RESHAPING APPROACHES TO DRUG USE

We need community-based prevention and intervention, says R. Gil Kerlikowske

"This is a struggle that will cost time, resource, and,
disgracefully, human lives and, unfortunately, the loss of brave
policemen, soldiers and sailors who sacrificed their lives for the
safety of all Mexicans." Mexican President Felipe Calderon spoke
these words last month in a national television and radio address,
asking his countrymen to support his efforts to break up the drug and
crime cartels that terrorize his nation. It was a message to the
United States as well as to the Mexican people. Calderon boldly
stated that demand for drugs - primarily in America - fuels much of
this violence.

I share his sentiments. Our nation's demand for drugs seems
insatiable. Each day, 8,000 Americans consume an illegal drug for the
first time. Approximately 23 million suffer from substance abuse or
dependency. Drug overdoses are fast approaching car crashes as the
leading cause of injury and death; one in eight weekend nighttime
drivers on U.S. roadways tested positive for illegal drugs.

Some have called for legalizing drugs as the way to end the killing
in Mexico and the "drug war" here. While legalization may appear to
be a simple solution, it is also simply wrong.

Legalization would increase drug availability and reduce price. More
drugs, at lower cost, would increase U.S. drug demand. Cartel
violence in Mexico would increase, as they would continue to sell
their products, undercutting legal prices and using their
distribution networks to deliver and sell to the still lucrative U.S. market.

If legalization is the wrong choice, how do we make our nation
healthier, communities safer and our relationship with Mexico stronger?

Some parallels can be drawn by looking to Colombia, which struggled
for years because of drug trafficking and violence. With American
support and strong leadership from President Alvaro Uribe, Colombia
is seeing reduced cocaine production while public safety and security
have greatly improved. U.S. cocaine use has also fallen - the
National Survey on Drug Use and Health showed significant declines in
use by 18-to-25 year olds in 2007 and 2008.

As I said shortly after being sworn in as director of National Drug
Control Policy, I reject the term "war on drugs." This term is an
inapt metaphor for our nation's struggle with drug use and its
consequences. We are not at war with our own people. Rather, we seek
to confront drug use at its core - through prevention, law
enforcement, treatment and strong international partnerships.

Our strategy is a blueprint for a fundamentally different approach to
drug policy, one that emphasizes prevention, treatment, recovery,
enforcement and renewed international collaboration. It stresses
community-based prevention - local strategies to combat local drug
problems. It involves health professionals screening for drug
problems and intervening early in primary healthcare settings.

It argues for access to effective treatment within the criminal
justice system - because more than half of all arrestees test
positive for drugs. Drug offenders leaving jail or prison should
receive services, like housing, health care and job opportunities, to
aid their re-integration into society.

The strategy emphasizes domestic law enforcement, border control and
international cooperation. Each of these approaches is essential, but
none, in isolation, fully addresses a challenge inherently tied to
our nation's public health. Our strategy sets us on the path to a
more balanced, integrated approach, and it can work.

Rather than legalizing drugs or solely using law enforcement tools,
we must make appropriate use of every tool at our disposal. If we do
so, we will make our country stronger, our people healthier and our
streets safer.