1. [Why drug policy?] Any activity that diminishes normal capacities for self-control can create
dangers for those who engage in it and for those around them. Drugs that threaten self-control,
either through intoxication or through addiction, are therefore matters of social as well as
personal concern. This applies to licit and illicit substances alike.
2. [Science and policy] Drug policies should be based on the best available knowledge and
analysis and should be judged by the results they produce rather than by the intentions they
embody. Too often, policies designed for their symbolic value have unanticipated and unwanted consequences.
3. [Minimizing overall damage] Drug control policies should be designed to minimize the
damage done to individuals, to social institutions, and to the public health by a) licit and illicit
drug-taking, b) drug trafficking, and c) the drug control measures themselves. Damage can be
reduced by shrinking the extent of drug abuse as well as by reducing the harm incident to any
given level of drug consumption.
4. [Forms of damage] The forms of damage to be minimized - whether caused by drugs or drug
control measures - include illness and accidents, crimes against person and property, corruption
and disorder, disruption of family and other human relationships, loss of educational and
economic opportunities, loss of productivity, loss of dignity and autonomy, loss of personal
liberty and privacy, interference in pain management and other aspects of the practice of
medicine, and the costs of public and private interventions.
5. [Laws and regulations] Laws and regulations are among the primary means of preventing
drug abuse. Lifting prohibition on a substance is likely to increase its consumption, perhaps
dramatically. Some substances present dangers such that even limited licit availability, other
than for medically supervised use, would be unlikely to yield the desired minimum-damage
outcome. Therefore, we cannot escape our current predicament by "ending prohibition" or
"legalizing drugs."
6. [Enforcement for results] Enforcement and punishment, like other policies, should be
designed to minimize overall damage. As long as some substances are illegal or tightly
regulated, there will be attempts to evade those controls and therefore a need for enforcement and
sanctions, in some cases including imprisonment. The use of disproportionate punishments to
express social norms is neither just nor a prudent use of public funds and scarce prison capacity.
7. [Stance towards users] Social disapproval of substance abuse can be a powerful and
economical means of reducing its extent. Such disapproval should not be translated into
indiscriminate hostility towards all drug users based solely on their drug use. Persons who
violate the rights of others under the influence of intoxicants or in order to obtain intoxicants are to be held fully responsible for their actions, criminally as well as civilly.
8. [Tailoring policies to drugs] Because each substance has its own profile of risks and patterns
of use, different substances call for different policies.
9. [What about alcohol?] Alcohol is familiar and widely accepted, yet it shares the intoxicating
and addictive risks of some of the illicit drugs. Current policies make alcohol too easily and
cheaply available and allow it to be too aggressively promoted. The resulting damage to users
and others is very large. Taxation, regulation, and public information are all justified means to
the end of reducing that damage.
10. [What about tobacco?] Nicotine, as commonly used, is not an intoxicant. But its addictive
potential is great, and chronic cigarette smoking carries severe health risks. The wide prevalence
of tobacco use under current policies makes cigarette smoking the leading cause of preventable
early death. More stringent regulation is needed to protect the public health.
11. [Valuing treatment properly] Successful treatment for people with substance abuse
disorders produces benefits for those treated and for those around them. Treatment episodes that
reduce drug use and damage to self and others but do not produce immediate, complete, and
lasting abstinence ought to be regarded as incomplete successes rather than as unredeemed
failures.
12. [Prevention] For drug abuse as for other ills, the more successful the prevention effort, the
less the need for remediation. Developing and implementing effective drug abuse prevention
strategies, especially for minors, is an essential means of drug abuse control. Prevention
messages should accurately reflect what is known about the effects and risks of the substances
they discuss.
13. [Taking measured steps] Drug policies need to be updated as social conditions change and
the base of scientific knowledge grows. Policy changes that can be introduced incrementally and
evaluated step by step are to be preferred over sweeping changes with less predictable
consequences.
14. [Integrity and civility] Debate about drug policies engages deeply felt values and therefore
often becomes heated and even acrimonious. Civility and honesty about facts, proposals, and
motives can serve both to improve drug policies and to advance the broader public interest in
healthy political discourse.
These principles may seem straightforward, hardly needing to be said. That they are in fact
controversial illustrates something important about the way drugs and drug policy now tend to be
discussed.
The current drug policy debate is marked by polarization into two positions stereotyped as "drug
warrior" and "legalizer." This creates the false impression that "ending prohibition" is the only
alternative to an unrestricted "war on drugs," effectively disenfranchising citizens who find both of those options unsatisfactory. Polarization and strong emotions give rise to
misrepresentations of facts and motives, oversimplification of complex issues, and denial of
uncertainty.
In the face of strong opposition, some of those who favor fundamental changes in the drug laws
have elected to concentrate on more modest proposals which they intend as way stations towards
their unstated longer-term goals. Partly as a consequence, some of those devoted to maintaining or intensifying present anti-drug efforts have taken to dismissing all criticisms of
current policies -- even those based on solid research showing that one or another policy or
program fails to serve its stated aim -- as mere fronts for a covert "legalization" effort.
In this climate, every idea, research finding, or proposal put forth is scrutinized to determine
which agenda it advances, and the partisans on each side are quick to brand anyone who deviates
from their "party line" as an agent of the opposing side. As a result, propositions of dubious validity achieve the status of loyalty oaths, and questions that ought to be addressed on technical
and practical grounds (what works in prevention, how well interdiction performs, which
treatment approaches help which clients) are instead debated as matters of ideological conviction.
The tendency in each camp is to focus on only one face of the problem. One extreme talks as if
the miseries surrounding drug distribution and abuse are entirely the product of unwise policies.
The other is just as likely to say or imply that the damage comes entirely from the drugs
themselves. In fact, both drugs and drug policies cause harm. Any policy, including inaction,
does harm as well as good. Once that is acknowledged, we can begin the hard work of shaping
policies that do more good than harm. That work will demand reasoned analysis and scientific
respect for evidence, and doing it well will require learning from mistakes rather than denying
them.
- - -
ENDORSEMENTS -- Principles for Practical Drug Policies -- 02 September 1997
Hamilton Beazley, former President, National Council on Alcoholism and Drug Dependence
George E. Bigelow, Professor of Behavioral Biology in the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
Joseph V. Brady, Professor of Behavioral Biology in the Department of Psychiatry and
Behavioral Sciences and Professor of Neuroscience, Johns Hopkins University School of
Medicine
William J. Bratton, CEO, First Security Consulting; former Commissioner of the New York City Police Department
Jonathan P. Caulkins, Professor of Public Affairs, Carnegie-Mellon University
Philip J. Cook, Professor of Economics and Policy Studies and Acting Director of the Terry Sanford Institute for Public Policy, Duke University
Harriet de Wit, Associate Professor of Psychiatry, University of Chicago
John J. DiIulio Jr., Professor of Politics and Public Affairs at Princeton University and Senior Fellow at the Brookings Institution
William A. Donohue, President, Catholic League for Religious and Civil Rights
Peter Edelman, Professor, Georgetown University Law Center and former Assistant Secretary for
Planning and Evaluation, U.S. Department of Health and Human Services
Margaret E. Ensminger, Associate Professor of Health and Policy Management, Johns Hopkins School of Hygiene and Public Health; joint appointment in Psychiatry, Johns Hopkins
University School of Medicine
Marian W. Fischman, Professor of Behavioral Biology, Department of Psychiatry, Columbia University College of Physicians and Surgeons
Avram Goldstein, M.D., Professor Emeritus of Pharmacology, Stanford University
Roland Griffiths, Professor of Behavioral Biology, Department of Psychiatry and Behavioral Sciences and Professor of Neuroscience, Johns Hopkins University School of Medicine
Francis X. Hartmann, Executive Director, Program in Criminal Justice Policy and Management, Kennedy School of Government, Harvard University
Chris-Ellyn Johanson, Professor of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine
Reese T. Jones, M.D., Professor of Psychiatry, University of California, San Francisco
Carl Kaysen, Professor Emeritus of Political Economy, MIT, and former Director, Institute for Advanced Study, Princeton
David McLean Kennedy, Senior Researcher, Program in Criminal Justice Policy and Management, Kennedy School of Government, Harvard University
Sheppard G. Kellam, M.D., Professor of Mental Hygiene, Johns Hopkins School of Hygiene and Public Health; joint appointment in Psychiatry, Johns Hopkins School of Medicine
Mark A.R. Kleiman, Professor, School of Public Policy and Social Research, University of California, Los Angeles
Stanley Korenman, M.D., Professor of Medicine and Associate Dean, UCLA Medical School
Robert E. Litan, Director of Economic Studies, Brookings Institution; former Associate Director, U.S. Government Office of Management and Budget
Glenn Loury, University Professor, Professor of Economics, and Director of the Institute on Race and Social Division, Boston University
Robert MacCoun, Associate Professor, Graduate School of Public Policy, University of California at Berkeley
Mark H. Moore, Professor of Criminal Justice Policy and Management, Harvard University
Dennis E. Nowicki, Chief of Police, Charlotte-Mecklenburg Police Department, North Carolina
John O'Hair, Prosecuting Attorney, Wayne County (Detroit), Michigan
Peter Reuter, Professor of Public Affairs and Criminology, University of Maryland
Michell S. Rosenthal, M.D., President, Phoenix House Foundation
Sally L. Satel, M.D., Lecturer, Yale Medical School
Thomas C. Schelling, Distinguished University Professor at University of Maryland
Charles R. Schuster, Professor of Psychiatry and Behavioral Neurosciences and Director of the Clinical Research Division on Substance Abuse, Wayne State University School of Medicine; former Director of the National Institute on Drug Abuse
Lewis Seiden, Professor and Chairman of the Department of Pharmacology, University of Chicago
Solomon H. Snyder, M.D., Distinguished Service Professor of Neuroscience, Pharmacology, and Psychiatry; Director, Department of Neuroscience, The Johns Hopkins University School of Medicine
George Vaillant, M.D., Professor of Psychiatry, Harvard Medical School