Substance Abuse, Vol. 15, No. 4, 1994

Editorial

Rethinking Drug Policy Options -Getting Beyond Prohibition Versus Legalization

David F. Duncan Dr.P.H. CA.S.

1

WHAT IS A DRUG POLICY?

On the rare occasions when most people think about drug policy at all, they tend to think of it as a simple two-way choice between continuing the war on"' drugs" and legalizing the currently illicit drugs. As Klinenberg and Lewis point out in this issue, policy at the White House level is characterized by this same myopic view - the differences in drug policy between politicians as different as Reagan and Clinton seem to reduce to mere differences in rhetoric. Neither politician can perceive any real alternative to prohibition except the politically unacceptable one of legalization.

It should be clear by now that our nations 80-year-long experiment with prohibition of drugs has been a failure. Heroin and cocaine abuse are both more widespread today than they were in 1914 when the Harrison Act was passed, and a massive, and violent black market has grown up, which sucks billions of dollars out of the legal economy. But that failure need not compel us to plunge headlong into an unregulated free market in heroin, cocaine, and marijuana.

We have a range of choices before us and we should be considering that full range in setting drug policy. To begin with, public policy on drugs can deal with the production, distribution, or possession of a drug or group of drugs. Drug policy may deal with production in terms of the questions Who may produce the drug? How much of the drug may be produced? and In what dosage forms, strengths, and purities may the drug be produced?

Policy regarding drug distribution determines the answers to the questions Who may sell the drug? To whom may it be sold? and Under what conditions is it to be sold?

Possession-related aspects of drug policy deal with the questions Who may possess the drug? How much may they possess? and Under what conditions are possession and use of the drug permissible?

Prohibition is only one of the policy options which can be applied to the production, distribution, or possession of drugs- Another option is restriction - a policy of limiting who is allowed to produce, distribute, or possess the drug by setting either inclusive or exclusive rules. An inclusive restriction might provide that a drug can only be distributed only by or on the order of a physician - prescription drug. An exclusive rule might forbid the use of the drug by minors.

A policy of discouragement refers to the use of the powers of government (including the power to tax) to persuade citizens to choose not to produce, distribute or possess a drug. Regulation sets standards of fair dealing or purity -in the production or distribution of a drug. Encouragement would be a policy which attempted to persuade citizens to choose to produce distribute, or possess a drug. Subsidization would provide financial assistance, to those who produce, distribute, or purchase a drug. A mandate would require the production, distribution, or use of a drug.

Drug policy regarding alcohol for instance, regulates who may produce and sell alcohol and when it may be sold, while restricting its use to adults and excluding use by children or the drivers of automobiles. At present, the production distribution, and use of marijuana are all generally prohibited, with a very limited exception of restricted production, distribution, and possession for research purposes. The production and distribution of vaccines are restricted while, use of them is encouraged. Distribution of chlorine into public water supplies is mandated and its production is somewhat regulated, while its possession is unrestricted by any public policy

Changes in our national drug policy will not occur through a single, congressional act shifting us from a policy of prohibition to one of regulation with a stroke of the presidential pen. Instead we are likely to see a gradual accumulation of changes. These might include policy shifts away from prohibition to policies of restricting heroin use to registered addicts, discouraging cocaine use and restricting its use to ;adults, and- regulating the sale of marijuana. We are also likely to see some of these policies given their first trial on a state or local level. The options are there; we must begin to consider seriously their full range. If we do, then we need not be cynical about the future of U.S. drug policy.