Who We Are

Problems: The U.S. "War on Drugs" is failing disastrously. The costs are enormous. They include the deaths and mental distress of the policemen and women whom we ask to interdict drug sales by undercover stings. They include the massive social and personal costs of incarceration of hundreds of thousands of non-violent drug users, and the adverse impact on families of the prolonged absence of fathers, brothers, husbands, and uncles. Punishment without rehabilitation is not working. It is also extraordinarily expensive. According to the New York Times Sunday Magazine, "The cost of warehousing nonviolent drug offenders is more than twice as great as treating them." Orenstein, "Staying Clean," February 10, 2002,

Sources: J. Alter, "A Well-Timed 'Traffic' Signal," Newsweek, January 15, 2001, p. 29; Ackerman and Alstott, The Stakeholder Society, New Haven: Yale University Press, 1999; Orenstein, "Staying Clean," New York Times Sunday Magazine, February 10, 2002.

"The prison population has soared over the last quarter century. In 1975 about one hundred of every 100,000 Americans were in the nation's prisons; now that number is about four hundred--and more than six hundred when the short term jail population is included." (Ackerman & Alstott, p. 100, citing Caplow & Simon, "Understanding Penal Policy," in Petersilia & Tonry (eds.), Crime and Justice: Prison Issue, University of Chicago Press, 1999.)

"The 'gulag' is one of the great under-covered stories of our time--400,000 Americans behind bars on drug charges. And it's not as if the system even treats them. About 85 percent of those released from prison have substance abuse problems, a recipe for rearrest." (Alter, p. 29)

Our current drug policy "costs [taxpayers] $19-20 billion a year." (Alter, p. 29)

The punitive approach of U.S. drug laws and policies, and discriminatory standards and processes of enforcement of those laws has had a devastating effect on African American and Latino communities. "According to federal government statistics, only 13 percent of monthly drug users are black; but 37 percent are arrested for possession, 55 percent are convicted of possession and 74 percent are imprisoned for possession. One of every three African American men between the ages of 20-29 are now under the jurisdiction of the criminal justice system. 14 percent of African American men are permanently disenfranchised." Glasser, ACLU, "Testimony before House Criminal Justice, Drug Policy and Human Resources Subcomittee, June 16, 1999.

Expense Without Payback: "The cost of warehousing nonviolent drug offenders is more than twice as great as treating them. Meanwhile, a study by the RAND corporation's drug-policy center found that for every dollar spent on treatment, taxpayers save more than seven in other services, largely through reduced crime and medical fees and increased productivity. A visit to the emergency room, for instance, costs as much as a month in rehab, and more than 70,000 heroin addicts are admitted to E.R.'s annually." (Orenstein)

It is not just the American Civil Liberties Union and international human rights groups such as Human Rights Watch that have decried current U.S. drug policy. Critics of very different perspectives have also recognized that current drug policy is not working and needs to be replaced with policies that are more treatment oriented, cost-effective and fair.

These critics include: former Governor, Gary Johnson (R-New Mexico); Senators Hatch (R-UT) and Leahy (D-VT); police chiefs from a number of cities [chiefs Murphy (NYC, Washington, DC), Pastore (New Haven, CT), McNamara (San Jose, Kansas City)]; conservative commentators (William F. Buckley,Jr.; George Schultz, Hoover Institution; Deroy Murdock, Cato Institute; and Milton Friedman); criminologists, public health experts, and a number of state and federal judges (U.S. District Judges Curtin, Knapp, Vaughn Walker, Robert Sweet, and John Kane, Jr).

Public Opinion: As a result of the above, public opinion is shifting. "[A 2002] ABC News poll showed that more than two-thirds of Americans favor treatment over jail for first- and second-time offenses." (Orenstein)

Reform: Efforts to reform drug laws are increasing, even in New York State, home of the landmark Rockefeller Laws that required 15 year mandatory sentences, even for first time, non-violent offenders. Other states are also pushing for reform. California and Arizona voters have passed referenda "requiring nonviolent drug offenders to be offered treatment with probation in lieu of jail. Similar measures are being targeted for November ballots in Michigan, Florida and Ohio. By 2003, systemic changes in the New York courts are expected to divert 10,000 nonviolent drug addicts to rehab annually." (Orenstein)

Reform: " Gov. Gary Locke signed a bill that will reduce prison sentences for nonviolent drug and property offenders. The governor, a Democrat, said the law would support existing drug rehabilitation efforts by reducing prison time for first-time heroin and cocaine offenders and transferring the savings realized by the state on incarceration costs to programs to treat addiction. The majority of the money, 75 percent, would go to county drug courts and court-supervised treatment programs." Preusch, "WASHINGTON [STATE]: REDUCING TERMS FOR DRUG OFFENDERS, New York Times, April 3, 2002.

Problem: In many cases, however, single-event drug counseling and treatment, as now practiced, may not provide an enduring solution. "Nationally, dropping out of treatment is the rule. Among those who do finish, few maintain the gold standard of total abstinence for long: a Congressionally mandated study showed that more than half of cocaine addicts and nearly two-thirds of those addicted to both heroin and cocaine were using drugs within a year."

Yet, as the same author points out, "Not all people with a drug or alcohol problem will self-destruct . . . In fact many, like President George W. Bush, will quit spontaneously before their lives unravel. Others do well (at less taxpayer expense than treatment) on probation with contingencies: rewards for abstinence and sanctions for testing positive for drugs. Those tend to be lighter-weight users with more to lose." (Orenstein)

Solutions: What's the solution? For some, the answer may be combining treatment with a drug that "blocks the high": "McLellan and James W. Cornish undertook a study comparing punishment in conjunction with treatment to stricter punish without treatment, to see which was more effective in reducing crime. They found that opiate addicts who were forced to increase the number of times they met with their probation officers were twice as likely to be rearrested or re-incarcerated within a year as those who received only standard probation but with therapy and naltrexone, a drug that blocks their high." (Orenstein)

For others, the answers may differ: "Meth and cocaine addicts, particularly males, respond to cognitive behavior therapy. Used primarily in outpatient programs, cognitive therapy does not focus much on the psychological causes of addiction. Instead, therapists act more like coaches, teaching addicts why they develop cravings and working on coping skills, like planning in microscopic detail how to get from today until Wednesday without using." (Orenstein)

"Another factor in successful rehab is matching a given addict to the program and services that will make him stick. Each approach will work for some, but none for all: the therapeutic community that clicks with a homeless crack addict who suffers from post-traumatic stress may not be appropriate for a medical resident who can't stop dipping into the morphine. With long waiting lists for treatment slots and pressure on programs, which are paid per client, to take whoever walks in the door, that has not been an easy task." (Orenstein)

"While improving all these aspects of treatment may well lead to better outcomes, according to a study of more than 10,000 addicts in 96 programs, the single most important factor (assuming a program is well run) is the length of time an addict stays in it. And 90 days -- not the managed-care-driven 28 or the brief 3-to-5-day detox that is the most common ''treatment'' in many cities -- was the minimum for enduring benefits to manifest." (Orenstein)

"If treatment is conceived of as an ongoing process rather than as a cure, a different, more optimistic notion of success emerges. Although addicts may relapse, a year after treatment their drug use decreases by 50 percent, according to the National Treatment Improvement Evaluation Study, and their illegal activity drops as much as 80 percent. They are also less likely than before to engage in high-risk sexual behavior or to require emergency room care. Other studies have shown that they are less likely to be on welfare, and that their mental health improves." (Orenstein)

Problem: The prognosis for women differs from that for men with drug problems.

"About half as many women as men enter treatment, but the ones who do are more than twice as likely to have additional mental disorders like anxiety, depression or post-traumatic-stress disorder. Though estimates vary, perhaps as many as two-thirds, like Sharon, were raped or molested before substance abuse. At least half have been victims of domestic violence. Because victims of such traumas are more likely to become addicts, and because, according to the National Center on Addiction and Substance Abuse, addicts are more likely to abuse and neglect their children, breaking the cycle among that population takes on particular urgency. Yet women, perhaps in response to the aggressive, male-dominated nature of many programs, drop out of treatment at far higher rates than men." (Orenstein)

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