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Drug Users: Jail Them or Treat Them? / the Drug Fix

Tom McNichol
USA Weekend

April 10, 1994

When U.S. Surgeon General Joycelyn Elders ignited a firestorm last December by suggesting that the nation study alternative drug policies - including, possibly, drug legalization - former police officer Joseph McNamara was reminded of a bitterly cold morning in New York more than 30 years ago. McNamara was patrolling the streets of Harlem when he noticed a group of about 50 men shivering under a bleak streetlight. Suddenly, the men broke into a dead run. There was a temporary shortage of heroin on the street, and the men were running after a pusher who had just emerged from a cab.

The image of a bunch of human beings stampeding like a herd of cattle is still etched in my memory, says McNamara, 59. As a police officer, I was a willing soldier in the drug war. But it was very apparent to me it wasn't doing much good. That's why the surgeon general's call for alternative drug policies isn't going to go away. She's not the only one who thinks we need a new strategy.

McNamara spent three decades on the front lines of the drug wars, pulling needles out of lifeless arms and seeing fresh-faced young men gunned down over drug deals gone sour. Before signing up as a research fellow with the reliably conservative Hoover Institution, he served as police chief in Kansas City, Mo., and San Jose, Calif. His experiences have left him with a sobering conclusion: The war on drugs can't be won, at least not the way this country has been fighting it.

That is a message now being embraced by an increasingly vocal, politically diverse group whose members say they have no intention of surrendering in the war on drugs - they just want to fight a smarter and more effective battle. Their emerging strategy, known as harm reduction, pursues a middle course between drug prohibition and legalization, with the emphasis on minimizing the risk to drug users and those around them.

One core proposal: Non-violent users are given treatment rather than a prison term. Users who commit violent crimes still would be prosecuted. When she was federal prosecutor in Dade County, Fla., now-Attorney General Janet Reno helped create a system in which non-violent offenders were routed to treatment rather than prison.

Other ways to reduce harm include several programs already in place, such as making clean needles available to heroin addicts, and a controversial program in England that makes small amounts of heroin and cocaine available free of charge to users, to divert them from crime.

For his part, McNamara is circulating a resolution that simply calls on Congress and President Clinton to convene an objective commission to recommend new tactics for the drug war. The petition, which has been presented to national drug czar Lee Brown - an adamant opponent of legalization - has the support of a surprisingly diverse group of citizens. Among the several thousand who signed the resolution: Nobel Prize-winning conservative economist Milton Friedman; former Reagan administration secretary of State George Shultz; clergy from the section of Los Angeles that saw rioting in 1992; and law enforcement officials.

This isn't a bunch of long-haired dope smokers calling for drug laws to be relaxed, McNamara says. This is a group of distinguished people who are saying there's a better way to discourage drug use than what we're doing now.

Others have joined the cause. Drug Strategies, a new non-profit organization supported in part by grants from the Carnegie Corp. of New York, plans to issue a report card to measure the effectiveness of the federal anti-drug strategy. The group's board of directors includes novelist Michael Crichton, Children's Defense Fund president (and Hillary Clinton associate) Marian Wright Edelman and ex-Defense secretary Robert McNamara.

President Clinton, who has said that he opposes legalizing or decriminalizing drugs, favors increased funding for treatment. The president's latest budget boosts spending for treatment and prevention programs by nearly $ 1 billion, making the budget split 64 percent law enforcement and interdiction, 36 percent treatment and prevention. (During the Reagan-Bush years, the funding split was about 70-30.)

THE BUZZ IN Washington, D.C., is that Clinton is unlikely to get directly involved in the fractious debate, partly because his I smoked marijuana but didn't inhale campaign sound bite continues to make him vulnerable to the soft-on-drugs charge he could face from the right if he were to pursue alternative strategies.

Most observers agree that any changes are likely to occur at the local level. That was the conclusion of a conference of local drug experts from 42 cities in 19 countries that met in Baltimore last November. (Among the 13 U.S. cities represented were Denver; St. Paul, Minn.; Chicago; and Meridian, Mich.) The first conference of the International Network of Cities on Drug Policy proclaimed that the world's cities must be the laboratories of change in drug policy, because most national governments continue to embrace a law enforcement model.

Already, a handful of U.S. cities have adopted alternative drug strategies. New Haven, Conn., has a program in which police officers go from door to door with health officials in areas of high drug use - not to make arrests, but to publicize treatment services. About three dozen cities, including New York and Chicago, have needle exchange programs for intravenous drug users, tolerating additional use in order to reduce the more significant harm of the spread of AIDS. The mayor of Baltimore, Kurt Schmoke, has unveiled a far-reaching harm-reduction plan under which the city would medicalize its drug problem. Hardened heroin addicts would receive free clean needles, medical treatment and methadone, a heroin substitute used to wean addicts. A special drug court would be established; violent criminals and pushers would be targeted for arrest. Non-violent drug users would be diverted into 10,000 new treatment slots.

FEW ISSUES ARE as emotionally charged as drug policy, and harm reduction has attracted its share of strong detractors. Most are convinced that tough law enforcement is essential to control drug use, and talk of any loosening of laws - much less decriminalization - sends shudders up their spines. We've already seen an unsuccessful experiment with decriminalization in the 1970s with marijuana, says Sue Rusche, executive director of National Families in Action, an Atlanta-based grass-roots organization that focuses on family issues. She says that experiment resulted in higher drug use.

Rusche and other proponents of zero tolerance point out that since 1979 illicit drug use has been reduced by more than half. They credit that to tough law enforcement and better education. After surgeon general Elders made her controversial comments, Rusche's group launched a letter-writing campaign urging Clinton to repudiate the idea of drug legalization(which he later did).

Others scoff at the notion of harm reduction, calling it a veiled attempt to soften drug laws.

Harm reduction is an idea that originated out of the drug culture, because they didn't think they had a chance to get drugs legalized, says Eric Voth, chairman of the International Drug Strategy Institute of Topeka, Kan. So what they've done is split off this issue to get enforcement out of the picture.

I'm all for treatment on demand and more prevention, says Voth, half of whose medical practice involves treating those addicted to drugs or alcohol. But the enforcement end is a very important hammer to get people to look at their problems. Most of the people I see are people who have been forced to get help by being in trouble with the law.

Both sides seem to agree on one critical issue: the need for more drug treatment and prevention. Many people favor implementing a treatment on demand program whereby those convicted of drug offenses would be diverted immediately into treatment programs, instead of waiting as long as six months to be sentenced. Prison space then would be freed for violent offenders.

We're not saying that the bad guys shouldn't be in jail, says Jim Copple, national director of the Community Anti-Drug Coalitions of America. But the people who need treatment should be able to get it. And we have to provide them with support mechanisms so that when they get out of jail they don't immediately go back to using drugs.

THE CALL FOR a new battle plan in the war on drugs, while still a minority opinion, is not new. But advocates insist that the national mood is beginning to favor change.

I have had many more senators and congressmen talk to me recently about debating these notions than five years ago, says Schmoke, who has been calling for new drug policies since 1988. I think there's a willingness now to challenge the prevailing wisdom, even if there's not yet a consensus on what we should be doing instead.

In the '80s, lawmakers passed tough mandatory sentencing laws, which put more drug offenders in prison. The drug war cost $ 64 billion over the 12 years of the Reagan and Bush administrations. The federal prison population has more than doubled since 1986, with drug offenders now occupying more than 60 percent of prison beds. Some argue that if the public wants to put more violent offenders behind bars, non-violent drug offenders should be diverted into less expensive treatment programs.

Harm reduction is paying dividends at San Francisco's Haight-Ashbury Free Clinics, established amid the heady excesses of the Summer of Love in 1967. Over the years, the group of clinics has grown to include a Recovery House that provides a 120-day live-in treatment plan for recovering addicts. Addicts, some of whom are plucked from courtrooms and agree on the spot to take treatment over prison, go through a 12-step recovery program, are tutored and receive help with job placement.

After serving 90 days of a 16-month prison sentence for petty theft, Rickey George, 34, applied for one of 20 treatment slots at Haight-Ashbury, hoping to break his addiction to crack cocaine. A year later, he is not only clean, but also a Free Clinics counselor. Locking people up makes people more vicious, says George, who was incarcerated at Pelican Bay, one of California's toughest prisons. I've seen people die in prison over a piece of strawberry shortcake. I've learned that drug treatment worked for people who allow themselves a chance to let it work. You gotta want it.

The drug debate is particularly hot in the black community. The sale or possession of crack, the prevalent form of cocaine in poor minority areas, carries heavier sentences than the sale or possession of powdered cocaine, more common in affluent white areas. Black people are three to four times more likely to be arrested on drug charges than are white people, even though the majority of users are white. A bitter saying is making the rounds: Whites do the lines; blacks do the time.

We're not saying, 'Let up on the war on drugs,' says the Rev. Leonard B. Jackson, associate minister of the First AME Church of Los Angeles. But the money we put into the prison system we should be putting into education. Instead of putting money on the caboose, we should be putting money on the engine.

Joseph McNamara hopes his petition and campaign will, at the very least, help people to think of drug abuse as a medical problem, not as a police matter. As he learned 30 years ago on that frigid Harlem morning, the grip of addiction can be far more powerful than fear of the law.

'Locking people up makes people more vicious. I've learned that drug treatment worked for people who allow themselves a chance to let it work. You gotta want it.'

- former addict and inmate Rickey George (at the head of the table), who now counsels other recovering drug users


Non-violent drug abusers should get:

A prison term: 1-900-773-5551

Drug treatment: 1-900-773-5552

Each call costs 29 cents.

Experts such as Eric Voth say only the threat of serving hard time will stop people from using drugs. But others disagree: Former police chief Joseph McNamara argues that non-violent drug users should be sent to treatment and rehabilitation programs, reserving overcrowded prisons for violent criminals.

One call per household, please; duplicate calls won't count. The lines are open from 6 a.m. Friday to midnight Tuesday, Eastern time. Callers under age 18 must have permission from a parent or guardian. If you aren't able to call, write PRISON TERM or DRUG TREATMENT on a postcard or on the back of an envelope and mail by April 11 to Drug Call-in, USA WEEKEND, 1000 Wilson Blvd., Arlington, Va. 22229-0012. Watch for the results in an upcoming issue.


Consider legalization?

Joycelyn Elders, U.S. surgeon general, ignited the drug policy debate in December by suggesting that alternatives, including legalization, be considered. She later retracted the suggestion.

Treatment and tough laws.

Eric Voth, who heads the International Drug Strategy Institute, supports increased drug treatment - but believes tough laws against drug use are a necessary hammer in helping addicts get clean.

View drugs as a health problem.

Baltimore mayor Kurt Schmoke, who called for the legalization of drugs six years ago, now is an advocate of medicalization, or treating addiction like a public health issue.

'Zero tolerance.'

Sue Rusche, executive director of National Families in Action, fears any softening of drug laws would result in increased drug abuse, especially among kids, as happened with marijuana legalization in the '70s.

Drug war now is unfair.

The Rev. Leonard B. Jackson, associate minister of the First AME Church in south-central L.A., calls for a new drug strategy because the war on drugs has become a war on the minority community.


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