Ethan A. Nadelmann, +quot;Drug Prohibition in the United States: Costs, Consequences, and
Ethan A. Nadelmann, "Drug Prohibition in the United States: Costs,
Consequences, and Alternatives," _Science,_ 1 September, 1989, pp. 939-947
Drug Prohibition in the United States: Costs, Consequences, and Alternatives
Ethan A. Nadelmann
"Drug legalization" increasingly merits serious consideration as both an
analytical model and a policy option for addressing the "drug problem."
Criminal justice approaches to the drug problem have proven limited in
their capacity to curtail drug abuse. They also have proven increasingly
costly and counterproductive. Drug legalization policies that are wisely
implemented can minimize the risks of legalization, dramatically reduce the
costs of current policies, and directly address the problems of drug abuse.
The author is an Assistant Professor of Politics and Public Affairs in the
Department of Politics and the Woodrow Wilson School of Public and
International Affairs at Princeton University, Princeton, NJ 08544.
As frustrations with the drug problem and current drug policies rise daily,
growing numbers of political leaders, law enforcement officials, drug abuse
experts, and common citizens are insisting that a radical alternative to
current policies be fairly considered: the controlled legalization (or
decriminalization) of drugs (1).
Just as "Repeal Prohibition" became a catchphrase that swept together the
diverse objections to Prohibition, so "Legalize (or Decriminalize) Drugs"
has become a catchphrase that means many things to many people. The policy
analyst views legalization as a model for critically examining the costs and
benefits of drug prohibition policies. Libertarians, both civil and economic,
view it as a policy alternative that eliminates criminal sanctions on the
use and sale of drugs that are costly in terms of both individual liberty
and economic freedom. Others see it simply as a means to "take the crime out
of the drug business." In its broadest sense, however, legalization
incorporates the many arguments and growing sentiment for de-emphasizing our
traditional reliance on criminal justice resources to deal with drug abuse
and for emphasizing instead drug abuse, prevention, treatment, and education,
as well as noncriminal restrictions on the availability and use of psychoactive
substances and positive inducements to abstain from drug abuse.
There is no one legalization option. At one extreme, some libertarians
advocate the removal of all criminal sanctions and taxes on the production
and sale of all psychoactive substances - with the possible exception of
restriction on sales to children. The alternative extremes are more varied.
Some would limit legalization to one of the safest (relatively speaking) of
all illicit substances: marijuana. Others prefer a "medical" oversight model
similar to today's methadone maintenance programs. The middle ground combines
legal availability of some or all illicit drugs with vigorous efforts to
restrict consumption by means other than resort to criminal sanctions. Many
supporters of this dual approach simultaneously advocate greater efforts to
limit tobacco consumption and the abuse of alcohol as well as a transfer of
government resources from anti-drug law enforcement to drug prevention and
treatment. Indeed, the best model for this view of drug legalization is
precisely the tobacco control model advocated by those who want to do
everything possible to discourage tobacco consumption short of criminalizing
the production, sale and use of tobacco.
Clearly, neither drug legalization nor enforcement of anti-drug laws
promises to "solve" the drug problem. Nor is there any question that
legalization presents certain risks. Legalization would almost certainly
increase the availability of drugs, decrease their price, and remove the
deterrent power of the criminal sanction - all of which invite increases in
drug use an abuse. There are at least three reasons, however, why these risks
are worth taking. First, drug control strategies that rely primarily on
criminal justice measures are significantly and inherently limited in their
capacity to curtail drug abuse. Second, many law enforcement efforts are not
only of limited value but also highly costly and counterproductive; indeed,
many of the drug related evils that most people identify as part and parcel
of "the drug problem" are in fact the costs of drug prohibition policies.
Third, the risks of legalization may well be less than most people assume,
particularly if intelligent alternative measures are implemented.
The Limits of Drug Prohibition Policies
Few law enforcement officials any longer contend that their efforts can do
much more than they are already doing to reduce drug abuse in the United
States. This is true of international drug enforcement efforts, interdiction,
and both high-level and street-level domestic drug enforcement efforts.
The United States seeks to limit the export of illicit drugs to this country
by a combination of crop eradication and crop substitution programs,
financial inducements to growers to abstain from the illicit business, and
punitive measures against producers, traffickers, and others involved in the
drug traffic. These efforts have met with scant success in the past and show
few indications of succeeding in the future. The obstacles are many:
marijuana and opium can be grow in a wide variety of locales and even the
coca plant "can be grown in virtually any subtropical region of the world
which gets between 40 and 240 inches of rain per year, where it never freezes,
and where the land is not so swampy as to be waterlogged. In South America,
this comes to [approximately] 2,500,000 square miles," of which less than
700 square miles are currently being used to cultivate coca (2). Producers
in many countries have reacted to crop eradication programs by engaging in
"guerilla" farming methods, cultivating their crops in relatively inaccessible
hinterlands, and camouflaging them with legitimate crops. Some illicit
drug-producing regions are controlled not by the central government but by
drug trafficking gangs or political insurgents, thereby rendering eradication
efforts even more difficult and hazardous.
Even where eradication efforts prove relatively successful in an
individual country, other countries will emerge as new producers, as has
occurred with both the international marijuana and heroin markets during the
past two decades and can be expected to follow from planned coca eradication
programs. The foreign export price of illicit drugs is such a tiny fraction
of the retail price in the United States [approximately 4% with cocaine,
1% with marijuana, and much less than 1% with heroin (3)] that international
drug control efforts are not even successful in raising the cost of illicit
drugs to U.S. consumers.
U.S. efforts to control drugs overseas also confront substantial, and in
some cases well-organized, political opposition in foreign countries (4).
Major drug traffickers retain the power to bribe and intimidate government
officials into ignoring or even cooperating with their enterprises (5).
Particularly in many Latin American and Asian countries, the illicit drug
traffic is an important source of income and employment, bringing in billions
of dollars in hard currency each year and providing liveable wages for many
hundreds of thousands. The illicit drug business has been described - not
entirely in jest - as the best means ever devised by the United States for
exporting the capitalist ethic to potentially revolutionary Third World
peasants. By contrast, United States-sponsored eradication efforts risk
depriving those same peasants of their livelihoods, thereby stimulating
support for communist insurgencies ranging from Peru's Shining Path (6)
to the variety of ethnic and communist organizations active in drug-producing
countries such as Colombia and Burma. Moreover, many of those involved in
producing illicit drugs overseas do not perceive their moral obligation
as preventing decadent gringos from consuming cocaine or heroin; rather it
is to earn the best possible living for themselves and their families. In the
final analysis, there is little the U.S. government can do to change this
Interdiction efforts have shown little success in stemming the flow of
cocaine and heroin into the United States (7). Indeed, during the past
decade, the wholesale price of a kilo of cocaine has dropped by 80% even
as the retail purity of a gram of cocaine has quintupled from 12 to about
60%; the trend with heroin over the past few years has been similar if less
dramatic (8). Easily transported in a variety of large and small aircraft
and sea vessels, carried across the Mexican border by legal and illegal
border crossers, hidden in everything from furniture, flowers, and
automobiles to private body parts and cadavers, heroin and cocaine shipments
are extraordinarily difficult to detect. Despite powerful congressional
support for dramatically increasing the role of the military in drug
interdiction, military leaders insist they can do little to make a difference.
The Coast Guard and U.S. Customs continue to expand their efforts in this
area, but they too concede that they will never seize more than a small
percentage of total shipments. Because cocaine and heroin are worth more
than their weight in gold, the incentives to transport these drugs to the
United States are so great that we can safely assume that there will never be
a shortage of those willing to take the risk.
The one success that interdiction efforts can claim concerns marijuana.
Because marijuana is far bulkier per dollar of value than either cocaine
or heroin, it is harder to conceal and easier to detect. Stepped-up
interdiction efforts in recent years appear to have reduced the flow of
marijuana into the United States and to have increased its price to the
American consumer (8). The unintended consequences of this success are
twofold: the United States has emerged as one of the world's leading
producers of marijuana; indeed, U.S. producers are now believed to produce
among the finest strains in the world (8); and many international drug
traffickers appear to have redirected their efforts from marijuana to
cocaine. The principal consequence of U.S. drug interdictions efforts, many
would contend, has been a glut of increasingly potent cocaine and a shortage
of comparatively benign marijuana.
Domestic law enforcement efforts have proven increasingly successful in
apprehending and imprisoning rapidly growing numbers of illicit drug
merchants, ranging from the most sophisticated international traffickers to
the most common street-level drug dealers. The principal benefit of law
enforcement efforts directed at major drug trafficking organizations is
probably the rapidly rising value of drug trafficker assets forfeited to the
government. There is, however, little indication that such efforts have any
significant impact on the price or availability of illicit drugs. Intensive
and highly costly street-level law enforcement efforts such as those mounted
by many urban police departments in recent years have resulted in the
arrests of thousands of low-level drug dealers and users and helped improve
the quality of life in targeted neighborhoods (9). In most urban centers,
however, these efforts have had little impact on the overall availability
of illicit drugs.
The logical conclusion of the foregoing analysis is not that criminal
justice efforts to stop drug trafficking do not work at all; rather, it is
that even substantial fluctuations in those efforts have little effect on
the price, availability, and consumption of illicit drugs. The mere existence
of criminal laws combined with minimal levels of enforcement is sufficient
to deter many potential users and to reduce the availability and increase
the price of drugs. Law enforcement officials acknowledge that they alone
cannot solve the drug problem but contend that their role is nontheless
essential to the overall effort to reduce illicit drug use and abuse. What
they are less ready to acknowledge, however, is that the very criminalization
of the drug market has proven highly costly and counterproductive in much
the same way that the national prohibition of alcohol did 60 years ago.
The Costs and Consequences of Drug Prohibition Policies
Total government expenditures devoted to enforcement of drug laws amounted
to a minimum of $10 billion in 1987. Between 1981 and 1987, federal
expenditures on anti-drug law enforcement more than tripled, from less than
$1 billion per year to about $3 billion (10). State and local agencies spent
an estimated $5 billion, amounting to about one-fifth of their total
investigative resources, on drug enforcement activities in 1986 (11). Drug
law violators currently account for approximately 10% of the roughly
550,000 inmates in state prisons, more than one-third of the 50,000 federal
prison inmates, and a significant (albeit undetermined) proportion of the
approximately 300,000 individuals confined in municipal jails (12). The
U.S. Sentencing Commission has predicted that in 15 years the federal prison
population will total 100,000 to 150,000 inmates, of whom one-half will be
incarcerated for drug law violations (13). Among the 40,000 inmates in New
York State prisons, drug law violations surpassed first-degree robbery in
1987 as the number one cause of incarceration, accounting for 20% of the
total prison population (14). In Florida, the 8,506 drug law violators
admitted to state prisons in fiscal 1987-1988 represented a 525% increase
from fiscal 1983-84 and 27.8% of all new admissions to prison in 1987-88 (15).
Nationwide, drug trafficking and drug possession offenses accounted for
approximately 135,000 (23%) of the 583,000 individuals convicted of felonies
in state courts in 1986 (16). State and local governments spent a minimum of
$2 billion last year to incarcerate drug offenders. The direct costs of
building and maintaining enough prisons to house this growing population
are rising at an astronomical rate. The costs, in terms of alternative
social expenditures foregone and other types of criminals not imprisoned,
are perhaps even more severe (17).
Police have made about 750,000 arrests for violations of the drug laws
during each of the last few years (18). Slightly more than three-quarters of
these have been not for manufacturing or dealing drugs but solely for
possession of an illicit drug, typically marijuana (19). [Those arrested,
it is worth noting, represent less than 2% of the 35 to 40 million Americans
estimated to have illegally consumed a drug during each of the past years
(20).] On the one hand, these arrests have have clogged many urban criminal
justice systems: in New York City, drug law violations in 1987 accounted for
more than 40% of all felony indictments, up from 25% in 1985 (21); in
Washington, D.C., the figure was 52% in 1986, up from 13% in 1981 (22). On
the other hand, they have distracted criminal justice officials from
concentrating resources on violent offenses and property crimes. In many
cities, urban law enforcement has become virtually synonymous with drug
The greatest beneficiaries of the drug laws are organized and unorganized
drug traffickers. The criminalization of the drug market effectively imposes
a de facto value-added tax that is enforced and occasionally augmented by
the law enforcement establishment and collected by the drug traffickers. More
than half of all organized crime revenues are believed to derive from the
illicit drug business; estimates of the dollar value range between $10 and
$50 billion per year (23). By contrast, annual revenues from cigarette
bootlegging, which persists principally because of differences among states
in their cigarette tax rates, are estimated at between $200 million and
$400 million (23). If the marijuana, cocaine, and heroin markets were legal,
state and federal governments would collect billions of dollars annually in
tax revenues. Instead, they expend billions in what amounts to a subsidy of
The connection between drugs and crime is one that that continues to
resist coherent analysis, both because cause and effect are so difficult to
distinguish and because the role of the drug prohibition laws in causing
and labeling "drug-related crime" are so often ignored, There are five
possible connections between drugs and crime, at least three of which
would be much diminished if the drug prohibition laws were repealed. First,
the production, sale, purchase, and possession of marijuana, cocaine, heroin,
and other strictly controlled and banned substances are crimes in and of
themselves, which occur billions of times each year in the United States.
In the absence of drug prohibition laws, these activities would largely
cease to be considered crimes. Selling drugs to children would, of course,
continue to be criminalized, and other evasions of government regulation
of a legal market would continue to be prosecuted, but by and large, the
connection between drugs and crime that now accounts for all of the criminal
justice costs noted above would be severed.
Second, many illicit drug users commit crimes such as robbery and
burglary, as well as other vice crimes such as drug dealing, prostitution,
and numbers running, to earn enough money to purchase cocaine, heroin, and
other illicit drugs - drugs that cost far more than alcohol and tobacco not
because they cost much more to produce, but because they are illegal (24).
Because legalization would inevitably lead to a reduction in the cost of the
drugs that are now illicit, it would also invite a significant reduction
in this drug-crime connection. At the same time, current methadone maintenance
programs represent a limited form of drug legalization that attempts to
break this connection between drugs and crime by providing and addictive
opiate at little or no cost to addicts who might otherwise steal to support
their illicit heroin habits. Despite their many limitations, such programs
have proven effective in reducing the criminal behavior and improving the
the lives of thousands of illicit drug addicts (25); they need to be made more
available, in part by adapting the types of outreach programs for addicts
devised in the Netherlands (26). Another alternative, the British system of
prescribing not just oral methadone but also injectable heroin and methadone
to addicts who take drugs intravenously, persists on a small scale even
today despite continuing pressures against prescribing injectables. This too
merits adoption in the United States, particularly if one accepts the
assumption that the primary objective of drug policy should be to minimize
the harms that drug abuses do to others (27).
The third connection between drugs and crime is more coincidental than
causal in nature. Although most illicit drug users do not engage in crime
aside from their drug use, and although many criminals do not use or abuse
illicit drugs or alcohol, substance abuse clearly is much higher among
criminals than among noncriminals. A 1986 survey of state prison inmates
found that 43% were using illegal drugs on a daily or near daily basis in
the month before they committed the crime for which they were incarcerated;
it also found that roughly one-half of the inmates who had used an illicit
drug did not do so until after their first arrest (28). Perhaps many of the
same factors that lead individuals into lives of crime also push them in the
direction of substance abuse. It is possible that legalization would diminish
this connection by removing from the criminal subculture the lucrative
opportunities that now derive from the illegality of the drug market. But it
is also safe to assume that the criminal milieu will continue to claim a
disproportionately large share of drug abusers regardless of whether or not
drugs are legalized.
The fourth link between drugs and crime is the commission of violent and
other crimes by people under the influence of illicit drugs. It is this
connection that seems to infect the public imagination. Clearly, some drugs
do "cause" some people to commit crimes by reducing normal inhibitions,
unleashing aggressive and other asocial tendencies, and lessening senses of
responsibility. Cocaine, particularly in the form of "crack," has gained such
a reputation in recent years, just as heroin did in the 1960s and 1970s and
marijuana did in the years before that. Crack cocaine's reputation for
inspiring violent behavior may well be more deserved than were those of
marijuana and heroin, although the evidence has yet to substantiate media
depictions (29). No illicit drug, however, is as strongly associated with
violent behavior as alcohol. According to Justice Department statistics,
54% of all jail inmates convicted of violent crimes in 1983 reported having
used alcohol just prior to committing their offense (30). The impact of
drug legalization on this aspect of the drug-crime connection is the most
difficult to assess, largely because changes in the overall level and nature
of drug consumption are so difficult to predict.
The fifth connection is the violent, intimidating, and corrupting
behavior of the drug traffickers. In many Latin American countries,
most notably Colombia, this connection virtually defines the "drug problem."
But even within the United States, drug trafficker violence is rapidly
becoming a major concern of criminal justice officials and the public at
large. The connection is not difficult to explain. Illegal markets tend to
breed violence, both because they attract criminally minded and violent
individuals and because participants in the market have no resort to legal
institutions to resolve their disputes (32). During Prohibition, violent
struggles between bootlegging gangs and hijackings of booze-laden trucks and
sea vessels were frequent and notorious occurrences. Today's equivalent
are the booby traps that surround some marijuana fields, the pirates of the
Carribean looking to rob drug-laden vessels en route to the shores of the
United States, the machine gun battles and executions of the more sordid
drug gangs, and generally high levels of violence that attend many illicit
drug relationships; the victims include not just drug dealers but witnesses,
bystanders, and law enforcement officials. Most law enforcement authorities
agree that the dramatic increases in urban murder rates during the past few
years can be explained almost entirely by the rise in drug dealer killings,
mostly of one another (33). At the same time, the powerful allure of illicit
drug dollars is responsible for rising levels of corruption not just in Latin
America and the Caribbean but also in federal, state, and local criminal
justice systems throughout the United States (34). A drug legalization
strategy would certainly deal a severe blow to this link between drugs and
Perhaps the most unfortunate victims of the drug prohibition policies have
been the poor and law-abiding residents of urban ghettos. Thost policies have
proven largely futile in deterring large numbers of ghetto dwellers from
becoming drug abusers, but they do account for much of what ghetto residents
identify as the drug problem. In many neighborhoods, it often seems to be the
aggressive gun-toting drug dealers who upset law-abiding residents far more
than the addicts nodding out in doorways (35). Other residents, however,
perceive the drug dealers as heroes and successful role models. In impoverished
neighborhoods from Medellin and Rio de Janeiro to many leading U.S. cities,
they often stand out as symbols of success to children who see no other
options. At the same time, the increasingly harsh criminal penalties imposed
on adult drug dealers have led to the widespread recruiting of juveniles by
drug traffickers (36). Where once children started dealing drugs only after
they had been using them for a few years, today the sequence is often reversed.
Many children start to use illegal drugs now only after they have worked for
older drug dealers for a while. And the juvenile justice system offers no
realistic options for dealing with this growing problem.
Perhaps the most difficult costs to evaluate are those that relate to the
widespread defiance of the drug prohibition laws; the effects of labeling as
criminals the tens of millions of people who use drugs illicitly, subjecting
them to the same risks of criminal sanction, and obliging many of those same
people to enter into relationships with drug dealers (who may be criminals in
many more senses of the word) in order to purchase their drugs; the cynicism
that such laws generate toward other laws and the law in general; and the
sense of hostility and suspicion that many otherwise law-abiding individuals
feel toward law enforcement officials. It was costs such as these that
strongly influenced many of Prohibition's more conservative opponents.
Among the most dangerous consequences of the drug laws are the harms that
stem from the unregulated nature of illicit drug production and sale (37).
Many marijuana smokers are worse off for having smoked cannabis that was grown
with dangerous fertilizers, sprayed with paraquat, or mixed with more
dangerous substances. Consumers of heroin and the various synthetic substances
sold on the street face even more severe consequences, including fatal
overdoses and poisonings from unexpectedly potent or impure drug supplies. In
short, nothing resembling an underground Food and Drug Administration has
arisen to impose quality control on the illegal drug market and provide users
with accurate information on the drugs they consume. More often than not, the
quality of a drug addict's life depends greatly on his or her access to
reliable supplies. Drug enforcement operation that succeed in temporarily
disrupting supply networks are thus a double-edged sword: they encourage
some addicts to seek admission into drug treatment programs, but they
oblige others to seek out new and hence less reliable suppliers, with the
result that more, not fewer, drug-related emergencies and deaths occur.
Today, about 25% of all acquired immunodeficiency syndrome (AIDS) cases
in the United States and Europe, as well as the large majority of human
immunodeficiency virus (HIV)-infected heterosexuals, children, and infants,
are believed to have contracted the dreaded disease directly or indirectly
from illegal intravenous (IV) drug use (38). In the New York metropolitan
area, the prevalence of a seropositive test for HIV among illicit IV drug
users is over 50% (39). Reports have emerged of drug dealers beginning to
provide clean syringes together with their illegal drugs (40). In England,
recent increases in the number of HIV-infected drug users have led to
renewed support among drug treatment clinicians for providing IV heroin
addicts with free supplies of injectable methadone and heroin; this reversal
of the strong since the early 1970s for oral methadone maintenance has been
spearheaded by Philip Connell, chairman of the Home Office Advisory Committee
on the Misuse of Drugs (41). But even as governments in England, Scotland,
Sweden, Switzerland, Australia, the Netherlands, and elsewhere actively
attempt to limit the spread of AIDS by and among drug users by removing
restrictions on the sale of syringes and instituting free syringe exchange
programs (42), state and municipal governments in the United States have
resisted following suit, arguing, despite mounting evidence to the contrary
(43), that to do so would "encourage" or "condone" the use of illegal drugs
(44). Only in late 1988 did needle exchange programs begin emerging in U.S.
cities, typically at the initiative of nongovernmental organizations. By
mid-1989, programs were under way or close to being implemented in New
York City; Tacoma, Washington; Boulder, Colorado; and Portland, Oregon (45).
At the same time, drug treatment programs remain notoriously underfunded,
turning away tens of thousands of addicts seeking help even as increasing
billions of dollars are spent to arrest, prosecute, and imprison illegal
drug sellers and users.
Other costs of current drug prohibition policies include the restrictions
on using the illicit drugs for legitimate medical purposes (46). Marijuana
has proven useful in alleviating pain in some victims of multiple sclerosis,
is particularly effective in reducing the nausea that accompanies chemotherapy,
and may well prove effective in the treatment of glaucoma (47-49); in
September 1988, the administrative law judge of the Drug Enforcement
Administration accordingly recommended that marijuana be made legally
available for such purposes (49), although the agency head has yet to
approve the change. Heroin has proven highly effective in helping patients
to deal with severe pain; some researcher have found it more effective than
morphine and other opiates in treating pain in some patients (50). It is
legally prescribed for such purposes in Britain (50) and Canada (51). The
same may be true of cocaine, which continues to be used by some doctors in
the United States to treat pain despite recently imposed bans (52). The
psychedelic drugs, such as LDS (d-lysergic acid diethylamide), peyote, and
MDMA (known as Ecstasy) have shown promise in aiding psychotherapy and in
reducing tension, depression, pain, and fear of death in the terminally
ill(53); they also have demonstrated some potential, as yet unconfirmed,
to aid in the treatment of alcoholism (47, 53). Current drug laws and
policies, however, greatly hamper the efforts of researchers to investigate
these and other potential medical uses of illegal drugs; they make it
virtually impossible for any of the illegal drugs, particularly those in
Schedule I, to be legally provided to those who would benefit from them; and
they contribute strongly to the widely acknowledged undertreatment of pain by
the medical profession in the United States (54).
Among the strongest arguments in favor of legalization are the moral ones.
On the one hand, the standard refrain regarding the immorality of drug use
crumbles in the face of most Americans' tolerance for alcohol and tobacco use.
Only the Mormons and a few other like-minded sects, who regard as immoral any
intake of substances to alter one's state of consciousness or otherwise cause
pleasure, are consistent in this respect; they eschew not just the illicit
drugs, but also alcohol, tobacco, caffeinated coffee and tea, and even
chocolate. "Moral" condemnation by the majority of Americans of some substances
and not others is little more than a transient prejudice in favor of some
drugs and against others.
On the other hand, drug enforcement involves its own immoralities. Because
drug law violations do not create victims with an interest in notifying the
police, drug enforcement agents must rely heavily on undercover operations,
electronic surveillance, and information provided by informants. In 1986,
almost half of the 754 court-authorized orders for wiretaps in the United
States involved drug trafficking investigations (55). These techniques are
certainly indispensable to effective law enforcement, but they are also
among the least desirable of the tools available to police. The same is
true of drug testing. It may be useful and even necessary for determining
liability in accidents, but it also threatens and undermines the right
of privacy to which many Americans believe they are morally and
constitutionally entitled. There are good reasons for requiring that such
measures be used sparingly.
Equally disturbing are the increasingly vocal calls for people to inform
not just on drug dealers but on neighbors, friends, and even family members
who use illicit drugs. Intolerance of illicit drug use and users is heralded
not merely as an indispensable ingredient in the war against drugs but as a
mark of good citizenship. Certainly every society requires citizens to assist
in the enforcement of criminal laws. But societies, particularly democratic
and pluralistic ones, also rely strongly on an ethic of tolerance toward
those who are different but do no harm to others. Overzealous enforcement
of the drug laws risks undermining that ethic and propagating in its place
a society of informants. Indeed, enforcement of drug laws makes a mockery
of an essential principle of a free society, that those who do no harm to
others should not be harmed by others, and particularly not by the state.
Most of the nearly 40 million Americans who illegally consume drugs each
year do no direct harm to anyone else; indeed, most do relatively little
harm even to themselves. Directing criminal and other sanctions at them, and
rationalizing the justice of such sanctions, may well represent the greatest
societal cost of our current drug prohibition system.
Alternatives to Drug Prohibition Policies
Repealing the drug prohibition laws clearly promises tremendous advantages.
Between reduced government expenditures on enforcing drug laws and new tax
revenues from legal drug production and sales, public treasuries would enjoy
a net benefit of at least $10 billion per year and possibly much more; thus
billions in new revenues would be available, and ideally targeted, for
funding much-needed drug treatment programs as well as the types of social
and educational programs that often prove most effective in creating incentives
not to abuse drugs. The quality of urban life would rise significantly.
Homicide rates would decline. So would robbery and burglary rates. Organized
criminal groups, particularly the up-and-coming ones that have yet to
diversify into nondrug areas, would be dealt a devastating setback. The police,
prosecutors, and courts would focus their resources on combating the types
of crimes that people cannot walk away from. More ghetto residents would
turn their backs on criminal careers and seek out legitimate opportunities
instead. And the health and quality of life of many drug users and even
drug abusers would improve significantly. Internationally, U.S. foreign
policymakers would get on with more important and realistic objectives, and
foreign governments would reclaim the authority they have lost to the
All the benefits of legalization would be for naught, however, if millions
more people were to become drug abusers. Our experience with alcohol and
tobacco provides ample warnings. Today, alcohol is consumed by 140 million
Americans and tobacco by 50 million. All of the health costs associated
with abuse of the illicit drugs pale in comparison with those resulting from
tobacco and alcohol abuse. In 1986, for instance, alcohol was identified as
a contributing factor in 10% of the work-related injuries, 40% of suicide
attempts, and about 40% of the approximately 46,000 annual traffic deaths in
1983. An estimated 18 million Americans are reported to be either alcoholics
or alcohol abusers. The total cost of alcohol abuse to American society is
estimated at over $100 billion annually (56). Estimates of the number of
deaths linked directly and indirectly to alcohol use vary from a low of 50,000
to a high of 200,000 per year (57). The health costs of tobacco use are
different but of similar magnitude. In the United States alone, an estimated
320,000 people die prematurely each year as a consequence of their consumption
of tobacco. By comparison, the Nation Council on Alcoholism reported that
only 3,562 people were known to have died in 1985 from the use of all
illegal drugs combined (58). Even if we assume that thousands more deaths
were related in one way or another to illicit drug use but not reported as
such, we still are left with the conclusion that all of the health costs of
marijuana, cocaine, and heroin combined amount to only a small fraction of
those caused by either of the two licit substances. At the very least, this
contrast emphasized the need for a comprehensive approach to psychoactive
substances involving much greater efforts to discourage tobacco and alcohol
The impact of legalization of the nature and level of consumption of those
drugs that are currently illegal is impossible to predict with any accuracy.
On the one hand, legalization implies greater availability, lower prices, and
the elimination (particularly for adults) of the deterrent power of the
criminal sanction - all of which would suggest higher levels of use. Indeed,
some fear that the extent of drug abuse and its attendant costs would rise to
those currently associated with alcohol and tobacco (59). On the other hand,
there are many reasons to doubt that a well-designed and implemented policy
of controlled drug legalization would yield such costly consequences.
The logic of legalization depends in part upon two assumptions: that
most illegal drugs are not as dangerous as is commonly believed; and that
those types of drugs and methods of consumption that are most risky are
unlikely to prove appealing precisely because they are so obviously dangerous.
Consider marijuana. Among the roughly 60 million Americans who have smoked
marijuana, not one has died from a marijuana overdose (49), a striking
contrast with alcohol, which is involved in approximately 10,000 overdose
deaths annually, half in combination with other drugs (57). Although there
are good health reasons for people not to smoke marijuana daily, and for
children, pregnant women, and some others not to smoke at all, there still
appears to be little evidence that occasional marijuana consumption does
much harm at all. Certainly, it is not healthy to inhale marijuana smoke into
one's lungs; indeed, the National Institute on Drug Abuse (NIDA) has
declared that "marijuana smoke contains more cancer-causing agents than is
found in tobacco smoke." (60). On the other hand, the number of "joints"
smoked by all but a very small percentage of marijuana smokers is a tiny
fraction of the 20 cigarettes a day smoked by the average cigarette smoker;
indeed the average may be closer to one or two joints per week than one or
two per day. Note that the NIDA defines a "heavy" marijuana smoker as one
who consumes at least two joints "daily." A heavy tobacco smoker, by contrast,
smokes about 40 cigarettes per day.
Nor is marijuana strongly identified as a dependence-causing substance. A
1982 survey of marijuana use by young adults (18 to 25 years) found that 64%
had tried marijuana at least once, that 42% had used it at least ten times,
and that 27% had smoked in the last month. It also found that 21% had passed
through a period during which they smoked "daily" (defined as 20 or more days
per month) but that only one-third of those currently smoked daily and only
one-fifth (or about 4% of all young adults) could be described as heavy daily
users (averaging two or more joints per day) (61). This suggests in part that
daily marijuana use is typically a phase through which people pass, after
which their use becomes more moderate. By contrast, almost 20% of high school
seniors smoke cigarettes daily.
The dangers associated with cocaine heroin, the hallucinogens, and other
illicit substances are greater than those posed by marijuana but not nearly
so great as many people seem to think. Consider the case of cocaine. In 1986,
NIDA reported that over 20 million Americans had tried cocaine, that 12.2
million had consumed it at least once during 1985, and that nearly 5.8
million had used it within the past month. Among 18- to 25-year-olds, 8.2
million had tried cocaine; 5.3 million had used it within the past year; 2.5
million had used it within the past month; and 250,000 had used it on the
average weekly (20). One could extrapolate from these figures that a quarter
of a million young Americans are potential problem uses. But one could also
conclude that only 3% of those 18- to 25-year-olds who had ever tried the drug
fell into that category, and that only 10% of those who had used cocaine
monthly were at risk. (The NIDA survey did not, it should be noted, include
persons residing in military or student dormitories, prison inmates, or the
All of this is not to say that cocaine is not a potentially dangerous drug,
especially when it is injected, smoked in the form of "crack," or consumed
in tandem with other powerful substances. Clearly, many tens of thousands of
Americans have suffered severely from their abuse of cocaine and a tiny
fraction have died. But there is also overwhelming evidence that most users
of cocaine do not get into trouble with the drug. So much of the media
attention has focused on the relatively small percentage of cocaine users
who have become addicted that the popular perception of how most people use
cocaine has become badly distorted, In one survey of high school seniors'
drug use, the researchers questioned those who had used cocaine recently
whether they had ever tried to stop using cocaine and found that they could
not stop. Only 3.8% responded affirmatively, in contrast to the almost 7% of
marijuana smokers who said they had tried to stop and found they could not,
and the 18% of cigarette smokers who answered similarly (62). Although
a survey of crack users and cocaine injectors surely would reveal a higher
proportion of addicts, evidence such as this suggests that only a small
percentage of people who snort cocaine end up having a problem with it. In
this respect, most people differ from captive monkeys, who have demonstrated
in tests that they will starve themselves to death if provided with unlimited
With respect to the hallucinogens such as LSD and psilocybic mushrooms,
their potential for addiction is virtually nil. The dangers arise primarily
from using them irresponsibly on individual occasions (53). Although many of
those who have used hallucinogens have experienced "bad trips," far more have
reported positive experiences and very few have suffered any long-term
harm (53). As for the great assortment of stimulants, depressants, and
tranquilizers produced illegally or diverted from licit channels, each
evidences varying capacities to create addiction, harm the user, or be used
Until recently, no drugs were regarded with as much horror as the opiates,
and in particular heroin. As with most drugs, it can be eaten, snorted,
smoked, or injected. The custom among most Americans, unfortunately, is the
last of these options, although the growing fear of AIDS appears to be
causing a shift among younger addicts toward intranasal ingestion (64). There
is no question that heroin is potentially highly addictive, perhaps as
addictive as nicotine. But despite the popular association of heroin use with
the most down-and-out inhabitants of urban ghettos, heroin causes relatively
little physical harm to the human body. Consumed on an occasional or regular
basis under sanitary conditions, its worst side effect, apart from the fact
of being addicted, is constipation (65). That is one reason why many doctors
in early 20th-century America saw opiate addiction as preferable to
alcoholism and prescribed the former as treatment for the latter where
abstinence did not seem a realistic option (66, 67).
It is both insightful and important to think about the illicit drugs as we
do about alcohol and tobacco. Like tobacco, some illicit substances are highly
addictive but can be consumed on a regular basis for decades without
demonstrable harm. Like alcohol, many of the substances can be, an are, used
by most most consumers in moderation, with little in the way of harmful
effects; but like alcohol they also lend themselves to abuse by a minority
of users who become addicted or otherwise harm themselves or others as a
consequence. And like both the legal substances, the psychoactive effects
of each of the illegal drugs vary greatly from one person to another. To be
sure, the pharmacology of the substance is important, as is its purity and
the manner in which it is consumed. But much also depends upon not just
the physiology and psychology of the consumer but his expectations regarding
the drug, his social milieu, and the broader cultural environment, what
Harvard University psychiatrist Norman Zinberg called the "set and setting"
of the drug (68). It is factors such as these that might change dramatically,
albeit in indeterminate ways, were the illicit drugs made legally available.
It is thus impossible to predict whether or not legalization would lead to
much greater levels of drug abuse. The lessons that can be drawn from other
societies are mixed. China's experience with the British opium pushers of the
19th century, when millions reportedly became addicted to the drug, offers
one worst-case scenario. The devastation of many native American tribes by
alcohol presents another. On the other hand, the decriminalization of
marijuana by 11 states in the Unites States during the mid-1970's does not
appear to have led to increases in marijuana consumption (69). In the
Netherlands, which went even further in decriminalizing cannabis during the
1970s, consumption has actually declined significantly; in 1976, 3% of
15- and 16-year-olds and 10% of 17- and 18-year-olds used cannabis
occasionally; by 1985 the percentage had declined to 2 and 6% respectively
(70). The policy has succeeded, as the government intended, "in making drug
use boring." Finally, late 19th-century America is an example of a society
in which there were almost no drug laws of even drug regulation but levels
of drug use were about what they are today (71). Drug abuse was regarded
as a relatively serious problem, but the criminal justice system was not
regarded as part of the solution (72).
There are however, strong reasons to believe that none of the currently
illicit substances would become as popular as alcohol or tobacco even if
they were legalized. Alcohol has long been the principal intoxicant in most
societies, including many in which other substances have legally available.
Presumably, its diverse properties account for its popularity: it quenches
thirst, goes well with food, often pleases the palate, promotes appetite
as well as sociability, and so on. The widespread use of tobacco probably
stems not just from its powerful addictive qualities but from the fact
that its psychoactive effects are sufficiently subtle that cigarettes can
be integrated with most other human activities. None of the illicit substances
now popular in the United States share either of these qualities to the
same extent, nor is it likely that they would acquire them if they were
legalized. Moreover, none of the illicit substances can compete with
alcohol's special place in American culture and history, one that it retained
even during Prohibition.
Much of the damage caused by illegal drugs today stems from their
consumption in particularly potent and dangerous ways. There is good reason
to doubt that many Americans would inject cocaine or heroin into their
veins even if given the chance to do so legally. And just as the dramatic
growth in the heroin-consuming population during the 1960s leveled off
for reasons apparently having little to do with law enforcement, so we
can expect, if it has not already occurred, a leveling off in the number
of people who smoke crack.
Perhaps the most reassuring reason for believing that repeal of the drug
prohibition laws will not lead to tremendous increases in drug abuse levels
is the fact that we have learned something from our past experiences with
alcohol and tobacco abuse. We now know, for instance, that consumption taxes
are an effective method for limiting consumption rates and related costs (73).
Substantial evidence also suggests that restriction and bans on advertising,
as well as promotion of negative advertising, can make a difference (74). The
same seems to be true of other government measures, including restrictions
on time and place of sale (75), bans on vending machines, prohibition of
consumption in public places, packaging requirements, mandated adjustments
in insurance policies, crackdowns on driving while under the influence (76),
and laws holding bartenders and hosts responsible for the drinking of
customers and guests. There is even some evidence that some education programs
about the dangers of cigarette smoking have deterred many children from
beginning to smoke (77). At the same time, we also have come to recognize
the great harms that can result when drug control policies are undermined
by powerful lobbies such as those that now block efforts to lessen the harms
caused by abuse of alcohol and tobacco.
Legalization thus affords far greater opportunities to control drug use
and abuse than do current criminalization policies. The current strategy
is one in which the type, price, purity, and potency of illicit drugs, as
well as the participants in the business, are largely determined by drug
dealers, the peculiar competitive dynamics of an illicit market, and the
perverse interplay of drug enforcement strategies and drug trafficking
tactics. During the past decade, for instance, the average retail purities
of cocaine of heroin have increased dramatically, the wholesale prices have
dropped greatly, the number of children involved in drug dealing has risen,
and crack has become readily and cheaply available in a growing number of
American cities (8). By contrast, marijuana has become relatively scarcer
and more expensive, in part because it is far more vulnerable to drug
enforcement efforts than are cocaine or heroin; the result has been to
induce both dealers and users away from the relatively safer marijuana
and toward the relatively more dangerous cocaine (8). Also by contrast,
while the average potency of most illicit substances has increased during
the 1980s, that of most legal psychoactive substances has been declining.
Motivated in good part by health concerns, Americans are switching from
hard liquor to beer and wine, from high tar and nicotine cigarettes to
lower tar and nicotine cigarettes as well as smokeless tobaccos and
nicotine chewing gums, and even from caffeinated coffees, teas, and sodas.
It is quite possible that these diverging trends are less a reflection
of the nature of the drugs than of their legal status.
A drug control policy based on approaches other than criminal justice
thus offers a number of significant advantages over the current criminal
justice focus in controlling drug use and extent, consumption out of the
hands of criminals and into the hands of government and government licensees.
It affords consumers the opportunity to make far more informed decisions
about the drugs they buy than is currently the case. It dramatically lessens
the likelihood that drug consumers will be harmed by impure, unexpectedly
potent or misidentified drugs. It corrects the hypocritical and dangerous
message that alcohol and tobacco are somehow safer than many illicit drugs.
It reduces by billions of dollars annually government expenditures on
drug enforcement and simultaneously raises additional billions in tax
revenues. And it allows government the opportunity to shape consumption
patterns toward relatively safer psychoactive substances and modes of
Toward the end of 1920s, when the debate over repealing Prohibition
rapidly gained momentum, numerous scholars, journalists, and private and
government commissions undertook thorough evaluations of Prohibition and
the potential alternatives. Prominent among these were the Wickersham
Commission appointed by President Herbert Hoover and the study of alcohol
regulation abroad directed by the leading police scholar in the United
States, Raymond Fosdick, and commissioned by John D. Rockefeller (78).
These efforts examined the successes and failings of Prohibition in
the United States and evaluated the wide array of alternative regimes for
controlling the distribution and use of beer, wine, and liquor. They
played a major role in stimulating the public reevaluation of Prohibition
and in envisioning alternatives. Precisely the same sorts of efforts are
The controlled drug legalization option is not an all-or-nothing
alternative to current policies. Indeed, political realities ensure
that any shift toward legalization will evolve gradually, with ample
opportunity to halt, reevaluate, and redirect drug policies that begin
to prove too costly or counterproductive. The federal government need not
play the leading role in devising alternatives; it need only clear the
way to allow state and local governments the legal power to implement
their own drug legalization policies. The first steps are relatively
risk-free: legalization of marijuana, easier availability of illegal
and strictly controlled drugs for treatment of pain and other medical
purposes, tougher tobacco and alcohol control policies, and a broader
and more available array of drug treatment programs.
Remedying the drug-related ills of America's ghettos requires more
radical steps. The risks of a more far-reaching policy of controlled
drug legalization - increased availability, lower prices, and removal
of the deterrent power of the criminal sanction - are relatively less
in the ghettos than in most other parts of the United States in good
part because drug availability is already too high, prices so low and
the criminal sanction so ineffective in deterring illicit drug use that
legalization would yield it greatest benefits in the ghettos, where
it would sever much of the drug-crime connection, seize the market
away from criminals, deglorify involvement in the illicit drug business,
help redirect the work ethic from illegitimate to legitimate employment
opportunities, help stem the transmission of AIDS by IV drug users, and
significantly improve the safety, health, and well-being of those do
use and abuse drugs. Simply stated, legalizing cocaine, heroin, and
other relatively dangerous drugs may well be the only way to reverse
the destructive impact of drugs and current drug policies in the ghettos.
There is no question that legalization is a risky policy, one that may
indeed lead to an increase in the number of people who abuse drugs. But
that risk is by no means a certainty. At the same time, current drug
control policies are showing little progress and new proposals promise
only to be more costly and more repressive. We know that repealing the
drug prohibition laws would eliminate or greatly reduce many of the ills
that people commonly identify as part and parcel of the "drug problem."
Yet that option is repeatedly and vociferously dismissed without any
attempt to evaluate it openly and objectively. The past 20 years have
demonstrated that a drug policy shaped by rhetoric and fear-mongering
can only lead to our current disaster. Unless we are willing to honestly
evaluate all our options, including various legalization strategies,
there is a good chance that we will never identify the best solutions
for our drug problems.
REFERENCES AND NOTES
1. The terms "legalization" and "decriminalization" are used interchangeably
here. Some interpret the latter as a more limited form of legalization
involving the removal of sanctions against users but not against producers
2. Statement by Senator D. P. Moynihan, citing a U.S. Department of Agriculture
report in _Congr. Rec._ 134 (no. 77), p. S7049 (27 May 1988).
3. Drug Enforcement Administration, Department of Justice, _Intell. Trends_ 14
(no. 3), 1 (1987).
4. See, for example, K. Healy, _J. Interam. Stud. World Aff._ 30 (no. 2/3), 105
5. E. A. Nadelmann, _ibid._ 29 (no. 4), 1 (winter 1987-88)
6. C. McClintock, _ibid._ 30 (no. 2/3), 127 (summer/fall 1988); J Kawell,
_Report on the Americas_ 22 (no. 6), 13 (March 1989).
7. P. Reuter, _Public Interest_ (no. 92) (summer 1988), p. 51.
8. See the annual reports of the National Narcotics Intelligence Consumers
Committee edited by the Drug Enforcement Administration, Department of
Justice, Washington, DC.
9. _Street-Level Drug Enforcement: Examining the Issues_, M. R. Chaiken, Ed.
(National Institute of Justice, Department of Justice, Washington, DC
10. National Drug Enforcement Policy Board, _National and International Drug
Law Enforcement Strategy,_ (Department of Justice, Washington, DC, 1987).
11. _Anti-Drug Law Enforcement Efforts and Their Impact_ (report prepared for
the U.S. Customs Service by Wharton Econometric Forecasting Associates,
Washington, DC, 1987), pp. 2 and 38-46.
12. _Sourcebook of Criminal Justice Statistics,_ 1987 (Bureau of Justice
Statistics, Department of Justice, Washington, DC, 1988), pp. 490, 494, and
518; and "Prisoners in 1987" _Bur. Justice Stat. Bull. (April 1988).
13. U.S. Sentencing Commission, _Supplementary Report on the Initial
Sentencing Guidelines and Policy Statements (U.S. Sentencing Commission,
Washington, DC, 18 June 1987), pp. 71-75
14. R. D. McFadden, _New York Times,_ 5 January 1988, p. B1.
15. _Annual Report, 1987-88,_ (Florida Department of Corrections, Tallahassee,
FL, 1988), pp. 26, 50, and 51.
16. "Felony sentences in state courts, 1986." _Bur. Justice Stat. Bull._
17. The numbers cited do not, it should be emphasized, include the many
inmates sentenced for drug-related crimes such as violent crimes committed
by drug dealers, typically against one another, and robberies committed to
earn the money needed to pay for illegal drugs.
18. See the annual editions of _Sourcebook of Criminal Justice Statistics_
(Bureau of Justice Statistics, Department of Justice, Washington, DC).
19. _Sourcebook of Criminal Justice Statistics, 1987_ (Bureau of Justice
Statistics, Department of Justice, Washington, DC, 1988), pp. 400-401.
20. _Data from the 1985 National Household Survey on Drug Abuse_ (National
Institute on Drug Abuse, Rockville, MD, 1987).
21. S. Raab, _New York Times,_ 7 June 1987, p. A38.
22. _Drug Use and Drug Programs in the Washington Metropolitan Area: An
Assessment_ (Greater Washington Research Center, Washington, DC, 1988),
23. Wharton Econometric Forecasting Associates, _The Impact: Organized Crime
Today_ (President's Commission on Organized Crime, Washington, DC, 1986),
24. B. D. Johnson et al., _Taking Care of Business: The Economics of Crime
By Heroin Abusers_ (Lexington Books, Lexington, MA, 1985).
25. B. D. Johnson, D. Lipton, E. Wish, _Facts About the Criminality of Heroin
and Cocaine Abusers and Some New Alternatives to Incarceration_ (Narcotic and
Drug Research, New York, 1986), p. 30.
26. G. F. van de Wijngart, _Am. J. Drug Alcohol Abuse_ 14 (no. 1), 125 (1988).
27. A controlled trial in which 96 confirmed heroin addicts requesting a
heroin maintenance prescription were randomly allocated to treatment with
injectable heroin or oral methadone showed that "refusal [by doctors] to
prescribe heroin is ... associated with a considerably higher abstinence
rate, but at the expense of an increased arrest rate and a higher level of
illicit drug involvement and criminal activity among those who did not become
abstinent." R. L. Hartnoll et al., _Arch. Gen. Psychiatry_ 37, 877 (1980).
28. "Drug use and crime," _Bur. Justice Stat. Spec. Rep._ (July 1988).
29. See the discussion in P. J Goldstein, P. A. Bellucci, B. J. Spunt,
T. Miller, _"Frequency of Cocaine Use and Violence: A Comparison Between Men
and Women"_ [in NIDA (National Institute on Drug Abuse) _Res. Monogr. Ser._,
30. _Sourcebook of Criminal Justice Statistics, 1986_ (Bureau of Justice
Statistics, Department of Justice, Washington, DC, 1987), p. 398.
31. _Sourcebook of Criminal Justice Statistics, 1987_ (Bureau of Justice
Statistics, Department of Justice, Washington, DC, 1988), p. 497.
32. P. J. Goldsten, in _Pathways to Criminal Violence,_ N. A. Weiner and
M. E. Wolfgang, Eds. (Sage, Newbury Park, CA, 1989), pp. 16-48.
33. "A tide of drug killing," _Newsweek,_ 16 January 1989, p. 44.
34. P. Shenon, _New York Times,_ 11 April 1988, p. A1.
35. W. Nobles, L. Goddard, W. Cavil, P. George, _The Culture of Drugs in the
Black Community_ (Institute for the Advanced Study of Black Family Life and
Culture, Oakland, CA, 1987).
36. T. Mieczowksi, _Criminology_ 24, 645 (1986).
37. C. L. Renfroe and T. A. Messinger, _Semin. Adolescent Med._ 1 (no. 4),
38. D. C. Des Jarlais and S. R. Friedman, _J. AIDS_ 1, 267 (1988).
39. D. C. Des Jarlais et al., _J. Am. Med. Assoc._ 261, 1008 (1989).
40. S. R. Friedman et al., _Int. J. Addict._ 22 (no. 3), 201 (1987).
41. T. Bennett, _Law Contemp. Prob._ 51, 310 (1988).
42. R. J. Battjes and R. W. Pickens, Eds., _NIDA Res. Monogr. Ser. 80_ (1988).
43. D. C. Jarlais and S. R. Friedman, _AIDS_ 2 (suppl. 1), S65 (1988).
44. M. Marriott, _New York Times,_ 7 November 1988, p. B1; ibid., 30 January
1989, p. A1.
45. _Int. Work. Group AIDS IV Drug Use Newsl._ 3, 3 (December 1988).
46. See, for example, P. Fitzgerald, _St. Louis Univ. Public Law Rev._ 6,
47. L. Grinspoon and J. B. Bakalar, in _Dealing with Drugs: Consequences of
Government Control,_ R. Hamowy, Ed. (Lexington Books, Lexington, MA, 1987),
48. T. H. Mikuriya, Ed., _Marijuana: Medical Papers, 1839-1972_ (Medi-Comp
Press, Oakland, CA, 1973).
49. _In the Matter of Marijuana Rescheduling Petition,_ Docket No. 86-22, 6
September 1988, Drug Enforcement Administration, Department of Justice.
50. A. S. Treback, _The Heroin Solution_ (Yale Univ. Press, New Haven, CT,
1982), pp. 59-84.
51. L. Appleby, _Saturday Night_ (November 1985), p. 13.
52. F. R. Lee, _New York Times, 10 February 1989, p. B3; F. Barre, _Headache_
22, 69 (1982).
53. L. Grinspoon and J. B. Bakalar, _Psychedelic Drugs Reconsidered_ (Basic
Books, New York, 1979).
54. M. Donovan, P. Dillon, L. McGuire, _Pain_ 30, 69 (1987); D. E. Weissman,
_Narc Officer_ 5 (no. 1), 47 (January 1989); D. Goleman, _New York Times,_
31 December 1987, p. B5. The Controlled Substances Act, 21 U.S.C. Sec. 801,
et. seq., defines a Schedule I drug as one that: (i) has a high potential
for abuse; (ii) has no currently accepted medical use in treatment in the
United States; and (iii) for which there is a lack of accepted safety for
use under medical supervision. It is contrary to federal law for physicians
to prescribe Schedule I drugs to patients for therapeutic purposes.
55. _Sourcebook of Criminal Justice Statistics,_ 1987 (Bureau of Justice
Statistics, Department of Justice, Washington, DC, 1988), p. 417.
56. "Toward a nation plan to combat alcohol abuse and alcoholism: A report
to the United States Congress" (Department of Health and Human Services,
Washington, DC, September 1986).
57. D. R. Gerstein, in _Alcohol and Public Policy: Beyond the Shadow of
Prohibition,_ M. H. Moore and D. R. Gerstein, Eds. (National Academy Press,
Washington, DC, 1981), pp. 182-224.
58. Cited in T. Wicker, _New York Times,_ 13 May 1987, p. A27.
59. M. M. Kondracke, _New Repub._ 198 (no. 26), 16 (27 June 1988).
60. "Marijuana" (National Institute on Drug Abuse, Washington, DC, 1983).
61. J. D. Millere and I. H. Cisin, _Highlights from the National Survey
on Drug Abuse,_ 1982 (National Institute on Drug Abuse, Washington, DC, 1983)
62. P. M. O'Malley, L. D. Johnston, J. G. Bachman, _NIDA Monogr. Ser. 61_
(1985), pp. 50-75.
63. T. G. Aigner and R. L. Balster, _Science_ 201, 534 (1978); C. E. Johanson,
_NIDA Monogr. Ser. 50_ (1984), pp. 54-71.
64. J. F. French and J. Safford, _Lancet_ i, 1082 (1989); D. C. Des Jarlais,
S. R. Friedman, C. Casriel, A. Kott, _Psychol. Health_ 1, 179 (1987).
65. J. Kaplan, _The Hardest Drug: Heroin and Public Policy_ (Univ. of Chicago
Press, Chicago, IL, 1983), p. 127.
66. S. Siegel, _Res. Adv. Alcohol Drug Probl._ 9, 279 (1986).
67. J. A. O'Donnell, _Narcotics Addicts in Kentucky_ (Public Health Service
Publ. 1881, National Institute of Mental Health, Chevy Chase, MD, 1969),
discussed in _Licit and Illicit Drugs_ [E. M. Brecher and the Editors of
Consumer Reports (Little, Brown, Boston, 1972), pp. 8-10].
68. See N. Zinberg, _Drug, Set and Setting: The Basis for Controlled
Intoxicant Use_ (Yale Univ. Press, New Haven, CT, 1984).
69. L. D. Johnston, J. G. Bachman, P. M. O'Malley, "Marijuana
decriminalization: the impact on youth 1975-1980" (Monitoring the Future,
Occasional Paper 13, Univ. of Michigan Institute for Social Research, Ann
Arbor, MI, 1981).
70. "Policy on drug users" (Ministry of Welfare, Health, and Cultural Affairs,
Rijswijk, the Netherlands, 1985).
71. D. Courtwright, _Dark Paradise: Opiate Addiction in America Before 1940_
(Harvard Univ. Press, Cambridge, MA, 1982).
72. E. M. Brecher and the Editors of Consumer Reports, _Licit and Illicit
Drugs_ (Little, Brown, Boston, 1972), pp. 1-41.
73. See P. J. Cook, in _Alcohol and Public Policy: Beyond the Shadows of
Prohibition,_ M. H. Moore and D. R. Gerstein, Eds. (National Academy Press,
Washington, DC, 1981), pp. 255-285; D. Coate and M. Grossman, _J. Law Econ._
31, 145 (1988); also see K. E. Warner, in _The Cigarette Excise Tax_ (Harvard
Univ. Institute for the Study of Smoking Behavior and Policy, Cambridge, MA
1985), pp. 88-105.
74. J. B. Tye, K. E. Warner, S. A. Glantz, _J. Public Health Policy_ 8, 492
75. O. Olsson and P. O. H. Wikstrom, _Contemp. Drug Probl._ 11, 325 (fall
1982); M. Terris, _Am. J. Public Health_ 57, 2085, (1967).
76. M. D. Laurence, J. R. Snortum, F. E. Zimring, Eds., _Social Control of the
Drinking Driver_ (Univ. of Chicago Press, Chicago, IL, 1988).
77. J. M. Polich, P. L. Ellickson, P. Reuter, J. P. Kahan, _Strategies for
Controlling Adolescent Drug Use_ (RAND, Santa Monica, CA, 1984), pp. 145-152.
78. R. B. Fosdick and A. L. Scott, _Toward Liquor Control_ (Harper, New York,
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