010s.

Sometimes the drug war has failed to push down production altogether, like in Afghanistan. The US spent $7.6 billion between 2002 and 2014 to crack down on opium in Afghanistan, where a bulk of the world's supply for heroin comes from. Despite the efforts, Afghanistan's opium poppy crop cultivation reached record levels in 2013.

On the demand side, illicit drug use has dramatically fluctuated since the drug war began. The Monitoring the Future survey , which tracks illicit drug use among high school students, offers a useful proxy: In 1975, four years after President Richard Nixon launched the war on drugs, 30.7 percent of high school seniors reportedly used drugs in the previous month. In 1992, the rate was 14.4 percent. In 2013, it was back up to 25.5 percent.

Still, prohibition does likely make drugs less accessible than they would be if they were legal. A 2014 study by Jon Caulkins, a drug policy expert at Carnegie Mellon University, suggested that prohibition multiplies the price of hard drugs like cocaine by as much as 10 times. And illicit drugs obviously aren't available through easy means — one can't just walk into a CVS and buy heroin. So the drug war is likely stopping some drug use: Caulkins estimates that legalization could lead hard drug abuse to triple, although he told me it could go much higher.

But there's also evidence that the drug war is too punitive: A 2014 study from Peter Reuter at the University of Maryland and Harold Pollack at the University of Chicago found there's no good evidence that tougher punishments or harsher supply-elimination efforts do a better job of pushing down access to drugs and substance abuse than lighter penalties. So increasing the severity of the punishment doesn't do much, if anything, to slow the flow of drugs.

Instead, most of the reduction in accessibility from the drug war appears to be a result of the simple fact that drugs are illegal, which by itself makes drugs more expensive and less accessible by eliminating avenues toward mass production and distribution.

The question is whether the possible reduction of potential drug use is worth the drawbacks that come in other areas, including a strained criminal justice system and the global proliferation of violence fueled by illegal drug markets. If the drug war has failed to significantly reduce drug use, production, and trafficking, then perhaps it's not worth these costs, and a new approach is preferable.

How does the US decide which drugs are regulated or banned?

The US uses what's called the drug scheduling system . Under the Controlled Substances Act , there are five categories of controlled substances known as schedules, which weigh a drug's medical value and abuse potential.

Universal Images Group via Getty Images

Medical value is typically evaluated through scientific research, particularly large-scale clinical trials similar to those used by the Food and Drug Administration for pharmaceuticals. Potential for abuse isn't clearly defined by the Controlled Substances Act, but for the federal government, abuse is when individuals take a substance on their own initiative, leading to personal health hazards or dangers to society as a whole.

Under this system, Schedule 1 drugs are considered to have no medical value and a high potential for abuse. Schedule 2 drugs have high potential for abuse but some medical value. As the rank goes down to Schedule 5, a drug's potential for abuse generally decreases.

It may be helpful to think of the scheduling system as made up of two distinct groups: nonmedical and medical. The nonmedical group is the Schedule 1 drugs, which are considered to have no medical value and high potential for abuse. The medical group is the Schedule 2 to 5 drugs, which have some medical value and are numerically ranked based on abuse potential (from high to low).

Marijuana and heroin are Schedule 1 drugs, so the federal government says they have no medical value and a high potential for abuse. Cocaine, meth, and opioid painkillers are Schedule 2 drugs, so they're considered to have some medical value and high potential for abuse. Steroids and testosterone products are Schedule 3, Xanax and Valium are Schedule 4, and cough preparations with limited amounts of codeine are Schedule 5. Congress specifically exempted alcohol and tobacco from the schedules in 1970.

Although these schedules help shape criminal penalties for illicit drug possession and sales, they're not always the final word. Congress, for instance, massively increased penalties against crack cocaine in 1986 in response to concerns about a crack epidemic and its potential link to crime. And state governments can set up their own criminal penalties and schedules for drugs as well.

Other countries, like the UK and Australia , use similar systems to the US, although their specific rankings for some drugs differ.

How does the US enforce the war on drugs?

The US fights the war on drugs both domestically and overseas.

David McNew/Getty Images

On the domestic front, the federal government supplies local and state police departments with funds, legal flexibility, and special equipment to crack down on illicit drugs. Local and state police then use this funding to go after drug dealing organizations.

"[Federal] assistance helped us take out major drug organizations, and we took out a number of them in Baltimore," said Neill Franklin, a retired police major and executive director of Law Enforcement Against Prohibition , which opposes the war on drugs. "But to do that, we took out the low-hanging fruit to work up the chain to find who was at the top of the pyramid. It started with low-level drug dealers, working our way up to midlevel management, all the way up to the kingpins."

Some of the funding, particularly from the Byrne Justice Assistance Grant program , encourages local and state police to participate in anti-drug operations. If police don't use the money to go after illicit substances, they risk losing it — providing a financial incentive for cops to continue the war on drugs.

Although the focus is on criminal groups, casual users still get caught in the criminal justice system. Between 1999 and 2007, Human Rights Watch found at least 80 percent of drug-related arrests were for possession, not sales.

It seems, however, that arrests for possession don't typically turn into convictions and prison time. According to federal statistics , only 5.3 percent of drug offenders in federal prisons and 27.9 percent of drug offenders in state prisons in 2004 were in for drug possession. The overwhelming majority were in for trafficking, and a small few were in for an unspecified "other" category.

Bloomberg via Getty Images

Mexican officials incinerate 130 tons of seized marijuana.

Internationally, the US regularly aids other countries in their efforts to crack down on drugs. For example, the US in the 2000s provided military aid and training to Colombia — in what's known as Plan Colombia — to help the Latin American country go after criminal organizations and paramilitaries funded through drug trafficking.

Federal officials argue that helping countries like Colombia attacks the source of illicit drugs, since such substances are often produced in Latin America and shipped north to the US. But the international efforts have consistently displaced , not eliminated, drug trafficking — and the violence that comes with it — to other countries.

Given the struggles of the war on drugs to meet its goals , federal and state officials have begun moving away from harsh enforcement tactics and tough-on-crime stances. The White House Office of National Drug Control Policy now advocates for a bigger focus on rehabilitation and less on law enforcement. Even some conservatives, like former Texas Governor Rick Perry , have embraced drug courts , which place drug offenders into rehabilitation programs instead of jail or prison.

The idea behind these reforms is to find a better balance between locking up more people for drug trafficking while moving genuinely problematic drug users to rehabilitation and treatment services that could help them. "We can't arrest our way out of the problem," Michael Botticelli, US drug czar, said , "and we really need to focus our attention on proven public health strategies to make a significant difference as it relates to drug use and consequences to that in the United States."

How has the war on drugs changed the US criminal justice system?

The escalation of the criminal justice system's reach over the past few decades, ranging from more incarceration to seizures of private property and militarization, can be traced back to the war on drugs.

After the US stepped up the drug war throughout the 1970s and '80s, harsher sentences for drug offenses played a role in turning the country into the world's leader in incarceration . (But drug offenders still make up a small part of the prison population: About 54 percent of people in state prisons — which house more than 86 percent of the US prison population — were violent offenders in 2012, and 16 percent were drug offenders, according to the Bureau of Justice Statistics .)

Sentencing Project

Still, mass incarceration has massively strained the criminal justice system and led to a lot of overcrowding in US prisons — to the point that some states, such as California , have rolled back penalties for nonviolent drug users and sellers with the explicit goal of reducing their incarcerated population.

In terms of police powers, civil asset forfeitures have been justified as a way to go after drug dealing organizations. These forfeitures allow law enforcement agencies to take the organizations' assets — cash in particular — and then use the gains to fund more anti-drug operations. The idea is to turn drug dealers' ill-gotten gains against them.

But there have been many documented cases in which police abused civil asset forfeiture, including instances in which police took people's cars and cash simply because they suspected — but couldn't prove — that there was some sort of illegal activity going on. In these cases, it's actually up to people whose private property was taken to prove that they weren't doing anything illegal — instead of traditional legal standards in which police have to prove wrongdoing or reasonable suspicion of it before they act.

Kevork Djansezian/Getty Images

Similarly, the federal government helped militarize local and state police departments in an attempt to better equip them in the fight against drugs. The Pentagon's 1033 program , which gives surplus military-grade equipment to police, was created in the 1990s as part of President George HW Bush's escalation of the war on drugs. The deployment of SWAT teams, as reported by the ACLU, also increased during the past few decades, and 62 percent of SWAT raids in 2011 and 2012 were for drug searches.

Various groups have complained that these increases in police power are often abused and misused. The ACLU, for instance, argues that civil asset forfeitures threaten Americans' civil liberties and property rights, because police can often seize assets without even filing charges. Such seizures also might encourage police to focus on drug crimes, since a raid can result in actual cash that goes back to the police department, while a violent crime conviction likely would not. The libertarian Cato Institute has also criticized the war on drugs for decades, because anti-drug efforts gave cover to a huge expansion of law enforcement's surveillance capabilities, including wiretaps and US mail searches.

The militarization of police became a particular sticking point during the 2014 protests in Ferguson, Missouri, over the police shooting of Michael Brown . After heavily armed police responded to largely peaceful protesters with armored vehicle that resemble tanks, tear gas, and sound cannons, law enforcement experts and journalists criticized the tactics.

Since the beginning of the war on drugs, the general trend has been to massively grow police powers and expand the criminal justice system as a means of combating drug use. But as the drug war struggles to halt drug use and trafficking, the heavy-handed policies — which many describe as draconian — have been called into question. If the war on drugs isn't meeting its goals, critics say these expansions of the criminal justice system aren't worth the financial strain and costs to liberty in the US.

How has the drug war contributed to violence around the world?

The war on drugs has created a black market for illicit drugs that criminal organizations around the world can rely on for revenue that payrolls other, more violent activities. This market supplies so much revenue that drug trafficking organizations can actually rival developing countries' weak government institutions.

In Mexico, for example, drug cartels have leveraged their profits from the drug trade to violently maintain their stranglehold over the market despite the government's war on drugs. As a result, public decapitations have become a particularly prominent tactic of ruthless drug cartels. As many as 80,000 people have died in the war. Tens of thousands of people have gone missing since 2007, including 43 students who vanished in 2014 in a widely publicized case.

Pedro Ugarte/AFP via Getty Images

But even if Mexico were to actually defeat drug cartels, this potentially wouldn't reduce drug war violence on a global scale. Instead, drug production and trafficking, and the violence that comes with both, would likely shift elsewhere, because the drug trade is so lucrative that someone will always want to take it up — particularly in countries where the drug trade might be one of the only economic opportunities and governments won't be strong enough to suppress the drug trade.

In 2014, for instance, the drug war significantly contributed to the child migrant crisis. After some drug trafficking was pushed out of Mexico, gangs and drug cartels stepped up their operations in Central America's Northern Triangle of El Salvador, Honduras, and Guatemala. These countries, with their weak criminal justice and law enforcement systems, didn't seem to have the capacity to deal with the influx of violence and crime.

The war on drugs "drove a lot of the activities to Central America, a region that has extremely weakened systems," Adriana Beltran of the Washington Office on Latin America explained . "Unfortunately, there hasn't been a strong commitment to building the criminal justice system and the police."

As a result, children fled their countries by the thousands in a major humanitarian crisis . Many of these children ended up in the US, where the refugee system simply doesn't have the capacity to handle the rush of child migrants.

Although the child migrant crisis is fairly unique in its specific circumstances and effects, the series of events — a government cracks down on drugs, trafficking moves to another country, and the drug trade brings violence and crime — is pretty typical in the history of the war on drugs. In the past couple of decades it happened in Colombia , Mexico , Venezuela , and Ecuador after successful anti-drug crackdowns in other Latin American countries.

The Wall Street Journal explained :

Ironically, the shift is partly a by-product of a drug-war success story, Plan Colombia. In a little over a decade, the U.S. spent nearly $8 billion to back Colombia's efforts to eradicate coca fields, arrest traffickers and battle drug-funded guerrilla armies such as the Revolutionary Armed Forces of Colombia, or FARC. Colombian cocaine production declined, the murder rate plunged and the FARC is on the run. But traffickers adjusted. Cartels moved south across the Ecuadorean border to set up new storage facilities and pioneer new smuggling routes from Ecuador's Pacific coast. Colombia's neighbor to the east, Venezuela, is now the departure point for half of the cocaine going to Europe by sea.

As a 2012 report from the UN Office on Drugs and Crime explained, "one country’s success became the problem of others."

This global proliferation of violence is one of the most prominent costs of the drug war. When evaluating whether the war on drugs has been successful, experts and historians weigh this cost, along with the rise of incarceration in the US, against the benefits, such as potentially depressed drug use, to gauge whether anti-drug efforts have been worth it.

How much does the war on drugs cost?

Enforcing the war on drugs costs the US more than $51 billion each year, according to the Drug Policy Alliance . As of 2012, the US had spent $1 trillion on anti-drug efforts.

AFP via Getty Images

The spending estimates don't account for the loss of potential taxes on currently illegal substances. According to a 2010 paper from the libertarian Cato Institute, taxing and regulating illicit drugs similarly to tobacco and alcohol could raise $46.7 billion in tax revenue each year.

These annual costs — the spending, the lost potential taxes — add up to nearly 2 percent of state and federal budgets, which totaled an estimated $6.1 trillion in 2013. That's not a huge amount of money, but it may not be worth the cost if the war on drugs is leading to drug-related violence around the world and isn't significantly reducing drug abuse .

Is the war on drugs racist?

In the US, the war on drugs mostly impacts minority, particularly black, communities. This disproportionate effect is why critics often call the war on drugs racist .

Although black communities aren't more likely to use or sell drugs, they are much more likely to be arrested and incarcerated for drug offenses.

When black defendants are convicted for drug crimes, they face longer prison sentences as well. Drug sentences for black men were 13.1 percent longer than drug sentences for white men between 2007 and 2009, according to a 2012 report from the US Sentencing Commission.

The Sentencing Project explained the differences in a February 2015 report: "Myriad criminal justice policies that appear to be race-neutral collide with broader socioeconomic patterns to create a disparate racial impact… Socioeconomic inequality does lead people of color to disproportionately use and sell drugs outdoors, where they are more readily apprehended by police."

One example: Trafficking crack cocaine, one of the few illicit drugs that's more popular among black Americans, carries the harshest punishment. The threshold for a five-year mandatory minimum sentence of crack is 28 grams. In comparison, the threshold for powder cocaine, which is more popular among white than black Americans but pharmacoligically similar to crack, is 500 grams.

New York Daily News via Getty Images

As for the broader racial disparities, federal programs that encourage local and state police departments to crack down on drugs may create perverse incentives to go after minority communities. Some federal grants , for instance, previously required police to make more drug arrests in order to obtain more funding for anti-drug efforts. Neill Franklin, a retired police major from Maryland and executive director of Law Enforcement Against Prohibition , said minority communities are "the low-hanging fruit" for police departments because they tend to sell in open-air markets, such as public street corners, and have less political and financial power than white Americans.

In Chicago, for instance, an analysis by Project Know , a drug addiction resource center, found enforcement of anti-drug laws is concentrated in poor neighborhoods, which tend to have more crime but are predominantly black :

Project Know

"Doing these evening and afternoon sweeps meant 20 to 30 arrests, and now you have some great numbers for your grant application," Franklin said. "In that process, we also ended up seizing a lot of money and a lot of property. That's another cash cow."

The disproportionate arrest and incarceration rates have clearly detrimental effects on minority communities. A 2014 study published in the journal Sociological Science found boys with imprisoned fathers are much less likely to possess the behavioral skills needed to succeed in school by the age of 5, starting them on a vicious path known as the school-to-prison pipeline .

As the drug war continues, these racial disparities have become one of the major points of criticism against it. It's not just whether the war on drugs has led to the widespread, costly incarceration of millions of Americans, but whether incarceration has created "the new Jim Crow" — a reference to policies, such as segregation and voting restrictions, that subjugated black communities in America.

What are the roots of the war on drugs?

Beyond the goal of curtailing drug use , the motivations behind the US war on drugs have been rooted in historical fears of immigrants and minority groups.

The US began regulating and restricting drugs during the first half of the 20th century, particularly through the Pure Food and Drug Act of 1906 , the Harrison Narcotics Tax Act of 1914 , and the Marijuana Tax Act of 1937 . During this period, racial and ethnic tensions were particularly high across the country — not just toward African Americans, but toward Mexican and Chinese immigrants as well.

National Library of Medicine

As the New York Times explained , the federal prohibition of marijuana came during a period of national hysteria about the effect of the drug on Mexican immigrants and black communities. Concerns about a new, exotic drug, coupled with feelings of xenophobia and racism that were all too common in the 1930s, drove law enforcement, the broader public, and eventually legislators to demand the drug's prohibition. "Police in Texas border towns demonized the plant in racial terms as the drug of 'immoral' populations who were promptly labeled 'fiends,'" wrote the Times's Brent Staples.

These beliefs extended to practically all forms of drug prohibition. According to historian Peter Knight , opium largely came over to America with Chinese immigrants on the West Coast. Americans, already skeptical of the drug, quickly latched on to xenophobic beliefs that opium somehow made Chinese immigrants dangerous. "Stories of Chinese immigrants who lured white females into prostitution, along with the media depictions of the Chinese as depraved and unclean, bolstered the enactment of anti-opium laws in eleven states between 1877 and 1900," Knight wrote .

Cocaine was similarly attached in fear to black communities, neuroscientist Carl Hart wrote for the Nation. The belief was so widespread that the New York Times even felt comfortable writing headlines in 1914 that claimed "Negro cocaine 'fiends' are a new southern menace." The author of the Times piece — a physician — wrote, "[The cocaine user] imagines that he hears people taunting and abusing him, and this often incites homicidal attacks upon innocent and unsuspecting victims." He later added, "Many of the wholesale killings in the South may be cited as indicating that accuracy in shooting is not interfered with — is, indeed, probably improved — by cocaine. … I believe the record of the 'cocaine n----r' near Asheville who dropped five men dead in their tracks using only one cartridge for each, offers evidence that is sufficiently convincing."

The LIFE Picture Collection via Getty Images

Most recently, these fears of drugs and the connection to minorities came up during what law enforcement officials characterized as a crack cocaine epidemic in the 1980s and '90s. Lawmakers, judges, and police in particular linked crack to violence in minority communities. The connection was part of the rationale for making it 100 times easier to get a mandatory minimum sentence for crack cocaine over powder cocaine, even though the two drugs are pharmacologically identical. As a result, minority groups have received considerably harsher prison sentences for illegal drugs. (In 2010, the ratio between crack's sentence and cocaine's was reduced from 100-to-1 to 18-to-1.)

Hart explained , after noting the New York Times's coverage in particular: "Over the [late 1980s], a barrage of similar articles connected crack and its associated problems with black people. Entire specialty police units were deployed to 'troubled neighborhoods,' making excessive arrests and subjecting the targeted communities to dehumanizing treatment. Along the way, complex economic and social forces were reduced to criminal justice problems; resources were directed toward law enforcement rather than neighborhoods’ real needs, such as job creation."

None of this means the war on drugs is solely driven by fears of immigrants and minorities, and many people are genuinely concerned about drugs' effects on individuals and society. But when it comes to the war on drugs, the historical accounts suggest the harshest crackdowns often follow hysteria linked to minority drug use — making the racial disparities in the drug war seem like a natural consequence of anti-drug efforts' roots.

What about the band The War on Drugs?

They're pretty great, though they don't have much to do with the actual war on drugs.

But since you mentioned them, take a break and listen to a couple songs from their latest album, Lost in the Dream .

The War on Drugs, "Red Eye":

The War on Drugs, "Under the Pressure":

Bonus from their 2011 album, Slave Ambient : The War on Drugs, "Best Night":

What are the most dangerous drugs?

This is actually a fairly controversial question among drug policy experts. Although some researchers have tried to rank drugs by their harms, some experts argue the rankings are often far more misleading than useful.

In a report published in The Lancet , a group of researchers evaluated the harms of drug use in the UK, considering factors like deadliness, chance of developing dependence, behavioral changes such as increased risk of violence, and losses in economic productivity. Alcohol, heroin, and crack cocaine topped the chart.

Anand Katakam/Vox

There are at least two huge caveats to this report. First, it doesn't entirely control for the availability of these drugs, so it's likely heroin and crack cocaine in particular would be ranked higher if they were as readily available as alcohol. Second, the scores were intended for British society, so the specific scores may differ slightly for the US. David Nutt, who led the analysis, suggested meth's harm score could be much higher in the US, since it's more widely used in America.

But drug policy experts argue the study and ranking miss some of the nuance behind the harm of certain drugs.

Jon Caulkins, a drug policy expert at Carnegie Mellon University, gave the example of an alien race visiting Earth and asking which land animal is the biggest. If the question is about weight, the African elephant is the biggest land animal. But if it's about height, the giraffe is the biggest. And if the question is about length, the reticulated python is the biggest.

"You can always create some composite, but composites are fraught with problems," Caulkins said. "I think it's more misleading than useful."

The blunt measures of drug harms present similar issues. Alcohol, tobacco, and prescription painkillers are likely deadlier than other drugs because they are legal, so comparing their aggregate effects to illegal drugs is difficult. Some drugs are very harmful to individuals, but they're so rarely used that they may not be a major public health threat. A few drugs are enormously dangerous in the short term but not so much the long term (heroin), or vice versa (tobacco). And looking at deaths or other harms caused by certain drugs doesn't always account for substances, such as prescription medications, that are often mixed with others, making them more deadly or harmful than they would be alone.

Given the diversity of drugs and their effects, many experts argue that trying to establish a ranking of the most dangerous drugs is a futile, misleading exercise. Instead of trying to base policy on a ranking, experts say, lawmakers should build individual policies that try to minimize each drug's specific set of risks and harms.

Why are alcohol and tobacco exempted from the war on drugs?

Tobacco and alcohol are explicitly exempted from drug scheduling, despite their detrimental impacts on individual health and society as a whole, due to economic and cultural reasons.

Tobacco and alcohol have been acceptable drugs in US culture for hundreds of years, and they are still the most widely used drugs , along with caffeine, in the nation. Trying to stop Americans — through the threat of legal force — from using these drugs would likely result in an unmitigated policy disaster, simply because of their popularity and cultural acceptance.

In fact, exactly that happened in the 1920s: In 1920, the federal government attempted to prohibit alcohol sales through the 18th Amendment . Experts and historians widely consider this policy, popularly known as Prohibition, a failure and even a disaster , since it led to a massive black market for alcohol that funded criminal organizations across the US. It took Congress just 14 years to repeal Prohibition.

Alcohol and tobacco are also major parts of the US economy. In 2013, alcohol sales totaled $124.7 billion (excluding purchases in bars and restaurants), and tobacco sales amounted to $108 billion. If lawmakers decided to prohibit and dismantle these legal industries, it would cost the economy billions of dollars and thousands of jobs.

Lawmakers were well aware of these cultural and economic issues when they approved the Controlled Substances Act of 1970 . So they exempted alcohol and tobacco from the definition of controlled substances.

If these drugs weren't exempted, tobacco and alcohol would likely be tightly controlled under the current scheduling regime. Mark Kleiman , one of the nation's leading drug policy experts, argued both would be considered schedule 1 substances if they were evaluated today, since they're highly abused, addictive, detrimental to one's health and society, and have no established medical value.

All of this gets to a key point about the war on drugs: Policymakers don't evaluate drugs in a vacuum. They also consider the socioeconomic implications of banning a substance, and whether those potential drawbacks are worth the gains of potentially reducing substance use and abuse.

But this type of analysis of the pros and cons is also why critics want to end the war on drugs today. Even if the drug war has successfully brought down drug use and abuse, its effects on budgets , civil rights , and international violence are so great and detrimental that the minor impact it may have on drug use might not be worth the costs.

How much of the war on drugs is tied to international treaties?

If lawmakers decided to stop the war on drugs tomorrow, a major hurdle could be international agreements that require restrictions and regulations on certain drugs.

There are three major treaties: the Single Convention on Narcotic Drugs of 1961 , the Convention on Psychotropic Drugs of 1971 , and the UN Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988 . Combined, the treaties require participants to limit and even prohibit the possession, use, trade, and distribution of drugs outside of medical and scientific purposes, and work together to stop international drug trafficking.

Guillermo Legaria/AFP via Getty Images

There is a lot of disagreement among drug policy experts, enforcers, and reformers about the stringency of the treaties. Several sections of the conventions allow countries some flexibility so they don't violate their own constitutional protections. The US, for example, has never enforced penalties on inciting illicit drug use on the basis that it would violate rights to freedom of speech.

Many argue that any move toward legalization of use, possession, and sales is in violation of international treaties. Under this argument, some governments — including several US states and Uruguay — are technically in violation of the treaties because they legalized marijuana for personal possession and sales.

Others say that countries have a lot of flexibility due to the constitutional exemptions in the conventions. Countries could claim, for instance, that their protections for right to privacy and health allow them to legalize drugs despite the conventions. When it comes to individual states in the US, the federal government argues that America's federalist system allows states some flexibility as long as the federal government keeps drugs illegal.

"It's pretty clear that the war on drugs was waged for political reasons and some countries have used the treaties as an excuse to pursue draconian policies," said Kasia Malinowska-Sempruch, director of the Open Society Global Drug Policy Program. "Nevertheless, we've seen a number of countries drop criminal penalties for minor possession of all drugs. We've seen others put drugs into a pharmaceutical model, including the prescription of heroin to people with serious addictions. This seems completely possible within the treaties."

Pablo Porciuncula/AFP via Getty Images

Even if a country decided to dismantle prohibition and violate the treaties, it's unclear how the international community would respond. If the US, for example, ended prohibition, there's little other countries could do to interfere; there's no international drug court, and sanctions would be very unlikely for a country as powerful as America.

Still, Martin Jelsma, an international drug policy expert at the Transnational Institute, argued that ignoring or pulling out of the international drug conventions could seriously damage America's standing around the world. "Pacta sunt servanda ('agreements must be kept') is the most fundamental principle of international law and it would be very undermining if countries start to take an 'a-la-carte' approach to treaties they have signed; they cannot simply comply with some provisions and ignore others without losing the moral authority to ask other countries to oblige to other treaties," Jelsma wrote in an email. "So our preference is to acknowledge legal tensions with the treaties and try to resolve them."

To resolve such issues, many critics of the war on drugs hope to reform international drug laws in 2016 during the next General Assembly Special Session on drugs .

"There is tension with the tax-and-regulate approach to marijuana in some jurisdictions," Malinowska-Sempruch said. "But it's all part of a process, and that's why we hope the UN debate in 2016 is as open as possible, so that we can settle some of these questions and, if necessary, modernize the system."

Until then, any country taking steps to revamp its drug policy regime could face criticisms and a loss of credibility from its international peers.

How do other countries deal with drugs?

There is a lot of variety in how different countries have adopted the UN conventions , ranging from levels of enforcement even more stringent than US drug laws to outright decriminalization. Here are a few examples:

• China carries out some of the harshest punishments for illicit drug trafficking. In the lead-up to International Anti-Drug Day , Chinese officials unveiled executions and other harsh punishments for drug traffickers in 2014 , 2013 , 2012 , 2010 , and 2009 .
• The United Kingdom maintains a classification system similar to America's scheduling system , with criminal penalties set based on a drug's classification. For example, selling class A substances can get someone up to life in prison, while class B sentences are limited to a maximum of 14 years.
• Portugal in 2001 decriminalized all drugs, including cocaine and heroin. A 2009 report authored by Glenn Greenwald for the libertarian Cato Institute found drug use fell among teenagers in Portugal following decriminalization, but use ticked up for young adults ages 20 to 24.
• Uruguay in 2012 legalized marijuana for personal use and sales to eliminate a major source of revenue for violent drug cartels. The government is now working to establish regulations for the sales and distribution of pot.

The varied approaches show that even though the US has been a major leader in the global war on drugs, its model of combating drug use and trafficking domestically is hardly the only option. Other countries have looked at the pros and cons and decided on vastly different drug policy regimes, with varying degrees of success.

What's the case for focusing more on rehabilitation and addiction treatment?

The most cautious reform to the drug war puts more emphasis on rehabilitation instead of locking up drug users in prison, but it does this without decriminalizing or legalizing drugs.

Allison Joyce/Getty Images

This is the approach recently embraced by the White House's Office of National Drug Control Policy, which plans to increase funding for rehabilitation programs in the coming years. The Obama administration also approved several legal and regulatory reforms , including Obamacare , that increased access to addiction treatment through health insurance. (However, the federal government still spends billions each year on conventional law enforcement operations against drugs.)

Drug courts , which even some conservatives like former Texas Governor Rick Perry (R) support, are an example of the rehabilitation-focused approach. Instead of throwing drug offenders into jail or prison, these courts send them to rehabilitation programs that focus on treating addiction as a medical, not criminal, problem. (The Global Commission on Drug Policy, however, argues that drug courts can end up nearly as punitive as the full criminalization of drugs, because the courts often enforce total drug abstinence with the threat of incarceration. Since relapse is a normal part of rehabilitation, the threat of incarceration means a lot of nonviolent drug offenders can end up back in jail or prison through drug courts.)

Other countries have taken even more drastic steps toward rehabilitation, some of which acknowledge that not all addicts can be cured of drug dependency. Several European countries prescribe and administer , with supervision, heroin to a small number of addicts who prove resistant to other treatments. These programs allow some addicts to satisfy their drug dependency without a large risk of overdose and without resorting to other crimes to obtain drugs, such as robbery and burglary.

Researchers credit the heroin-assisted treatment program in Switzerland, the first national scheme of its kind, with reductions in drug-related crimes and improvements in social functioning, such as stabilized housing and employment. But some supporters of the war on drugs, such as the International Task Force on Strategic Drug Policy , argue that these programs give the false impression that drug habits can be managed safely, which could weaken the social stigma surrounding drug use and lead more people to try dangerous drugs.

For drug policymakers, the question is whether potentially breaking this stigma — and perhaps leading to more drug use — is worth the benefit of getting more people the treatment they need. Generally, drug policy experts agree that this tradeoff is worth it.

What's the case for decriminalizing drugs?

Pointing to the drug war's failure to significantly reduce drug use, many drug policy experts argue that the criminalization of drug possession is flawed and has contributed to the massive rise of incarceration in the US. To these experts, the answer is decriminalizing all drug possession while keeping sales and trafficking illegal — a scheme that would, in theory, keep nonviolent drug users out of prison but still let law enforcement go after illicit drug supplies.

Mark Kleiman , one of the leading drug policy experts in the country, once opposed the idea of decriminalization, but he warmed up to it after looking at the evidence. "What I've learned since then," he said, "is nobody's got any empirical evidence that shows criminalization reduces consumption noticeably."

Saul Loeb/AFP via Getty Images

Kleiman said decriminalization could be paired with a focus on rehabilitation. He advocated for policies like 24/7 Sobriety Programs that require twice-daily alcohol testing for every single person convicted of drunk driving; anyone who fails the test is swiftly sent to jail for a few days. In South Dakota, alcohol-related traffic deaths declined by 33 percent between 2006 and 2007 — the highest decrease in the nation — after implementation of a 24/7 Sobriety Program.

In a paper , Kleiman analyzed a similar program in Hawaii for illicit drug users. Participants in that program had large reductions in positive drug tests and were significantly less likely to be arrested during follow-ups at three months, six months, and 12 months.

"Nobody's got any empirical evidence that shows criminalization reduces consumption noticeably"

A 2009 report from the libertarian Cato Institute found that after Portugal decriminalized all drugs, people were more willing to seek out rehabilitation programs. "The most substantial barrier to offering treatment to the addict population was the addicts' fear of arrest," Glenn Greenwald, who authored the paper, wrote. "One prime rationale for decriminalization was that it would break down that barrier, enabling effective treatment options to be offered to addicts once they no longer feared prosecution. Moreover, decriminalization freed up resources that could be channeled into treatment and other harm reduction programs."

As with heroin-assisted treatment programs, supporters of the war on drugs argue decriminalization legitimizes and increases drug use by removing the social stigma attached to it. But the research doesn't appear to support this point.

Some drug policy reform advocates and experts, however, are critical of decriminalization without the legalization of sales. Isaac Campos , a drug historian at the University of Cincinnati, argued that keeping the drug market in criminal hands lets them maintain a huge source of revenue. "The black market might even be fueled somewhat by the fact that people won't be arrested anymore, because maybe more people will use," Campos said. "We don't know if that's the case, but it's possible."

The concern for decriminalization supporters is that letting businesses come in and sell drugs could lead to aggressive marketing and advertising, similar to how the alcohol industry behaves today. This could lead to more drug use, particularly among problem users who would likely make up most of the demand for drugs. The top 10 percent of alcohol drinkers, for example, account for more than half the alcohol consumed in any given year in the US.

Decriminalization, then, is a bit of a compromise in reforming the war on drugs. It would reduce some of the incarceration caused by the drug war, but it would continue operations that seek to reduce drug trafficking and hopefully make a drug habit less affordable and accessible.

What's the case for legalizing drugs?

Given the concerns about the illicit drug market as a source of revenue for violent drug cartels , some advocates call for outright legalization of drug use, possession, distribution, and sales. Exactly what legalization entails, however, can vary.

Seth McConnell/Denver Post via Getty Images

Drug policy experts point out that there are several ways to legalize a drug. For example, in a January 2015 report about marijuana legalization for the Vermont legislature , some of the nation's top drug policy experts outlined several alternatives, including allowing possession and growing but not sales (like DC), allowing distribution only within small private clubs, or having the state government operate the supply chain and sell pot.

The report particularly favors a state-run monopoly for marijuana production and sales to help eliminate the black market and produce the best public health outcomes, since regulators could directly control prices and who buys pot. Previous research found that states that maintained a government-operated monopoly for alcohol kept prices higher, reduced access to youth, and reduced overall levels of use — all benefits to public health. A similar model could be applied to other drugs.

There are other options. Governments could spend much, much more on prevention and treatment programs alongside legalization to deal with a potential wave of new drug users. They could require and regulate licenses to buy drugs, as some states do with guns. Or they could limit drug use to special facilities, like supervised heroin-injection sites or special facilities in which people can legally use psychedelics.

But Jeffrey Miron , an economist at Harvard University and the libertarian Cato Institute, supports full legalization, even it means the commercialization of drugs that are currently illegal. This, he said, is the only complete answer to eliminating the black market as a source of revenue for violent criminal groups.

John Moore/Getty Images

When asked about full legalization, Mark Kleiman , a drug policy expert who supports decriminalization, pushed back against the concept. He said full legalization could foster and encourage more problem drug users. For-profit drug businesses, just like alcohol and tobacco companies, would prefer heavy users, because the heavy users tend to buy way more of their product. In Colorado's legal marijuana market , for example, the heaviest 30 percent of users make up nearly 90 percent of demand for pot. "They are an industry with a set of objectives that flatly contradicts public interest," Kleiman said.

Miron argued that even if sales or distribution are legalized, the harder drugs could be taxed and regulated similarly to or more harshly than tobacco and alcohol, although he personally doesn't support that approach. "You could absolutely legalize it and have restrictions on commercialization," Miron said. "Those should be separate questions."

Kleiman argued the alcohol model has clear pitfalls . Alcohol still causes health problems that kill tens of thousands each year, it's often linked to violent crime, and some experts consider it one of the most dangerous drugs .

Still, some evidence suggests the alcohol model could be adjusted to reduce its issues. In a big review of the evidence , Alexander Wagenaar, Amy Tobler, and Kelli Komro concluded that increasing alcohol taxes — and, as a result, getting people to drink less alcohol — would significantly reduce violence, crime, and other negative repercussions of alcohol use.

But there's evidence that the drug war increases prices and decreases accessibility far beyond taxes and regulation could. A 2014 study by Jon Caulkins, a drug policy expert at Carnegie Mellon University, found that prohibition multiplies hard drug prices by as much as 10 times, so legalization — by eliminating prohibition and allowing greater access to drugs — could greatly increase the rates of drug abuse.

The question of legalization, then, goes back once again to considerations about balancing the good and the bad: Is reducing the rates of drug abuse, particularly in the US, worth the carnage enabled by the money violent criminal organizations make off the black market for drugs? This is a common refrain of drug policy that's repeated again and again by experts: A perfect solution doesn't exist, so policymaking should focus on picking the best of many bad options.

"There are always choices," Keith Humphreys, a drug policy expert at Stanford University, explained. "There is no framework available in which there's not harm somehow. We've got freedom, pleasure, health, crime, and public safety. You can push on one and two of those — maybe even three with different drugs — but you can't get rid of all of them. You have to pay the piper somewhere."

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The war on drugs is a failure.

The war on drugs has failed. And it's high time to replace an ineffective strategy with more humane and efficient drug policies. This is the central message of the report by the Latin American Commission on Drugs and Democracy we presented to the public recently in Rio de Janeiro.

Prohibitionist policies based on eradication, interdiction and criminalization of consumption simply haven't worked. Violence and the organized crime associated with the narcotics trade remain critical problems in our countries. Latin America remains the world's largest exporter of cocaine and cannabis, and is fast becoming a major supplier of opium and heroin. Today, we are further than ever from the goal of eradicating drugs.

Over the last 30 years, Colombia implemented all conceivable measures to fight the drug trade in a massive effort where the benefits were not proportional to the resources invested. Despite the country's achievements in lowering levels of violence and crime, the areas of illegal cultivation are again expanding. In Mexico – another epicenter of drug trafficking – narcotics-related violence has claimed more than 5,000 lives in the past year alone.

The revision of U.S.-inspired drug policies is urgent in light of the rising levels of violence and corruption associated with narcotics. The alarming power of the drug cartels is leading to a criminalization of politics and a politicization of crime. And the corruption of the judicial and political system is undermining the foundations of democracy in several Latin American countries.

The first step in the search for alternative solutions is to acknowledge the disastrous consequences of current policies. Next, we must shatter the taboos that inhibit public debate about drugs in our societies. Antinarcotic policies are firmly rooted in prejudices and fears that sometimes bear little relation to reality. The association of drugs with crime segregates addicts in closed circles where they become even more exposed to organized crime.

In order to drastically reduce the harm caused by narcotics, the long-term solution is to reduce demand for drugs in the main consumer countries. To move in this direction, it is essential to differentiate among illicit substances according to the harm they inflict on people's health, and the harm drugs cause to the social fabric.

In this spirit, we propose a paradigm shift in drug policies based on three guiding principles: Reduce the harm caused by drugs, decrease drug consumption through education, and aggressively combat organized crime. To translate this new paradigm into action we must start by changing the status of addicts from drug buyers in the illegal market to patients cared for by the public-health system.

We also propose the careful evaluation, from a public-health standpoint, of the possibility of decriminalizing the possession of cannabis for personal use. Cannabis is by far the most widely used drug in Latin America, and we acknowledge that its consumption has an adverse impact on health. But the available empirical evidence shows that the hazards caused by cannabis are similar to the harm caused by alcohol or tobacco.

If we want to effectively curb drug use, we should look to the campaign against tobacco consumption. The success of this campaign illustrates the effectiveness of prevention campaigns based on clear language and arguments consistent with individual experience. Likewise, statements by former addicts about the dangers of drugs will be far more compelling to current users than threats of repression or virtuous exhortations against drug use.

Such educational campaigns must be targeted at youth, by far the largest contingent of users and of those killed in the drug wars. The campaigns should also stress each person's responsibility toward the rising violence and corruption associated with the narcotics trade. By treating consumption as a matter of public health, we will enable police to focus their efforts on the critical issue: the fight against organized crime.

A growing number of political, civic and cultural leaders, mindful of the failure of our current drug policy, have publicly called for a major policy shift. Creating alternative policies is the task of many: educators, health professionals, spiritual leaders and policy makers. Each country's search for new policies must be consistent with its history and culture. But to be effective, the new paradigm must focus on health and education – not repression.

Drugs are a threat that cuts across borders, which is why Latin America must establish dialogue with the United States and the European Union to develop workable alternatives to the war on drugs. Both the U.S. and the EU share responsibility for the problems faced by our countries, since their domestic markets are the main consumers of the drugs produced in Latin America.

The inauguration of President Barack Obama presents a unique opportunity for Latin America and the U.S. to engage in a substantive dialogue on issues of common concern, such as the reduction of domestic consumption and the control of arms sales, especially across the U.S.-Mexico border. Latin America should also pursue dialogue with the EU, asking European countries to renew their commitment to the reduction of domestic consumption and learning from their experiences with reducing the health hazards caused by drugs.

The time to act is now, and the way forward lies in strengthening partnerships to deal with a global problem that affects us all.

Mr. Cardoso is the former president of Brazil. Mr. Gaviria is a former president of Colombia. Mr. Zedillo is a former president of Mexico.

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How the war on drugs impacts social determinants of health beyond the criminal legal system

Aliza cohen.

a Department of Research and Academic Engagement, Drug Policy Alliance, New York, NY, USA

Sheila P. Vakharia

Julie netherland, kassandra frederique.

b Drug Policy Alliance, New York, NY, USA

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Data sharing is not applicable to this article as no new data were created or analysed in this study.

There is a growing recognition in the fields of public health and medicine that social determinants of health (SDOH) play a key role in driving health inequities and disparities among various groups, such that a focus upon individual-level medical interventions will have limited effects without the consideration of the macro-level factors that dictate how effectively individuals can manage their health. While the health impacts of mass incarceration have been explored, less attention has been paid to how the “war on drugs” in the United States exacerbates many of the factors that negatively impact health and wellbeing, disproportionately impacting low-income communities and people of colour who already experience structural challenges including discrimination, disinvestment, and racism. The U.S. war on drugs has subjected millions to criminalisation, incarceration, and lifelong criminal records, disrupting or altogether eliminating their access to adequate resources and supports to live healthy lives. This paper examines the ways that “drug war logic” has become embedded in key SDOH and systems, such as employment, education, housing, public benefits, family regulation (commonly referred to as the child welfare system), the drug treatment system, and the healthcare system. Rather than supporting the health and wellbeing of individuals, families, and communities, the U.S. drug war has exacerbated harm in these systems through practices such as drug testing, mandatory reporting, zero-tolerance policies, and coerced treatment. We argue that, because the drug war has become embedded in these systems, medical practitioners can play a significant role in promoting individual and community health by reducing the impact of criminalisation upon healthcare service provision and by becoming engaged in policy reform efforts.

KEY MESSAGES

• A drug war logic that prioritises and justifies drug prohibition, criminalisation, and punishment has fuelled the expansion of drug surveillance and control mechanisms in numerous facets of everyday life in the United States negatively impacting key social determinants of health, including housing, education, income, and employment.
• The U.S. drug war’s frontline enforcers are no longer police alone but now include physicians, nurses, teachers, neighbours, social workers, employers, landlords, and others.
• Physicians and healthcare providers can play a significant role in promoting individual and community health by reducing the impact of criminalisation upon healthcare service provision and engaging in policy reform.

Introduction

Social determinants of health (SDOH) are “the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” [ 1 ] There is a growing recognition in the fields of public health and medicine that SDOH play a key role in driving health inequities and disparities, such that a focus on individual-level medical interventions will have limited effects without the consideration of the macro-level factors that dictate how effectively individuals can manage their health. For instance, differences in access to nutritious foods, safe neighbourhoods, stable housing, well-paying job opportunities, enriching school environments, insurance, and healthcare can lead to differential health outcomes for individuals, their families, and their communities. And as these mid- and downstream SDOH have gained more attention, we must also focus on more macro SDOH in order to understand “how upstream factors, such as governance and legislation, create structural challenges and impose downstream barriers that impact the ability and opportunity to lead a healthy lifestyle.” [ 2 ]

One underexplored upstream SDOH is the “war on drugs” in the United States and how it exacerbates many of the factors that negatively impact health and wellbeing, disproportionately affecting low-income communities and people of colour who already experience structural challenges including discrimination, disinvestment, and racism [ 3 ]. President Richard Nixon launched the contemporary drug war in the U.S. in 1971 when he signed the Controlled Substances Act and declared drug abuse as “public enemy number one.” [ 4 ] Since the declaration of the U.S. drug war, billions of dollars each year have been spent on drug enforcement and punishment because it was made a local, state, and federal priority [ 5 ]. For the past half century, the war on drugs has subjected millions to criminalisation, incarceration, and lifelong criminal records, disrupting or altogether eliminating access to adequate resources and supports to live healthy lives.

Drug offences remain the leading cause of arrest in the nation; over 1.1 million drug-related arrests were made in 2020, and the majority were for personal possession alone [ 6 ]. Black people – who are 13% of the U.S. population – made up 24% of all drug arrests in 2020, despite the fact that people of all races use and sell drugs at similar rates [ 6–8 ]. While incarceration rates for drug-related offences skyrocketed in the 1980s and 1990s, they have decreased in recent years motivated both by cost savings and criminal legal reform efforts to promote a public health approach to drug use. However, estimates still suggest that roughly 20% of people who are incarcerated are there for a drug charge, and racial disparities in incarceration persist [ 9 , 10 ].

Meanwhile, the illicit drug supply has become increasingly unpredictable and contaminated due to drug supply disruptions, contributing to an exponential increase in drug overdose deaths [ 11 , 12 ]. Estimates suggest that one million people died of a drug-involved overdose between 1999 and 2020, with over 100,000 deaths occurring in a calendar year for the first time in 2021 [ 13 , 14 ]. Since 2015, overdose deaths have disproportionately impacted racial and ethnic minorities; Black people have had the biggest increase in overdose fatality rates, and today, Black and Native people have the highest overdose death rates across the U.S [ 15 ]. The most recent “fourth wave” of the overdose crisis can be attributed to a fentanyl-contaminated drug supply caused by drug prohibition; criminalisation that leads to stigma and fear of punishment that deters people from getting support they might need; and a lack of robust, scaled-up investment in harm reduction and evidence-based treatment services [ 16 , 17 ]. Although harm reduction interventions, including supervised consumption spaces (also called supervised injection facilities, drug consumption rooms, or overdose prevention centres) and heroin-assisted treatment have been widely studied and found effective outside of the U.S., these strategies have not been widely adopted in this country [ 18–21 ].

The drug war has also become deeply embedded within many of the systems and structures of U.S. life well beyond the criminal legal apparatus [ 3 ]. Since the health impacts of incarceration have been studied elsewhere, this paper will specifically discuss the impacts of criminalisation in other facets of life [ 22 ].

We argue that an underlying drug war logic has fuelled the expansion of drug surveillance and control mechanisms in numerous facets of everyday life in the U.S. We define drug war logic as a logic that prioritises and justifies drug prohibition, criminalisation, and punishment to purportedly address the real and perceived health harms of drug use over a public health approach to address these issues. In coining this term, we hope to make more visible the implicit assumptions about drug use that are often unnamed but common in the policies and practices across different institutions. We acknowledge that many actors in these settings where drug war logic is embedded, including physicians and other healthcare providers, are often well-intentioned yet unaware of how they may be perpetuating this logic through their own actions. We argue that drug war logic defies and contradicts widely accepted understandings of addiction as a health issue and has, in many cases, made a public health approach more challenging to implement [ 23 ]. Notably, the American Society of Addiction Medicine defines addiction as “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences.” [ 24 ] As this paper will outline, drug war logic undermines rather than supports the health of people who use drugs, their families, and their communities by treating drug use as a criminal issue.

Drug war logic is made concrete, not just within criminal legal systems, but also through mandated drug reporting and monitoring systems in treatment and healthcare settings, compulsory drug testing in employment and for the receipt of social services, the proliferation of zero-tolerance workplaces and school zones, mandated treatment in order to receive resources or avoid loss of benefits, background checks for work and housing, and numerous other measures which will be discussed in detail below. As a result, the drug war’s frontline enforcers are no longer police alone but now include physicians, nurses, teachers, neighbours, social workers, employers, landlords, and others who are required to engage in these forms of surveillance and punishment.

This commentary will use a SDOH lens to explore a number of systems where the drug war and its logic have taken root, impacting individual and community health and subjecting many people in the U.S. to surveillance due to suspected or confirmed drug use. Healthcare providers must have a robust understanding of the impact of drug war logic in employment, housing, education, public benefits, the family regulation system (commonly referred to as the child welfare system), the drug treatment system, and the healthcare system because these deeply impact the health of their patients, particularly their patients who use drugs (For the purposes of this paper, we are using the term “Family Regulation System,” coined by Emma Williams and used by other scholars, instead of the more commonly used term “Child Welfare System” to reflect the fact that, particularly for low-income families and families of color, state intervention often occurs in order to regulate their families rather than to prioritize the welfare of the entire family unit, of which the child is a part).

Employment, with its link to income and health insurance, is an important determinant of health. However, drug testing, criminal background checks, and exclusions of those with criminal histories from certain professions create significant barriers to obtaining and maintaining employment. Beginning in the 1980s, employment-based drug testing became widespread. In a 1994 report, the National Research Council noted that “[i]n a period of about 20 years, urine testing has moved from identifying a few individuals with major criminal or health problems to generalized programs that touch the lives of millions of citizens.” [ 25 ] Between 2017 and 2020, the National Survey on Drug Use and Health found that approximately 21% of respondents were tested as part of the hiring process, and 15% were subject to random employee drug testing [ 26 ].

Despite the widespread use of testing, less than 5.5% of results are positive for any drug, according to data from Quest Diagnostics, one of the largest testing companies in the country [ 27 ]. There is little evidence that these policies are effective in reducing drug use, improving workplace safety, or increasing productivity [ 28–30 ]. Notably, drug tests cannot specify how much of a drug was consumed, whether the person is currently intoxicated or impaired, or if they have a SUD. Drug tests cannot indicate if drug use will impact a person’s ability to perform their work or if they present a safety risk. Rather, drug tests simply show whether or not someone has a particular metabolite in their system [ 31–35 ].

Beyond workplace drug testing, hundreds of thousands are excluded from stable, well-paid work because of drug-related convictions. Over 70 million people – more than 20% of the U.S. population – have some type of criminal record [ 36 ]. A drug arrest or charge, even without a conviction, can be a barrier to getting a job because it can appear in many web searches and background checks [ 37 ]. Criminal background checks have become cheaper and easier to access, even though these records are notoriously inaccurate [ 38 , 39 ]. In addition, more than a quarter of jobs in the U.S. require some kind of licence, and a drug conviction history can automatically prevent people from getting a professional licence for their trade, like trucking or barbering [ 40 ].

These employment barriers disproportionately affect Black men, who already face additional impediments to employment and who are most harmed by the drug war and criminalisation [ 41 ]. The federal Equal Employment Opportunity Commission issued guidance stating that denying employment based on criminal records could be a form of racial discrimination because people of colour are more likely to be targeted by law enforcement and thus more likely to have an arrest or conviction record [ 42 , 43 ]. As a recent report by the Brennan Centre points out: “the staggering racial disparities in our criminal justice system flow directly into economic inequality” [ 36 ]. This same report found that those with a history of imprisonment earned 52% less than those with no history of incarceration.

Employment is a health issue that should be of concern to healthcare providers because it provides income, access to health insurance and medical treatment, and social connection [ 44 ]. Precarious employment and low income are linked to poor health, and some research has shown that people who use drugs and who are precariously employed face increased vulnerability to violence and HIV infection [ 45–47 ]. Being unemployed can lead to poverty and negative health effects and is associated with increased rates of drug use and SUDs [ 48 ].

Rather than supporting people who use drugs in accessing employment and the health benefits attached to it, drug war logic in employment settings can erect barriers. Eliminating or greatly restricting workplace drug testing as well as banning criminal background checks and professional licencing restrictions are important steps towards restoring access to employment and the many health benefits it confers.

Housing is another key SDOH that is significantly impacted by drug war policies and practices. Drug war surveillance in housing began with the passage of the Anti-Drug Abuse Act of 1988, which prohibited public housing authorities (PHAs) from allowing tenants to engage in drug-related activity on or near public housing premises and deemed such activity grounds for immediate eviction [ 49 ].

The Cranston-Gonzalez National Affordable Housing Act of 1990 expanded on this so that if a tenant’s family member or guest - regardless of whether they live on-site - engages in drug-related activity, the tenant and their household can be evicted [ 50 ]. Additionally, the Act states that evicted households must be banned from public housing for a minimum of three years unless the tenant completes an agency-approved drug treatment program or has otherwise been “rehabilitated successfully.” [ 50 ]

Six years later in 1996, Congress passed the Housing Opportunity Program Extension Act, which established “One Strike” laws and expanded on previous acts to give PHAs the authority to evict tenants if they or a guest was suspected of using or selling drugs, even outside of the premises [ 51 ]. This series of public housing policies requires neither a drug arrest nor proof that a tenant or their guest is involved in drug use, sales, or activity [ 52 ].

Private housing markets can also enforce zero-tolerance drug policies. In over 2,000 cities across the U.S., landlords can certify their property as “crime-free” by taking a class, implementing “crime prevention” architecture, and including clauses in their leases that allow for immediate eviction should a tenant, family member, or guest engage in “criminal activity,” particularly drug-related activity, on or off the premises [ 53 , 54 ]. Landlords, in close partnership with law enforcement, can invoke these laws by claiming to enforce crime-free ordinances, regardless of whether the alleged drug-related activity is illegal. In states across the U.S., private landlords have evicted tenants following an overdose [ 55–59 ]. In practice, these programs and ordinances increase the surveillance and displacement of low-income Black and Latinx tenants while not decreasing crime and potentially deterring someone from calling 911 for medical assistance in case of an overdose [ 55 ].

Evictions can lead to unstable housing or homelessness, which is associated with a host of chronic health problems, infectious diseases, emotional and developmental problems, food insecurity, and premature death [ 60–63 ]. Lacking a permanent address and reliable transportation makes it more difficult to receive and store medications and travel to a hospital or clinic; this is compounded with the stigma and discrimination that unhoused people often face from healthcare providers [ 64 ]. Being unhoused or housing unstable is also associated with difficulty obtaining long-term employment and education [ 65–67 ]. Longitudinal studies have found that family eviction has both short- and long-term impacts among newborns and children, including adverse birth outcomes, poorer health, risk of lead exposure, worse cognitive function, and lower educational outcomes [ 68 ]. These negative health outcomes are compounded for people with SUDs [ 69 ]. Unhoused people who use drugs are often forced into more unsafe, more unsanitary, and riskier injection and drug-using practices to avoid detection [ 70 ]. Evictions and homelessness are also associated with increased risk of drug-related harms, including non-fatal and fatal overdose, infectious diseases, and syringe sharing [ 71–73 ]. In addition, evictions can disrupt relationships between users and trusted sellers, making an already unregulated drug supply even more unpredictable [ 70 ].

While housing is understood as a key component of health and safety for all people, including people who use drugs, drug war logic can encourage and facilitate displacement, making it hard for housed people to remain so and creating barriers for those who are unhoused to find safe, affordable housing options. Solutions for improving housing access include ending evictions and removing housing bans based solely on drug-related activity or suspected activity, restricting landlords from using criminal background checks to exclude prospective tenants, and ending collaborations between housing complexes and law enforcement. Housing interventions that can improve the health of people who use drugs, in particular, include investing in Housing First programs and permanent supportive housing, providing eviction protection to people who call for help during an overdose emergency (i.e. expanding 911 Good Samaritan laws), and establishing overdose prevention centres.

Education is also understood as a strong predictor of health [ 74–76 ], but drug war logic in educational settings can subject young people who use drugs to punishment rather than needed support. Adolescent substance use is associated with sexual risk behaviour, experience of violence, adverse childhood experiences, and mental health and suicide risks, which should justify greater mental health and support services in schools [ 77 ]. Despite this, punitive responses to suspected or confirmed drug use, ranging from surveillance and policing to drug testing and expulsion, are commonplace in the field of education.

In 2018, 94% of high schools used security cameras, 65% did random sweeps for contraband, and 13% used metal detectors [ 78 ]. Twenty-four states and the District of Columbia have almost as many police and security officers in schools as they do school counsellors [ 79 , 80 ]. Drug use is one of the most common sources of referrals of students to police [ 80 ]. And recent estimates show that over a third of all U.S. school districts with middle or high schools had student drug testing policies [ 81–83 ].

Drug war policies also impact higher education, which is integral to economic mobility [ 84 ]. Prior to December 2020, federal law prohibited educational grants and financial aid to people in prison, one-fifth of whom were there for a drug offence, and drug convictions could lead to temporary or indefinite suspension of federal financial aid for students [ 85 ]. Still today, fourteen states have some temporary or permanent denial of financial aid for college or university education for people with criminal records [ 86 ].

These education policies – surveillance, policing, drug testing, zero tolerance, and barriers to financial aid – restrict access to education and ultimately impede economic wellbeing and positive health outcomes. For example, dropout risk increases every time a student receives harsh school discipline or comes into contact with the criminal legal system, including through school police officers [ 87 ]. Dropping out, in turn, is associated with higher unemployment and chronic health conditions [ 88 ]. In addition, discipline, such as expulsion for a drug violation, can contribute to more arrests for drug offences or the development of SUDs [ 89–91 ]. In contrast, school completion can help reduce higher risk substance use patterns [ 92 ], and education is a strong predictor of long-term health and quality of life [ 93 ].

Rather than supporting young people in completing their education and getting the support they may need, drug war logic prioritises punishing them in schools while often restricting access to financial aid and educational services for those seeking higher education. If we want to improve the health of young people, we need to reverse these policies. For example, the American Academy of Paediatrics opposes the random drug testing of young people based on an exhaustive review of the literature finding it did more harm than good [ 94 ]. Removing police from schools, ending zero-tolerance policies, and offering young people who use drugs counselling and support, instead of expulsion, could also help improve completion rates, ultimately leading to better health outcomes.

Public benefits

Though economic and food insecurity are linked with poor health outcomes, decades of drug policies have restricted access to public assistance programs. In 1996, Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) [ 95 ], and one of the stated goals was to facilitate the transition from reliance on public assistance to full-time employment [ 96 ]. This law restricted benefits for people who use drugs, people with prior drug convictions, and their families in several ways.

The PRWORA introduced a lifetime ban on Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) cash assistance benefits for people with felony drug convictions, unless the state modified or opted out of the ban. Today, one state - South Carolina - fully bars people with felony drug convictions from receiving SNAP, and twenty-one states have instituted a modified SNAP ban [ 97 ]. Seven states fully bar people with felony drug convictions from receiving TANF, and seventeen states and the District of Columbia have instituted modified TANF bans [ 97 ]. Common features of modified bans can include mandatory drug treatment, drug testing, and parole compliance [ 98 , 99 ]. These zero-tolerance bans have discriminatory and disproportionate impacts among Black and Latinx people and women, who are disproportionately incarcerated for federal and state drug offences [ 100 ].

Drug testing of public benefits applicants is less discussed in the peer-reviewed literature [ 101 ]. Although the PRWORA authorised, but did not require, drug screenings of public benefits applicants, today 13 states drug test TANF applicants [ 102 , 103 ]. States that drug test as a condition of receiving TANF can only test if drug use is suspected. For example, some states automatically require people with felony drug convictions to take a drug test [ 104 ], while other states require all applicants to undergo a drug screening questionnaire and then require a test if there is suspicion of drug use [ 105 ]. Many TANF applicants, who are already low income, are expected to pay for their drug tests. The impact of drug testing on people with felony drug convictions is compounded since they are already disproportionately poor, unemployed, and food insecure compared to people who have never been incarcerated [ 106–108 ].

In most states that test, a positive drug test can temporarily or permanently disqualify a person from receiving TANF benefits [ 105 ]. Even if cash assistance is allocated to other household members (e.g. children) through a different parent or guardian, overall benefits for the family can be reduced. In some cases, a person who tests positive for drugs may still receive benefits but only if they complete mandated, abstinence-based treatment [ 105 ]. Such policies and practices can deter many eligible candidates and those in need of support from ultimately seeking these public benefits altogether [ 109 ].

There are numerous negative health consequences associated with food and economic insecurity [ 110–112 ]. In particular, studies have found that loss or reduction of SNAP is associated with increased odds of household and child food insecurity and increased odds of forgoing health or dental care [ 113 ]. Loss or reduction of TANF is associated with increased risk of hunger, homelessness or eviction, utility shutoff, inadequate medical care, and poor health [ 114 ].

When people are seeking financial and nutritional support to better care for themselves and their families, especially in crisis, drug war logic justifies more barriers to SNAP and TANF and the discontinuation of assistance precisely when people need it the most. To better support financial and economic security of low-income people, advocates can support removing TANF and SNAP bans for people who have felony drug convictions, ending drug testing requirements for public assistance, eliminating mandatory drug treatment requirements for public benefits applicants and recipients, and adequately investing in public benefit programs to ensure they provide enough assistance for families.

Family regulation

The family regulation system (FRS) often treats any drug use as a predictor of child abuse or neglect, even though research shows that poverty is one of the largest predictors of adverse infant and child health outcomes [ 115 ]. Drug war logic within the FRS justifies the separation and punishment of families for drug use even absent evidence of abuse or neglect. Half of all states and the District of Columbia require healthcare professionals to report any suspected drug use during pregnancy to FRS authorities, and eight states require them to drug test patients suspected of drug use [ 116 ]. Statutes in nineteen states and the District of Columbia define any drug use during pregnancy as a form of child maltreatment [ 117 ]. These policies exist even though most people who use drugs use them infrequently and do not meet criteria for SUDs [ 118 ]. Additionally, evidence proving causal links between prenatal drug use and child harm and maltreatment is limited. Research finds that in utero exposure to drugs may not have long-term negative developmental impacts on the child and that confounding variables, like poverty and food insecurity, have significant and often stronger impacts on child development than drug use [ 117 ].

Drug testing, mandatory reporting, and the prospect of punishments result in poorer health outcomes for pregnant people who use drugs, especially if they struggle with their use. A fear of punishment and family separation leads some pregnant people who use drugs to avoid honest, open conversations about healthcare needs or how to reduce drug use harms so that many delay, avoid, or forgo prenatal care altogether [ 119 , 120 ].

Like healthcare professionals, most school teachers, counsellors, social workers, and mental healthcare providers are required by law to report any suspicion of child maltreatment or neglect, which then initiates an FRS investigation [ 121 ]. A child can be removed from their home if the caregiver tests positive for drugs, even absent any other evidence of mistreatment or abuse. In addition, a positive drug test can lead to a parent being mandated to complete abstinence-based treatment even if the parent does not meet criteria for a diagnosable SUD [ 122 ]. Intervention by the FRS, such as placing children in foster care, can lead to adverse education, employment, and mental and behavioural health outcomes among children; increased parental mental illness diagnoses; and increased parental drug use to cope with the trauma of family separation [ 123–125 ].

These policies have disproportionate impacts on Black people. Black pregnant women are more likely to be tested for drug use, and Black women are reported to the FRS at higher rates than white women [ 126–128 ]. Over half of Black children will experience an FRS investigation at some point during their lifetime [ 129 ]. One study that analysed cumulative foster system removals between 2000 and 2011 found that 1 in 17 U.S. children, 1 in 9 Black children, and 1 in 7 Indigenous children will experience foster placement before they turn 18, and data show that many FRS cases involve allegations of parental drug use at some point [ 130 ]. These disparities in FRS involvement are not because Black parents are using drugs or mistreating their children at higher rates; rather, it’s because Black families, especially poor Black families, more often encounter state systems – like public hospitals and public benefits offices – and mandated reporters within these systems that monitor behaviour and drug use [ 131 ].

Drug war logic prioritises separation, coercion, and punishment in families where drug use occurs or is suspected. For pregnant people and parents who do use problematically, their use should be treated as a public health issue, according to international bodies like the United Nations General Assembly Special Session on drugs [ 132 ]. Advocates can support legislative policy changes to prohibit removals based on drug tests alone, eliminate mandatory reporting for drug use alone, and repeal laws that define drug use during pregnancy as de facto child abuse or maltreatment. Healthcare professionals can also advocate to only allow drug testing when medically necessary and when the parent provides informed consent; support practices that keep parents and infants together, like breastfeeding and skin-to-skin contact, that can mitigate the effects of neonatal abstinence syndrome [ 133 , 134 ]; and create programs providing both perinatal healthcare and SUD treatment to improve access and continuity of care as well as initiation and maintenance of medications for addiction treatment.

Substance use treatment system

Substance use treatment can be an essential lifeline for people with SUD working towards recovery. Yet surveillance and punishment are embedded into SUD treatment through the numerous constraints placed upon clients because of the role of institutional referral sources in treatment, such as the criminal legal system, the FRS, social services, and others. Studies suggest that roughly 25% of clients in publicly funded treatment were referred from the criminal legal system as a condition of their probation, parole, or drug court program [ 135 ]. This has led to therapeutic jurisprudence: the belief that the criminal legal system can support and facilitate efforts towards rehabilitation using the threat of incarceration [ 136 ]. Another 25% of clients are referred to treatment by other sources, including the FRS, social services, schools, and employers [ 133 ]. Criminal legal controls such as those from the courts, or formal social controls such as those from the other aforementioned institutions, coerce clients to either comply with treatment or face other harsh consequences, like incarceration, the termination of parental rights, or losing public benefits [ 137 ].

Treatment providers monitor client compliance and abstinence by conducting and observing routine urine drug tests, and providers are often in regular contact with referral sources about client progress in treatment. Any drug use or negative progress reports can be used as grounds to sanction those on probation, parole, or in drug court which can lead to incarceration and, in cases of drug courts, longer sentences than if participants had accepted a jail sentence [ 136 ]. Clients referred by other sources can also face ramifications for positive drug tests or treatment non-compliance, impacting child custody hearings as well as their ability to secure certain social services and resources, stay enrolled in school, or remain employed.

Referral sources influence the type of care that clients receive in facilities, including evidence-based treatments. Research suggests that only 5% of clients with opioid use disorder (OUD), who were referred to treatment from the criminal legal system, received either methadone or buprenorphine, compared to nearly 40% those who were not referred by the system [ 138 ]. This represents an extension of a broader problem within the criminal legal system wherein access to these gold standard medications for OUD is almost nonexistent in most jails and prisons across the U.S [ 139 ].

Drug war logic is also deeply rooted in the restrictions for prescribing and dispensing methadone and buprenorphine since they are controlled substances under the oversight of the Drug Enforcement Agency, a federal law enforcement entity. When taken in effective doses, these life-saving medications can cut the risk of overdose and all-cause mortality dramatically among people with OUD [ 140 ]. However, due to tight federal restrictions and guidelines for these controlled medications, patients can be subjected to routine drug testing, counselling requirements, daily clinic visits, and observed or highly monitored medication dispensing. Patients deemed non adherent to medications or who test positive for other drugs can then be subjected to dose reductions, required to attend treatment more frequently, or even terminated from care altogether [ 141 ]. The tight restrictions on both methadone and buprenorphine, combined with the oversight of the DEA, create obstacles for prescribers and stigmatise these medications by conveying that they cannot be used like other medications in routine healthcare [ 142 ]. These policies have also contributed to striking racial disparities in who receives buprenorphine versus methadone due to costly co-pays and insurance coverage issues [ 143 ]. Studies also suggest that the DEA’s involvement in monitoring buprenorphine has made pharmacies reluctant to stock the medication or to dispense it to patients for fear of triggering an investigation [ 144 , 145 ]. Ultimately, it is estimated that only 10% of all people with OUD receive these medications [ 146 ].

Providers can take steps to extract the drug war from our substance use treatment system, through their conscious and judicious documentation of treatment progress since those records could be used by criminal legal and other referral sources in decisions about clients and their families. In addition, eligible buprenorphine prescribers should begin prescribing to patients and join advocacy efforts to change policies to expand access to buprenorphine and methadone through looser restrictions.

Healthcare system

People with SUDs often have high rates of co-occurring medical needs requiring treatment, including psychiatric disorders, infectious diseases, and other chronic health conditions. However, research suggests that people with SUDs are often deterred from seeking healthcare to address their medical needs due to prior negative and stigmatising experiences with providers, and that having experienced discrimination in healthcare is associated with greater risk behaviours, psychological distress, and negative health outcomes among people who use drugs [ 147–149 ]. Some of these challenges are due to a lack of training on how to work with patients with SUDs, in addition to pre-existing personal biases and stigmatising views held by healthcare professionals, which impacts the type of care they provide [ 142 ].

The widespread use of drug testing in healthcare settings also creates ethical challenges and conflicts for providers and patients since results are often entered into the electronic health record (EHR). While EHRs are typically thought of as beneficial and intended for greater transparency and access, they also pose challenges surrounding patient privacy, confidentiality, and autonomy; they can, therefore, make patients reluctant to disclose drug use or consent to drug testing [ 150 ]. For instance, medical records that include drug test results, can be accessed by a wide variety of actors in the medical system, subpoenaed for court, and used in future medical decision making without the patient’s knowledge or consent. Providers might not receive adequate training to weigh the need for these tests as part of treatment adherence monitoring with the potential social or legal ramifications of these tests for the patient. Patients might also not be adequately informed of these potential consequences prior to testing.

Universal drug screening and testing in obstetric and gynecological care is an example wherein testing intersects with the role of most healthcare providers as mandated reporters. Mandated reporting for suspected child abuse or neglect due to parental drug use is purported to protect the foetus or children in the parents’ custody, yet this can often be a deterrent for patients to seek medical treatment altogether if they believe that they may lose their children or be subject to other mandates. The racial and class disparities in how such testing is used, as well as the punitive measures used against families, have been noted earlier in the text but is a compelling reason for healthcare providers to consider making recommendations for counselling or supportive case management in order to address family challenges.

Healthcare providers need more training and resources to work with patients with SUDs to ensure that they are engaging them in evidence-based treatments and treating their complex medical needs while avoiding some of the lifelong and harmful ramifications that can occur when drug testing, health records, and mandated reporting deter patients from seeking and receiving care.

Because of the social, economic, and health effects of drug policies, the work of ending the drug war cannot be situated within criminal legal reform efforts alone. The drug war and a punitive drug war logic impact most systems of everyday life in the U.S., subjecting people to surveillance, suspicion, and punishment and undermining key SDOH, including education, employment, housing, and access to benefits. Combined, these have resulted in poorer health outcomes for individuals, families, and communities, particularly for people who use drugs. These policies and practices, while race-neutral as written, are not [ 151 ]. The targeted effects on people of colour further entrench health and economic disparities. As the public and policymakers call for a health approach to drug use, it is vital to recognise how systems meant to care and support are often unable to serve their intended purposes; rather than help people who use drugs or are suspected of using drugs, they frequently punish them.

In their day-to-day practice, healthcare professionals must understand the deep roots of the drug war as well as their role in both perpetuating and undermining drug war logic and practices. Healthcare providers can treat people who use drugs with dignity, respect, and trust and ensure that healthcare and treatment decisions are made in partnership with individuals. Medical professionals can also work to situate drug use within a larger social and economic context [ 152 ], understanding that drug-related harms often stem from lack of resources – like housing and food precarity, economic insecurity, and insufficient healthcare – rather than from drugs themselves. Treatment need not be the only antidote for people who experience drug-related harms but should be one option among an array of health services, resources, and support.

At the mezzo- and institutional levels, healthcare providers can advocate to shift hospital and programmatic policies around drug testing, mandatory reporting, and collaborations with law enforcement. As outlined in this paper, drug testing is not an effective monitoring strategy for care and support, but rather, it is more often a punitive tool of surveillance. If drug testing cannot be eliminated, at the very least, patients should have the right to understand the implications of drug testing and provide explicit consent for the test. To the extent possible, providers should not share private patient information with police or state agencies. Healthcare professionals should understand the implications of reporting positive drug tests and suspicion of use and should work to change these policies where possible and inform their patients of them. Providers can ensure that their patients who use drugs have access to evidence-based, non-coercive harm reduction and treatment options in addition to robust and supportive primary healthcare. Healthcare professionals involved with medical education and licensure can work to ensure that all students graduate with a deep understanding of SDOH and the impact of the drug war on individual and community health.

Finally, healthcare providers can get involved with policy-level changes to end drug testing, mandatory reporting, zero-tolerance policies, coerced treatment, and denial of services and resources based on arrest or conviction records at the municipal, state, and federal levels. Providers can follow the leadership and expertise of people who use drugs, some of whom have organised themselves into user unions [ 153 ]. Policy advocacy can include drafting and joining sign-on letters, delivering expert testimony, speaking to media, writing op-eds, and lobbying medical professional organisations to release policy statements. Providers, who see firsthand the consequences of the war on drugs, are well positioned to be effective advocates in undoing these harmful policies that have for too long undermined key SDOH [ 154 ]. In order to improve individual and collective health, healthcare providers should resist drug war logic and work to transform these systems so they can truly promote health and safety.

For the purposes of this paper, we are using the term “Family Regulation System,” coined by Emma Williams and used by other scholars, instead of the more commonly used term “Child Welfare System” to reflect the fact that, particularly for low-income families and families of color, state intervention often occurs in order to regulate their families rather than to prioritize the welfare of the entire family unit, of which the child is a part.

Authors contribution

All authors (AC, SV, JN, KF) were involved in the conception and drafting of the paper, revising it critically for intellectual content; and the final approval of the version to be published. All authors agree to be accountable for all aspects of the work.

Disclosure statement

All authors are employed by the Drug Policy Alliance, a non-profit policy advocacy organisation. No other interests to disclose.

Data availability statement

The views expressed in the submitted article are those of the authors.

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Jay Z: ‘The War on Drugs Is an Epic Fail’

By Asha Bandele

• Sept. 15, 2016

Jay Z: 'The War on Drugs Is an Epic Fail'

Why are white men poised to get rich doing the same thing african-americans have been going to prison for.

TRANSCRIPT In 1986, when I was coming of age, Ronald Reagan doubled down on the War on Drugs that had been started by Richard Nixon in 1971. Drugs were bad, fried your brain. And drug dealers were monsters, the sole reason neighborhoods and major cities were failing. No one wanted to talk about Reaganomics and the ending of social safety nets, the defunding of schools, and the loss of jobs in cities across America. Young men like me who hustled became the sole villain and drug addicts lacked moral fortitude. And in the 1990s, incarceration rates in the U.S. blew up. Today we imprison more people than any other country in the world. China, Russia, Iran, Cuba—all countries we consider autocratic and repressive. Yeah, more than them. Judges’ hands were tied by “tough on crime” laws and they were forced to hand out mandatory life sentences for simple possession and low-level drug sales. My home state of New York started this with Rockefeller Laws. Then the Feds made distinctions between people who sold powder cocaine and crack cocaine—even though they were the same drug. Only difference is how you take it. And even though White people used and sold crack more than Black people, somehow it was Black people who went to prison. The media ignored actual data. To this day, crack is still talked about as a Black problem. The NYPD raided our Brooklyn neighborhoods while Manhattan bankers openly used coke with impunity. The War on Drugs exploded the U.S. prison population, disproportionately locking away Black and Latinos. Our prison population grew more than 900%. When the War on Drugs began in 1971, our prison population was 200,000, today it is over 2 million. Long after the crack era ended, we continued our war on drugs. There were more than 1.5 million drug arrests in 2014, more than 80% were for possession only. Almost half were for marijuana. People are finally talking about treating an addiction to harder drugs as a health crisis, but there’s no compassionate language about drug dealers. Unless of course we’re talking about places like Colorado, whose state economy got a huge boost by the above ground marijuana industry. A few states south in Louisiana, they’re still handing out mandatory sentences to people who sell weed. Despite a booming and celebrated 50 billion legal marijuana industry, most states still disproportionately hand out mandatory sentences to Black and Latinos with drug cases. If you’re entrepreneurial and live in one of the many states that are passing legalized laws, you may still face barriers to participating in the above ground economy. Venture capitalists migrate to these states to open multi-billion dollar operations, but former felons can’t open a dispensary. Lots of times those felonies were drug charges, caught by poor people who sold drugs for a living, but are now prohibited from participating in one of the fastest growing economies. Got it? In states like New York, where holding marijuana is no longer grounds for arrest, police issue possession citations in Black and Latino neighborhoods at a far higher rate than other neighborhoods. Kids in Crown Heights are constantly stopped and ticketed for trees. Kids at dorms in Columbia, where rates of marijuana use are equal to or worse than those in the hood, are never targeted or ticketed. Rates of drug use are as high as they were when Nixon declared this so-called war in 1971. Forty-five years later, it’s time to rethink our policies and laws. The War on Drugs is an epic fail.

This short film, narrated by Jay Z (Shawn Carter) and featuring the artwork of Molly Crabapple, is part history lesson about the war on drugs and part vision statement. As Ms. Crabapple’s haunting images flash by, the film takes us from the Nixon administration and the Rockefeller drug laws — the draconian 1973 statutes enacted in New York that exploded the state’s prison population and ushered in a period of similar sentencing schemes for other states — through the extraordinary growth in our nation’s prison population to the emerging aboveground marijuana market of today. We learn how African-Americans can make up around 13 percent of the United States population — yet 31 percent of those arrested for drug law violations, even though they use and sell drugs at the same rate as whites.

The project came about when, last year, Dream Hampton, the filmmaker and a co-author of Jay Z’s book “Decoded,” approached the Drug Policy Alliance about collaborating with Revolve Impact, the social impact agency she works with. Revolve Impact connects artists and influencers to community organizers, and with marijuana legalization taking hold across the nation — and about to be considered in her own state, California — Ms. Hampton wanted to tackle the contradiction raised by Michelle Alexander, the author of “The New Jim Crow: Mass Incarceration in the Age of Colorblindness,” in 2014: Why were white men poised to get rich doing the very same thing that African-American boys and men had long been going to prison for? Ms. Hampton proposed creating an animated video that the D.P.A. would produce about the impact of the drug war in African-American communities.

Policy makers are joining advocates in demanding an end to biased policing and mass incarceration, and in November, Californians specifically have the opportunity to vote Yes on Prop 64, the most racial-justice-oriented marijuana legalization measure ever. Prop 64 would reduce (and in many cases eliminate) criminal penalties for marijuana offenses, and it’s retroactive — people sitting in prison for low-level marijuana offenses would be released and have their records expunged. In addition, Prop 64 would drive millions of dollars in direct funding and investments to those communities most harmed by the criminal justice system.

Jay Z and Molly Crabapple are inviting us all to stand on the right side of history.

Asha Bandele ( @ashabandele ) is a senior director at the Drug Policy Alliance.

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Essay on The Failure of the War on Drugs

In the early 1980s, policymakers and law enforcement officials stepped up efforts to combat the trafficking and use of illicit drugs. This was the popular “war on drugs,” hailed by conservatives and liberals alike as a means to restore order and hope to communities and families plagued by anti-social or self-destructive pathologies. By reducing illicit drug use, many claimed, the drug war would significantly reduce the rate of serious nondrug crimes - robbery, assault, rape, homicide and the like. Has the drug war succeeded in doing so? In Illicit Drugs and Crime, Bruce L. Benson and David W. Rasmussen (Professors of Economics, Florida State University, and Research Fellows, the Independent Institute), reply with a resounding no. Not …show more content…

Certainly many violent and property criminals use drugs. But only a small percentage of drug users commit violent or property crimes. Drug offenders are far more likely to recidivate for a drug offense than for a violent offense or property crime. Is drug use to blame for the crimes drug users do commit? Benson and Rasmussen suggest that the reverse is closer to the mark: Many criminals who use drugs did not begin to do so until after they began committing nondrug crimes. A Bureau of Justice Statistics survey of prison inmates found that about half of the inmates who had used a major drug, and about 60 percent of those who used a major drug regularly, did not do so until after their first arrest for a nondrug crime. “Similarly,” Benson and Rasmussen note, “more than half of local jail inmates who reported they were regular drug users in the survey . . . said that their first arrest for a crime occurred an average of two years before their drug use. Once an individual has decided to turn to crime as a source of income, he or she may discover that drugs are more easily obtained within the criminal subculture and perhaps that the risks posed by the criminal justice system are not as great as initially anticipated. Furthermore, criminal activity generates income with which to buy goods that previously were not affordable, including drugs. Thus, crime leads to drug use, not vice versa.” Because relatively few illicit drug offenders commit

The War On Drugs And The United States Essay

For many years, drugs have been the center of crime and the criminal justice system in the United States. Due to this widespread epidemic, President Richard Nixon declared the “War on Drugs” in 1971 with a campaign that promoted the prohibition of illicit substances and implemented policies to discourage the overall production, distribution, and consumption. The War on Drugs and the U.S. drug policy has experienced the most significant and complex challenges between criminal law and the values of today’s society. With implemented drug polices becoming much harsher over the years in order to reduce the overall misuse and abuse of drugs and a expanded federal budget, it has sparked a nation wide debate whether or not they have created more harm than good. When looking at the negative consequences of these policies not only has billions of dollars gone to waste, but the United States has also seen public health issues, mass incarceration, and violent drug related crime within the black market in which feeds our global demands and economy. With this failed approach for drug prohibition, there continues to be an increase in the overall production of illicit substances, high rate of violence, and an unfavorable impact to our nation.

Drugs and its Offenders Essay

• 7 Works Cited

The United States has the world's highest incarceration rate. With five percent of the world's population, our country houses nearly twenty-five percent of the world's reported prisoners. Currently there are approximately two million people in American prisons or jails. Since 1984 the prison population for drug offenders has risen from ten percent to now over thirty percent of the total prison population. Federal prisons were estimated to hold 179,204 sentenced inmates in 2007; 95,446 for drug offenses. State prisons held a total of 1,296,700 inmates in 2005; 253,300 for drug offenses. Sixty percent of the drug offenders in prisons are nonviolent and were purely in prison because of drug offenses (Drug War Facts). The question then arises,

Tougher Sentencing for Drug Crimes

Tougher sentencing is not likely to reduce illegal drug use or serious crime associated with drugs (Alexander, 2010; Mauer, 2009; Whitford & Yates, 2009). Despite that, politicians and law enforcement personnel continue to advocate for stronger sentences for those who take or sell drugs of any kind. The jails and prisons across the United States are filling up with drug offenders, and some believe that there are better uses for those jail cells and that there are many crimes that are more severe and significant. These are the crimes that should be provided with tougher sentencing guidelines, but yet illegal drug use is still a serious crime and should not go unpunished. What should be done, and how should changes be made? Those are tough questions that have to be explored and that do not have any easy answers for those who make the laws and those who enforce them. Drug incarceration has been on the rise, with mixed results. According to King (2008), "overall, between 1980 and 2003, the number of drug offenders in prison or jail increased by 1100% from 41,100 in 1980 to 493,800 in 2003, with a remarkable rise in arrests concentrated in African American communities."

How Did The War On Drugs Affect Policing

The war on Drugs played a heavy role in minority American society. It affected policing and most importantly the American minority people. The war on drugs started by President Nixon and up until President Bush was a disaster that affected America with high incarceration and high recidivism rates for low level and non-violent drug offenses that mainly targeted minorities in America. The war on drugs was a massive American failure that mainly affected minorities. President Obama and his drug reform alongside the American public’s strong opinion to switch towards marijuana reform which we see in places like Colorado and Washington has caused the war on drugs to lose steam. The American public’s decision for drug reform is no surprise after nearly 40 years of the unsuccessful war on drugs.

The War On Drugs And Mass Incarceration Essay

The War on Drugs not only has many acts that have been in place due to it, but there has been a domino effect with other topics. The War on Drugs has become a complicated, yet important aspect of the U.S. as well as other countries. It was to be believed that the War on Drugs has influenced incarceration. This effect was the ability to imprison those who are using drugs, and the amount of crime will begin to decrease (Lloyd, 2015). Margaret Lloyd (2015), also discussed how a community that has less crime could be a better living area for children, in hopes they will not act in deviant behaviors.

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Drug abuse is shown to be connected to all different kinds of crime in the United States, and in many circumstances, crime is inspired by drug abuse and addiction. In fact, 80% of criminal offenders abuse drugs or alcohol (National Association of Drug Court Professionals). Also, 60% of those who are arrested test positive for illicit drugs when they are arrested, and 60-80% commit another crime, typically drug-related, after leaving prison (National Association of Drug Court Professionals). And, even after these individuals put in the time in prison that would allow them to go through the uncomfortable process of detoxing, 95% of them will chose to go back to drug abuse after prison (National Association of Drug Court Professionals). Given these overwhelming statistics, it is clear that drug abuse, and repeated or continued drug abuse, are a serious problem facing the criminal justice system.

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The war on drugs has been an ongoing fight that many presidents and foreign allegiances have tried to stop the trafficking, distribution and use of illegal drugs into the United States and around the world. Policy and laws have been created and maintained and changed to try and prevent illegal drugs being made in other countries as well as the United States and from being brought across the borders into the United States. The punishment for the drug traffickers and users has been an issue with the campaign to stop illegal drug use and trafficking. Through the United States history the president’s and their administration have been focusing on how to deal with the war on drugs

The Failure of the War on Drugs Essay

• 8 Works Cited

The War on Drugs in the United States has a profound influence on both the incarceration rates and activities of the criminal justice system. Many politicians and advocates of the policy claim that the War on Drugs is a necessary element to deter criminal behavior and reduce the crime rate. However, studies show that drug deterrent policies on possession and use have been inadequate and unsuccessful (Cole & Gertz, 2013). Studies also show that the War on Drugs has not attained its objectives because the policy exhibits racial discrepancy as it has led to the disproportionate incarceration of Blacks and minorities. Specifically, evidence indicates that the upper class, generally White individuals, is more likely to use powered cocaine while

The Drug Of Drugs And Crime

There has always been a close association between drugs and crime. Drugs have been seen as a way out of suffering in one’s life and so as long as there is suffering there will always be a market for drugs. The struggle to keep one’s self sane when away from a substance they need can cause them to do crazy and even violent things to others. Things like murdering someone because they did not have proper control of themselves is not something unheard of by any means. These people can been seen as both victims and criminals, as they were not in a sound state of mind when doing these actions, however them doing the actions does not mean they should get off scot-free. The users are only one side of the coin, the other is the drug dealers. The dealers do not have to be selling purely illegal drugs, they may be selling prescription drugs too, but in the pursuit of their own survival in a struggling life, they turn to selling substances to others. By doing so they can even amass a fortune, but this is still a crime, and what people will do to try to get all this potential money can span from robbing to murder. The articles I read from different media support the fact there is indeed a tie with crime and drugs, being that an increase of drugs on the street leads to more crime.

Relationship Between Drug Abuse And Crime

In a study that was done back in 1970 by Sutherland and Cressey, they pointed out that in the U.S. alone, “felons are overrepresented in the addict population, [and] crime rates are increased considerably by drug addiction” (1970, p. 164). Despite having proposed several hypotheses attempting to explain the correlation between drug abuse and crime, they could not reach a conclusion. A decade later, the knowledge about the drug/crime relationship had steadily increased due to numerous studies of the incarcerated or addicted population. However, the information didn’t reveal any viewpoints that made sense aside from heroin. This view was

Argumentative Essay On The War On Drugs

For a start, Dan Baum talks about in his book, “Smoke and Mirrors: The War on Drugs and The Politics of Failure”, on how the War on Drugs is ineffective with many variables. Buam claims that the War on Drugs costs the administration more than the Commerce, Interior, and State departments joined. According to the Drug Policy Alliance, in over the past four decades, both federal and state governments have poured over $1 trillion the drug war and relied on taxpayers to foot the bill. In addition, The United States had roughly around 50,000 people behind bars for drug law violations. Currently, that number had multiplied ten times to half a million. Either way, drug war advocates

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“At the Federal level, prisoners incarcerated on a drug charge comprise half of the prison population, while the number of drug offenders in state prisons has increased thirteen-fold since 1980. Most of these people are not high-level actors in the drug trade, and most have no prior criminal record for a violent offense.” (sentencingpolicy.org)

The War On Drugs Essay

The “War on Drugs” is the name given to the battle of prohibition that the United States has been fighting for over forty years. And it has been America’s longest war. The “war” was officially declared by President Richard Nixon in the 1970’s due to the abuse of illegitimate drugs. Nixon claimed it as “public enemy number one” and enacted laws to fight the importation of narcotics. The United States’ War on Drugs began in response to cocaine trafficking in the late 1980’s. As the war continues to go on, winning it hardly seems feasible. As stated by NewsHour, the National Office of Drug Control Policy spends approximately nineteen billion dollars a year trying to stop the drug trade. The expenses shoot up, indirectly, through crime,

Drug Research Proposal

Incarceration can influence the accessibility of drugs and the opportunity for a user to commit crime. Interviewers will only track and assess subjects in halfway houses, psychiatric facilities, individuals who are homeless, and other known areas of abundant drug circulation (streets). For research clarity, we would like to note that interviewers will not be assessing subjects in jail or prison, as both locations inhibit a subjects’ ability to obtain and/or use illegal substances, as well as their opportunity to partake in criminal activity.

Economic Impacts Of Drug Abuse

Drug abuse and crime is not a new concept and the statistics around the problem have continued to rise. According to (Office of Justice Programs, 2011), there were an estimated 1,846,400 state and local arrests for drug abuse in the United States. Additionally, 17 percent of state prisoners and 18 percent of federal inmates said they committed their current offense to obtain money for drugs (Office of Justice Programs, 2011). Based on this information, we can conclude that our criminal justice systems are saturated with drug abusers. The United States has the highest imprisonment rate and about 83 percent of arrests are for possession of illegal drugs (Prisons & Drug Offenders, 2011). Based on these figures, I can conclude that we should be more concerned about solving the drug abusers problems and showing them an alternative lifestyle rather than strict penalty of long term incarceration which will inevitably challenge their ability to be fully functioning citizens after release.

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Home — Essay Samples — Law, Crime & Punishment — War on Drugs — Ending The War On Drugs In America

Ending The War on Drugs in America

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The War on Drugs and the Incarceration of Black Women Analytical Essay

Introduction, the war on drugs as the war against black women, works cited.

The war on drugs is often associated with controversy. Issues of gender and race have been raised on numerous occasions in the war against drugs. The war on drugs was declared in the United States over three decades ago, and individuals of color have been greatly affected by this war.

The policies that have been put in place in the war on drugs have exhibited a discriminatory element. In particular, black women and individuals from the minority groups have been targeted in this war. In this case, such individuals are predisposed to harassment from the state officials.

It can be noted that black women have been made to bear the brunt of police cruelties in the name of war on drugs. Considering the plight of black women in the war on drugs, this paper discusses the concept of war on drugs as the war against black women.

The period between 1986 and 1991 was a critical time for the African American community as a whole. At this time, the community was facing a high amount of oppression making them take out their frustration on the use of drugs. Essentially, top of the list of substance abusers were the black females who recorded twice the number of drug offences compared to their male counterparts. Despite the high number of black women incarcerated for drug abuse, authorities do not place emphasis on this issue.

Criminologists often focus on male oriented cases ignoring the plight of the female community. Feminists specialized in criminology have thus dubbed the exclusion of black female drug offenders as discriminatory policies. This has given rise the campaign that accuse criminologist on the war on drugs as the war against black women (Bush-Baskette, p. 5).

The legislations on drugs have been known to affect the black women more than any other group. It has been established that the black women form the rapidly expanding population that is arrested on drug related offences.

Notably, from the late 1980s, the number of black women who have been arrested on drug related offences increased by 800%. This was double the rate of women from other racial groups. In New York, the percentage of black women arrested on drug offences was over 90% while they make barely a third of the women population in the state (Bush-Baskette, p. 43).

The early form of the war on drugs constituted of the arrest of low level drug users and dealers, as opposed to high-ranking people in the trade. This removed the attention from the drug lords who control the dynamics of the industry across the globe.

Another issue regarding the control of drug use was the misrepresentation and improper recording of the people arrested. Fabricated statistics saw the Increase in the number of blacks arrested for the use of drugs and the decrease in the arrest of whites. This triggered a national out raw which advocated for the equal treatment of all races regarding the eradication of drugs.

Women may get involved in drug dealings due to similar reasons as the male culprits. Nonetheless, there are certain gender-specific aspects that should be considered. It can be observed that black women are faced with various forms of oppressions and thus find it difficult to support their families.

In this case, they are forced to engage in street crimes for survival. Most of these women become involved with males who are drug traffickers and find themselves using the prohibited drugs. These women are often threatened with violence and abusive relationship if they refuse to cooperate with their male partners in drug activities (Bush-Baskette, p. 14).

Though the drug trade is said to be profitable, it can be observed that women do not accrue the benefits associated with this trade is equal measure to their male counterparts. Indeed it has been established that women are likely to spend more time in prison on drug related crimes compared to the male dealers. This is because women are likely not able to reveal their male accomplices to earn shorter sentence. On the other hand, males are known to reveal their female counterparts in the trade when required to do so (Chesney-Lind, p. 37).

Heroin was mostly abused by blacks as opposed to whites faring differently from marijuana which was consumed equality by both blacks and whites. The term the war on drugs as the war on women is used to display the level of disregard the society has for the welfare of the black women.

Women associated with drug use recorded fewer cases of the application of force and violence during their consumption or purchase. Poverty and unemployment are the leading factors for the reason of drug on both male and female cases (Stevens and Wexler, p. 28).

The state of Florida recorded drug peddling as the single most recurring primary offence in the years of 1993-1994. Drug peddling was the main offence reported in the criminal files and records. These records only represent the cases concerning drug use, as opposed to drug use accompanied with lesser charges (Nelson, p. 184).

An analysis of the statistics of the incarcerated women lists black women who take the lead representing 51% of the population. Black males take the second slot recording 49% of the country’s population. In the third position are white women who record a competitive 43%. White males take the last slot recording 38% representing the lowest group in reference to the consumption of drugs (Gartner and Kruttschnitt, p. 29).

The police and state authorities are often accused of racial profiling when it comes to war on drugs. This is because there are significant racial disparities observed in arresting, convicting, and incarcerating black women. Arrest, conviction, and incarceration depend on the discretion of the law enforcers in their war on drugs. It is assumed that black women are vessels for prohibited drugs. In this case, the black women are often perceived by the law enforcers as couriers in the drug trade (Stevens and Wexler, p. 19).

Consequently, these women are targeted by the state and federal officers for strip search aimed at identifying drugs. Therefore, black women have been stereotypes as possible drug dealers. It has been established that black women are most likely to be subjected to X-rays after being frisked than white women. On the contrary, the chance of finding black women with contraband products is half compared to white women who stand a high chance of carrying contraband products (Bush-Baskette, p. 45).

Black women are often exposed to regular and offensive strips and searches by the law enforcement agents in the war against drugs. The war on drugs has gone to the extreme. Enhanced surveillance and policing of the reproduction of black women has been reported in the fight against drugs.

Essentially, discriminatory testing of black women who are pregnant to establish drug use is carried out by state officials. Also, there is enhanced surveillance and policing of poor women of African descent under the guise of monitoring child abuse and neglect. This can be argued as being part of a wider scheme in the protracted war on drugs (Bush-Baskette, p. 32).

It is estimated that about two hundred women in over thirty states have faced prosecution on drug related crimes. In some instances, child or fetal abuse is associated with the use of drugs when the woman is pregnant.

In South Carolina State, there is legislation that women who use drugs during while pregnant can be charged with child abuse. In this case, such women are reported to the state authorities by their doctors. Instead of offering rehabilitation services to such women, they are arrested and prosecuted based on child abuse laws (Bush-Baskette, p. 51).

In conclusion, the fight against drugs has come a long way for the time of its rise in the ten years ago. The U.S. has the greatest number of consumers owing to a number of factors. This rate has been on the rise due to the political, social and economic factors experienced today.

Top of the list are black women who are notorious for the frequent consumption of the substance. This is not ideal because a large number of the same culprits are single mothers. It is thus ideal for authorities to place more emphasis on black women so as to tackle the bulk of the problem.

Bush-Baskette, Stephanie. Misguided Justice: The War on Drugs and the Incarceration of Black Women . Bloomington, IN: Universe, Inc, 2010. Print.

Chesney-Lind, Meda. Girls, Women, and Crime: Selected Readings . London [u.a.: SAGE, 2004. Print.

Gartner, Rosemary, and Candace Kruttschnitt. Marking Time in the Golden State: Women’s Imprisonment in California . Cambridge: Cambridge University Press, 2005. Print.

Nelson, Jennifer. Women of Color and the Reproductive Rights Movement . New York [u.a.: New York Univ. Press, 2003. Print.

Stevens, Sally J. and Harry K. Wexler. Women and Substance Abuse: Gender Transparency . New York: Routledge, 1998. Print.

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1. IvyPanda . "The War on Drugs and the Incarceration of Black Women." June 27, 2019. https://ivypanda.com/essays/the-war-on-drugs/.

Bibliography

IvyPanda . "The War on Drugs and the Incarceration of Black Women." June 27, 2019. https://ivypanda.com/essays/the-war-on-drugs/.

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The War on Drugs and its Impact on the United States

How it works

Illegal drugs have been a very prevalent issue in the United States for decades, with almost no clear solution to stop the spreading and use of them. With the epidemic of opium currently ravaging the U.S, it all stemmed from a colossal failure in the 1980s: The War on Drugs. While the intent of the War on Drugs was to stop the spreading of illegal drugs, it managed to become more negative for America than it was originally intended. The War on Drugs was one of the most influential but detrimental movements for modern America on an economic, societal, and political level.

There were several instances of combating the use of drugs throughout history before the start of the drug wars within the United States.

A few of the bigger examples were the Opium wars in China where Britain forced their opium onto the Chinese population, the Harrison Narcotics Act which made the dealing of cocaine illegal in America and directly targeting the Southern black population, and the first anti marijuana laws which aimed specifically Hispanics in the southwest (Drug Policy Alliance). Drugs were also used to manipulate certain groups within the United States by the CIA, which the allegations towards them weren’t addressed until much later. However, in those situations, these laws or actions were made to either manipulate a body of people or were due to the lack of urgency in researching these drugs. Soon after these events, there was a rapid increase in drug use within the United States rapidly increased, which resulted in the United States started to take the drug epidemic seriously in the form of the War on Drugs.

Concerning the politics of the Drug Wars, there were many Presidential administrations and policies enacted that all combated the use of drugs, but most of the attempts were lackluster. The first president to address the issue of drugs in America was the Richard Nixon, who was credited with starting the War on Drugs. During the press conference to which he addressed the issue, he proclaimed that all illegal drugs and the abuse of them were “public enemy number one” and that “it was necessary to wage a new, all out offensive,” leading to the start of the War on Drugs (Nixon, 1971). To continue the political wave against drug abuse, President Reagan also addressed the rising use of drugs and America as a whole, stating “Drug abuse is a repudiation of everything America is. The destructiveness and human wreckage mock our heritage’ (Reagan, 1986).

However, this mentality did not last, as both Presidents failed to enforce their initial stances towards drugs. There were also some policies enacted for drug reform, the most drastic being the Three Strikes Rule in California. The Three Strikes Law was simple, as it was a mandatory sentencing law if one has committed more than three felonies. Unfortunately, since the use of recreational drugs were treated as such, there were a surplus of people incarcerated for upwards of a life sentence for minor drug offences (United States Justice Department). Many of these political attempts to counter drug use were failures and ended up hurting the United States in the long run, which help establish the War on Drugs as a failure itself. In addition to the political fumbles in dealing with drug use, the economic repercussions in dealing with drug use were substantial. Because of the way drugs were smuggled into the U.S, it took an immense amount of money and resources to try to stop the spreading of drugs.

However, it is difficult to stop the many cartels and drug hustles going on, so a lot of what was put in to stop them was wasted. There were also many healthcare costs for using drugs, as if physicians prescribed certain drugs to their patients, they could become convicted drug traffickers if “prosecutors decided that their prescription practices were not appropriate,” which led to them facing prison time (McNamara, 2011). Even the people using drugs would have to pay for their choice drug, which all varied in price over the course of the 80s-90s period but were all costly. Whoever used most illegal drugs back then almost certainly get themselves injured due to lack of knowledge and awareness, so they had to pay medical bills for rehabilitation and other injury costs, especially if one was an addict. For an example of how much money illegal drugs have costed the us, drug abuse cost the US economy around $180 billion in 2002 (ONDCP 2004). All of this money could have gone towards to more beneficial areas, like funding for schools, construction, or medical facilities. Because of these immense expenses of the War on Drugs, it would have been more profitable if it did not occur. Finally, American society was greatly affected by the War on Drugs, as more people were using illegal drugs than ever before. In order to combat the rising use of drugs, a new organization was formed that specifically targeted younger demographics of people to teach them about the horrors of drugs, called D.A.R.E.

The D.A.R.E campaign’s main goal was to spread awareness of illegal drugs and the effects of those drugs so children and adolescents wouldn’t be tempted to use them. They even had celebrities star in some drugs PSAs, one of the more popular ones being Mr. T’s ad, where he used his persona to “shake some sense into [the] kids” and scare them out of using drugs (Mr. T, 1984). However, these attempts backfired, as drug use continued to rise well into the 2000s and to the present day. While D.A.R.E was trying to oppose the use of drugs, the movement ignored the injustices of those who have already been convicted. For the incarcerations from cocaine-use, 84.7% of cases were brought onto African Americans while only 5.7% of cases were brought onto Whites, even though the amount of white crack users vastly outnumbers black crack users (ACLU). These proportions stay consistent with the use of other drugs as well, exhibiting signs of racial biasing when it came to the strictness of drug sentencing. Because of this, many black people were jailed for minor offences, and with the overflow of prisons happening due to increased sentencing overall, prisons didn’t have enough resources to feasibly handle the new prisoners.

The drug problem was and still is difficult for American society even with the existence of D.A.R.E and with the racial profiling that comes with drug incarcerations, resulting in the War on Drugs not being worthwhile foe America. Because of all the controversies and policies resulting from the War on Drugs, it became one of the main contributors to the development of current America. While there are some who think that the War on Drugs was beneficial to the country overall, there were too many faults with the way it was handled to truly call it a success, with statistics also supporting the negative impact of the movement.

Works Cited

• Barber, Chris. “Public Enemy Number One: A Pragmatic Approach to America’s Drug Problem » Richard Nixon Foundation.”
• Richard Nixon Foundation, Richard Nixon Foundation, 20 Oct. 2016, www.nixonfoundation.org/2016/06/26404/.
• Bush, George. The National Drug Control Strategy: 2004.
• White House, Office of National Drug Control Policy, Executive Office of the President, 1997.
• McNamara, Joseph D. “The Hidden Costs of America’s War on Drugs.” Journal of Private Enterprise, vol. 26, no. 2, Spring 2011, pp. 97–115.
• EBSCOhost, doi:http://journal.apee.org/index.php/Category:Issues. ‘Editorial Opinion: Reagan Declares War on Drugs.’ World News Digest, Infobase Learning, 1986,
• http://wnd.infobaselearning.com.eznvcc.vccs.edu:2048/recordurl.aspx?wid=98275&nid=471325&umbtype=0. Accessed 4 Jan. 2019.

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This Is a Very Weird Moment in the History of Drug Laws The Ezra Klein Show

• Society & Culture

Drug policy feels very unsettled right now. The war on drugs was a failure. But so far, the war on the war on drugs hasn’t entirely been a success, either. Take Oregon. In 2020, it became the first state in the nation to decriminalize hard drugs. It was a paradigm shift — treating drug-users as patients rather than criminals — and advocates hoped it would be a model for the nation. But then there was a surge in overdoses and public backlash over open-air drug use. And last month, Oregon’s governor signed a law restoring criminal penalties for drug possession, ending that short-lived experiment. Other states and cities have also tipped toward backlash. And there are a lot of concerns about how cannabis legalization and commercialization is working out around the country. So what did the supporters of these measures fail to foresee? And where do we go from here? Keith Humphreys is a professor of psychiatry at Stanford University who specializes in addiction and its treatment. He also served as a senior policy adviser in the Obama administration. I asked him to walk me through why Oregon’s policy didn’t work out; what policymakers sometimes misunderstand about addiction; the gap between “elite” drug cultures and how drugs are actually consumed by most people; and what better drug policies might look like. Mentioned: Oregon Health Authority data “Why are there so many illegal weed stores in New York City? (Part 1)” by Search Engine “Why are there so many illegal weed stores in New York City? (Part 2)” by Search Engine Book Recommendations: Drugs and Drug Policy by Mark A.R. Kleiman, Jonathan P. Caulkins and Angela Hawken Dopamine Nation by Anna Lembke Confessions of an English Opium Eater by Thomas De Quincey Thoughts? Guest suggestions? Email us at [email protected]. You can find transcripts (posted midday) and more episodes of “The Ezra Klein Show” at nytimes.com/ezra-klein-podcast. Book recommendations from all our guests are listed at https://www.nytimes.com/article/ezra-klein-show-book-recs. This episode of “The Ezra Klein Show” was produced by Annie Galvin. Fact-checking by Michelle Harris, with Kate Sinclair and Mary Marge Locker. Our senior engineer is Jeff Geld, with additional mixing by Aman Sahota and Efim Shapiro. Our senior editor is Claire Gordon. The show’s production team also includes Rollin Hu and Kristin Lin. Original music by Isaac Jones. Audience strategy by Kristina Samulewski and Shannon Busta. The executive producer of New York Times Opinion Audio is Annie-Rose Strasser. Special thanks to Sonia Herrero.

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INSTITUTE FOR POLICY RESEARCH

Unraveling the drug crisis: providing timely data to break the cycle.

IPR’s Lori Ann Post is leading a drug data research center to combat overdose deaths

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The problem is that we're too late. Data were just released for 2021; it's 2024. It's as helpful to me today to combat drug overdose deaths to study the year 2021 as it is 1850. It's just a whole different ballgame out there.”

Lori Ann Post Demographer, epidemiologist, and IPR associate

Throughout its history, the U.S. has battled waves of widespread drug addiction. From painkiller addictions on Civil War battlefields to the 1980s era of crack cocaine, each crisis gives way to a new one.

Today, however, with new drugs constantly emerging, it's becoming harder to keep up with creating drug screenings and medicine to reverse overdoses. This lag leads to more overdose deaths, according to demographer, epidemiologist, and IPR associate Lori Ann Post.

Post emphasizes that we are not in a drug epidemic: We’re in a continuous, evolving drug crisis. Pandemics and epidemics have a clear beginning, middle, and end, she says, but the shape-shifting nature of the drug crisis leaves no end in sight.

The Ohio River Valley Corridor Regional Drug Data Research Center (ORVC-C) , led by Post, aims to keep history from repeating itself. The center aims to support prevention, harm reduction, treatment, public safety, and recovery services, and to create a drug data-sharing model for others. Currently, overdose death data lags two or three years behind.

“The problem is that we're too late. Data were just released for 2021; it's 2024,” Post said. “It's as helpful to me today to combat drug overdose deaths to study the year 2021 as it is 1850. It's just a whole different ballgame out there.”

“By the time we get the evidence we have, it's already too late and the problem has evolved, and it's a new variant of concern and has new treatment and needs,” she explained.

Approximately 107,622 drug overdose deaths were reported in 2021, up nearly 15% from 93,655 deaths in 2020. Over 75% of those deaths involved opioids. The COVID-19 pandemic is commonly blamed for the surge in overdose deaths, but Post said the rates were "skyrocketing" before the pandemic.

Since 1999, almost 645,000 people have died from overdoses involving opioids. This rise in opioid overdose deaths can be explained in waves, according to Post:

• The first wave started in the 1990s due to an increase in opioid prescriptions.
• The second wave began in 2010, marked by a sharp increase in overdose deaths involving heroin.
• The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids, particularly illicitly manufactured fentanyl.
• The fourth wave began around 2019 and is largely still driven by fentanyl with the addition of stimulants such as cocaine and methamphetamines.

Post explains that the fourth wave is further evolving into drug cocktails that are adulterated with animal tranquilizers . This wave is more dangerous than its predecessors, as these drug combinations are more lethal and reversal agents are limited to fentanyl overdoses.

The ORVC-C launched in October with $3.55 million in funding from the Bureau of Justice Assistance. It operates in the Ohio River Valley Corridor, encompassing Delaware, Illinois, Indiana, Maryland, Michigan, Ohio, Pennsylvania, Virginia, Washington, D.C., and West Virginia. These regions bear a lopsided burden of escalating rates of drug overdoses, individuals with substance use disorder, and drug/narcotic violations, Post says.

The Bureau of Justice Assistance has doubled the funding to create a second regional center extending the initial center to New England, New York, and New Jersey.

Within the center, Post established a Central Data Repository (CDR) and a Dissemination and Engagement Center (DEC). The CDR collects, analyzes, and shares comprehensive drug-related data from existing information collected by local, state, and national agencies. This covers labor, crime, public health indicators, and demographic data. The DEC fosters partnerships and produces educational materials to address needs as they arise.

Post says that the center processes data to provide actionable insights for policymakers, public health practitioners, law enforcement, and other stakeholders, while also ensuring accessibility for fellow researchers.

Streamlining the data collection process reduces administrative burdens. It also allows researchers to delve directly into addressing critical issues without unnecessary hurdles.

“The more people doing research on it, the better we're going to do,” she said. “The timelier the data is, the more relevant it is to solving drug use and preventing drug overdose deaths. That’s the whole point.”

Lori Ann Post is the Buehler Professor for Aging, director of the Buehler Center for Health Policy and Economics, and an IPR associate.

Photo credit: iStock

Published: May 10, 2024.

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