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Pubdate: 14 Mar 1999 Source: San Francisco Chronicle (CA) Copyright: 1999 San Francisco Chronicle Contact: http://www.sfgate.com/chronicle/ Forum: http://www.sfgate.com/conferences/ Author: Steve Heilig Page: 4 (Book Review) BATTLE FATIGUE IN THE WAR ON DRUGS Three books urge treatment and prevention instead of crime & punishment. Drugs are front page news again, with reports of heroin overdoses and suffering striking in high and low places. But, unfortunately, this problem is not new. Drug abuse has continually been named one of America's most serious problems for more than a century. And for the past few decades, politicians have declared war on a wide range of illegal drugs. So how goes this lengthy campaign? According to the authors of three compelling books on American drug policies, the drug war has been a failure on many fronts. More than one-third of Americans over I I have consumed illegal drugs and use of such drugs has fluctuated regardless of government efforts. Our prisons are overflowing from drug-related convictions, while drug-related crime has risen; AIDS has spread among drug users-drug treatment is often not available to those who want it. doctors are afraid to prescribe even needed medications; and countless lives are being ruined by the drug war's policies. As New York journalist Michael Massing states bluntly in THE FIX (Simon & Schuster; 335 pages; $25), "It would be hard to think of an area of U.S. social policy that has failed more completely than the war on drugs." According to Mike Gray, a Hollywood screenwriter and producer and author of DRUG CRAZY: How We Got Into This Mess and How We Can Get Out (Random House; 251 pages; $23.95), the best measure of failure comes from the law of supply and demand: "After blowing hundreds of billions of dollars and tens of thousands of lives, the drugs on the street today are stronger, cheaper, more pure and more widely available than at any time in history." Further, the drug war has poisoned much else in American society, "blanketing the nation in a smog of delusion so pervasive nobody can see it, even as it warps U.S. foreign policy, corrodes the Bill of Rights and successfully reverses years of progress in race relations." Strong words indeed, but Massing and Gray, who might both be seen as liberal critics, are joined from the right by Southern California businessman Dirk Chase Eldredge, author of ENDING THE WAR ON DRUGS: A Solution for America (Bridge Works; 207 pages; $22.95). A conservative Republican, Eldredge argues that our efforts have been based largely on ignorance about the true risks of most drugs. 'Fighting the war on drugs with myths is a lot like hurling boomerangs at the enemy," he writes. "They are unlikely to do the opponent any harm, and are likely to return to the throwers with devastating force." All three authors say that the majority of people who experiment socially with illegal drugs suffer little harm and do not progress to addiction. Eldredge notes that the actual dangers posed by illegal drugs are dwarfed by the hazards of legal ones: "When compared to the annual number of premature deaths from tobacco (400,000) and from alcohol (100,000), drug deaths lag far behind." Gray agrees: "The medical literature is filled with thoroughly documented records of addicts who functioned normally throughout their lives." It's also true that the vast majority of casual users of drugs such as marijuana do not go on to try harder drugs. Even for those who do, "fewer than I percent of those who try cocaine become daily users," as Eldredge notes. Such facts have been known for a long time, but, as Gray points out, ideological opposition to any kind of drug use or to any hint of its approval have "overwhelmed the handful of scientists who tried to put the brakes on this juggernaut." For example, Massing relates how one medical expert, San Francisco's Dr. David Smith, founder of the Haight-Ashbury Free Medical Clinics, was labeled as "pro-drug" in the '80s by anti-drug parent activists. "Having [Smith] on programs to fight drug use is like having Adolf Hitler teaching the American Generals how to fight the German Army," wrote one such parent who was "disgusted" by Smith's factual, non judgmental approach to drug education. And with the rise of the "Just Say No" movement, "the most remembered phrase of the Reagan presidency ... and the most ridiculed," all discussion of such innovative strategies as methadone maintenance or needle exchange "were just out.... You had to just say no to all of it." By the end of the '80s, "Just Say No" was a largely discredited and commercialized slogan, but the effect of its "zero tolerance" imperative has been more lasting and pernicious. To implement that policy, the government has turned to the military and the police. The failures of alcohol prohibition earlier in the century are wellknown, but the situation now is even worse. Addicts have no constituency, Gray notes, and since Prohibition, "whenever senators or congressmen found themselves outflanked on the right, they could come down on addicts like avenging angels to prove how tough they were on crime." In the process, the courts have been swamped with futile "revolving door" arrests on the one extreme and handing out inhumane mandatory sentences on the other. Bribery and other scandals are rife among enforcement authorities, for as Eldredge quips, "corruption is the cancer, money the carcinogen." Addiction has been a nightmare for millions of Americans, and drugrelated crime has destroyed many communities. But while they differ somewhat in the details, these writers, none of whom could be called soft on drugs, all agree that we need a radically different approach to these problems. What then should be done? The consensus here is that a public health-oriented approach is needed, focusing on prevention and treatment rather than crime and punishment. Prevention relies on reality-based education, argues Gray, for "apparently the one sure-fire way to cut down on drug use is to give people the facts and let them use their own judgment." Eldredge argues that "just as we cannot arrest our way out of the drug problem, neither can we frighten our way out." Guaranteed treatment for addicts, both free and imprisoned, is also necessary, without the long waiting lists that has those who want to quit drugs being, as Massing puts it, " sucked back into the street." Contrary to popular perception, drug treatment, while admittedly far from foolproof, is preferable to the law enforcement approach, even for preventing crime and saving money In order to implement these and other policy improvements, such as the decriminalization of marijuana (which was favored in California and four other states in recent elections), drug laws would need to be c hanged, entailing a lot of activism and education. These books are welcome in terms of educating the public. Gray and Massing's books are the more scholarly, and they admirably summarize the complex history of our drug policies. They also effectively utilize "street stories" featuring cops, addicts, drug treatment workers and more to illustrate the reallife impact of drug policies. Eldredge's book is more of a populist polemic, but no less effective for that. All three lend powerful support to the growing list of observers of all political and professional stripes who are questioning the path the United States is on. But it is still unknown whether these crucial and eloquent calls for reform will be heeded. Steve Heilig is on the staff of the San Francisco Medical Society,co-editor of the Cambridge Quarterly of Healthcare Ethics and guest editor of the Journal of Psychoactive Drugs published at the Haight-Ashbury Free Clinics. - --- MAP posted-by: Mike Gogulski