Drug Policy as a Health Issue

Among the most disastrous costs of the war on drugs are its detrimental consequences for health. These range from the prohibition of doctors from advising patients about possible courses of treatment to the pouring of federal funds into incarceration efforts rather than treatment programs to actually making drug use itself more dangerous. Governmental drug policy hurts not only drug users, although it hurts them as well. Among the hardest-hit victims of the policies' detrimental health consequences are the terminally ill and a generation of African Americans.

Medical Marijuana:

• Marijuana has been found to relieve symptoms of many serious diseases, including asthma, glaucoma, muscle spasms, and loss of appetite and nausea due to AIDS wasting syndrome and chemotherapy treatment.

  Source: ACLU Spring Spotlight 98, among others.

• Many professional medical associations, including the American Medical Association, the American Public Health Association, and the New England Journal of Medicine have publically supported prescriptive access to marijuana.

  Source: ACLU Spring Spotlight 98.

• A report released in March of 1999 by the National Academy of Science's Institute of Medicine, the end result of two years of government-funded research, concluded that marijuana has beneficial medical effects, ranging from pain reduction, particularly for cancer patients, to nausea reduction and appetite stimulation, in certain circumstances. The report strongly recommended moving marijuana to the status of a schedule II drug, available for prescription by doctors. It also stated that many of the drug's supposed ill affects are false or unsubstantiated by scientific evidence. Among these are:
  • the supposed anti-motivational or anti-social affects of the drug;
  • that legalizing medical marijuana will increase overall use of the drug;
  • that the drug more addictive than other drugs available for prescription;
  • that its side affects are more harmful than those of other drugs;
  • that marijuana serves as a gateway drug;
  • that marijuana causes brain damage;
  • that marijuana causes fertility problems; and
  • that marijuana shortens life expectancy.

  Source: National Academy of Science's Institute of Medicine 1999 report: "Marijuana and Medicine: Assessing the Science Base" and the Marijuana Policy Project.

• To find out more about this important study, and its reassuring answers to many common questions concerning the dangers of marijuana use, visit the Marijuana Policy Project. Also read the Project's Medical Marijuana Briefing Paper 2000.

  Source: Marijuana Policy Project (at above link).

• A 1999 Gallop Poll found that 73% of Americans favored legalizing the prescription of marijuana by doctors. Since 1996, Alaska, Arizona, California, Colorado, the District of Columbia, Nevada, Oregon, and Washington State have approved ballot initiatives legalizing medical marijuana.

  Source: April 9,1999 Gallop Poll Press Release (available at above site) and Harper's article.

• The federal government, worried that the states were breaking rank, was quick to respond. When California passed its medical marijuana initiative in 1996, the government responded by threatening to arrest doctors who recommended the drug to patients. It again used gag-tactics in its attempt to shut up the voters of the District of Columbia, blocking the release of the election results of their medical marijuana ballot initiative in 1998.

Treatment versus Incarceration:

• A 1998 study conducted by the public health group Physician Leadership on National Drug Policy (PLNDP), a group of 37 distinguished physicians that includes high ranking officials from the Administrations of Presidents Reagan, Bush, and Clinton, shows that on a nationwide average, imprisoning an addict costs $25,900 per year, while treatment costs only $4400-6800 per year.

  Source: "Addiction and Addiction Treatment," a report put out by the PLNDP, March 1998 (at above website).

• The study also reports that because incarcerated drug addicts, unlike those placed in treatment programs, are turned back out onto the streets after serving their long sentences still addicted, incarceration is not only a more costly but also a less effective means of preventing future crimes. Addicts who have been treated for their addiction have a significantly lower rearrest rate than those who go untreated.

  Source: "Addiction and Addiction Treatment," from the PLNDP.

• Arizona's Proposition 200, ratified by voters in 1996, made the state the first in the nation to prohibit incarceration of first-and second-time nonviolent drug offenders in favor of mandatory treatment. According to a report issued by the Arizona Supreme Court, the policy has met with great success, saving over $2.6 million in taxes in its first year of operation. 77% of offenders sentenced to treatment rather than time have already made at least one payment toward the cost of their treatment. Over 61% of offenders placed in treatment programs completed those programs successfully. Of the 2622 people sentenced to treatment and probation rather than jail time for low-level drug offenses, 78% have subsequently tested free of drugs.

  Source: Arizona Supreme Court report, issued April 20, 1999, as quoted by C. Wren in the New York Times, April 21, 1999 (article available at above MarijuanaNews.com site).

• For more information on Proposition 200, and the benefits of treatment over incarceration, visit Common Sense for Drug Policy.

Drug Policy Makes Using Drugs More Dangerous:

• When drugs are illegal, the government cannot enact standards of quality, purity or potency. Consequently, street drugs are often contaminated or extremely potent, causing disease and sometimes death to those who use them.

  Source: ACLU Briefing Paper: "Against Drug Prohibition."

• Unsterilized needles are known to transmit HIV among intravenous drug users. Yet drug users share needles because laws prohibiting possession of drug paraphernalia have made needles a scarce commodity. These laws, then, actually promote epidemic disease and death.

  Source: ACLU Briefing Paper: "Against Drug Prohibition."

• In New York City, more than 60% of intravenous drug users are HIV positive; by contrast, the figure is less than 1% in Liverpool, England, where clean needles are readily available. For more information concerning harm-reduction techniques, read a recent report issued by the American Medical Association.

  Source: ACLU Briefing Paper: "Against Drug Prohibition;" similar stats are recorded in the report issued by the American Medical Association (available at above link).

Syringe Exchange Programs:

• Syringe Exchange Programs (SEPs) work. A recent review by the U. S. Surgeon General of all peer-reviewed, scientific studies of SEPs indicates that they effectively reduce the spread of HIV and other blood-borne diseases without encouraging illegal drug use.

  Source: "Evidence-based Findings on the Efficacy of Syringe Exchange Programs: An Analysis from the Assistant Secretary for Health and Surgeon General of the Scientific Research Completed Since April 1998," hereafter, Surgeon General's Report (available through above link).

• In fact, the report states, studies have indicated that other services provided by SEPs, such as treatment referrals, have resulted in reduced drug-use in a very hard-to-reach, at-risk portion of the user population. Over half of SEP participants referred to treatment programs entered such programs, 76% of whom successfully completed 13 weeks of treatment. These numbers are comparable to the success rates of more traditional treatment referrals, despite the fact that these clients had more severe drug use, less employment, and greater engagement in illegal behavior than average treatment clients.

  Source: Surgeon General's Report (available through above link).

• According to the report of the American Medical Association mentioned above (which advocates SEPs along with other harm reduction techniques), the HIV infection rate among injection drug users is 1-2% in Glasgow, Scotland, where a needle-exchange program was established early on, but has reached 70% in nearby Edinburgh, Scotland, where the response of government officials to increased drug use was to implement even more stringent controls over injection equipment.

  Source: American Medical Association report (available at above link).

• Some states have legalized and implemented needle exchange programs. But many of these states, such as Connecticut, still criminalize the possession of residual amounts of narcotics. Thus drug users participating in such programs face harassment and possible prosecution. It is the hope of the Drug Policy Litigation Project that through litigation we can convince the courts to rule that the Syringe Exchange Program legislation effectively amended the narcotics possession statute to allow possession of used syringes. Alternatively, we may be able to convince the courts to change their interpretation of the possession statute to allow possession of unusable, trace amounts of narcotics, such as might be found on a used syringe.

Turf Wars:

• As with the gangsterism fueled by alcohol prohibition, most drug-related violence today is not committed by people who are high on drugs but as a result of supplier rivalries. A major study of "crack-related" crimes in New York City, conducted in 1997, found that 85% of such crimes were the result of turf wars and disagreements of the illegal drug market. Crimes created by offenders while under the influence of crack, on the other hand, were very rare (Goldstein, et. al., 1992).

  Source: Goldstein, Paul, Henry Brownstein and Patrick Ryan. (1992). "Drug-Related Homicides in New York: 1984 and 1988," as reported by Common Sense for Drug Policy (two links below).

• Despite the popular belief that drug use causes violent crime, studies have found that very few violent crimes are committed under the influence of illegal drugs. Columbia University researchers found that alcohol is associated with far more violent crime that all illegal drugs combined. Of all prisoners incarcerated in state prisons for violent offenses, 21% committed their crimes under the influence of alcohol alone. In contrast, only 1 % were high on heroin at the time and only 3% had used cocaine or crack (Califano, 1998). That research is confirmed by federal statistics which show that 30.7% of all crimes are committed "under the influence of" alcohol, while only 8.8% are committed under the influence of illegal drugs alone (Rasmussen, et al., 1994: 106). The misleadingly high rate of drug-related violent crime is in fact almost entirely the result of turf wars, the effect of drug prohibition.

  Source: "Behind Bars: Substance Abuse and America's Prison Population," by Joseph Califano, 1998, and , D. & Benson, B., The Economic Anatomy of a Drug War, by D. W. Rasmussen and B. Benson, 1994

• Click here for more information on the supposed link between drugs and crime and for a discussion of these studies.

  Source: ACLU Briefing Paper.

• Homicide is the leading cause of death for black men aged 18-25. This crime is not psychopharmological: turf wars (caused by drug prohibition), not drug craziness, cause deaths.

  Source: National Vital Statistics Reports from the Center for Disease Control (at above site)

• AIDS is the leading cause of death for blacks aged 25-44. 60% of these deaths from AIDS (90% of those of women and babies) are attributed to shared needles. Government limitations of needle exchange programs make it very difficult for drug users to obtain clean needles.

  Source: National Vital Statistics Reports from the Center for Disease Control (at above site)

• Rates of overdoses and ER visits for drugs for African-Americans have soared, even as drug use has decreased. Drug law enforcement drives drug taking behavior to be much more dangerous.

Drug prohibition, and the current state of American drug policy, which emphasizes incarceration rather than treatment, is as much or more responsible for the health threats of drug use as drug use itself.