Drug Policy: Overview

Introduction

The drug policy in the United States, often referred to as “the war on drugs,” seeks to limit, prevent, and punish the importation, distribution, possession, and use of illegal drugs. Brought to national attention in 1969 by President Richard Nixon, who deemed drugs “America’s public enemy number one,” US drug policy has changed and been updated many times since the nation’s founding. Questions of health, crime, morality, and free will have all been raised in the debate concerning the country’s restrictive federal drug policy, which prohibits the use or misuse of most known illegal drugs.

Opponents of existing US drug policy have claimed that the complete prohibition of drugs, based on the assumption that even occasional drug use is morally wrong, does little to prevent drug abuse. These critics have contended that research and education, as well as social programs addressing poverty and unemployment and medical treatment for addiction as a public health problem, would have more of an effect on the drug problem. They compare the country’s zero-tolerance drug policy to the United States’ prohibition of alcohol between 1920 and 1933, which spawned organized crime and ironically contributed to increased national alcohol consumption.

Other critics have noted the seemingly arbitrary nature of drug legalization, claiming that many illegal drugs are no more dangerous—and are sometimes less dangerous—than many legal drugs such as tobacco and alcohol. Critics have also claimed that even so-called hard drugs, such as cocaine and heroin, have shown no evidence of causing serious, long-term damage when used moderately over long periods of time. Drug policy opponents have contended that, when contrasted with the harmful effects of tobacco or alcohol use, a drug such as marijuana is essentially harmless.

Supporters of existing drug policy have pointed to evidence of the dangers of drug use and its negative effects on society as reasons why many substances should continue to be outlawed. The health risks of drugs, such as heroin and LSD, have been documented, they have argued. These health risks include brain damage, impaired judgment, and immunocompromisation (an immunodeficiency of any kind). Supporters of the war on drugs have asserted that policymakers should concentrate on these larger problems, rather than the drug problem itself.

Understanding the Discussion

Addiction: Habitual use of a substance, or chronic activity, resulting in physical or psychological dependence and uncomfortable withdrawal symptoms when use is discontinued. Physical dependence usually means that, over time, increasing amounts of the substance or activity are required to achieve the desired effect, while psychological dependence means that a general sense of ill-will is felt when the substance or activity is absent. Addiction also usually implies a disruption in the normal life of the person experiencing addiction.

Drug: A term used since the time of Hippocrates, the ancient Greek founder of modern medicine, to mean any substance that overcomes the body’s natural reactions (digestion, infection, rejection, etc.) to substances to effect a change in either mood, physiology or both.

Drug Enforcement Administration (DEA): Formed by President Richard Nixon in 1973 as an arm of the Department of Justice, consolidating several other autonomous drug regulation agencies. The DEA enforces laws that relate to drugs and other controlled substances.

Pharmaceutical drug: A medicinal drug prescribed by a doctor for use in treating a specific ailment.

Psychoactive drug: A drug that affects the mind or brain.

History

When Hernán Cortés led the Spanish conquest of Mexico in 1518, he reportedly found the inhabitants so adept at curing wounds and disease with the aid of botanically derived drugs that he wrote to the king and requested that he not send any doctors to the New World. The Indigenous peoples’ skill with drugs was due, in part, to the fact that the Americas have approximately ten times as many varieties of psychoactive plants as in Europe. Early settlers in Virginia, Carolina, and Maryland quickly discovered the pleasing effects of the tobacco plant, which originated in America; they began growing the crop on a large scale, despite its depletive effect on the soil and its labor-intensive cultivation. This early infatuation with tobacco quickly led to one of the first drug policies, imposed by King James I of England, who publicly condemned tobacco use but also taxed its sale, thereby cloaking it with legitimacy.

During the nineteenth century, many so-called panaceas with mysterious ingredients were sold in the United States, likely incorporating recently discovered plant-derived drugs such as morphine, codeine, atropine, caffeine, cocaine, heroin, mescaline, and barbiturates. As these derivatives became better understood, it became easier for doctors to carry and administer drugs. Morphine (derived from the opium plant), in particular, was a medical breakthrough. Within a decade of its discovery, however, morphine addiction was identified as a problem in the United States. Doctors nevertheless continued to use morphine for the treatment of pain and other ailments. As methods for refining the opium plant improved, however, heroin, and, in turn, cocaine, began to displace morphine as the drug of choice for doctors and pharmacists. Heroin was used as a treatment for morphine addiction, while cocaine, touted as a cure-all, was used as the primary ingredient in the health tonic that eventually became Coca-Cola. It has been estimated that the ready availability of psychoactive drugs in the nineteenth century resulted in 2 to 5 percent of the adult population of the United States being addicted to a drug.

With the turn of the twentieth century, American public opinion about drugs began to shift drastically, as certain drugs became associated with particular social ills. Certain Christian groups began pressuring the government to enact prohibition laws. The American Medical Association and American Pharmaceutical Association supported the efforts of groups such as the Prohibition Party of the United States and the Society for the Suppression of Vice, recognizing that drug regulation would benefit doctors: If drugs could only be administered by licensed doctors, they alone stood to profit from the use of the drugs upon which a substantial portion of the country had become dependent.

The first domestic regulation imposed by the United States government was the Harrison Narcotic Act, passed in 1914, which regulated and taxed opiates and products containing opiates. It also allowed authorities to prosecute doctors who distributed opiates to addicts. The Eighteenth Amendment to the United States Constitution, ratified in 1919, prohibited the sale, trade, importation, exportation, creation, or consumption of alcohol. This amendment then became the only drug restriction to be reversed (with the ratification of the Twenty-First Amendment in 1933). The Marihuana Tax Act of 1937 did not prohibit the sale of marijuana but made it logistically prohibitive and instituted harsh penalties for disobedience.

With the passage of the Drug Abuse Prevention Act in 1970, federal penalties for the possession and sale of marijuana were relaxed, and eleven states decriminalized the drug. The Controlled Substances Act, which classified marijuana as a schedule I drug, alongside LSD and heroin, was also passed in 1970. According to the DEA, during this period of legalization, marijuana use by Alaska teenagers was more than twice what it was in the rest of the country. By 1990, most of these states, including Alaska, had recriminalized marijuana, after experiencing similar jumps in teenage drug use.

This example has commonly been cited by those who believe that the United States should maintain its existing drug policy, arguing that the legalization of drugs such as cocaine and heroin would lead to increased use and abuse and would not remove the organized crime element of the drug trade, just as the repeal of prohibition in 1933 did not disband organized crime syndicates. The administrations of Ronald Reagan and George H. W. Bush increased the penalties for drug possession and trafficking, instituting what is known as the zero-tolerance policy, under which drug offenses, no matter how minor, were prosecuted to the full extent of the law.

In August 2015, the Office of National Drug Control Policy, a branch of the US federal government, announced it would be allocating $2.5 million in funding to hire public safety and public health coordinators whose sole job would be to focus on treating and helping, rather than punishing and prosecuting, people addicted to drugs. The government's new “Heroin Response Strategy” would aim to work together and coordinate with officials from the public health and public safety sectors in five regions throughout the country to share best practices, proven strategies, and innovative programs to confront and stem the tide of the increased opioid use and overdose deaths. The administration of Barack Obama introduced measures that would provide training to federal health-care professionals on the prescribing of opioid drugs, to curtail unnecessary use of the drugs, and would improve access to addiction treatment.

Under the administration of Donald Trump, the Justice Department reversed course on a number of federal drug policies. In May 2017, Attorney General Jeff Sessions ordered federal prosecutors to pursue the maximum penalty available, even for low-level offenders. In January 2018, Sessions revoked the Obama-era memo that deprioritized marijuana enforcement in states with well-regulated legalized marijuana industries, leaving enforcement open to the discretion of federal prosecutors. That March, Sessions instructed federal prosecutors to seek the death penalty for certain convicted drug offenders, as part of the administration's response to the opioid addiction epidemic. Critics noted that seeking capital punishment for drug trafficking might be unconstitutional as well as counterproductive, potentially bogging down the justice system while failing to reduce addiction rates and drug sales.

Drug Policy Today

United States drug policy outlaws drug abuse, which is defined in legal terms as the use of either an illegal substance or non-medicinal use of pharmaceutical drugs. Following the inception of the War on Drugs, the number of inmates in US prisons increased dramatically. At the end of 2022, US state and federal prisons held more than 1.2 million persons, according to the US Bureau of Justice Statistics. According to the Prison Policy Institute, by the early 2020s, one in five people serving time in a US prison or jail were convicted of nonviolent drug offenses.

In 2021, the administration of Joe Biden stated that drug addiction and overdose levels in the United States had reached epidemic proportions and were therefore an urgent priority for the administration. That March, Biden signed the American Rescue Plan, which included $4 billion in funding to expand access to behavioral health services. According to an April 2021 press release from the president's Office of National Drug Control Policy, in addition to expanding access to treatment instead of incarceration, the Biden administration sought to advance racial equity in drug policy, enhance harm-reduction efforts, support efforts to prevent youth substance use, reduce the supply of illicit drugs, advance "recovery-ready" workplaces, and increase access to recovery support services.

Marijuana tends to be the most commonly cited drug when questions of legality are raised. Many people favor the legalization of marijuana, citing that it is less dangerous than other legal drugs such as alcohol and tobacco; others claim that marijuana should be legal for medicinal use only. Supporters of the United States’ drug policy have claimed that drugs such as marijuana are more difficult to control and to regulate than legal drugs such as tobacco and alcohol, and thus can be more dangerous, even if approved only for medicinal use. Marijuana is relatively easy to produce, making government regulation a difficult proposition. Those who advocate for drug policy reform have argued that marijuana would be both safer and more reliable if the government legalized it and regulated its sale through an agency such as the Food and Drug Administration (FDA). Additionally, supporters of marijuana legalization have noted that the federal government would raise substantial revenue through the tax and regulated sale of the drug. In 2010, two states, Colorado and Washington, legalized the personal recreational use of marijuana by individuals ages twenty-one and older. By 2024, twenty-four states and the District of Columbia had legalized the personal use and possession of recreational marijuana. At the federal level, the Justice Department made a formal proposal that same year to downgrade marijuana to a Schedule III drug.

The controversy surrounding medicinal marijuana use has focused on the government’s ability to control and limit marijuana use to patients if it were to become legal. By 2024, thirty-eight states and the District of Columbia had legalized medical marijuana. The federal government has continued to adhere to its criminalization of marijuana, however, and the United States Supreme Court has ruled that doctors cannot prescribe marijuana for patients suffering from pain caused by serious illnesses. Globally, however, many countries, including Canada, have legalized medicinal marijuana use.

The US opioid epidemic has also raised questions about US federal drug policy. According to the Centers for Disease Control and Prevention, from 1999 to 2022, approximately 727,000 people died from an opioid overdose. In 2022 alone, 76 percent of the 108,000 deaths from drug overdose involved opioids.

Oregon became the first US state to decriminalize possession of small amounts of drugs such as heroin, LSD, methamphetamine, and oxycodone for personal use with voters' passage of Measure 110 in November 2020. Under the measure, which took effect by February 2021, those found with small amounts of such drugs can pay a $100 fine or enroll in one of the state's cannabis industry–funded addiction recovery centers instead of being tried in criminal court and possibly sentenced to jail. By early 2024, however, public opinion in Oregon had turned against decriminalization in the face of an increase in fentanyl use in public spaces and one of the largest spikes in overdose deaths in the country. A bill reestablishing possession of these drugs as a crime was passed and went into effect in September of that year.

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Bibliography

Boyum, David et al. Drug Addiction and Drug Policy: The Struggle to Control Dependence. The President and Fellows of Harvard College, 2001.

Carson, E. Ann. Prisoners in 2022—Statistical Tables. Bureau of Justice Statistics, Nov. 2023, bjs.ojp.gov/document/p22st.pdf. Accessed 13 Dec. 2024.

Caulkins, Jonathan P. How Goes the War on Drugs?: An Assessment of US Drug Problems and Policy. RAND, 2005.

Cox, Tony. “Analysis: America’s War on Drugs.” Tavis Smiley, NPR. EBSCOhost, 26 Feb. 2009.

Escohotado, Antonio. A Brief History of Drugs: From the Stone Age to the Stoned Age. Park Street Press, 1999.

Gurman, Sadie. "Sessions Terminates US Policy That Let Legal Pot Flourish." Associated Press, 4 Jan. 2018, www.apnews.com/19f6bfec15a74733b40eaf0ff9162bfa. Accessed 27 June 2018.

Isralowitz, Richard. Drug Use, Policy, and Management. Auburn House, 2002.

Leeds Mathews, Alex, and Christopher Hickey. "More US States Are Regulating Marijuana. See Where It's Legal across the Country." CNN, 19 Apr. 2024, www.cnn.com/us/us-states-where-marijuana-is-legal-dg/index.html. Accessed 13 Dec. 2024.

Legare, Robert. "Justice Department Moves Forward with Easing Federal Restrictions on Marijuana." CBS News, 16 May 2024, www.cbsnews.com/news/justice-department-marijuana-schedule-3-reclassification/. Accessed 13 Dec. 2024.

Mears, Bill. “Supreme Court Allows Prosecution of Medicinal Marijuana.” CNN, 7 June 2005, www.cnn.com/2005/LAW/06/06/scotus.medical.marijuana/index.html. Accessed 22 Jan. 2009.

Miron, Jeffrey A. Drug War Crimes: The Consequences of Prohibition. The Independent Institute, 2004.

Roubein, Rachel. "Sessions Issues Memo on Use of Death Penalty in Drug-Related Cases." The Hill, 21 Mar. 2018, thehill.com/policy/healthcare/379508-sessions-issues-memo-on-use-of-death-penalty-in-drug-related-cases. Accessed 27 June 2018.

Rush, Claire. "Oregon Law Rolling Back Drug Decriminalization Set to Take Effect and Make Possession a Crime Again." AP, 30 Aug. 2024, apnews.com/article/oregon-drugs-law-recriminalization-decriminalization-d188a0c678973d0d65419c52467f09a4. Accessed 13 Dec. 2024.

Rush, Claire. "With Oregon Facing Rampant Public Drug Use, Lawmakers Backpedal on Pioneering Decriminalization Law." AP News, 23 Jan. 2024, apnews.com/article/oregon-drug-decriminalization-law-3f851183d45e9c29609360b09e996d04. Accessed 31 Jan. 2024.

Sawyer, Wendy, and Peter Wagner. “Mass Incarceration: The Whole Pie 2023.” Prison Policy Initiative, 14 Mar. 2023, www.prisonpolicy.org/reports/pie2023.html. Accessed 13 Dec. 2024.

Selsky, Andrew. "Oregon Leads the Way in Decriminalizing Hard Drugs." AP News, 4 Nov. 2020, apnews.com/article/oregon-first-decriminalizing-hard-drugs-01edca37c776c9ea8bfd4afdd7a7a33e. Accessed 31 Jan. 2024.

"Understanding the Opioid Overdose Epidemic." CDC, 1 Nov. 2024, www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html. Accessed 13 Dec. 2024.

United States. "The Biden-Harris Administration's Statement of Drug Policy Priorities for Year One." Executive Office of the President, Office of National Drug Control Policy, www.whitehouse.gov/wp-content/uploads/2021/03/BidenHarris-Statement-of-Drug-Policy-Priorities-April-1.pdf. Accessed 31 Jan. 2024.