The Role of an Effective Office of National Drug Control Policy

August 2009

Drug Policy Alliance Headquarters Drug Policy Alliance

70 West 36th St. Office of National Affairs
16th Floor 925 15th Street, NW
New York, NY 10018 2nd Floor
T: (212) 613-8020 Washington, DC 20005
T: (202) 683-2030
ETHAN A. NADELMANN IRA GLASSER
EXECUTIVE DIRECTOR PRESIDENT

Report Summary

For more than three decades the United States has waged a war on drugs. The foundation of this war is two-fold: (1)
a heavy reliance on criminalization and the criminal justice system in dealing with certain drugs; and (2) a rejection
of anything other than abstinence-only approaches in drug prevention, treatment and enforcement. These policies
have overwhelmingly failed.

Despite incarcerating millions of Americans and spending hundreds of billions of dollars, illegal drugs remain
cheap, potent, and widely available, and the harms associated with them – addiction, overdose, and the spread of
HIV/AIDS and hepatitis C – continue to persist in every community. Meanwhile the war on drugs is creating
problems of its own - broken families, increased poverty, wasted tax dollars, prison overcrowding, and eroded civil
liberties. America desperately needs a coherent and compassionate national drug policy that reduces the problems
associated with both drugs and the war on drugs.

Numerous polls show the public wants change. Public sentiment is shifting from favoring a criminal justice
approach towards a less expensive and more effective public health approach to drugs. This shift has been reflected
in 20 statewide popular votes in favor of drug policy reform since 1996. Moreover, legislators in dozens of states
have passed major drug policy reforms in recent years, including making sterile syringes more available to reduce
the spread of HIV/AIDS and reforming harsh mandatory minimum sentences that have proven costly, ineffective
and counter-productive.

ONDCP has a historic opportunity to put U.S. drug policy on a new track; not just fulfilling President Obama’s
campaign promises to eliminate the crack/powder cocaine sentencing disparity, repeal the federal syringe ban, and
allow states to set their own medical marijuana policies, but fundamentally changing how the United States
addresses substance use and misuse. U.S. drug policy should reflect both President Obama’s broad vision of a more
effective and transparent government and his specific support for “shifting the paradigm, shifting the model, so that
we focus more on a public-health approach [to drugs].” Five principles should guide reforms to our national drug
policy:

1) Relying primarily on the criminal justice system to solve problems associated with drugs is misguided. The
United States ranks first in the world in per capita incarceration rates, with less than 5 percent of the world’s
population but almost 25 percent of the world’s prisoners. The incarcerated population has grown from 500,000 in
1980 to 2.3 million today, of which almost one-fourth are for drug law violations. In addition, nearly one-third of
the roughly 5.1 million probationers and parolees in 2007 were supervised on account of a drug law violation. The
U.S. incarcerates more of its citizens for drug law violations than all of Western Europe (with a much larger
population) incarcerates for all offenses combined. As U.S. Senator Jim Webb (D-VA) recently said, “either we
have the most evil people in the world or we are doing something wrong with the way we approach the issue

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of criminal justice.” And “the central role of drug policy in filling our nation's prisons makes clear that our
approach to curbing illegal drug use is broken.”

2) Proven public health strategies can reduce much harm associated with drugs. The United States lags behind
much of the advanced industrialized world, and even many developing nations, in making sterile syringes widely
available to reduce the spread of HIV/AIDS, enacting life-saving overdose prevention policies, ensuring that people
with drug-related problems have on-going access to healthcare, and making methadone and other quality drug
treatment readily available to those who seek it. When it comes to the most widely used drugs in the U.S. – alcohol
and tobacco – comprehensive public health strategies have reduced misuse and saved lives without incarcerating
millions of Americans. Applying similar strategies to marijuana, cocaine, heroin and other drugs could reduce the
problems associated with those drugs while also reducing incarceration.

3) U.S. drug policies should be evaluated based upon their capacity to reduce the negative consequences of both
drug use and drug control policies. Our country’s failed drug policies persist in part because of ineffective evaluation
and assessment. There are two problems. First, the key measurements - drug seizures, arrests and annual surveys of drug
use – tell us little of importance and mostly distract from more important criteria. Second, many programs persist even in
the face of overwhelming evidence that they fail to meet their stated objectives. What is needed are a new set of criteria
for evaluating the success or failure of federal drug policies. Key measurements should focus on reducing the death,
disease, crime and suffering associated with both drugs and prohibitionist policies. Programs proven to be ineffective or
counterproductive should be eliminated.

4) The best policy solutions will emerge from intellectually rigorous debate. Certain legal and regulatory
obstacles limit the flow of ideas when it comes to drug policy. But more insidious is the chilling effect of what
some have called “drug war politics.” For example, with respect to certain, taboo topics, U.S. researchers dare not
submit proposals of the sort underway in other countries because they are considered politically untenable in the
U.S. – not because they offend scientific standards or civil rights, but because they ostensibly offend some people’s
moral sensibilities. Federal employees at CDC, NIH and other agencies commonly avoid even using certain terms,
such as harm reduction, out of fear of a congressional or administrative backlash. Intelligence and national security
analysts refrain from investigating and proposing alternative strategies and policy options because they fear the
professional consequences of doing so. Like any other area of public policy, all possible drug policies should be
considered and objectively evaluated. It is time for the new ONDCP to break with prior practice and encourage -
not discourage - vigorous debate and scientific inquiry.

5) America should play a leadership role in promoting effective, science-based drug policies across the globe.
As part of the Obama Administration’s commitment to restoring respectful collaboration to U.S. foreign policy, it
appears that the United States is reducing its bellicose posture towards nations that adopt alternative drug policies,
and beginning to use scientific evidence as the basis for U.S. policy related to drug use and the global AIDS
pandemic. But there is still far to go. Numerous research studies have concluded that drug treatment is far more
cost-effective at reducing the problems associated with drug misuse than eradication, interdiction, and enforcement,
which get the lion’s share of both domestic and international drug war funding. The role prohibition and punitive
enforcement policies play in sustaining and enlarging international crime and terrorist networks has barely been
explored. The U.S. can - and should - play a leadership role in rethinking global drug policy and breaking the long-
standing taboo against openly debating all alternatives to the status-quo, a taboo that has silenced critical analysis of
current policy.

The Role of an Effective Office of National Drug Control Policy

ONDCP is statutorily required to set “[c]omprehensive, research-based, long-range, quantifiable goals for reducing illicit
drug use and the consequences of illicit drug use in the United States.” But historically, the office has focused its efforts
primarily on reducing drug use per se rather than the negative consequences of drug use. A reversal of priorities is long
overdue. The last thing the country needs today is to repeat the mistakes of the 1980s and early 1990s, when drug war
proponents lauded the drop in the number of people using illicit drugs even as drug addiction, drug-related disease and
deaths, and the human and fiscal costs of drug enforcement jumped dramatically.

Evaluating drug policies solely in the context of drug use rates also ignores the collateral damage of the war on drugs
itself, and its effect on other important policy goals, such as reducing racial disparities in the criminal justice system,
upholding the Constitution and protecting civil liberties, promoting democracy abroad, and reducing poverty and
government waste (to name a few).

Whatever one’s views on drug use as a moral issue, there should be no argument that certain kinds of drug use are more
problematic than others, with some drug use relatively benign in the context of the grave consequences associated with
other types of drug use. And yet, ONDCP’s historically undifferentiated views on drug use – where marijuana is as serious
as methamphetamine – distorts this obvious dimension. Moreover, ONDCP’s focus on drug use rates obscures whether
drug policies actually reduce the negative consequences of drug use, such as overdose fatalities or new HIV or hepatitis C
infections.

In addition to reducing the negative consequences of drug use, ONDCP must take responsibility for weighing and
reducing the negative consequences of drug policies themselves. The fact of 1.8 million drug arrests in 2007 (the latest
year national data is available) represents a severe cost in both human lives and taxpayer dollars. Hundreds of thousands
of children are growing up with one or both parents behind bars because of punitive drug laws. Post-conviction
punishments, such as bans on voting and receiving public assistance, are devastating entire communities.

ONDCP should develop a strategy for moving U.S. drug policy from a criminal justice model to a public
health model and adopt criteria to measure progress. In terms of its general approach to drugs and drug
use, ONDCP has the opportunity to embrace three broad reforms:

• Set new national goals: ONDCP has never set short- or long-term objectives for reducing the public health threats
associated with drug misuse, such as overdose fatalities and the spread of HIV/AIDS. Nor has ONDCP ever
explicitly evaluated the efficacy of the war on drugs nor developed performance measures that consider its
negative consequences – the number of nonviolent Americans behind bars, racial disparities in the criminal justice
system, the number of formerly incarcerated individuals who are barred from voting and/or prohibited from
accessing student loans, TANF, or other public assistance.

The ONDCP Director does, however, possess broad statutory latitude to set both national goals and performance
measures. Setting short- and long-term objectives for reducing the negative consequences associated with both
drugs and the war on drugs would go a long way towards shifting U.S. drug policy to a new paradigm. ONDCP
should consider the resolutions passed in recent years by the United States Conference of Mayors and the
National Black Caucus of State Legislators in support of this sensible approach.

• Establish a blue-ribbon commission. Perhaps the best way to begin a national dialogue on the issue and
build support for a paradigm shift is to establish a blue-ribbon commission to study U.S. drug policy. Such a
commission should evaluate every aspect of U.S. drug policy, compare U.S. policies to those of other
countries, and make recommendations for change. Senator Jim Webb (D-VA) has introduced the National
Criminal Justice Commission Act of 2009 (S.714), which would create a commission to broadly study the
U.S. criminal justice system and, among other things, make recommendations for reducing the number of
nonviolent drug law offenders behind bars. ONDCP should fully support this effort.

• Re-orient drug law enforcement agencies. Federal drug law enforcement agencies and federally-funded
regional narcotics taskforces are often graded on Vietnam-war-like “body count” statistics, such as the
number of people arrested and/or number of warrants served. There is ample evidence, however, that arrests
have little impact on drug availability or the problems associated with substance misuse. Moreover, such
 benchmarks provide an incentive for agencies to arrest low-level offenders, who are far more plentiful and
easier to catch than major traffickers. As experience has repeatedly shown, the pressure to meet arrest and
seizure quotas can lead to civil rights abuses with rogue officers in some cases going so far as to fabricate
informants, raid homes on false evidence, lie to judges, and plant evidence to inflate their numbers.

Texas recently established a groundbreaking performance measurement system for drug law enforcement.
State narcotics officers are now graded less by arrests and more on how well they disrupt and dismantle
dangerous crime organizations. Gathering intelligence, building connections, and working up a crime
network’s ladder takes precedence over arresting low-level offenders. It may be possible to establish this
kind of performance measurement system federally.

An Optimal Approach to Drug Policy

Among industrialized nations, those with the lowest rates of death, disease, family dissolution, crime, and
incarceration related to the misuse of alcohol and other drugs are those that place the greatest emphasis on public
health policies instead of the criminal justice system. The most effective strategy for drug use and misuse is a
balanced one often referred to as the Four Pillars approach because it emphasizes prevention, treatment,
enforcement and harm reduction.
Originating in Switzerland in the early 1990s, the Four Pillars approach is increasingly the norm in Western Europe
and Canada and is beginning to take hold in some areas of the U.S., most notably urban areas like Baltimore,
Chicago, New York, Salt Lake City, San Francisco and Seattle, and statewide in New Mexico.
A national Four Pillars drug strategy would have the following goals:

Prevention – encouraging people to make healthy choices, overhauling failed drug education programs,
and providing opportunities to help reduce the likelihood of substance abuse, including after-school
programs for youth and employment training and jobs for adults.

Treatment – making treatment available to all who need it, ensuring that treatment programs meet the
needs of populations that have faced unique hurdles to treatment in the past, increasing access to methadone
and other replacement treatments, and diverting nonviolent offenders to treatment instead of jail or prison.

Enforcement – keeping neighborhoods safe by focusing law enforcement resources on violent criminals
and organized crime instead of low-level nonviolent offenders, and decreasing racial disparities in the
criminal justice system.

Harm reduction - reducing the spread of HIV/AIDS and hepatitis C from injection drug use, preventing
drug overdose deaths, increasing contact with health care services and drug treatment programs, and
reducing public nuisance associated with drugs.

While the Four Pillars model could provide the optimal framework for a national drug policy, implementing such an
approach in the United States would be complicated by the daunting task of mitigating the profound consequences
of its failed 40-year war on drugs. The discussion and recommendations following pertain to specific aspects of the
U.S.’s current approach to drug policy.