Published in Sacramento Medicine, June 1994

Surgeon General Elders has suggested legal alternatives to our drug war to reduce the crime and violence associated with the black market. Although we associate drug use with potential harm, we have ignored the harms associated with drug war policies.

We have committed vast resources to arrest and imprison drug users, especially Black and Hispanic Americans who are imprisoned at rates far disproportionate to their drug use. Prison industries are booming. Criminal justice budgets are bankrupting local governments and taking money from schools, community services, and health care. The vast narcotic industry (DEA, police, courts, attorneys, prisons, parole, probation) has been the beneficiary of "drug war" budgets, now more than $33 billion per year. Incarceration of non-violent drug users has made Americans the most imprisoned people on earth. Yet the drug dealing business is booming and criminal profits have never been higher, because prison policies have simply failed to prevent, and may actually promote, drug use.

The millions with little or no health care include large numbers of IV drug users at high risk for HIV, hepatitis B, C, and delta, HTLV, and a host of bacterial infections. These diseases are related more to drug war policies than to drug use itself. The poverty, unemployment, and lack of education and comprehensive health care, which more cops and prisons do not address, has caused drug demand to remain very high. When the only drugs available are contaminated and when clean needles are denied as part of the "zero tolerance, no mixed message" ideology, then we have a prescription for widespread infectious diseases. Addiction-related prostitution, spreading HIV and other diseases, is another menacing effect of inflated drug prices. Ironically, if interdiction efforts were truly effective at driving drug prices up (which they aren’t), the more sex and crime for drugs would occur and the less safe our communities would become.

Another ominous drug war spin-off is the return of tuberculosis. While the Reagan-Bush drug war spent billions on prisons, futile interdiction efforts, and lost wars in drug-producing countries, homelessness became a national scourge. Overcrowded shelters and prisons provided fertile ground for TB, just as political resistance to alternative drug policies guaranteed the spread of HIV, which in turn fostered more TB. Inadequate follow-up of TB cases because of health care cutbacks (the Reagan Administration tried repeatedly to discontinue TB funding) led to multi-drug resistant strains. Drug war ideologues feel that the purity of the message of contempt for drug use makes alternatives unacceptable. However, the purity of the message is at total odds with the impurity of the results, as preventable diseases spread to users and non-users alike.

Public health has been further harmed by local defunding of mental health to fund incarceration policies. Those with mental illness were thereby placed at risk for substance abuse, since untreated mental illness is a major risk factor for drug use, as are physical and sexual abuse. In some addicted populations of women, the abuse rate is 90 percent. We have no money to spend on mental health treatment for these trauma. But, if victims of abuse use a drug to ease their pain, we have no shortage of money to lock them up and dump their children in foster care. The traumas of arrests and incarcerations create more mental health and social problems, destroying families and making recovery less likely.

Most drug users are parents. Their children are abused and traumatized also. They often witness these horrific drug raids: their doors smashed in, their parents thrown to floors and guns put at their heads, their homes torn apart. If no drugs are found the family is left with humiliation and rage. If some "drug" is found, the parents are hauled off and the separation traumas to the children are ignored. To take a parent from a child, who has been a primary drug war strategy, is really a form of child abuse, creating further problems for these already high-risk children. There are now millions of children across the country victims of parent loss by incarceration. Many suffer chronic post-traumatic stress disorders from these drug raids and harbor a deep rage at law enforcement and society. We are already paying the price in anti-social behavior from these drug war orphans. Many will join gangs and all they will get is more criminal justice attention in the cycle of societal destruction that characterizes the drug war.

Society is also expected to accept the endless prohibition-related crime and violence which prisonfilling can never solve. Our drug policies produce annual "windfall profits" for criminals in the $100 billion range, courtesy of the same politicians who get elected for being tough on crime. If we fund criminals, we shouldn’t be surprised at the resulting crime and violence fighting over drug turf, using guns bought with drug profits. Drug use has some relationship to violence, but the drug most associated with violence is alcohol. Stimulant drugs are a distant second. Opiate and marijuana use may actually reduce violence since they are tranquilizing and stress relieving. To blame violence on drugs, however, is dishonest propaganda. Complex behaviors like violence are heavily determined by the personal characteristics of the user and the setting in which the drug is taken. Cocaine taken in the context of a violent inner city black market is far more likely associated with violent behavior than the same drug used by a Wall Street broker at a party. The relationship of violence to prohibition has been deliberately suppressed in favor of propaganda that demonizes drugs as an easy scapegoat for any and all social problems.

As with alcohol prohibition, policies designed to reduce drug use end up causing crime and violence and having little effect on drug use. And the corruption engendered by obscene drug profits corrupts all levels of society, from the cop on the beat to the DEA and CIA, from the poor to the children of the poor. Drug prohibition is the most corrupting force in the world today. Yet instead of a plan to take the profit out of the drug trade (the only way to end the corruption and violence) we imprison drug users.

Does the dangerousness of illegal drugs justify the drug war? On many measures of destructiveness, tobacco and alcohol abuse is of greater harm than the illegal drugs. Our laws are the products of cultural biases, historical accidents, and ignorance, not science or rational planning. Even the notorious "crack baby" that provoked the self-righteous ire of the media and politicians has proven to be another drug-war myth. Cocaine exposure has now been shown to be only one of many potentially destructive influences affecting these babies. We ignored the alcohol and tobacco use, poor nutrition, domestic violence, and lack of health care that combined to cause poor fetal outcome in these babies. Worse still, our lust for punishment drove drug-using women out of the health care system in fear of losing their children. And so these unborn children suffered from lack of prenatal care that now appears to be more damaging to the babies than drug use.