This paper draws parallels between the failed U.S. alcohol prohibition of 1920–1933 and contemporary drug prohibition policy, arguing that both share the same structural failures: rising use, increased crime, ballooning costs, and public health deterioration. Using data from the National Household Survey on Drug Abuse and other sources, the paper documents rising illicit drug use rates and the enormous financial burden of the War on Drugs. It then introduces harm reduction as an alternative policy framework, surveying programs such as needle exchanges, outreach efforts, contact centers, methadone maintenance, and cannabis decriminalization. The paper concludes that moralistic American drug policy lags behind more effective public-health-oriented approaches adopted in countries such as the Netherlands and Australia.
Alcohol Prohibition from 1920 to 1933 did not work. There are many parallels between this failed effort and the current laws prohibiting drugs in the United States. Alcohol prohibition was undertaken to reduce crime and corruption, solve social problems, reduce the tax burden created by prisons and poorhouses, and improve the health of Americans. According to research, alcohol consumption fell at the beginning of Prohibition, but subsequently increased. Alcohol became more dangerous to consume; crime increased and became "organized"; the court and prison systems were stretched to the breaking point; and corruption of public officials was rampant.
Instead of producing measurable gains in productivity or reduced absenteeism, Prohibition removed a significant source of tax revenue and greatly increased government spending. It led many drinkers to switch to more dangerous substances — such as opium, marijuana, patent medicines, and cocaine — that they would have been unlikely to encounter in the absence of Prohibition. As Mark Thornton noted in his Cato Institute analysis, the structural failures of alcohol prohibition serve as a direct template for understanding the failures of contemporary drug prohibition.
Just as alcohol prohibition failed, prohibition on drugs is not working. The National Household Survey on Drug Abuse, conducted by the Substance Abuse and Mental Health Services Administration, reveals the following findings:
An estimated 15.9 million Americans age 12 or older were current users of illicit drugs in 2001, representing 7.1% of the population aged 12 or older. By comparison, in 2000 the survey found that 6.3% of this population were current illicit drug users. The survey also found statistically significant increases between 2000 and 2001 in the use of particular drugs or groups of drugs, including marijuana (from 4.8% to 5.4%), cocaine (from 0.5% to 0.7%), and the non-medical use of pain relievers (from 1.2% to 1.6%) and tranquilizers (from 0.4% to 0.6%).
Among youths aged 12–17 in 2001, 10.8% had used an illicit drug within the 30 days prior to being interviewed, compared to 9.7% in 2000 and 5.3% in 1992. The number of persons reporting they had ever tried Ecstasy (MDMA) increased from 6.5 million in 2000 to 8.1 million in 2001. The number of persons reporting use of OxyContin for non-medical purposes at least once in their lifetime increased fourfold from 1999 to 2001.
An estimated 16.6 million persons age 12 or older were classified with dependence on or abuse of either alcohol or illicit drugs in 2001, representing 7.3% of the population — up from 14.5 million (6.5% of the population) in 2000. Of these, 2.4 million were classified with dependence on or abuse of both alcohol and illicit drugs, and 3.2 million were dependent on or abused illicit drugs but not alcohol.
Not only is the War on Drugs failing to achieve its stated goals, it is also enormously expensive and causes significant damage. The direct cost of the War on Drugs amounts to approximately 40 to 50 billion dollars per year. In 2001, the federal government spent 19 billion dollars, while state and local law enforcement agencies expended another ten billion dollars. The United States also spends an additional 10 to 20 billion dollars every year to incarcerate approximately 2 million drug users. Indirect costs — stemming from factors such as crime, disease, lost wages, and lost tax revenue — are estimated at 200 to 400 billion dollars per year.
Intangible costs are also significant. Some experts believe that drug laws are widely disregarded and erratically enforced, which diminishes respect for law and government. Drug laws fund organized crime and corrupt law enforcement, and the War on Drugs is accused of destabilizing foreign countries such as Colombia as well as communities within the United States itself.
The United States has the highest incarceration rate in the Western world — four times that of the United Kingdom and France on a per capita basis. The inmate population in 1996 grew by 1,849 prisoners per week, with one out of every 155 U.S. residents behind bars. A large part of this problem is the incarceration of nonviolent drug offenders. In California and New York, prison budgets outstripped budgets for higher education during the mid-1990s. Increasingly, experts are labeling the growing reliance on imprisonment a policy failure and recommending a moratorium on new prison construction, alternative correctional programs, and/or decriminalization of drug offenses.
"Framework and key questions guiding harm reduction policy"
"Needle exchanges, contact centers, methadone, and cannabis policy"
"Why the U.S. lags behind international harm reduction models"
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