THAT 'OTHER' DRUG AGENCY

Most of us in the pharmaceutical sciences come in contact with only
one drug regulatory agency - the FDA. And while there may be
legitimate grounds to complain about its bureaucracy, on occasion
ponderous, few would argue that the FDA is anything but an agency that
works on behalf of the health and welfare of the American population.
The FDA is also widely respected in international circles where it
cooperates with other similarly oriented national agencies to craft
worldwide standards for drug use and approval. But there is another
drug regulatory agency whose function is very much the opposite -
namely, the disapproval of drugs designated as illegal. Whether the
Drug Enforcement Administration also works on behalf of the health and
welfare of the American population is increasingly open to question,
and most of us should be grateful that we will not run up against this
other agency.

The war on drugs is fueled by that uniquely American mix of
Puritanism, love of punishment, and political expediency, and it has
generated as its major product a prison population that now exceeds,
in both absolute number and percentages, any other country save
Russia. This should be naught for our comfort as we contemplate a
prison population approaching 2 million and where approximately 80%
are in jail for alcohol and drug-related offences. In a recent article
in The Washington Monthly, Joseph Califano, former Secretary of
Health, Education, and Welfare, estimated that one out of every 20
Americans born in 1997 would spend some time in jail and that one in
four black Americans would suffer a similar fate. Mark Twain once
observed that "the non-sustainable tends to become exactly that -
non-sustainable," and so it is with our rate of imprisonment, spending
on prisons, and the sheer amplifying effect of this major
incarceration on the social structure and function of the United
States. Consider that the approximately 1.5 million drug-incarcerated
inhabitants are the parents of almost 2.5 million children and
consider that this jailed population is predominantly black and
Hispanic. The effect on family structure and child welfare is not
difficult to foresee.

There are also other consequences to our war on drugs, namely the
sacrifice of individual liberties and respect for law as they become
lost in "no knock" raids, property confiscation, mandatory jail terms,
and horror stories of "sorry, wrong address" raids by paramilitary
SWAT teams. We also insult our geographical neighbors, notably Mexico,
by certifying or decertifying them for their cooperation, or lack
thereof, in stemming the cultivation or transportation of drugs,
whilst we ignore the fact that supply rarely exists in the absence of
a demand. And that demand is dominantly American.

Finally, the war on drugs, activated by Ronald Reagan in the early
1980s, has cost and still costs a vast amount of money - over $300
billion and counting. It has displaced national priorities so that the
costs of prison construction and support challenge the funds available
for higher education and prisons become a growth industry.

There is only one solution and that also will cost money, but in the
end it will be the least costly solution. That solution is drug abuse
education and treatment. Absent that, the release of addicted
individuals merely ensures an increase in the disaffected and
drug-addicted public population. The cost? With a high estimate of
$10,000 per year per treatment there is an immediate benefit and
return to society by a reduction in crime and a stabilization of
family life. But before this can happen, there must be a political
acceptance that drug addiction is a disorder and that treating drug
addiction as a disorder does not mean "soft on crime."

And now there is an almost delicious irony with the publication of the
report from the Institute of Medicine (commisioned by the White House
Office of National Drug Control Policy) that there may well be medical
uses for marijuana and that for some disorders - AIDS and cancer - it
may well be the best available agent. This report should be well read
and its conclusions studied long and hard, particularly in light of
the over 700,000 arrests a year for marijuana possession or use. Will
we change our policies? Probably not, or at least not in the near
term. We like our "villains" too much to give up this one without some
really convincing evidence and, more important, some real political
bravery.
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References:

Dan Baum, Smoke and Mirrors: the War on Drugs and the Politics of Failure,
Little, Brown, Boston, MA (1997).

Mike Gray, Drug Crazy, Random House, New York (1998).

Joseph A. Califano, The Washington Monthly, October, 1998.

J. E. Joy et al., Marijuana and Medicine: Assessing the Science Base, National
Academy Press, Washington, DC (1999).