The Drug War Goes Up in Smoke
New Mexico's harm-reduction approach seems to be bearing fruit. A study from 1997 found that while the majority of the state's injection-drug users had been exposed to hepatitis C--suggesting that considerable needle-sharing was taking place--less than 1 percent of injection-drug users tested positive for HIV. Health experts saw a brief window of opportunity in which to create workable needle-exchange programs that could prevent HIV from spreading, as hepatitis C already had. So far, the programs appear to have worked: In a state with one of the largest per capita injection-drug-using populations in the country (New Mexico recorded 11.6 heroin deaths per 100,000 between 1993 and 1995, compared with a national averge of 5.4 deaths per 100,000), the needle-exchange program has kept HIV to a bare minimum within the close-knit community of users. Department of Health experts estimate that even today, that number is around 11 percent--a low rate, compared with data from the federal Centers for Disease Control and Prevention showing that 27 percent of injection-drug users are HIV-positive in cities like Boston, Miami and Washington.
"My whole attitude about drugs and drug users has changed," says Rosie Clifford, a nurse who works in a public health center in the hardscrabble community of Los Lunas, twenty miles south of Albuquerque. "I used to be very conservative, very law and order. But even if you're really conservative, and you look at needle exchange, you ought to see it as a good way to stop the further spread of HIV and hepatitis and any blood-borne disease."
Danny, a twentysomething heroin addict, has been a client of YDI since 1999 and speaks with gratitude about the group's services. "I don't have to worry about used needles, about diseases," he says. "There was a time if I needed a new syringe I'd have to buy it for five bucks, and you don't know if it's new or not." YDI has provided Danny with health information, and, if he needs it, the group will arrange for a doctor to visit him at home.
Elsewhere in the state, in Rio Arriba County, near the nuclear laboratories of Los Alamos, public health workers are distributing not only needles but Narcan, an injected medication that can reverse the effects of a heroin overdose. So far, they believe they have saved about a dozen lives by training addicts in its use.
Many of the communities in this beautiful mountainous region are desperately poor. Often the roads are dusty and unpaved, dotted with impromptu altars set up in memory of those killed in car accidents--or murdered in battles over drugs and drug money. Heroin and methamphetamine addiction is so widespread here that in some houses, three generations of users share drugs with one another. Yet, while the police in many parts of the country routinely arrest users--and even level paraphernalia charges against addicts bringing dirty needles into exchange programs--in the town of Española, police chief Richard Guillen allows harm-reduction coordinators into his jail and encourages his officers to coax addicts to seek treatment.
Guillen believes that the old approach to drug addiction has failed: "All we're doing is interdiction at the federal level," he says, "and we haven't been successful in reducing demand." By contrast, he says, his local police have recognized that "an addiction to drugs is just like any other illness. Let's try to get them treatment, counseling. Without treatment, all we have is a revolving door."
In the 1980s and early '90s, faced with a growing crack epidemic and the attendant media reports of out-of-control drug gangs and waves of violent crime, the public threw its support behind extremely coercive antidrug policies. Then the crime rates began falling and, gradually, public attitudes began to soften. High-profile research projections and a growing cadre of advocacy groups--many, like the Lindesmith Center and the Drug Policy Foundation, funded by billionaire philanthropist George Soros--encouraged this shift in attitudes by suggesting that treatment was more effective than prison at lowering both addiction and crime. The advocacy groups drafted model reform legislation and promoted ballot initiatives like those that have diverted nonviolent drug offenders away from prisons in Arizona and California. The researchers produced numerous studies showing that it costs far less to place an addict in treatment than in prison--and that treatment has a higher success rate in breaking the addiction cycle. A survey conducted by the Pew Research Center in 2001 found that fully 73 percent of Americans favored permitting medical marijuana prescriptions; 47 percent favored rolling back mandatory-minimum sentences for nonviolent drug offenders; and 52 percent believed drug use should be treated as a disease rather than a crime. Faced with this grassroots shift, local elected officials, too, began to re-examine the beliefs and theories underlying America's antidrug strategy.
Ever since recession hit two years ago, these changes in thinking have been bolstered by fiscal realities. While the Bush Administration may think it can fight a war on terror and run an occupation of Iraq while also cutting taxes and continuing the drug-war imprisonment boom, states are dealing with a more bitter reality. The Administration may want to devote resources to shutting down medical-marijuana buyers' clubs set up legally under new state laws, but states are no longer so enthusiastic. They are realizing that their budgets, buffeted by declining tax revenues, simply can't support major domestic-security spending and, at the same time, continued high expenditures on drug-war policing and mass incarceration. With drug treatment cheaper than incarceration and increasingly viable in the court of public opinion, drug-law reform is gaining ground despite federal intransigence. More and more elected officials are beginning to conclude that it's time to bring home the troops in the war on drugs as we know it. "Treatment instead of incarceration across the whole country has become a political safe ground," former Governor Johnson says. "It could not have been said safely prior to three years ago. Now it's totally safe."