DRCNet Book Review: "An Analytic Assessment of US Drug Policy," by David Boyum and Peter Reuter 7/22/05

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2005, American Enterprise Institute, 131 pp., $20.00 pb.

In this latest publication from the American Enterprise Institute's Evaluative Studies series on public policy issues, health policy consultant David Boyum and University of Maryland drug policy scholar Peter Reuter examine US drug policy largely on its own terms. That means there is no talk of ending the drug war in this analysis. Instead, Boyum and Reuter examine the stated goal of US drug policy, the means chosen by policymakers to reach those goals, and the efficacy of those means in achieving those broad policy goals.

Fire-breathing drug legalizers will not be happy. For Boyum and Reuter, ending drug prohibition is not even on the radar. While that is disappointing, it is not surprising, especially given this work's charge to analyze current American drug policy. Still, there is much that is valuable for drug reformers in this book, both in gaining a firmer grasp on that squirming, monstrous, multi-limbed beast that is federal drug policy and in examining what works and what doesn't when it comes to existing policy.

It is worth noting, as Boyum and Reuter do, that federal drug policy is only half the game. While the feds spend nearly $20 billion a year on the drug war, the states spend a similar amount. Still, federal drug policy sets the pace and the tone, largely driving drug war spending in the states and localities.

Even on its own terms, Boyum and Reuter find that US drug policy largely fails to do what it is supposed to do, is enormously and wastefully expensive, and is unnecessarily cruel and inhumane. As they point out, the central and almost single-minded goal of US drug policy is to reduce the prevalence of drug use and, almost as an afterthought, the individual and social harm resulting from it. But using accepted measures of drug use, such as the Monitoring the Future and National Household surveys, they show that despite three decades of drug war, illicit drug use levels remain almost unchanged. In 1975, for example, 44% of high school seniors reported past-year drug use. While that number declined during the 1980s, it rose again in the 1990s before plateauing so far this decade to hover around 40%. Three decades of drug war, with the billions of dollars spent and the millions arrested, have achieved only marginal results.

It could have been much worse if there had been no drug war, Boyum and Reuter note. Drug use levels could have skyrocketed. But there is no evidence for that, they are careful to point out. The authors' stolid insistence on relying on solid empirical evidence, evident throughout the book, is sometimes frustrating -- it makes them extremely cautious with any policy recommendations -- but is certainly a refreshing tonic to the propaganda and certitude that typically pass for reasoned debate on drug policy.

The US government attempts to reduce drug use on three broad fronts: law enforcement, treatment, and prevention. (The missing fourth pillar, harm reduction, is addressed only briefly at the very end of the book.) Law enforcement activities can be divided into stopping the supply outside the US (crop eradication, interdiction) and domestic drug law enforcement. Boyum and Reuter find little evidence crop eradication and anti-smuggling efforts work. As they note, the black market economics of coca production in Colombia or opium production in Afghanistan mean that increased prices at the farm gate have a negligible impact on retail drug prices in the US. "These numbers cast serious doubt on the merits of crop eradication as an enforcement strategy," they conclude.

Similarly, interdiction, while imposing considerable costs on traffickers, has not been shown to have much impact on US drug prices, either, said Boyum and Reuter. "What is not clear is whether interdiction adds more than 10% or 20% to the retail price of drugs." What else is clear, the authors conclude, is that "the case for more expenditures on interdiction remains unproven."

Domestic drug law enforcement, intense as it is, has seemingly paradoxical effects, Boyum and Reuter note. Although law enforcement undoubtedly causes prices to rise, the 10-fold increase in drug enforcement intensity in the 1980s, as measured by arrests, convictions, and sentences, took place at the same time cocaine prices dropped dramatically.

When it comes to drug treatment, Boyum and Reuter are more sanguine, although still skeptical. They are willing to embrace the notion that drug treatment "works" -- in reducing drug use and reducing crime -- but, as good social scientists, want more, better data. As for prevention, the authors find school drug programs unproven, particularly DARE, and media advertising campaigns difficult to evaluate.

While they complain about the lack of good, solid numbers, Boyum and Reuter do venture into the realm of policymaking and have some suggestions to make. "The bulk of the evidence points to the same conclusions: As currently implemented, American drug policies are unconvincing," they write. "They are intrusive, as illustrated by the prevalence of drug testing of student athletes; divisive, because of the disproportionate share of the burdens (both of drug abuse and of drug control) borne by minority communities; and expensive, with an approximate $35 billion annual expenditure on drug control. And yet they leave the nation with a massive drug problem, greater than any other Western nation."

We can do better in a number of areas, Boyum and Reuter suggest. On domestic drug law enforcement, they credit enforcement with driving up prices somewhat, but argue that it has reached the point of marginal returns. Street-level drug law enforcement should concentrate on what it can accomplish, such as reducing the negative side effects of illicit drug markets by breaking up the most violent and disruptive, instead of what it cannot accomplish, which is raising prices high enough to have a meaningful impact on drug use.

America could get by with half the current number of drug prisoners, Boyum and Reuter suggest. "Long sentences for minor, nonviolent drug offenders are perhaps the least defensible aspect of drug policy," they write. "Sentencing laws and guidelines should be reformed to reduce total drug incarceration and to concentrate long sentences on those who engage in violence or recruit juveniles into the drug trade."

And marijuana should be decriminalized. "Much marijuana enforcement is simply unjustifiable -- it does little to prevent problem use, but imposes great costs on non-problem users." Reuters and Boyum even suggest allowing users to grow their own, but don't make the obvious leap to simply legalizing the weed.

The pair are big on treatment. "The case for expanding treatment is strong," and not just for those who seek it. Boyum and Reuter pronounce themselves fans of forced drug treatment. "The enhanced use of enforcement as a recruiting scheme for treatment" is promising, they write. Citing research that suggests those forced into treatment do as well as those who seek it voluntarily, the pair argue that "the criminal justice system should make greater use of its authority to compel treatment for drug-involved offenders."

That is the creepiest passage in this whole work. While Boyum and Reuter argue that drug treatment should be targeted at the most problematic drug users, that is not what happens in the real world, as they acknowledge. Drug courts generally cherry-pick clients with little criminal history; not those who are doing the most harm to society. And if the numbers are any indication, judges and prosecutors across the country are sending rinky-dink pot law violators into drug treatment to keep them out of jail.

But that's not the creepy part. The creepy part is reading American social scientists blithely recommending that the government come in and force even more people to engage in a medical activity (drug treatment) in which they do not willingly participate. This perverse melding of medicine and the law in an effort to force people to think and act a certain way has too many implications for personal freedom and too many resonances of Soviet-style psychiatric care to be easily accepted. I, for one, would like to hear Boyum and Reuter expound on the ethics, and not just the efficacy, of coerced drug treatment.

Again, Boyum and Reuter are not wild-eyed radicals. They are not drug legalizers. They are mainstream academics and social scientists, and while we can critique the timidity of their positions, we should also be prepared to grasp the support they give us. The war on drugs need not be so indescribably stupid and brutal, and Boyum and Reuter make sound suggestions on how to make it smarter and more humane. Their book should be read by drug reformers of all stripes, if only to familiarize themselves with the contours of the arguments that will, if we are lucky, play out one day in Capitol Hill hearings rooms. But it is also a very useful tool for disaggregating and analyzing the beast; for making sense of a topic that sometimes seems overwhelming in scope.

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Issue #396 -- 7/22/05

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Feature: Congressman Sensenbrenner Making Name as Drug War Extremist | Medical Marijuana: Steve McWilliams Remembered at Tuesday Vigils | DRCNet Interview: Cher Ford-McCullough and Jean Marlowe of the Women's Organization for National Prohibition Reform | DRCNet Book Review: "An Analytic Assessment of US Drug Policy," by David Boyum and Peter Reuter | Medical Marijuana: California Reinstates ID Card Program | Medical Marijuana: Nearly a Thousand Rally in Santa Cruz | Weekly: This Week's Corrupt Cops Stories | New Zealand: In Pragmatic Retreat, Nandor Tanczos Introduces Marijuana Decriminalization Bill | Europe: Magic Mushrooms Now Illegal in Great Britain | Asia: Philippines Man Gets 15 Years for Two Joints | Coerced Treatment: Pennsylvania Legal Challenge Threatens Drug Courts, Judge Complains | Web Scan: NOW Resolution, American Chronicle, NYT Editorial on Richard Paey, NORML Report, APHA/DPA Oregon Amicus | Weekly: This Week in History | Weekly: The Reformer's Calendar

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