PERSPECTIVE ON DRUGS: LEGALIZATION WOULD BE THE WRONG DIRECTION

Hiding just beneath the theory of harm reduction is a whole other agenda in
dealing with substance abuse.

The so-called harm-reduction approach to drugs confuses people with
terminology. All drug policies claim to reduce harm. No reasonable person
advocates a position consciously designed to be harmful. The real question
is which policies actually decrease harm and increase good. The approach
advocated by people who say they favor harm reduction would in fact harm
Americans.

The theory behind what they call harm reduction is that illegal drugs
cannot be controlled by law enforcement, education and other methods;
therefore, proponents say, harm should be reduced by needle exchange,
decriminalization of drugs, heroin maintenance and other measures. But the
real intent of many harm reduction advocates is the legalization of drugs,
which would be a mistake.

Lest anyone question whether harm reductionists favor drug legalization,
let me quote some articles written by supporters of this position. Ethan
Nadelmann, director of the Lindesmith Center, a Manhattan-based drug
research institute, wrote in American Heritage (March, 1993): "Should we
legalize drugs? History answers 'yes.' " In Issues in Science and
Technology (June, 1990), Nadelmann aligns his own opinion with history's
supposed verdict: "Personally, when I talk about legalization, I mean three
things: The first is to make drugs such as marijuana, cocaine and heroin
legal." With regard to labels, Nadelmann wrote: "I much prefer the term
'decriminalization' or 'normalization.' " People who advocate legalization
can call themselves anything they like, but deceptive terms should not
obscure a position so that it can't be debated coherently. Changing the
name of a plan doesn't constitute a new solution or alter the nature of the
problem.

The plain fact is that drug abuse wrecks lives. It is criminal that more
money is spent on illegal drugs than on art or higher education, that crack
babies are born addicted and in pain and that thousands of adolescents lose
their health and future to drugs.

Addictive drugs were criminalized because they are harmful; they are not
harmful because they were criminalized. The more a product is available and
legitimized, the greater will be its use. If drugs were legalized in the
U.S., the cost to the individual and society would grow astronomically. In
the Netherlands when coffee shops started selling marijuana in small
quantities, use of this drug doubled between 1984 and 1992. A 1997 study by
Robert MacCoun and Peter Reuter from the University of Maryland notes that
the percentage of Dutch 18-year-olds who tried pot rose from 15% to 34%
from 1984 to 1992, a time when the numbers weren't climbing in other
European nations. By contrast, in 1992 teenage use of marijuana in the
United States was estimated at 10.6%.

Many advocates of harm reduction consider drug use a part of the human
condition that will always be with us. While we agree that murder,
pedophilia and child prostitution can never be eliminated entirely, no one
is arguing that we legalize these activities.

Some measures proposed by activist harm reductionists, like heroin
maintenance, veer toward the absurd. The Lindesmith Center convened a
meeting in June to discuss a multicity heroin maintenance study, and a test
program for heroin maintenance may be launched in Baltimore. Arnold Trebach
argues for heroin maintenance in his book "Legalize It? Debating American
Drug Policy": "Under the legalization plan I propose here, addicts . .

. would be able to purchase the heroin and needles they need at reasonable
prices from a nonmedical drugstore." Why would anyone choose to maintain
addicts on heroin as opposed to oral methadone, which eliminates the
injection route associated with HIV and other diseases? Research from the
National Institute for Drug Abuse shows that untreated addicts die at a
rate seven to eight times higher than similar patients in methadone-based
treatment programs.

Dr. Avram Goldstein, in his book "Addiction: From Biology to Drug Policy,"
explains that when individuals switch from heroin to methadone, general
health improves and abnormalities of body systems (such as the hormones)
normalize. Unlike heroin maintenance, methadone maintenance has no adverse
effects on cognitive or psychomotor function, performance of skilled tasks
or memory, he said. This research indicates that the choice of heroin
maintenance over methadone maintenance doesn't even meet the criteria of
harm reduction that advocates claim to apply.

Treatment must differ significantly from the disease it seeks to cure.
Otherwise, the solution resembles the circular reasoning spoofed in
Saint-Exupery's "The Little Prince" by the character who drinks because he
has a terrible problem, namely, that he is a drunk. Just as alcohol is no
help for alcoholism, heroin is no cure for heroin addiction.

As a society, we are successfully addressing drug use and its consequences.
In the past 20 years, drug use in the United States decreased by half and
casual cocaine use by 70%. Drug-related murders and spending on drugs
decreased by more than 30% as the illegal drug market shrunk.

Still, we are faced with many challenges, including educating a new
generation of children who may have little experience with the negative
consequences of drug abuse, increasing access to treatment for 4 million
addicted Americans and breaking the cycle of drugs and crime that has
caused a massive increase in the number of people incarcerated. We need
prevention programs, treatment and alternatives to incarceration for
nonviolent drug offenders. Drug legalization is not a viable policy
alternative because excusing harmful practices only encourages them.

At best, harm reduction is a half-way measure, a half-hearted approach that
would accept defeat. Increasing help is better than decreasing harm. The
"1998 National Drug Control Strategy"--a publication of the Office of
National Drug Control Policy that presents a balanced mix of prevention,
treatment, stiff law enforcement, interdiction and international
cooperation--is a blueprint for reducing drug abuse and its consequences by
half over the coming decade. With science as our guide and grass-roots
organizations at the forefront, we will succeed in controlling this problem.

Pretending that harmful activity will be reduced if we condone it under the
law is foolhardy and irresponsible.

- - - - Barry R. Mccaffrey Is Director of the Office of National Drug Control
Policy

Copyright 1998 Los Angeles Times. All Rights Reserved

Checked-by: Mike Gogulski