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Ethan Nadelmann
Executive Director, Drug Policy Alliance
San Francisco often seems out-of-step with the rest of the country in ways I find inspiring and refreshing. But when it comes to drug policy, San Francisco may be leading the way. Yesterday in Congress, two-thirds of the Democrats in the House of Representatives and even a dozen Republicans voted to tell the Justice Department and the DEA that they could not spend a penny to go after medical marijuana in California and other states that had passed ballot initiatives legalizing medical marijuana.
What's happening here is providing the models and inspiration for what's going to happen around the state and eventually the country. What's happening here is also not so distant from what's happening in Europe, Canada, Australia, New Zealand and a range of other places which share our values and many of our social problems, and which are finding different ways of dealing with drugs.
We're a wealthy nation. If we want to lock up millions of our fellow citizens, we can afford to do that. If we want to have have millions dying of HIV/AIDS, we can afford to do that. On the other hand, our economy is not what it once was. In the 1990s, incarcerating millions of people was something we could afford - ten, 20, 30 billion dollars: a drop in the bucket of the national economy. But now, in state governments that do not have the luxury of running major budget deficits the way the federal government can, we can no longer afford this failed war on drugs.
In 1980 we had 50,000 people behind bars on drug charges. Today, almost half a million people. We lock up more people on drug charges than all of Western Europe locks up for everything - and they have 100 million more people. We lock up African Americans at a rate that exceeds the rate of incarceration of black South Africans in apartheid South Africa. We lock up African Americans and Latinos at a rate that exceeds the rate of incarceration of people in the gulags of the Soviet Union in the 1930s, '40s and '50s.
We have over a quarter of a million people infected with HIV/AIDS directly or indirectly because of injection drug use - most of which could have been prevented if we had adopted the same sensible harm reduction measures, the same sensible public health measures that our allies and friends throughout Europe and Canada adopted ten, 15 and almost 20 years ago.
We cannot afford this failed war on drugs. What's the alternative? You've had former heads of the DEA and the drug czar's office, Asa Hutchinson and Barry McCaffrey, speak here; you've heard from the horse's mouth what the drug war is supposed to be about, the rhetoric that we must create a drug-free society. In 1988 Congress passed a resolution declaring America must be drug-free by 1995 - makes you wonder what they were smoking. In 1998 the United Nations held its once-every-decade anti-drug assembly and proclaimed a drug-free world: "We can do it!"
There has never been a drug-free society, so far as we know, and there will never be a drug-free society (with the possible exception of the Eskimos, because they couldn't grow anything). Every society has used, experimented, found, discovered, uncovered, devised, designed mind-altering substances. Anthropologists find tribes living in the Amazon or the South Pacific; they learned how to make fire last week. But what have they been doing for decades? They figured that when that piece of fruit dropped from that tree over there and you let it marinate for a little while and then you drank it: amazing. Societies that had no contact with one another figured out booze - from grapes, corn, maize. In Mongolia, they drink booze made out of yak's milk. How many societies figured out that if you chewed on that mushroom or piece of bark, that might create a religious experience?Andrew Weil in The Natural Mind speculates that people have an innate need to alter their state of consciousness. He analogizes it to children who spin themselves in circles to get dizzy. Perhaps it's an innate drive just like our desires for food and sex and other forms of pleasure. Maybe the challenge is not, as the drug czar would have it, to create a drug-free society. Maybe calling on people to pay any price and bear any burden to create a drug-free society can do far more harm than good: incarcerating an ever-increasing number of citizens, creating harms to environments and peoples throughout the world, spreading disease, throwing hundreds of billions of dollars into prisons and military enforcement rather than the areas which might most help people. Maybe instead the challenge is to learn how to live with drugs so that they cause the least possible harm and the greatest possible benefit.
What Do We Know About Drugs?
Any drug can be used responsibly and any drug can be used irresponsibly. The same drug used in one dose has no effect, in another dose becomes recreational; in another dose medicine; in another dose can kill you. The dose, oftentimes, is what matters. It's not just the pharmacology and your genetic makeup which predisposes you one way or another. It's also the set, what you think this drug will do; it's also the setting, what your culture and your milieu tell you about this drug. It's learning to live with drugs that they cause the least possible harm.
The legal divides we make between alcohol and nicotine products and caffeinated beverages on the one hand, and opiates, cocaine, amphetamines, marijuana, ecstasy and hallucinogens on the other - and the Prozacs and Viagras - these distinctions are not grounded in science or, typically, regard for public health. They're grounded in politics, culture, prejudice, money and fear. The first anti-opium laws were not motivated by health concerns but targeted Chinese migrants. The first anti-cocaine laws happened a hundred years ago in the South, directed at blacks who, we were afraid, would take this white powder and forget their proper place in society and go their proper place in society and go out and rape white women. The first anti-marijuana laws were directed at Mexican migrants and Mexican Americans in the Midwest in the 1910s and 1920s.
Ninety-five percent of all the people incarcerated in New York on the punitive Rockefeller drug laws are black or brown, not white. In federal and state prisons they are incarcerated by proportions of two and five and ten and 20 times disproportionate to white people - targeted more by police, subject to higher sentences. If a vast majority of people being incarcerated in this country for drug offenses were white, society would not have tolerated what it has.
Learning to Live with Drugs
There is an approach to dealing with drug and drug policy known as harm reduction. The first notion of harm reduction came from the idea of needle exchange; it emerged 20 years ago when HIV started to spread among drug-injecting communities, and people began to figure out it involved sharing drugs. Early studies found diabetic junkies were less likely to be HIV positive than non-diabetic junkies, because diabetic junkies had access to legal syringes. When people realized that, people from around the world - including Margaret Thatcher - instantly instituted needle exchange programs. Drug addiction was dangerous and possibly deadly, but HIV was a disease for which we had no cure. Stopping the spread of HIV/AIDS was more important than stopping drug addiction. Harm reduction emerged as a philosophy, an intervention that sought to reduce negative consequences of drug use among people who could not or would not stop using drugs today.
Harm reduction began to develop more broadly: as motorcycle and bicycle helmets, seat belts and teaching better driving skills, designated driving, as a general approach to seek to reduce harms of activities that were inherently dangerous.
One of the projects we are trying to lead in is Safety First. It takes a sex education model and applies it to drug education, saying, "No, don't do it. But if you do, there's some things you should know about mixing drugs and about when you take drugs and about which drugs are more or less dangerous."
As a parent, ultimately what's most important to me with my kids is not, Did they or didn't they? What's most important is, Did they come home safely that night and are they going to grow up and make me healthy grandkids? Our teenagers live in a world in which 80 percent will try alcohol by the time they graduate from high school; over 50 percent will try cigarettes; almost 50 percent will try marijuana; 5, 10, 20, 30 percent will try ecstasy. I better have an honest approach. The book Safety First has been endorsed by the California PTA; it's something that all parents of teenagers hopefully are reading, and that will begin to become a national model. That's harm reduction in the broader sense.
You also have harm reduction as a different way of thinking about drug policy - which says the optimal drug policy is not the one that most substantially reduces the number of drug users. The government likes to look at polls and say, "Marijuana went up by 3 percent, cocaine went down by 4 percent, something else went up by 6 percent. Are we winning? Are we losing?"
What's important is to ask more fun damental questions: How many people died of an overdose last year? How many contracted HIV/AIDS? How many were sent to prison for a non-violent offense? How much money was spent on prisons instead of schools and health care? How many lives were destroyed by drug use made more dangerous by a prohibitionist system? Those are the fundamental questions.
Harm Reduction & Morals
We live in a society where we say, "Budweiser or Chivas, okay," or, "We may not approve or your cigarette smoking, but that's okay. But if you take that marijuana joint, if you take that ecstasy or that hallucinogen, if you take that ayahuasca or snort that cocaine, you're a criminal! If you're one of the growing millions under supervision in the criminal justice system, under probation or parole, we'll take away your freedom. We'll take away your job and we may take away your child, too. Not because you did any harm to anybody else, not because you harmed your family or your children or your fellow employees or your fellow citizens, but solely because you chose to put that forbidden substance into your body."
There is a core principle of drug policy reform and a core principle of harm reduction: people should not be punished or discriminated against solely based upon substances they choose to put into their body. Hold people responsible for their behavior and the actions. Just because you may have the right to consume a substance does not give you the right to get behind the wheel of a car and endanger others; does not give you the right to harm your family or to say, "My drug addiction made me go out and steal and hurt people."
Harm reduction as a way of dealing with substance addiction is grounded in the same fundamental principles as the 12-steps movement: respect for human dignity, empowering people to find their recovery, understanding the conditions of relapse and the fact that people struggling with drugs quit and quit and quit and quit and quit again until one day they finally embrace recovery, until one day they are finally in the clear. Harm reduction says abstinence may be optimal for many, maybe for most - but it is not the only way. When we fought for Prop 215, the medical marijuana initiative, and when we fought for Prop 36, the treatment instead of incarceration initiative, we were fighting for the same basic principles: the idea that this society, this state, this country, has to learn to live with drugs in ways that are grounded in science, compassion, health and human rights.
The Big Lie
*- Last week, UCLA - official evaluator of Prop 36 - reported that over 30,000 people had been sent to treatment instead of incarceration in just the last couple of years. California taxpayers have saved possibly a quarter billion dollars, even after the doubling in funding for drug treatment that came with Prop 36. Proposition 36 is the single most significant piece of sentencing reform legislation since the repeal of alcohol prohibition in terms of the number of people not being incarcerated. That initiative is grounded in the same principles as Prop 215 - that people should be entitled to have access to marijuana for legitimate medical purposes.
What I find galling about this administration in Washington and the other drug war politicians is the frequency and the audacity in which they engage in the Big Lie: "Marijuana has no medical value." The National Academy of Sciences, Institute of Medicine and dozens of studies and thousands of doctors and tens of thousands of patients have sworn to the opposite. How many times can they say needle exchange sends the wrong message - and never provide a shred of evidence? How many times can they say that needle exchange programs should not be available - notwithstanding the fact that there's no increase in drug use and they do work to reduce HIV? The bold and audacious lies perpetrated and propagated by the drug warriors - that's what needs to be challenged.
I and my colleagues are building the Drug Policy Alliance. We are the leading organization in the country, and perhaps the world, fighting for a more decent way to deal with drugs and drug users in our society. It's about dealing with our fellow human beings with a combination of brains and heart that we would expect in dealing with our family members; it's about treating other members of society and wanting them to have their drug addictions and drug problems and drug use dealt with in the same way we would wish for our own family members.
We are people working in criminal justice and people working in medicine and people working in religion and the clergy and in the schools and every other walk of life. We are people who can speak publicly and people who can never speak publicly. We are poor and rich and from every state in this country and around the world. We come from Republicans and Democrats and Libertarians and Independents and Greens. But we agree that this war on drugs is doing more harm than good. We believe that the state has no right to take away people's freedom or jobs solely because of what they put into their body. We are fighting for a more decent way to deal with drugs in our society - the people who use them, abuse them, grow them, make them, sell them, buy them - anybody who comes into contact and all those who come into contact with them, effectively, all of American society.
