What to Do About Drugs (Abridged)

by Mark Kleiman

Seven years ago, another blogger asked me for a post-length summary of my practical views about drug policy. What's scary is how little has changed in the meantime. I've reposted that note below verbatim, with a couple of parenthetical updates.

The original note deliberately omitted the question of the hallucinogens and MDMA, which pose a different set of challenges from the drugs that cause most of our actual problems. The issue of religious/spiritual use gets especially tricky. There's also no discussion of the medical uses of currently banned drugs. That can and should be handled through the FDA approval process; in the case of cannabis, that would require that the federal government stop obstructing medical research

Warning: Believing all of the stuff below will make people on both sides of the drug-war debate look at you funny

1. Leave heroin, cocaine, and methamphetamine illegal for non-medical use.

2. Allow use of cannabis, and growing for personal use or gratis distribution. Forbid commercial activity.

3. Shift drug law enforcement and sentencing to focus on reducing the side-effects of dealing: violence, neighborhood disruption, and the recruitment of juveniles. (Update: The High Point strategy shows how this can work.) Cut back on base sentences for drug-selling. Target a reduction in total drug-related imprisonment from 400,000 to 200,000. (Update: The current number is probably north of 500,000.)

4. Require users of expensive illicit drugs who are also criminally active to abstain from drug use as a condition of bail, probation, parole, or other supervised release. Enforce that requirement with frequent drug tests and predictable, immediate, and mild punishments for each violation. (Update: We now have a decisive proof-of-concept on this, in the form of the HOPE program.)

5. Integrate school-based and mass-media drug prevention efforts into broader efforts aimed at health risk management and self-command. Stop running drug-war propaganda as "drug abuse prevention." (Update: "Resilience" is a theme of the new national drug strategy, and some actual progress is being made.)

6. Tell the National Institute on Drug Abuse that its job is science, not providing support for drug prevention efforts or the latest proposal to stiffen drug sentences on the one hand or the drug treatment lobby on the other.

7. Expand drug treatment by convincing medical providers and their financing machinery that diagnosis of and intervention in substance abuse is an essential part of routine and acute medical care. (Update: The Affordable Care Act and laws requiring parity for drug treatment in health insurance represent movement in this direction; medical education and the actual management of health-care organizations have yet to catch up.)

8. Reduce regulatory burdens on opiate maintenance therapies: methadone, LAAM, and buprenorphine.

9. Continue to raise cigarette taxes. Identify currently addicted smokers and either give them coupons good for exemption from the taxes or just give them lump sums in cash. The point of the policy is to reduce the number of new users to somewhere near zero without impoverishing existing users, not to generate windfalls for the states. Dealing with the resulting smuggling and black-marketing should be considered drug law enforcement.

10. Raise taxes on alcohol from the current average of a dime per drink to something closer to a dollar.

11. Make getting drunk (as opposed to drinking) the object of a big negative-advertising campaign. Goal: make being drunk, or having been drunk, something people—especially young people—try to hide, rather than something they brag about.

12. Abolish the age restriction on alcohol.

Here's a somewhat longer and more recent statement.