America's Habit

Drug Abuse, Drug Trafficking, & Organized Crime

President's Commission on Organized Crime, 1986

Consultant Paper: Winning the War Against Drugs

By Mitchell S. Rosenthal, M.D. Submitted: October 1, 1985. Dr. Rosenthal is President of the Phoenix House Foundation, a drug rehabilitation program.

There is a popular perception these days that America is locked in a "no win" struggle against drugs. This notion of "the endless battle," in which we seem unable to prevail, that has prompted a good many lawyers, scientists, and writers to suggest that it might be time for the United States to quit.

Some Americans have always believed that the use of certain illicit drugs is not such a terrible thing and others have argued that the government has no right to tell citizens what they can or cannot ingest. But the strongest opposition to the nation's drug laws and policies has come from those who believe that they should be scrapped because they do not work well. The latest converts to this cause contend that legalization of marijuana and cocaine (some would include heroin) would eliminate drug profits and crime overnight and substantially reduce the costly burden of enforcing drug laws.

The "quit now" crowd plainly does not recognize that there is a world of difference between "not winning" a war and "losing" one. The war against drugs, although it is going badly at the moment, is far from lost. But quitting now and attempting to solve the drug crime problem through legalization would he tantamount to losing - at least in terms of the impact on drug abuse.

The notion that we could make drugs legal, while simultaneously mounting (as some advocates of legalization suggest) a massive public education campaign to discourage their use would give cocaine and marijuana the same status as cigarettes. The most likely result, according to the former director of the National Institute on Drug Abuse, would be a tenfold increase in cocaine use. There would be just about as many Americans using cocaine as now smoke cigarettes.

Another reason not to give up the fight is because we can win. After more than 20 years of treating and curing drug abuse, I see enough evidence to convince me that the war is winnable - not now, but in time. It is winnable because what denies us victory today is the nature of the war we are waging and not the nature of the enemy we are fighting.

The war is going badly for much the same reasons that any war goes badly. In part, it is inappropriate strategy fighting the wrong enemy, in the wrong place and with the wrong weapons. In part, it is a failure of will.

We are on the defensive, with battle lines stretching along our borders. Our main weapon is interdiction. Most of the billion dollars a year the Federal government spends enforcing drug laws (two-thirds of all it spends to fight drug abuse) goes to halt the flow of illicit drugs into our country.

Yet, the drugs keep flowing, even though 13 tons of cocaine and 1,500 tons of marijuana (with a total street value of $11 billion) were seized by federal agents last year. It would seem that when $5 million or $50 million or $500 million worth of drugs is impounded, the total available for distribution would he reduced by a like amount. Hut that is not the case. Drugs lost through seizure are instantly replaced by producers and importers. The more Federal agents seize at our end of the pipeline, the more drug traffickers feed into the other end. Although interdiction efforts have expanded dramatically and vast quantities of drugs have been seized, the flow to the street has diminished hardly at all, and cost to consumers has actually fallen.

In frustration, Americans have turned their ire on producing nations. Apparently, we feel more comfortable and justified pressuring Colombians, Peruvians and Bolivians to stop producing cocaine than pressuring Americans to stop using it.

In spite of minimal success, we remain committed to battling drugs primarily by reducing supply rather than by reducing demand. Yet, the supply side is obviously harder to hit and to hurt. Producers are beyond our reach. Major dealers are sophisticated, secretive, and ruthless, willing to accept enormous risks and enormous losses as long as profits remain equally enormous.

The demand side, however, is easier to reach. It is vast, barely concealed at all these days, and it consists of the more than 20 million Americans who now regularly use illicit drugs. What's more, the demand side is where all three weapons at our disposal can be deployed - not only law enforcement, but drug treatment and drug prevention as well.

Our reluctance to attack demand as vigorously as we attack supply reflects nothing less than a failure of will - not on the part of the administration, law enforcement agencies or drug abuse professionals, but on the part of the American public. Public attitudes and public expectations determine how we go about fighting this war, limit how much we can do and how far we dare go.

What limits drug treatment is not just reduced government support. Even if resources were available, there is no way we could help the great majority of drug abusers in this country to overcome their drug dependency because most of them are not seeking help. They are not seeking help because society does not require them, and the law does not compel them.

Limits on what drug prevention can accomplish reflect what can only be called a public demand for selective prevention the prevention of some but not necessarily all drug use. Just about everyone wants to prevent one kind of drug use or another. Most parents believe that kids shouldn't use drugs. Most employers are convinced that workers ought not use them. The public in general would like to see criminals stop using drugs and stop stealing in order to buy drugs. But, beyond this point, public demand softens considerably and attitudes become ambivalent.

Nowhere is our ambivalence more evident than in our attitudes towards law enforcement. We are content with a "trickle down" approach - one that focuses almost exclusively on putting major dealers behind bars. But we learned during the days of strict enforcement in New York State during the 1960's and from recent crackdowns on street dealers in New York City, that the real victories of law enforcement are not the number of dealers or users arrested or convicted but the number motivated to seek treatment. We know that when it becomes too dangerous or too difficult to sell drugs or to buy them, then a great deal of drug use will simply disappear and demand for treatment will rise rapidly to the level of real need.

Lenient or selective enforcement of drug laws - what amounts to non-enforcement and de facto legalization - in some areas - is a reflection of our ambivalence. It comes down to the way that Americans feel personally about drugs - not only about our own use, but about use by our grown and half-grown children and by our friends, and about what is wrongheadedly called "recreational" use of marijuana and cocaine. While it may make us uncomfortable, most of us do not think of it in the same way as we think about drug use by nine- and ten-year-olds or about the heroin addiction of criminals. And we are generally unwilling to see our friends and children at risk of arrest and prosecution because of drug use.

But I do not believe we can win the war against drugs until we have positive consensus on the strict enforcement of drug laws. However, we need not make that decision any harder than it must be. We don't have to agree that drug users should go to jail. The purpose of drug laws is not punishment - certainly not when applied to users. These laws serve what must be recognized as a public health function - a means of controlling a contagious disease by imposing on its carriers the requirement of whatever it takes in the way of education and treatment to overcome their drug use.

We are not likely to see this consensus come soon. Too many drug-using young adults are still convinced they enjoy some special "right" to use illicit drugs and believe they can handle them. Too many Americans are torn between the urge to condemn behavior, of which they disapprove, and the need to tolerate behavior they have somehow come to believe is a matter of individual freedom or simply none of their business.

But both drug users and drug tolerators ignore the contagious nature of drug abuse. The hostess who overlooks a little discreet after-dinner pot-smoking or the professional who pointedly ignores covert coke-sniffing by his or her colleagues must eventually come to realize that a person can no more tolerate a little recreational drug use than he or she can tolerate a little recreational smallpox. As for users, even those convinced that their own drug habits are under control cannot guarantee that the friends, coworkers or teenagers they influence will be able to avoid drug dependency and the other high risks of drug use. Nor is there any basis for them to believe that they will continue to enjoy immunity from the costs of drug use - if indeed they enjoy it now.

Broad societal disapproval of illicit drug use is needed before we can come to a consensus about strict drug law enforcement. Needless to say, active disapproval and the use of informal social sanctions will make more aggressive law enforcement irrelevant in most cases. The hostess who is certain enough of her own unwillingness to tolerate pot smoking in her home doesn't need to call the cops to keep her guests from lighting up - no more than she need call them to stop her guests from stealing the silver or spitting in the soup. Nor do professionals who recognize the danger of drug use to their colleagues, need to turn to the law. They have far more effective ways of bringing the behavior of these colleagues into line - once they accept the need to draw such a line.

In many ways our society resembles the American family in the 1960's. Many parents then believed they were doing their children a favor by laying back and not taking a hard-line stand against drugs. They allowed youngsters to stumble through the drug experience. Only later they came to realize the costs. Those costs ran high, both in chronic impairment and lost educational and career opportunities. As a result, parental attitudes have changed markedly. Parents are now taking the hard line, which is really the loving line, one that shows responsible concern.

More recently, the Navy has demonstrated how to go about attacking drug use on the demand side. While it brought heavy weapons into play - drug tests and disciplinary actions - it also effectively reduced widespread tolerance for drug use. By stressing the interdependence of seamen, the Navy began replacing this attitude with a far more responsible one expressed by the motto: "Not on my watch, not on my ship, not in my Navy."

This is the kind of attitudinal change I expect to see occurring throughout the country over the next decade. It is already underway. Adolescents have become far more critical of drug use by their friends, and this is the result not only of better drug education in the schools, but also of more awareness of drug dangers on the street. Employers are now responding to increasing evidence of economic costs directly attributable to drug use in the work force.

So, there is every reason to believe that public attitudes about illicit drugs will become firmer and more responsible. As a result, the limitations on what we have been able to achieve through prevention, through treatment, and through law enforcement, will gradually be removed. They will no longer dictate strategy that prevent us from moving as aggressively against domestic demand as we do against foreign supply.

If law enforcement is to work effectively in cooperation with treatment and with prevention in this attack on the demand side, then we need to adopt consistent goals. While we should certainly persist in interdiction and target major dealers, we cannot focus most of our energy and resources on these high visibility efforts. It is on the street that the final battle is going to be won, and it will be won by constant pressure, over time, that will be felt by every drug dealer and every drug user.

This kind of pressure will not result in any impressive string of convictions, but it will respond directly to the desperate needs of drug-ridden communities. It will strengthen drug-troubled families, and it will improve the quality of life for millions of Americans.

This kind of pressure, supported by a popular mandate, will result in the gradual erosion of the drug market and the gradual decline of drug use. Demand for treatment will grow. Prevention will cease to be selective but reach out broadly across all society. And drug abuse, while it may never entirely disappear, will cease to pose any substantial threat to the nation, its youth.