Hooked on Narcomyths
Despite the wealth of research available to help guide drug policy, the tests and calculations--essentially on the harm-reduction principle--MacCoun and Reuter are under no illusion that there's any specific formula by which to evaluate reform proposals. In the end, value judgments still have to be made, weights attached to each element of harm. Politically, moreover, the burden of proof is still on reformers to show why their proposals are preferable to the status quo, no matter how dismal it is. And that's often complex. Much easier, unfortunately, are the simplistic warnings put out by government prohibitionists that any experiment--say, with safe-use programs or even good medical studies on the safety and efficacy of marijuana in reducing the nausea associated with chemotherapy or the loss of appetite of AIDS patients--would "send the wrong signal."
MacCoun and Reuter may overestimate the political obstacles blocking the kind of reform that they clearly seem to prefer. A call for "nonzero tolerance," they write, is tantamount to treason in some circles; but such a call might encourage more humane, less intrusive, less damaging ways of coping with drugs and their harms. They cite the passage of the first initiatives, in California and Arizona in 1996, permitting the medical use of marijuana, which they call "at best sloppy," because those ask doctors to make decisions without adequate scientific evidence. But their book apparently went to press before the wave of recent ballot measures and state laws: medical marijuana initiatives in six or seven other states, state laws liberalizing sterile syringe access and reducing prison terms for drug possession, and California's Proposition 36, passed in the fall of 2000, which requires all those convicted of simple drug possession or drug use to be sent to treatment rather than prison. All suggest that, at least before the terrorist attacks of September 11, the public may have been in a far more tolerant and reformist mood than its elected leaders.
Still, the authors are right that despite polls showing that Americans believe the drug war has been a failure, it's a political standard, not a philosophical or analytic one, that reformers have to meet. And that standard is quite protective of the status quo. The combination of high uncertainty about the outcome of any change; the partial irreversibility of any bad outcomes; and a pervasive tendency for decision-makers to favor the status quo pose steep barriers for reformers. Despite the high number of Americans incarcerated for nothing more than marijuana offenses--an affront to a liberal society's belief in the benevolence of government--reactions to existing policies have not been strong enough for politicians to risk any real reforms. A punitive stasis prevails.
Yet even in the face of such passive resistance, Drug War Heresies should pose a formidable challenge, not necessarily to cause pursuit of the policies and trial programs that MacCoun and Reuter seem to favor--maintenance, reducing the penalties for use of marijuana, more judicious drug law enforcement--but to pay attention to the data, end the misrepresentation of information where it exists and go after it where fear has repressed even research, especially in assessing the consequences and efficacy of existing policies.
More fundamentally, the book may also introduce policy-makers to the relatively novel thought that prevalence reduction and use reduction are not the same. While cocaine prevalence has gone down, they point out, "total cocaine consumption and its related harms have remained relatively stable." It may also make clearer that harm reduction is not simply a flag flown by closet libertarians who are philosophically opposed to all prohibitive drug laws.
At the same time, Drug War Heresies leaves no doubt about the limits of policy--and on that score it's important for a lot of other fields. It's doubtful, as the authors say, that a complete solution to the US drug problem exists. The major differences between the American and European illicit drug situations, they suggest, may be rooted as much in broader societal differences, in the peculiarities of geography or in other policies--in lack of healthcare or unequal income distribution--as in drug law per se and its enforcement. That's particularly true of treatment programs, which, even under the best of circumstances, will only be partially successful. But that hardly eliminates the need for reform, in reducing the severity of sentences and the intrusiveness of drug law enforcement, and shifting to more selective, targeted enforcement.
Such a course, MacCoun and Reuter acknowledge, reflects only their opinion. But they leave little doubt that the evidence indicating a need for major reform has both an empirical and an ethical basis. "To scorn discussion and analysis of such major changes, in light of the extraordinary problems associated with current policies, is frivolous and uncaring." For many reasons this book isn't easy; but for anybody seriously and earnestly concerned about drug policy, it is likely to become indispensable.