IT'S NOT ENOUGH TO CUT OFF DRUGS

No public policy argument is so familiar and fatiguing, yet so central and
urgent, as the decades-long battle over whether to focus more on the supply
end of our illicit-drug problem or on the demand end.

I got into the issue 30 years ago partly in response to a call by now-Sen.
Daniel Patrick Moynihan (D-N.Y.), then working for President Richard Nixon
to stanch the flow of illegal drugs at the "source." The State Department's
traditional indifference to engagement in gritty law enforcement seemed to
Moynihan, and in turn to me, as outdated and dangerous. He had a role in the
Nixon administration's experiment with supply interdiction: It produced what
he now acknowledges to be "at most a brief success" in closing down the
"French Connection," while "opium and heroin production merely moved
elsewhere."

This is pretty much the story of supply interdiction since then. Prodigies
of law enforcement are overwhelmed by the ease with which traffickers can
meet a seemingly insatiable American demand. Moynihan confronted the
political reality behind policy as a U.S. senator in 1988 while working to
focus new drug legislation on users. Some 60 percent of the money was to be
earmarked for demand reduction, 40 for supply reduction.

But, Moynihan now relates, "as the bill made its way through House and
Senate deliberations and quasi-conference committee negotiations, its
emphasis shifted incrementally from demand reduction to supply reduction
and, especially, to law enforcement. I suppose this was inevitable. Fear of
crime far outstripped concern for addicts. And just a few weeks away from
the 1988 elections. . . . The deal was a 60-40 ratio in favor of demand
reduction; in the end it was the other way around. Now the ratio is about
two-to-one the other way."

This episode and much else shaped the conclusions he presented at a Yale
conference on the century of American experience with heroin. "While the
science of drug abuse and addiction holds great therapeutic promise," he
said, "the politics are self-defeating, punitive and vainglorious."

What? The science of drug abuse and addiction holds great therapeutic
promise? An emphasis on cutting down the demand for illegal drugs, on
focusing on users rather than producers and traffickers, appeals to many of
us who are frustrated by the shortfalls of law enforcement and troubled by
the foreign-policy complications of a supply-oriented strategy. Up to now,
however, there don't appear to have been the research breakthroughs that
would make a treatment-oriented policy a medically, economically and
politically feasible alternative to sending in the cops.

I am not a student of the science, but let me cite Moynihan and one of his
gurus:

Moynihan: "Ours surely is the great age of discovery in the field of
neuroscience. We are exploring the brain, not least with respect to the
effect of drugs. . . . I think it safe to assume that we may never win a
'war' against drugs. Perhaps the closest we can come, through scientific
research, will be to identify 'pre-exposure' vulnerability in the population
and develop some sort of active or passive immunization. We're making
progress. . . . Supply interdiction doesn't work, although absent it things
could be even worse. We spend twice as much on it as we do on biomedical
research. But the latter moves."

Alan Leshner, director, National Institute on Drug Abuse: "If we know that
criminals are drug addicted, it is no longer reasonable to simply
incarcerate them. If they have a brain disease, imprisoning them without
treatment is futile. If they are left untreated, their recidivism rates to
both crime and drug use are frighteningly high; however, if addicted
criminals are treated while in prison, both types of recidivism can be
reduced dramatically. . . .

"Understanding addiction as a brain disease explains in part why historic
policy strategies focusing solely on the social or criminal justice aspects
of drug use and addiction have been unsuccessful. They are missing at least
half of the issue. If the brain is the core of the problem, attending to the
brain needs to be a core part of the solution."

Moynihan: "The outcome of narcotics prohibition over the past century has
been to concentrate drug abuse and addiction principally among an urban
underclass most don't know and for whom there is currently little public
understanding or sympathy. So Congress and the public continue to fixate on
supply interdiction and harsher sentences (without treatment) as the
'solution' to our drug problems, and adamantly refuse to acknowledge what
Dr. Leshner and others now know and are telling us."