America's Habit

Drug Abuse, Drug Trafficking, & Organized Crime

President's Commission on Organized Crime, 1986

Chapter VII Reducing the Demand for Drugs

The Limitations of Tactics Affecting Supply

Traditionally, efforts to reduce the trafficking and abuse of illicit drugs in this country have been based on the theory that significant reductions of drug supplies would lead to equal reductions in drug-related problems. While this seems plausible, a review of the 75-year history of these efforts reveals that they have not reduced social, economic or crime problems related to drugs. Despite continuing expressions of determination, America's war on drugs seems nowhere close to success. Now more than ever, drugs present problems of vast proportions.

This does not suggest that efforts to reduce supply, such as crop eradication, border interdiction, and prosecution, have failed. To the contrary, they have achieved a measure of success. In 1983, for example, authorities estimated that approximately 10 percent of the drugs destined for illicit markets were interdicted. Crop eradication programs were significantly expanded in Colombia, where most of the world's cocaine is processed and nearly one-half of the marijuana consumed in the United States is grown. In addition, indictments and convictions of some of the world's most notorious traffickers have been obtained in recent years.

Despite these efforts, American consumption of cocaine increased an estimated 12 percent and dangerous drug use increased an estimated 15 percent between 1983 and 1984. Cocaine, heroin, amphetamine, and methamphetamine-related deaths increased, as did cocaine, PCP, and methamphetamine-related emergency room visits.

In short, strategies to reduce supply are "working" by some standards, but only to a limited degree.

Although some inherent factors limit the effectiveness of these tactics, the overwhelming and continuing demand for illicit drugs among Americans is the primary cause of their limited success. Millions want illicit drugs and are willing to violate the law, spend billions of dollars, and in many cases risk their lives to obtain them.

Supply Versus Demand

Although the supply of and demand for drugs have often been considered separate issues, by both the public and private sectors, they are in fact inseparable parts of a single problem. The success of supply efforts are related to commitments made to reduce the demand for drugs through drug abuse education, treatment, research, vigorous enforcement of drug abuse laws, and effective sentencing. Drug supply and demand operate in an interrelated and dynamic manner. The strategies employed to limit each should be similarly connected.

The national fight against illicit drugs relies on two fundamental strategies: organized crime policy and drug abuse policy. Organized crime policy targets specific criminal groups and seeks to destroy those already in existence and prevent the emergence of new ones. In contrast, drug abuse policy attempts to reduce drug use and its associated adverse effects. Theoretically, organized crime policy and drug abuse policy can conflict. Reducing the demand for drugs advances the goals of both organized crime policy and drug abuse policy. A significantly smaller drug market, which would likely result from a substantially reduced demand for drugs, would attack organized crime groups by limiting the huge profits currently available in drug trafficking, while simultaneously reducing the number of drug users, the goal of drug abuse policy.

A clear example of the relationship of supply and demand is provided by the case of heroin trafficker Cecily Lermusiaux, who with several associates, moved heroin into an area of Las Vegas where its use among "middle to high-class whites" was previously unknown. In a scheme which began with the distribution of free samples of heroin, Lermusiaux's independent heroin business generated a profit of several million dollars in approximately six years.

The demand for drugs is also widely recognized as the fuel that the illicit drug industry needs to operate. According to Colombian President Belisario Bentancur:

In the world war against narcotics, we need the commitment of the consumer nations to attack the traffic with the same vigor we have shown. We can make all the sacrifices possible, but if there is enormous demand, production will never be completely eradicated.

This sentiment has been echoed by the other side of the law. Carlos Lehder, who heads one of Colombia's most notorious cocaine cartels, sees the American demand for drugs as the driving force behind the "bonanza" of drug trafficking:

The demand for drugs in the United States is so great that the producer countries like Colombia play a really tiny role compared to the total consumption of the United States.

Tactics to Reduce Demand

Efforts to reduce demand are not hampered by international political complications, or other factors that limit the effectiveness of tactics to reduce supply. This Commission is of the opinion that since reducing demand is the single policy option pursuable entirely within our own borders, it deserves greater attention.

More successful tactics to reduce demand may in the long-run decrease the need for current high levels of funding for approaches to reduce supply. A significant reduction in the demand for drugs as a complement to aggressive enforcement efforts is likely to make drug trafficking less lucrative for organized crime and thus prompt many organized crime groups to drop out of the drug business. According to analyst Mark Kleiman:

Demand reduction is clearly the strategy of choice with respect to its effects on organized crime . . . anything that tends to depress demand will reduce both trafficking-related ancillary crime and the level of drug enforcement resources needed to attain any given level of reduction in drug consumption.

Skeptics have argued that past tactics to reduce demand have not been successful. However, the history of drug abuse prevention and treatment programs has been relatively short. It was not until the upsurge of drug use in the 1960's that these programs developed. Some early prevention approaches were ill-conceived. For example, they often presented information about drugs without persuasive arguments to deter their use, and other programs used exaggerated information. Such programs have been criticized for unintentionally encouraging experimentation with drugs or squandering the credibility of anti-drug information. The most recent and effective drug abuse education and prevention programs focus on the psychological and sociological factors that contribute to the onset of drug use. Drug education programs must be continually evaluated and improved to keep pace with changing drug abuse patterns.

In a model program, the National Institute on Drug Abuse (NIDA) used the strategy of the anti-smoking campaigns of the late 1970's, which many feel were effective, to develop its "Just Say No" campaign against drug use which recognizes the impact of social pressure. NIDA seeks to show adolescents through a music video, television commercials, and other media that they can turn down drugs by simply saying "no" to them.

While it is difficult to measure precisely the effectiveness of such anti-drug advertising, it is clear that the media can help shape attitudes. Just as beliefs about cigarette smoking have changed in recent years, so too can attitudes about drugs. Anti-drug advertising has an advantage over the anti-smoking campaigns: drug dealers cannot openly advertise their product. According to the New York advertising firm of Trout and Ries,

Unlike cigarette manufacturers, drug producers and sellers cannot use advertising to promote a fashionable image for their drugs. Quite the opposite, the government can use advertising to make drugs less and less fashionable to use. This, if America runs true to form, will dramatically reduce demand. When it's 'out' in America, it doesn't sell.

Reducing the demand for drugs requires a long-term commitment because it takes time to change attitudes. This commitment must be made by Federal, State, and local governments and the private sector. Each must unequivocally reassert that any and all illicit drug use is unacceptable in light of the effects of drugs on individuals, families, communities, and governments. It is only in this context that a war against drugs that seeks to limit both the supply of and demand for drugs can be effective.

Federal Government

Federal Priorities

Three of the five elements of the current National Strategy for Prevention of Drug Abuse and Drug Trafficking are directed to reduction of demand: drug abuse prevention, medical detoxification and treatment, and research.

The importance of reducing demand has, in addition, been, publicly acknowledged by leading law enforcement officials. According to Attorney General Edwin Meese III, for example:

All the enforcement efforts that we can try in this country, all the police agencies in this nation and worldwide will never be able to stem the supply of drugs in this nation until we have first decreased the number of users and have decreased the demand for these drugs.

John Lawn, administrator of the Drug Enforcement Administration (DEA), concurs:

Were we [DEAl to increase dramatically in size, the drug problem would continue to exist until we could do something about demand reduction.

While the importance of strategies to reduce demand has been acknowledged, it is reduction of supply that has consumed the bulk of the Federal drug abuse budget. This may be due, in part, to the fact that certain enforcement operations are inherently more expensive, and they are exclusively a Federal function. In addition, primary responsibility for developing and maintaining programs to reduce demand has been shifted to the States and the private sector.

The concept of our current National Strategy, assigning complementary roles to the Federal government, on the one hand, and State and local governments and the private sector, on the other, is commendable for its recognition of the unique roles of each component. However, the adoption of this coordinated approach carries with it the responsibility for ensuring that the components perform in a truly coordinated and complementary fashion. There is insufficient evidence today that this responsibility is being met. Moreover, in precisely the same way that approaches to reduce supply recognize a unique Federal capability, there are certain functions in the area of demand that, by their nature, can only be performed by the Federal government. The Federal government's exclusive role in reducing the demand for drugs includes providing national coordination in the conduct of research, gathering nationwide data, and developing and disseminating standards for drug prevention and treatment programs across the country.

Current budgetary figures reflect the emphasis on drug law enforcement. while programs to reduce demand at one time received the larger share of the Federal budget, the focus on enforcement has increased dramatically during the last decade. For example, between fiscal year 82 and 86, Federal funding for drug abuse prevention has decreased by 5 percent, while Federal funding for drug law enforcement has increase by 70 percent. For fiscal year 1986 Federal expenditures on drug law enforcement constitute 84 percent of the total Federal drug abuse budget outlay of $1.7 billion. Interdiction alone consumes 38 percent of this budget. In the same year Federal funding for drug abuse prevention constitutes one percent, treatment and rehabilitation 6 percent, and research 4 percent of the total Federal drug abuse budget.

In addition to this funding the Federal government provides funding to the States for drug abuse prevention and treatment through the Alcohol, Drug Abuse, and Mental Health Block Grants. For fiscal year 1986 between $65 and $244 million is made available to the States for drug programs. However, prior to 1981 under the formula grant program, 40 percent more funds were available to the States for these purposes. A thorough review of the current budgetary allotments for anti-drug efforts, now contemplated by the National Drug Enforcement Policy Board, should be placed at the top of the agenda of the Board immediately. This Commission concludes that such a review will indicate that greater Federal resources should be devoted to programs to reduce demand, and that the Board should pursue appropriate action without hesitation.

Asset Forfeiture

Expanded efforts to reduce demand would, of course, require additional funding at all levels. A particularly promising source of such funding is the considerable amount of money and property obtained annually through forfeiture and seized by law enforcement officials. In 1984 Federal agencies obtained an estimated $400 to 450 million through the forfeiture and seizure of drug traffickers assets. Rudolph Guiliani, U.S. Attorney for the Southern District of New York, observes:

The drug dealers are just about paying for the drug law enforcement, and hopefully we can get them to pay for drug education.

Under current policy, the Federal government channels all seized and forfeited assets into Federal, State, and local law enforcement agencies and the Department of Justice Assets Forfeiture Fund. Presently, no portion of these funds is used for Federal drug demand reduction programs, such as prevention, treatment, and research. However, pending legislation is being considered that would direct use of portions of the Assets Forfeiture Fund for drug abuse prevention and treatment programs. A portion of the Federal government's asset forfeiture fund derived from drug cases should be devoted to programs to reduce demand in whatever proportion is indicated by the Policy Board's budgetary review. Funding to reduce demand should include a responsible contribution to the States for their own programs in this area. However, any funding directed to the States should be made contingent upon their vigorous pursuit of such programs, and after a reasonable grace period, funding should be denied to any State failing this requirement. Failure to enact State electronic surveillance measures and asset forfeiture provisions, with the proceeds thereof directed to anti-drug programs, should constitute per se failure.

Research

Because data concerning drug abuse are in many instances relatively incomplete, and in all cases, subject to change based on new discoveries, continuing research is a fundamental component of any drug strategy. Recent discoveries concerning cocaine provide an example. The 1967 President's Commission on Law Enforcement and Administration of Justice reported that cocaine did not "create tolerance or physical dependence;" however, research during the 1980's showed that cocaine does, in fact, create tolerance and some argue, physical dependence. Despite this increased understanding about cocaine, many experts, such as Dr. Arnold Washton, argue that research about the effects of cocaine is still in its "infancy."

Continuing research is required not only by the complex nature of drugs and their effects on the human mind and body, but also by the constantly shifting patterns of drug abuse. While heroin has traditionally been the most frequently encountered drug of abuse among individuals in treatment programs, cocaine now follows closely behind and has, in fact, overtaken heroin as the primary drug of abuse by those in treatment in 18 States. While requests for treatment by cocaine users are estimated to have increased by as much as 600 percent in the last three years, research about cocaine and its effects has not kept pace with this growing problem. The development of new drugs, such as controlled substance analogs, presents another compelling need for continuing research.

Data Collection and Dissemination

As part of its research responsibilities, NIDA supports two continuing epidemiological surveys, the National Household Survey on Drug Abuse and the High School Senior Survey. While these two surveys provide valuable information about the extent of drug use, neither NIDA nor any other agency systematically collects or disseminates information about the thousands of drug abuse programs.

State governments, which disbursed 46 percent ($642.5 million) of the funding for alcohol and drug abuse prevention and treatment services in fiscal year 1984, do not systematically report to the Federal government about these programs. This lack of data is due primarily to the absence of any statutory requirement for such reporting, and is a major obstacle to effective drug policy planning. The States should be required to report to the National Institute on Drug Abuse information about their prevention and treatment programs. With this information, and reports obtained from private programs, NIDA will be better able to identify the best prevention and treatment programs and to develop and disseminate standards and guidelines for such programs to the States. The States should, in turn, provide this information to all groups engaged in prevention, treatment, and related research.

Guidelines

Because the Federal government does not systematically collect and evaluate information about drug abuse prevention and treatment programs, it cannot develop substantive guidelines for such efforts. The history of drug abuse prevention has demonstrated that certain approaches are considerably more effective than others. Some have even unwittingly encouraged experimentation with drugs. As an increasing number of school and community-based prevention programs are created, the need for guidelines for drug abuse programs is particularly acute. Officials at NIDA acknowledge that many programs use outdated factual information and philosophies; however, the Federal government is in a unique position to establish and disseminate such guidelines to improve both State and private sector drug abuse programs. Its current failure to do so is a major deficiency in the campaign against drug abuse.

In addition to contributions to reducing the demand for drugs through research, data collection and dissemination, and the formation of guidelines, the Federal government should provide an example of the unacceptability of drug use. The President should direct the heads of all federal agencies to formulate immediately clear policy statements, with implementing guidelines, including suitable drug testing, expressing the utter unacceptability of drug use by Federal employees. Government contracts should not be awarded to companies which fail to implement drug programs, including suitable drug testing.

State and Local Governments

State and local governments are key components in the national campaign against drug abuse. Their unique capabilities in the area of reducing demand include State-sponsored media campaigns against drug use, prevention and education programs in the schools, drug treatment programs, more vigorous enforcement of State drug laws, and the inclusion of mandatory treatment or jail sentences, as appropriate, for those individuals convicted of possession of drugs. Because the nature of drug use tends to vary among different geographical areas, State and local governments are best positioned to tailor techniques to reduce demand to suit their particular drug problem.

Drug Education

The public school systems of State and local governments provide an appropriate forum for drug abuse prevention programs. Consistent with identified measures of success, State governments should establish credentialing standards for prevention and treatment programs. They should further require that all elementary, junior high, and high schools within the State include drug abuse prevention programs in their curricula, designed in a manner consistent with such credentialing standards. State funding should be made available to assure the proper training of educators assigned to such programs.

Combining prevention programs, clear school policies about the consequences of drug use, increased discipline, and higher academic standards has been demonstrated to be effective. For example, Northside High School in Atlanta, Georgia implemented such a program in the late 1970's in the face of "poor academic performance . . . student apathy . . . discipline problems . . . class cutting and open drug use on campus." By the early 1980's, performance on standardized tests improved significantly and "the use and possession of drugs on campus [had] all but disappeared." Every employer, public and private, and public education institutions at all levels should have clearly-stated policies prohibiting drug use, possession of drugs, or being under the influence of drugs on their premises. The consequences of violating these prohibitions should be clearly explained.

Law Enforcement

A critical part of a national campaign to reduce demand is vigorous enforcement by State and local governments of their laws regarding the possession of controlled substances. The Department of Justice Uniform Crime Report for 1984 states that 552,552 arrests were made in 1984 by State and local police agencies for possession of drugs. Given that in 1984 there were estimated to be 20 million monthly marijuana users, over four million monthly cocaine users, and approximately 520,000 heroin addicts, it is clear that the statistical probability of arrest for possession was and is quite low. This low probability of arrest vitiates in large part whatever deterrent value laws against drug possession and use may have.

In addition to increasing the likelihood of arrest for drug possession, punishment for those convicted of such offenses can be more effective. Drug users are not "victims" who bear no responsibility for their actions. Imprisonment for recidivists provides both deterrent value and an opportunity to break the cycle of drug use. Uniform and rational sentencing for drug offenses is essential. Such a system should provide a sentence of probation and a fine for a first offense involving possession of drugs. The terms of probation should include a requirement to remain drug-free, to be verified through periodic drug testing. A second offense for possession of drugs should result in a jail sentence or mandatory treatment, if appropriate, or fines or all three. The results of random drug screening should be used in considering parole in cases of both drug possession and trafficking.

Society's commitment to the unacceptability of illicit drug use is properly expressed in vigorous enforcement of the laws regarding possession of drugs and sentencing of recidivist users to jail terms and mandatory treatment. Such a national commitment is in conflict with various States' relaxation of criminal penalties for the possession of marijuana. Because such measures were based on limited information and popular misinformation about the effects of marijuana, it is appropriate for those States that reduced these penalties during the 1970's to reconsider these laws. This reconsideration is warranted, especially in light of a Federal campaign against marijuana smuggling and the considerable evidence that a substantial share of marijuana trafficking is dominated by organized crime groups, which are both ruthless and involved in smuggling other drugs. In addition, the sale of drug paraphernalia undermines this Nation's anti-drug efforts. States that have not already done so should enact and enforce laws prohibiting the sale of drug paraphernalia.

Reducing demand and increased enforcement of drug possession laws will undoubtedly place a greater burden on our courts and will generate the need for more jail cells and treatment facilities. The accompanying increase in expenditures, however, could be met in part with funding extracted from the illicit drug industry itself. All 50 States currently authorize forfeiture of assets in connection with drug trafficking and manufacturing, making available millions of dollars in cash and property each year to State governments.

The Private Sector: Attitudes and Actions

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.

"Great scent. Lousy name." - Advertising Age, a trade journal commenting on "Opium," a popular perfume marketed by Charles of the Ritz, a subsidiary of Squibb Pharmaceuticals.

Drug abuse is fundamentally a social problem, which cannot be solved by the government alone. Federal and State governments can support drug abuse prevention and treatment programs, conduct research, enforce drug laws and provide leadership in the fight against drug abuse and drug trafficking. However, not until public and individual attitudes change will illicit drugs and the organized criminal groups that traffic in them be eliminated. Individuals need not accept drug use in their midst. There is no "right" to use drugs. Government efforts to combat drug trafficking and drug abuse are a vital effort, but they are ultimately only a holding action, while consensus continues to build among individuals concerning the utter unacceptability of drug use.

Despite this growing consensus, a profound disparity exists between principle and practice. Popular entertainment arid advertising, sometimes subtle, sometimes not, regularly reflects and even promotes the view that the use of illicit drugs is glamorous, exciting, and sophisticated, or at least harmless and amusing.

The illusion that drug use is glamorous is regularly, if somewhat indirectly, reinforced by revelations that drug use is commonplace among celebrities in the sports and entertainment worlds. In August 1985, for example, the New York Times reported cocaine's alleged use by players on virtually every team in the major leagues, prompting the Commissioner of Baseball to declare drug use the "number one" problem facing the game.

It is even possible to find purportedly responsible groups urging not only recognition but acceptance of drug use as a feature of daily life. An article in the January/February 1984 issue of Social Work, the journal of the National Association of Social Workers, prescribes the following for adolescent marijuana use:

Use should be moderate . . no more than four to five joints per week seem advisable.

Such acceptance of drug use may be shared by many who resign themselves to the fact that drug abuse is inevitable. Such a view reflects a failure of will on the part of the American public. American society may view drug use in the abstract as wrong, and many People agree that heroin addicts who commit additional crimes to support their drug habits should be jailed. However, many people react with ambivalence to the drug use in their midst. Even while the United States government spends almost a billion and one-half dollars on drug law enforcement, threatens to cut off foreign aid to drug producing countries, and extradites and imprisons foreign nationals on trafficking charges, we appear to lack the same degree of resolve to hold this country's drug users, as well as those who directly or indirectly promote drug use, accountable for their actions and the consequences thereof.

While attitudes are ultimately an individual matter, actions need not be. It is in combination with others that private citizens have been most effective in combatting drug abuse. As discussed earlier, athletes, entertainers, manufactures, advertisers and media can promote drug use by their individual examples or by favorable portrayals of drug use. However, these elements of society also have the power to shape different public attitudes about drug use by presenting the truth about drugs. The media and entertainment industries should carefully review their portrayals of drug use and its consequences and ensure their accuracy.

Efforts to combat drug abuse can also be successful in the workplace. Many businesses across the country have Employee Assistance Programs (EAPs), which seek to prevent drug abuse at the worksite and which offer treatment and referrals. In addition, many businesses now test employees or prospective employees for drug use. According to a survey of 100 Fortune 500 companies, two-thirds refuse to hire job applicants who fail such tests, 25 percent fire employees and 41 percent require treatment for employees who fail. Drug testing protects businesses, which lose billions of dollars each year in reduced productivity as a result of drug use, employees, and the public. Drug testing in certain "critical positions," such as in the transportation industry, law enforcement, and education is particularly important.

In addition to efforts in the workplace to combat drug abuse, health professionals, such as physicians, nurses, psychologists, and social workers can help identify and treat drug users. However, currently formal training in the diagnosis and treatment of drug abuse is limited. Health professionals should be thoroughly trained to identify and counsel drug abusers.

Decisions to use or not to use drugs are ultimately derived from values that are best inculcated and reinforced in families, churches, civic organizations, schools and local communities. The efforts of organizations, which seek to help families prevent drug use, such as the National Federation of Parents for Drug-Free Youth, are essential to the fight against drug use and drug trafficking. First Lady Nancy Reagan has made an important contribution to this effort to reduce the demand for drugs. Relying on the task force approach which law enforcement officials have used successfully, parents, churches, schools, civic organizations, and business associations should form community task forces in every community across the country to provide a unified front against drugs.