HEALTH TALK: THE WAR ON DRUGS

You may have seen commercials that begin with "Where do terorists get
their money?" and end with "If you buy drugs, some of it might come
from you." This is the latest ad campaign aimed at teenagers from the
White House that links the war on drugs with the war on terrorism.
The message implies that if you start or don't stop taking drugs, you
are supporting Osama bin Laden and other terrorist networks that are
funded by drug money. But to many people, mixing the old war on drugs
with the new war on terrorism seems to be a stretch. The strategy may
even be counter-productive.

At the same time, the Partnership for a Drug-Free America is
launching another campaign against the use of Ecstasy, the newest
illegal drug trend for teenagers.

Welcome to Health Talk with Post Health columnist Abigail Trafford.
To talk about how we're doing in the war on drugs is Peter Reuter, a
professor of public policy at the School of Public Affairs and
Department of Criminology at the University of Maryland. He is also a
co-author of the book "Drug War Heresies."

The transcript follows.

Editor's Note: Washingtonpost.com moderators retain editorial control
over Live Online discussions and choose the most relevant questions
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questions.

Abigail Trafford: Here's a great big general question. We've been
waging the war on drugs for years. But people are still using drugs.
What are we doing wrong?

Peter Reuter: The drugs we are talking about are very attractive, at
least initially. In the context of a democratic society, with high
rates of all kinds of crime, it is hardly surprising that there are
many people willing to take large risks to supply them. The right way
of thinking about the war on drugs is not whether it has eliminated
use of these illicit drugs but whether it has helped reduce the
adverse consequences of drug use in society. That includes addiction,
intoxication, crime and diseases. The War is not doing well in these
respects; though the drug problem in this country is slowly getting
better, we still have a worse problem than any other western nation.

Abigail Trafford: Hello and welcome, Peter Reuter. This a subject
where everybody has a passionate point of view. We've got lots of
questions from viewers. Let's start with an easy one. The White House
Office of National Drug Control Policy has just launched a major
antidrug campaign linking the war on drugs with the war on terror.
What do you think of this strategy? Will it be effective in keeping
kids away from illegal drug use?

Peter Reuter: The connection between drug use in this country and
international terrorism is slight indeed. Most people who use drugs
will buy marijuana or some synthetic like Ecstasy or methamphetamine.
Those drugs are produced and distributed by people who have no
connection to international terrorism. Al Quaeda certainly received
money from the heroin trade but almost no Afghan heroin comes to the
U.S.

This campaign strains the viewer's credulity. Adolescents are
skeptical, as shown in a great deal of research. A message which is
in fact demonstrably either false, or a great exaggeration, is not
likely to do well....and to further undermine the credibility of the
anti-drug campaign generally.

Abigail Trafford: The Partnership for a Drug-free America has also
launched a major advertising campaign aimed at alerting kids and
their parents to the dangers of Ecstacy. The ads feature real stories
of people to show the dangers of this drug. What do you think of this
strategy?

Peter Reuter: Real people make for credible messages. Seeing a
successful basketball player talk about his drug problem creates
ambiguity. While I haven't seen these particular messages, they may
well be sensible.

Fairfax, Va.: Anyone else notice the irony of the ONDCP ads used
during an event whose major sponsor is a BEER company?

Abigail Trafford: What about this, Peter? what are the pros and cons
of lumping all addictive substances together--drugs, alcohol,
tobacco--in trying to prevent kids from using these substances?

Peter Reuter: Most good prevention programs in schools try to cover
alcohol and tobacco as well as other drugs. They don't have to be
treated in exactly the same way, because they each cause harm in
different ways. But the notion of imbedding this in a general program
concerned with health, self-esteem, peer pressure is a sensible one
and helps give credibility to the messages targeted against illicit
drugs.

Oregon, Ohio: Why do we waste so much money on ad campaigns, when the
money could be better spent helping those who need help? Three
million dollars could have helped fund a lot of drug treatment,
instead it was wasted calling America's kids traitors, why?

Abigail Trafford: Just to be fair to the White House campaign. First,
a well-accepted strategy of prevention is an advertising campaign.
The Partnership for a Drug-Free America is also launching a major
media campaign against the use of Ecstasy. So, advertising is a
prevention strategy. The question is: is public advertising a
successful way to get the message across? And what kinds of ads are
most successful? Your thoughts, Peter? And a P.S. here. At the bottom
of the newspaper ads from the White House Campaign is a toll free
number for treatment: 800 662 HELP.

Peter Reuter: Abbie has it right. There is no single program that
will solve the US drug problem. Treatment helps those who already
have a serious drug problem; it doesn't, except very indirectly, cut
down on the number who start using drugts. Prevention programs deall
with the future problem; treatment is much more present-oriented.

Whether this is the right prevention campaign is another matter. Hard
to evaluate this kind of mass media effort.

Washington, d.c.: Don't you ever wish you could actually say,
publicly, what you really believe about marijuana? I know, I know.
But you really believe that it should be legal -- controlled but
legal -- that it is less dangerous than alcohol, that banning it is
creating a criminal class, etc.? Right? You can't say it, can you? We
would respect you more if you did. Then we'd believe you on the other
stuff.

Peter Reuter: Actually in "Drug War Hereies" Robert MacCoun and I do
say exactly what we believe about marijuana. It can produce
dependence and lead to accidents, like any other psychoactive drug.
But that does not mean it should be subject to heavy criminal
regulation. Removing criminal penalties for possession is only one
step, because that still leaves a huge black market (estimated at $10
billion last year), We think that the scheme adopted in a number of
Australian jurisdictions may be more reasonable; they remove criminal
penalties for cultivating a small number of plants which can be used
for own consumption or gifts to tohers. No doubt there are some sales
but it seems to keep trafficking down and provide a bit mroe
consistency.

Chicopee, MA: If the federal government is so concerned about
terrorists making money from drugs, why not regulate them as we do
tobacco and alcohol -- taxed and sold only to adults by reputable
American businesses? It's our policies that fund terrorism -- not
drug users.

Peter Reuter: Legalization removes one set of problems, like
financing terrorism and creating violence in inner city communities,
and replaces them with others. Use of these attractive substances
would certainly rise substantially and, given their addictive
properties, many will become addicted. I am skeptical of clever
regulatory schemes, given our failure with alcohol and tobacco; that
reflects the Supreme Court's dedication to commercial free speech and
campgain financing in this country. So we trade reductions in crime
and some health problems, for increased addiction and a different set
of health problems. In "Drug War Heresies" we try to pose the
trade-offs but there is no compellin way of choosing among them.

Oakland, Calif.: Mixing the Drug War and the War on Terrorism is more
than a stretch. First, to the extent that drug money gets into the
hands of terrorists, it is because of the obscene profits created by
Drug Prohibition. Certainly not using drugs is a good idea but not
everyone has such a choice available to them. Second, the Drug War
bureaucrats are desperate because they know that they are losing
"fear of drugs" as a source of funding for jobs. They're trying to
piggy back on the War on Terrorism into public favor

Abigail Trafford: I have a problem with the war terminology. The war
on drugs makes it sound as though the only goal is "to win." But drug
use and addiction are not a tone-time battle where there are winners
and losers. This is a huge health and social problem that needs to be
addressed. Peter, how can we redefine the "war on drugs" so that it
will become open to multiple solutions--not just one winner?

Peter Reuter: Almost everyone involved in this business, except
elected officials, agrees that the War metaphor is a misleading one.
Drugs present a social problem, like many others. Our goal should be
to manage that problem.

Making sure that we define the problem right, not just the number of
people who use drugs but the harms they cause themselves and others,
is critical. Very tough enforcement might reduce drug use, though
there is a troubling lack of evidence for the proposition, but it may
lead to more crime, more HIV, corruption etc.

Kremmling, Colo.: Why is it so hard for the American people to
realize the futility, the harm, and the complete corruption of
America's war on drugs?

Abigail Trafford: Some people think that we've made progress in the
war on drugs. . . . Peter you call for a new approach in your book,
"Drug War Heresies." Tell us about the strategy you would recommend.

Peter Reuter: The American public sees drug use itself as dangerous
(or at least the non-users do). Almost any reform proposal runs a
risk of increasing drug use; it is not certain that such measures
would but credible arguments can be made. Given that populace is so
alarmed about drug use itself, we seem to be locked in to this very
punitive approach.

Our book has more to say about how to think about the problem than it
has strong recommendations. We think that the Swiss experience with
heroin maintenance makes this an option worth experimenting with
here. The crackdown on marijuana use in the last years (arrests have
doubled in the last ten years, while marijuana use has been stable)
is almost indefensible. These are the easy argets. Generally being
less "tough" is certainly one way of reducing our drug problem,
because policy itself (the incarceration of so many young people for
so long) has become part of the problem.

Washington, D.C.: I am so glad you're covering this! My friends and I
saw one of these ads during the Super Bowl. we were perplexed and
nonplussed the whole way through, and absolutely IRATE at the final
line, spoken by a teenage girl-"It's my life; it's my choice." We all
(mostly liberal dems, admittedly) are attuned to phrases like that as
pro-choice slogans. and we felt that its use in this ad was a
subversive and insidious attempt to imply that the selfishness/evil
of drug use, terror support, and yes, abortion-all go hand in hand.
Disgusting. You can't tell me that no one in the ad agency or in the
Office of Natl Drug Control Policy noticed that that phraseology was
strikingly similar to pro-choice sloganry throughout the years. In
this day and age of government corruption and right-wing conspiracy,
I find it far more likely that the parallel was intentionally drawn.
Your thoughts on this?

Abigail Trafford: Ummmmmmmm. I'm not a conspiracy-minded person. I
think people use effective arguments to further their cause. "It's my
life; it's my choice" goes to the heart of American rugged
individualism. It's a good line. But you're right to be wary. This
subject is highly political. It reflects a clash of values and
beliefs. In other words, it's a dynamite issue. So how do we take it
out of the realm of political emotionalism and deal rationally with
the issues? Peter, what's your "sober" response?

Peter Reuter: I don't see a connection.

Arlington, VA: I don't understand why a questionable link between
drugs and terrorism is so much worse than the questionable statistics
usually trotted out in anti-drug campaigns. For example, the "huge
rise" in Ecstasy use cited in this morning's column. Since Ecstasy is
a synthetic drug that didn't exist a few years ago, it doesn't take
much to create a dramatic rise. Similarly the story of the girl who
died after taking Ecstasy. Is she the only death? Out of how many
users? How does the death rate from E compare with typical over-the-
counter medication?

There's a demonstrable link between drugs and terrorism. As you
rightly point out, the link between the drugs most commonly used in
the U.S. and terrorism is something of a stretch. But why is
stretching the truth here so much worse than manipulative statistics?
It doesn't take a rocket scientist to see through either one.

Abigail Trafford: According to a nationwide survey by Ipsos-Reid U.S.
Public Affiars company, more than 70 percent of those who saw the
advertisements during the Super Bowl thought that the ads were an
innovative approach to discouraging illegal drug use. If the ads give
teeenagers another reason not to do drugs, why isn't it a good
strategy?

Peter Reuter: I'm not only against stretching the truth on the drugs-
terrorism connection but also manipulated statistics. It seems a
modest defense to say this is no worse than another common failing of
these campaigns.

I don't have the figures on Ecstasy related hospital admissions and
deaths; my guess is that given the large user base now, it will
probably appear to have modest health risks compared to other
synthetics such as methamphetamine and PCP. Not a ringiing
endorsement of the drug (it's not as bad as some others) but it is
useful to keep these harms in context when making decisions about how
hard to crack- down on one drug rather than another.

Maryland: The liberal Democrats want drug treatment. The conservative
Republicans want drug prevention. How about both?

Peter Reuter: Actually, both Democrats and Republicans want both. The
Democrats want more treatment than the Republicans but they do not
critique the centerpiece of the drug war, namely zero tolerance and
tough penalties. This is a bi-partisan failure.

VA: The bestanti-drug message I have ever seen is the young woman who
has been doing PSAs about ecstasy. She was covered in many news shows
the last year or two in which they showed her brain scan. She was in
her 20s, but her brain was that of an 80 year-old who had suffered
strokes. That's not a scare tactic, that's the truth. I think such
ads are really effective in giving kids the real face of the damage
done.

Peter Reuter: I do think that showing people with real drug problems
is a sensible approach.

DC: Why help people with drug problems? They want to die, so let them.

Abigail Trafford: Sorry, I completely disagree. People with drug
problems are in trouble. They need help--medical treatment and social
supports. The may not make it, but we as a society have to try--just
the way we'd treat a person with heart disease or lung cancer. We'd
do that even if the person couldn't stop over-eating and that lead to
a fatal heart attack or a person couldn't stop smoking and that lead
to the lung cancer. We don't just stand by and let people drown.
Peter, your thoughts?

Peter Reuter: More than half of all 18 year olds have used an illicit
drug . I doubt that you mean that this group either wants to die or
should be left to die. I assume that what you mean is that there are
some drug users who cause great harm to the rest of society and
immiserate themselves and that at some point this is suicidal in
intent. Yet most of those who become dependent on these drugs
eventually quit and do so without treatment. They can be helped.

Lexington, KY: Something my friends and I always come back to is all
through school we're taught how bad drugs are and all the horror
stories of addiction or loss of control. (Classic stories of people
thinking they're OJ after taking LSD.) But when some of came to try
them it seemed a lot of the stories and warnings were exaggerated if
not false. This of course totally undermined everything we learned
about drugs in school. Has drug education become any more honest? Can
it be honest without making drugs seems appealing?

Abigail Trafford: You've hit on the key to successful prevention.
Exaggeration usually backfires. The National Institute on Drug Abuse
has evaluated a lot of prevention programs for schools. The most
important element, researchers found, is truth. That means
recognizing the appeal and pleasure drugs hold out for teenagers. It
also means assessing the risks and dangers and not exaggerating them.
The difference comes down to one word: "can" Drug use can destroy
your brain. That's true.

Peter Reuter: Abbie has given the elegant formulation of the central
problem. Drug use "can" damage your brain and life. But it is
unlikely that anything very bad will happen the first few times you
use a drug. So the campaigns have to find a way of coming to terms
with the fact that initial experiences are generally benign while the
long-term dangers are very serious.

Washington, DC: It seems to me that the drug war has always relied on
scapegoating and scare tactics. Our social ills are simply blamed on
some illicit plant or chemical derivative, while the complex social
and economic problems endemic to our society are hidden away. It's
easy to play this scapegoating game:

First, cars fund terrorism. It's our addiction to oil that makes our
government turn a blind eye toward Saudi complicity in terrorism.
Second, the illicit diamond trade funds terrorism as the Washington
Post documented. What's the obvious conclusion from such silly
reasoning? The biggest supporters of terrorism are traitorous SUV-
driving soccer moms sporting big diamond rings. But then, affluent
soccer moms are a desirable political demographic! What are your
thoughts about scapegoating, sleights of hand, logical leaps in
relation to selling the drug war to the public?

Abigail Trafford: You make some interesting connections! Personally
I'm against scapegoating. In all arenas from the bedroom to the
boardroom! Your thoughts, Peter?

Peter Reuter: The connections between drug use and terrorism are
indeed remote. There is more of a connection between drug use in the
U.S. and corruption and violence in Colombia and Mexico. That may
still not be much of a reed on which to rest a prevention message.
There are lots of better reasons for discouraging drug use.

Baltimore, Md.: It is one of the hallmarks of intellectual dishonesty
by the drug warriors that they use teenagers as the benchmark by
which all policy decisions are made. Nobody would think to close all
the bars and ban alcohol simply because underage drinking exists.
Nobody would reasonably suggest that cigarette sales be prohibited
because some teenagers are able to buy them illegally. Yet all the
propoganda by the Partnership for a Drug Free America and all the
political rhetoric is couched in terms of what drugs do to kids.
These groups and politicians are clearly unwilling or afraid to hold
a debate on what responsible, consenting ADULTS should or should not
be able to put in thier bodies. The fact remains that no child should
have access to any drug, legal or illegal, but that truth should not
drive the debate for the rest of the population.

There clearly needs to be a voice against groups like Partnership for
a Drug Free America so that the constant one-sided story that the
media eats hook, line, and sinker has some balance and that others
realize that there are people out here that don't agree with the lies
they are spreading.

Abigail Trafford: Wow. You feel pretty strongly about this. I like
your point about gearing anti-drug campaigns to teenagers. At the
same time, they are the natural targets in preventing drug use. My
personal bias is that teenagers need to learn about the potential
dangers of many harmful substances, not just illegal drugs. And, as
you point out, what is the proper strategy to educated adults? Peter,
what do you think?

Peter Reuter: There is a bit of the Willy Sutton approach here; you
go to where you can find targets. Prevention in the U.S. is aimed at
young people who have either not tried drugs or are still in the
experimental phase. They are relatively easy to reach throuhg schools
(though less in high school than in elementary or intermediate
schools); perhaps they are more media oriented as well. Persuading
adults who are experienced uses to quit is much harder work; need
different messages and different media.

Reston, Va: The problem with lumping alcohol and drugs together is
that a person can have one drink and feel no effect. People do drink
wine and beer for the taste. I've never seen anyone take one hit off
of a joint and be fine for the night. Instead of telling kids that
alcohol is as bad as drugs, we need to tell them that getting drunk
is as bad (or worse) as using drugs.

I've been in AA for 12 years, sober for 7, so I have some experience with this.

Abigail Trafford: Thanks for your story. I think you say it just right. Peter?

Peter Reuter: Your point about alcohol being consumed for reasons
other than intoxication is very important, both for political and
substantive reasons. All the illicits are associated with one
motivation for use, namely some change in mood, typically
disnhibition. I'm not sure that is inherent in marijuana. A Dutch
researcher once desribed to me his irritation with a US teenager who
persisted in getting stoned when marijuana was passed around, while
the rest of the crowd smoked a very small amount as a supplement to
their after-dinner brandy, and sat around chatting. My guess is that
most of the illicits do not lend themselves to this kind of "tasting"
but marijuana effects may be "socially defined"

Chicago, Ill.: Why do the bureaucrats in Washington stick to the same
old tired song & dance?

Abigail Trafford: Actually, the White House media campaign that links
drug use with international terror is a first. Most ads stress the
harm that drugs do to the user and those around him or her. This
reminds users of illegal drugs that there is a violent underworld
that envelops illegal drugs. So you could argue that this is a
department from the old song and dance. Your thoughts, Peter?

Peter Reuter: I agree with Abbie. The underlying rationale for the
ads may be the same but the campaign is quite innovative in its
choice about messages.

Abigail Trafford: Thank you Peter Reuter and thank you all for your
questions and comments. This was a wonderful disucssion. Join me same
time same place next week.