THOSE ON FRONT LINES AGREE: RETHINK DRUG-WAR STRATEGY

While his fellow Republicans shun the topic like a communicable disease and
Democrats, for the most part, see in it only an opportunity to take potshots
at the GOP, there is one group of people who find it perfectly reasonable
that Gov. Gary Johnson engages the nation in a dialogue over its drug
policies.

Those who work in the trenches - getting addicts into treatment and trying
to get them to stay clean - say Johnson is right to raise the issue. They
agree that the drug war hasn't worked. And although not all agree with him
that decriminalization is the answer, they think it's time to rethink our
$17 billion-a-year assault on illegal drugs.

"I think it's great that the governor is bringing it up," said Judy Marks,
director of the outpatient chemical dependency unit at St. Vincent Hospital
in Santa Fe. "Right now our drug policies are confused and befuddled."

But don't look toward this group for a unified solution, either. Those who
work with addicts here in New Mexico advocate changes in drug policy that
stretch across the spectrum:

* Decriminalize marijuana and other substances so experts can collect some
accurate data on dependency, recommends Marks.

* Keep marijuana and other drugs illegal, but - like drunken-driving laws -
make the punishment more closely match the hazard the user creates for the
public, says a Santa Fe doctor who treats addicts.

* Refocus interdiction efforts away from marijuana, but step up efforts to
stop cocaine and heroin from entering the United States, suggests an
EspaF1ola doctor who has witnessed first-hand the toll those drugs have
taken on his community.

* Divvy up the federal drug-money pie more evenly between interdiction,
prevention and treatment, so that more money is spent on prevention and
treatment and less on interdiction, says state Health Secretary Alex Valdez,
who doesn't work directly with addicts but has a strong interest in Rio
Arriba County's heroin epidemic.

One thing these experts agree on is that drug use is distinct from true
dependency. True addicts make up a minority of the drug-using population,
even when their substance of choice is a "hard" drug such as heroin, says
Dr. Steven Wright, a Santa Fe-based family-practice physician who
specializes in addiction.

Wright and others who treat addicts say punitive measures might help deter
social users, but they don't do much to stop the truly addicted. And it is
this population that is responsible for the majority of crimes and other
social ills caused by drugs, many experts think.

"One of the hallmarks of addiction is that the consequences can become very
negative and people still won't stop using," Marks said. "So the question
is: What is the wisdom of imprisoning people whose behavior isn't
volitional?"

Marks said that the most-studied drug - alcohol - causes dependency in
between 7 percent and 10 percent of people who ever drink it. The potential
for marijuana to cause chemical dependency is probably lower, she says,
though the study of marijuana has been hindered by the fact that it is
illegal, she says.

Marks said that lack of good data makes her distrust the "gateway"
hypothesis that those who use marijuana are more likely to move on to
"harder" drugs. That theory was most recently promulgated in a study by the
Center on Addiction and Substance Abuse at Columbia University. That study
claims that adolescent pot smokers are more likely to move on to cocaine.

"You could also do a study showing a 100 percent correlation between
drinking milk as a child and becoming an alcoholic. It would be true, but
the numbers don't mean anything," Marks said. "There could be a bazillion
people out there who use marijuana socially who don't ever look for
treatment. We just don't have good information."

"I'm inclined to say, 'Lets decriminalize everything and let the chips fall
where they may,' " said Marks, who admits she is "probably more radical"
than most of her colleagues. "Let's get some real numbers and some real
understanding of this problem, instead of half-treating, half-punishing
people."

Wright agrees with Marks that the drug war has failed. As a medical doctor
who specializes in addiction, he is not surprised.

"From what we know clinically, it was doomed to failure, because it was
based on the belief that addicts are swayed by criminal penalties," Wright
said. "We never should have been thinking that criminal justice could solve
the problem."

Wright thinks that although the threat of negative consequences is
ineffective in making addicts stop using drugs, laws against illicit drugs
such as marijuana are necessary because illicit drug users, like drunken
drivers, can cause a public-safety hazard.

"Laws need to be in place because of public safety. But it would be frankly
wise to consider matching the penalty more closely to the level of the
crime," Wright said. "The penalties have probably exceeded what is
reasonable for the impairment."

Wright agrees with his colleagues that the lack of effective treatment is a
major obstacle. Treatment specialists decry the lack of a heroin-detox unit
in Northern New Mexico, a region where the death rate from drug overdose is
nearly three times the national average and believed to be the highest in
the country.

Dr. Murray Ryan, an Espanola family doctor who sees many patients whose
lives have unraveled due to drugs, thinks the decriminalization debate is
important because it makes people think about the impact of different
substances rather than lumping them together.

"To me, even the word 'drugs' shouldn't be used," said Ryan. " It makes
people equate these different substances in their minds, when, in fact, to
equate marijuana with heroin and cocaine is ridiculous. Heroin and cocaine
are just awesomely destructive while marijuana probably isn't as damaging as
alcohol," Ryan said.

At the same, keeping marijuana "mildly illegal," is a good idea, at least
for adolescents, Ryan said. "It gives us a chance to intervene with
juveniles who are at risk of more serious problems. It brings the problem to
the surface when its more mild. Once the kids get involved in heroin and
cocaine then they're really lost, and it's harder to help."

While Ryan believes that marijuana use among his adolescent patients may be
red flag for more serious problems to come, he thinks the gateway approach
to prevention: warning kids that if they smoke pot they're likely to end up
as hard-core addicts isn't a realistic prevention technique.

"How destructive drugs become in someone's life has to do more with the
severity of family dysfunction. If the family dysfunction is profound, the
child is much more likely to progress to harder drugs," Ryan said. "It's
much more important to understand what's driving the addiction."

While Ryan agrees that efforts to reduce drug supply have largely failed, he
doesn't think the answer is to give up the battle. "I think when it comes to
heroin and cocaine, interdiction should be even more aggressive and
draconian than it has been. I think the lack of effective law enforcement
led to a horrendous epidemic in my community," Ryan said. "Had interdiction
been more successful, I think it would have prevented a lot of my
16-year-old patients from getting addicted in the first place."

"I think we can say we've lost the battle and we may need a new plan, but we
shouldn't give up,' he said. "That's just giving in to hopelessness."

The 1999 federal drug budget of more than $17 billion allocated $11.2
billion for interdiction and $5.9 billion for prevention and treatment.
Health Secretary Valdez said the equation should be balanced to reflect "a
three-legged stool."

Valdez believes the early 1970s as the last time when the United States had
an effective drug policy.

In The Fix, a 1998 book on shifting policies concerning illegal drugs,
author Michael Massing argues that President Nixon, faced with the prospect
of thousands of heroin-using soldiers returning home from Vietnam, made
treatment a focus of his administration. Massing argues that the Nixon was
right in focusing efforts on those who needed help. He argues that
subsequent administrations' efforts to stop drugs from entering the country
and to convince drug users to "just say no," have largely been a waste of
money.

Valdez agrees for the most part with Massing. "Right now, a tremendous
amount of resources are being spent on interdiction, and it hasn't been as
effective in reducing the demand," he said.

But he worries that decriminalizing marijuana would "send the wrong message"
and increase in the number of people who use pot.

None of the treatment specialists advocate outright legalizing of "hard
core" drugs. Citing an experimental governmental program in England which
provides maintenance doses of heroin to addicts, Judy Marks said. "I don't
think they have solved the problem. And they've created the additional
problem of making people dependent on the government for their drugs."