Coming Out of the Drug War Haze?

Cautious optimism may be appropriate.

President Obama's recent speech on the opioid overdose epidemic offers a ray of hope that the country's approach to drugs might one day adopt what has been called the first rule of American business: When all else fails, try doing it right.

Noting with considerable understatement that "treatment is underfunded," the president proposed $1.1 billion for expanded opioid-addiction treatment. This is a good step in the right direction. But it is still $50 billion less than the U.S. will spend this year alone on its current, fatally flawed policy of the war on drugs, and only one-third of what the federal government allocates to lock up drug criminals— whose incarceration accounts for half of the entire Bureau of Prisons budget.

The president himself is to blame for continuing to wage that war. Despite his own youthful enjoyment of marijuana, and despite the spreading decriminalization of marijuana (27 states have legalized it for medical or recreational use or both), and despite a Gallup poll showing nearly three out of five Americans agree with such policies, the Obama administration has targeted pot more severely than the Bush administration did.

It also defends its ludicrous Schedule I classification, which is reserved for the "most dangerous" drugs. This might be the point at which to mention that while the CDC attributes more than 20,000 deaths each year to alcohol, the number of deaths caused by cannabis is so low that, while probably not zero, it is apparently unmeasured.

Opioids, of course, have caused tens of thousands of deaths from overdose. The spike in opioid fatalities over the past few years is being blamed in part on doctors' purported over-prescription of painkillers. Patients can easily get hooked, and when they cannot get any more—or cannot get enough—from a physician, they turn to the black market.

This has become a middle-class epidemic, which has sensitized political leaders to the reality of addiction in ways the crack epidemic never did. As Marc Mauer of The Sentencing Project puts it, when the drug users are "primarily people of color, then the response is to demonize and punish. When (they are) white, then we search for answers." (One exception: New Jersey Gov. Chris Christie, who has been calling the war on drugs a failure for years. His personal testimony about the death of a drug-addicted law-school friend drew widespread praise last fall.)

Unfortunately, as the Drug Policy Alliance points out, while the Obama administration has given lip service to addressing drug addiction as a medical issue, it continues to follow the law-enforcement model. The same holds true for most of the rest of the country. In 1980 America locked up about 50,000 people for drug-related violations. Now we lock up more than half a million, under the ignorant delusion that drug use is a character flaw correctable through the infliction of unpleasant consequences. Well.

The possibility of going to prison six months or a year from now does not weigh heavily on the mind—it does not even enter the mind—of an addict who is jonesing for a fix so badly she wants to rip off her own skin and so sick from withdrawal she can hardly stand up.

Try to threaten an addict who has emptied her life savings to feed her addiction. Who goes to work high even though she promised her boss, again, that it would never happen again. Whose own parents won't let her in the door at Thanksgiving—or any other time—because she keeps stealing things to hock for drug money. Who breaks down in tears when she begs her landlord not to evict her for nonpayment of rent. Who can't stop seeing the look in her children's eyes when three strangers hauled them away to the Social Services van idling at the curb.

Tell the addict who has been to rehab after rehab that her problem is, she doesn't really want to quit. Tell her she's a useless piece of human garbage who isn't fit to live. Tell her she ought to get her act together for once in her miserable life. She's heard it all before a thousand times, from the woman she sees in the mirror—the woman she has grown to hate and sometimes wants to kill. Every one of her waking moments is filled with shame and self-loathing so intense that nothing can relieve them except a needle in the arm or a bullet in the brain.

And you're going to make her get clean by threatening her with jail? Please.

Most drug addicts would love nothing more than to straighten themselves out. But simply ordering them to do so is about as effective as ordering a diabetic to produce more insulin. They can't—or they would have long ago.

Drug courts can help. Because they involve substance-abuse counseling and other social services, they are expensive. But they have a good record: In Virginia, those who go through drug court have a recidivism rate of 14 percent, compared to 38 percent for similar offenders who go through regular courts.

Nationwide, three-fourths of drug-court graduates remain arrest-free for two or more years. The commonwealth has 37 drug courts now, up from zero a couple of decades ago.

In this regard Virginia and other states have begun to emulate Portugal, which decriminalized drug use (but not distribution) in 2001. Those cited for possession are sent to administrative, rather than criminal, courts. The dissuasion commissions, as they are called, encourage drug users to enter treatment programs by suspending fines if they do.

Drug use has not risen in Portugal; in fact, it has declined. So have drug-related deaths and HIV infection rates. And deaths from drug overdose rates? They're the second-lowest in Europe, behind Romania's. Portugal's rate of drug-overdose deaths is 3 per 1 million citizens. That is the total for all drugs of any kind.

If the U.S. had an equivalent rate, the number of Americans who died from drugs in a given year would be 954—instead of 47,000, including 10,000 for heroin alone.

In the war on drugs, maybe the time has come to try doing it right.

This column originally appeared in the Richmond Times-Dispatch.