|Ending the “Drug War;” Solving the Drug Problem|
Ending the “Drug War;” Solving the Drug Problem, is a new book by Steven Jonas.
“Ending the Drug War.” That has been a rallying cry for drug policy reformers almost since the “Drug War,” aimed at the marijuana, heroin, and cocaine, was first declared by Richard M. Nixon in 1971. In fact, in 1972 there was a National Commission on Marijuana and Drug Abuse report, their first, which recommended that marijuana be legalized. But the Nixon Administration would hear none of it. As a former top Nixon aide, John Erlichman, later told us, they wanted to “wage the war” for political, not health-improvement, purposes. And so the “Drug War” has proceeded unchecked for 45 years.
A basic premise of the “Drug War” is that there is a dichotomy among what I call the “Recreational Mood Alerting Drugs,” the RMADs. Indeed, I place the term “Drug War” in quotation marks precisely because it is not a war on the use of the RMADs in general. Rather it is rather a very limited war, on certain users of certain RMADs. There are the “illicits,” primarily marijuana, heroin and cocaine, joined in more recent years by the “white heroin,” methamphetamine. And then there are the “licits,” primarily alcoholic beverages and tobacco products. While the latter are orders of magnitude more widely used and more harmful to the health of the nation than the illicits, the “Drug War” has managed to maintain that artificial dichotomy since its inception.
I became active in the drug policy reform movement (DPRM for short) in the late 80s and stayed with it into the mid-90s. I left the formal DPRM when I realized that the bulk of it had a) bought into the artificial dichotomy created by the “Drug War,” b) was becoming more-and-more focused on the legalization of one of the illicits (of course that was marijuana) rather than dealing with the negative effects of all RMAD-use, best dealt with by legal methods, and c) with the exception of Dr. Joyce Lowinson who in the 1990s published my work in the standard textbook Substance Abuse for which she was the Senior Editor, members of the DPRM were not even interested in discussing my concepts, which became the “Public Health Approach to the Drug Problem.”
I fully agreed with all of the criticisms of the “Drug War” developed by the DPRM (and certainly still do). It: a) has been totally ineffective in achieving its publicly stated objectives, b) has a racist basis that has become ever more apparent over the years, c) is enormously costly, d) has led directly to the problem of massive incarceration of minority young men, e) like Prohibition, has created a large, very profitable, criminal enterprise which would otherwise not exist, and so on and so forth. BUT, I strongly disagreed with the increasingly narrow focus of the DPRM in how to go about dealing with the “Drug War,” which remains in place to this very day.
Even more strongly, as a public health physician I felt that if it were to be possible to effectively deal with the negative health outcomes of the use of the illicits, and there are such, one first had to deal with the much more widespread negative health effects of the use of the licits. Further, one had to recognize that it is the use of alcoholic beverages and tobacco products by children that directly leads, through the “Gateway Drug Effect,” not only to the use of those two RMADs by adults, but also to the use by teen-agers and adults of the illicits.
And so, I developed the principal focus of this book: the Public Health Approach to the Drug Problem (PHADP). It is spelled out in detail in chapter 5. The PHADP is based on five important principles:
1) The drug problem is a unity not a duality;
2) The United States has a broad-based Drug Culture, which promotes not only the use of the “licit” RMADs themselves. It also heavily promotes the use of both pharmaceutical and over-the-counter drugs as problem-solvers --- “have a problem? Take this pill” --- when such use is not always indicated and can easily become excessive. As well, many state governments and private enterprises openly promote a non-drug but highly addictive behavior, gambling. The Drug Culture will have to be dealt with in one way or another if the drug problem is to be brought under control;
3) RMAD-use, part of human culture apparently since there has been human culture, will never be eliminated, nor should any attempt be made to do that; rather the focus should be on reducing the negative health effects of the use to the extent possible, using tried-and-true public health methods which have been shown to work (see below);
4) That at its base dealing with both the “Drug War” and the negative effects of RMAD-use are political/economic problems;
5) that there is a series of major Stakeholders in the maintenance of the “Drug War,” which range, among others, from certain political interests, through the currently licit RMAD industries, through certain elements of the prison-industrial complex, to the drug cartels themselves, which would have to be dealt with were the PHADP to be introduced and successfully implemented; and thus
6) Along with its many negatives the “Drug War” actually interferes with solving the drug problem.
Finally, we have right in front of us in the United States an outstanding example of how the PHADP can be very successful, over time. That is of course, the United States’ Public Health Service’s National Anti-Smoking Campaign which has been in existence since the publication of the first Surgeon General’s Report on Smoking and Health in 1964. This, the most successful non-infectious disease control program ever implemented in the United States, has reduced the rate of adult smoking from 45% in 1964 to about 18% presently. And guess what? It did so without locking up even one cigarette smoker. The PHADP has approximately 20 separate elements, ranging from the development of a rational classification system for the RMADs, through the development of a regulated sale model, to the development of a rational RMAD-use control educational and advertising campaign.
And so, this is what this book is about. Indeed, “Ending the Drug War; Solving the Drug Problem”. The author is of course available for interviews, debates, discussions, and further writing. I may be reached through:
Steven Jonas, MD, MPH, MS, FNYAS Professor Emeritus, Stony Brook Medicine Dept. of Preventive Medicine and the Program in Public Health, Stony Brook University 450 Route 25A, PO Box 843 East Setauket, NY, 11733;
Tel. (631) 473-7228
June 7, 2010
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