Drug Czar Gets Grilled on "New Directions in Drug Policy" from Drug war Chronicle

Drug Czar Gets Grilled on "New Directions in Drug Policy" By Skeptical Solons, Activists, and Academics

Gil Kerlikowske, head of the Office of National Drug Control Policy (ONDCP -- the drug czar's office), testified on Capitol Hill Wednesday that the Obama administration is seeking "a new direction in drug policy," but was challenged both by lawmakers and by a panel of academics and activists on the point during the same hearing. The action took place at a hearing of the House Domestic Policy Subcommittee in which the ONDCP drug budget and the forthcoming 2010 National Drug Strategy were the topics at hand.

The hearing comes in the wake of various drug policy reforms enacted by the Obama administration, including a Justice Department policy memo directing US attorneys and the DEA to lay off medical marijuana in states where it is legal, the removal of the federal ban on needle exchange funding, and administration support for ending or reducing the sentencing disparity between crack and powder cocaine offenders.

But it also comes in the wake of the announcement of the ONDCP 2011 drug budget, which at $15.5 billion is up more than $500 million from this year. While treatment and prevention programs got a 6.5% funding increase, supply reduction (law enforcement, interdiction, and eradication) continues to account for almost exactly the same percentage of the overall budget -- 64%--as it did in the Bush administration. Only 36% is earmarked for demand reduction (prevention and treatment).

Citing health care costs from drug use and rising drug overdose death figures, the nation "needs to discard the idea that enforcement alone can eliminate our nation's drug problem," Kerlikowske said. "Only through a comprehensive and balanced approach -- combining tough, but fair, enforcement with robust prevention and treatment efforts -- will we be successful in stemming both the demand for and supply of illegal drugs in our country."

So far, at least, when it comes to reconfiguring US drug control efforts, Kerlikowske and the Obama administration are talking the talk, but they're not walking the walk. That was the contention of subcommittee chair Rep. Dennis Kucinich (D-OH) and several of the session's panelists.

"Supply side spending has not been effective," said Kucinich, challenging the budget breakdown.

"Supply side spending is important for a host of reasons, whether we're talking about eradication or our international partners where drugs are flowing," replied the drug czar.

"Where's the evidence?" Kucinich demanded. "Describe with statistics what evidence you have that this approach is effective."

Kerlikowske was reduced to citing the case of Colombia, where security and safety of the citizenry has increased. But he failed to mention that despite about $4 billion in US anti-drug aid in the past decade, Colombian coca and cocaine production remain at high levels.

"What parts of your budget are most effective?" asked Kucinich.

"The most cost-effective approaches would be prevention and treatment," said Kerlikowske.

"What percentage is supply and what percentage is demand oriented?" asked Rep. Jim Jordan (D-OH).

"It leans much more toward supply, toward interdiction and enforcement," Kerlikowske conceded.

Rep. Darrell Issa (R-CA) was more old school, demanding a tougher response to Mexico's wave of prohibition-related violence and questioning the decision not to eradicate opium in Afghanistan. "The Southwest border is critical. I would hope the administration would give you the resources you need for a Plan Colombia on steroids," said Issa.

"There is no eradication program in Afghanistan," Issa complained. "I was in areas we did control and we did nothing about eradication."

"I don't think anyone is comfortable seeing US forces among the poppy fields," Kerlikowske replied. "Ambassador Holbrooke has taken great pains to explain the rationale for that," he added, alluding to Holbrooke's winning argument that eradication would push poppy farming peasants into the hands of the Taliban.

"The effectiveness of eradication seems to be near zero, which is very interesting from a policy point of view," interjected Rep. Bill Foster (D-IL).

Kucinich challenged Kerlikowske about harm reduction. "At the UN, you said the US supported many interventions, but you said that, 'We do not use the phrase harm reduction.' You are silent on both syringe exchange programs and the issue of harm reduction interventions generally," he noted. "Do you acknowledge that these interventions can be effective in reducing death and disease, does your budget proposed to fund intervention programs that have demonstrated positive results in drug overdose deaths, and what is the basis of your belief that the term harm reduction implies promotion of drug use?"

Kerlikowske barely responded. "We don't use the term harm reduction because it is in the eye of the beholder," he said. "People talk about it as if it were legalization, but personally, I haven't spent a lot of time thinking about whether to put a definition on it."

When challenged by Kucinich specifically about needle exchange programs, Kerlikowske conceded that they can be effective. "If they are part of a comprehensive drug reduction effort, they make a lot of sense," he said.

The grilling of Kerlikowske took up the first hour of the two-hour session. The second hour consisted of testimony from Drug Policy Alliance executive director Ethan Nadelmann, Brookings Institute foreign policy fellow and drugs and counterinsurgency expert Vanda Felbab-Brown, former ONDCP employee and drug policy analyst John Carnevale, and University of Maryland drug policy expert Peter Reuter. It didn't get any better for drug policy orthodoxy.

"Let me be frank," said Nadelmann as he began his testimony. "We regard US drug policy as a colossal failure, a gross violation of human rights and common sense," he said, citing the all too familiar statistics about arrests, incarceration, the spread of HIV/AIDS, and drug overdose deaths. "All of these are an egregious violation of fundamental American values."

"Congress and the Obama administration have broken with the costly and failed drug war strategies of the past in some important ways," Nadelmann. "But the continuing emphasis on interdiction and law enforcement in the federal drug war budget suggest that ONDCP is far more wedded to the failures of the past than to any new vision for the future. I urge this committee to hold ONDCP and federal drug policy accountable to new criteria that focus on reductions in the death, disease, crime and suffering associated with both drugs and drug prohibition."

Nadelmann identified four problems with current drug strategy:

The drug war's flawed performance measures;
The lop-sided ratio between supply and demand spending in the national drug budget;
The lack of innovation in the drug czar's proposed strategies;
The administration's failure to adequately evaluate drug policies.
"They want to move toward a public health model that focuses on reducing demand for drugs, but no drug policy will succeed unless there are the resources to implement it," said Carnevale. "Past budgets emphasizing supply reduction failed to produce results, and our drug policy stalled -- there has been no change in overall drug use in this decade."

Carnevale noted that the 2011 ONDCP budget gave the largest percentage increase to prevention and treatment, but that its priorities were still skewed toward supply reduction. "The budget continues to over-allocate funds where they are least effective, in interdiction and source country programs."

"The drug trade poses multiple and serious threats, ranging from threats to security and the legal economy to threats to legality and political processes," said Felbab-Brown, "but millions of people depend on the illegal drug trade for a livelihood. There is no hope supply-side policies can disrupt the global drug trade."

Felbab-Brown said she was "encouraged" that the Obama administration had shifted toward a state-building approach in Afghanistan, but that she had concerns about how policy is being operationalized there. "We need to adopt the right approach to sequencing eradication in Afghanistan," she said. "Alternative livelihoods and state-building need to be comprehensive, well-funded, and long-lasting, and not focused on replacing the poppy crop."

"Eradication in Afghanistan has little effect on domestic supply and reduction," said Kucinich. "Should these kinds of programs be funded?"

"I am quite convinced that spending money for eradication, especially aerial eradication, is not effective," replied Carnevale. "The point of eradication in Colombia was to reduce the amount of drugs coming into the US, but I see no such effect."

"We're dealing with global commodity markets," said Nadelmann. "If one source is knocked out, someone else will pop up. What's missing is any sort of strategic analysis or planning. If you accept that these drugs are going to be produced, you need to manage it to reduce the harms."

"The history of the last 20 years of the cocaine and heroin trade shows how much mobility there is in cultivation and trafficking," said Reuter. "What we do has a predictable effect. When we pushed down on trafficking in Florida, that lead to increases in Mexico. The evidence is striking that all we are doing is moving the trade."

Times are changing in Washington. What was once unassailable drug war orthodoxy is not under direct assault, and not just from activists and academics, but among members of Congress itself. But while the drug czar talks the happy talk about "new directions in drug policy," the Obama administration -- with some notable exceptions -- looks to still have a drug policy on cruise control.

http://stopthedrugwar.org/chronicle/628/drug_czar_ondcp_kerlikowske_testimony_nadelmann_felbab_brown_carnavale_reuter_kucinich

Drug Arrests Decline Slightly in 2008

Drug War Chronicle - world’s leading drug policy newsletter
Feature: Marijuana Arrests, All Drug Arrests Declined Slightly in 2008, FBI Reports
view
translation
Printer Friendly Version Email this Article
from Drug War Chronicle, Issue #601, 9/18/09
The number of people arrested for drug offenses in the United States declined slightly last year, according to the FBI's Uniform Crime Report. And for the first time since 2002, the number of people arrested on marijuana charges also declined. The number of arrests for all drug offenses declined from 1,841,182 in 2007 to 1,702,537 last year, while the number of people arrested on marijuana charges dropped from 872,721 in 2007 to 847,864 last year.
( See the table from http://www.fbi.gov/ucr/cius2008/arrests/ )
More people were arrested for drug offenses last year than live in the cities of Phoenix (pop. 1.55 million) or Philadelphia (pop. 1.45 million). More people were arrested for marijuana offenses than live in the cities of Jacksonville (pop. 805,000) or San Francisco (pop. 764,000). Based on the overall drug arrest figures, somebody got busted for dope every 18 seconds in 2008, and somebody got busted for pot every 37 seconds.
Last year, marijuana arrests accounted for nearly half -- 49.8% -- of all drug arrests, up slightly from the 47% in 2007. The vast majority of marijuana arrests -- 89% -- were for possession only, meaning that more than three-quarters of a million Americans got busted last year not for drug trafficking or manufacture, but as nothing more than pot consumers. In two regions of the country, the South and the Midwest, simple marijuana possession arrests accounted for more than half of all drug arrests.
Similarly, when all drug arrests are tabulated, possession arrests constituted 83.3% of the total. That means out of the 1.7 million total drug arrests, only about 300,000 were for "drug dealing" or manufacture, and 93,640 of those were for marijuana, which includes people growing even one plant or for medical reasons.
While last year's pot bust numbers represent a 3% decline from 2007, the 2008 numbers are still the second highest annual toll on record. Marijuana arrests stood at about 300,000 in 1991 before climbing sharply during the Clinton administration to more than 700,000 by 2000. During the Bush administration, annual pot arrests continued to climb, but more slowly, going over 800,000 in 2006 and reaching the all-time high of more than 872,000 in 2007.
While the trend over the past two decades has been upwards, this isn't the first year that marijuana arrests have declined over the previous year. Similar blips have happened five times since 1990.
The number of drug arrests in 2008 was about three times the number of people arrested for all violent crimes (595,000) and greater than the number of people arrested for all property crimes (1.68 million).
Defenders of the status quo eager to downplay the consequences of drug prohibition are wont to argue that many arrests aren't really arrests -- some people are ticketed or cited and released -- or that hardly anybody goes to jail, especially for marijuana. There is a small degree of truth in each argument, but being arrested on a drug charge, even a marijuana possession charge, carries serious consequences for the arrestee.
People arrested face legal fees, fines, and, quite possibly, time behind bars, even for marijuana offenses. Upon conviction, they also face a raft of collateral consequences ranging from loss of access to student loans, public housing, and other federal benefits to loss of (or inability to obtain) professional licenses, problems with employment, and loss of children to state child welfare agencies.
The 2008 arrest figures come just days after the National Survey on Drug Use and Health reported that the number of adult marijuana smokers increased from 22 million in 2007 to 22.5 million last year. The number of Americans over age 12 who admitted ever smoking marijuana was also at an all-time, both in raw numbers and as a percentage of the population. Last year, 41%, or more than 102 million Americans said they had tried marijuana.
Drug reformers were quick to use the arrest figures to call for change. "In our current economic climate, we simply cannot afford to keep arresting more than three people every minute in the failed 'war on drugs,'" said Jack Cole, a retired undercover narcotics detective who now heads Law Enforcement Against Prohibition.
Cole also warned of the collateral consequences of a drug arrest. "You can get over an addiction, but you will never get over a conviction," he said.
The pot people, revved up by a seeming seismic shift in popular attitudes now underway, were also quick on the attack. "Federal statistics released just last week indicate that larger percentages of Americans are using cannabis at the same time that police are arresting a near-record number of Americans for pot-related offenses," said Allen St. Pierre, head of the National Organization for the Reform of Marijuana Laws (NORML). "Present enforcement policies are costing American taxpayers tens of billions of dollars, ruining the lives of hundreds of thousands of Americans, and having no impact on marijuana availability or marijuana use in this country. It is time to end this failed policy and replace prohibition with a policy of marijuana regulation, taxation, and education."
"This slight dip in the number of marijuana arrests provides a small amount of relief to the tens of millions of American marijuana consumers who have been under attack by their own government for decades," said Marijuana Policy Project executive director Rob Kampia. "It's time to stop wasting billions of tax dollars criminalizing responsible Americans for using a substance that's safer than alcohol, and to put an end to policies that simply hand this massive consumer market to unregulated criminals."
Do the slight declines in marijuana arrests or overall drug arrests mean that change is around the corner or that policing policies are becoming more enlightened? The answer is "no," said Eric Sterling, head of the Criminal Justice Policy Foundation.
"The declines are so slight as to be almost insignificant," said Sterling. "What we do know is that in various law enforcement agencies around the country, they've been laying off cops. Chiefs have been getting orders from mayors and county executives to cut overtime. There are 10,000 different law enforcement agencies, and they're all facing financial trouble. These kinds of pressures reduce the number of police hours that can be devoted to these kinds of cases," he said.
The small declines in drug arrests do not represent any serious policy change, Sterling said. "If there was any significant change in policies, you wouldn't see a minor dip. If we saw a drop of a third, that would tell us there is a change in policy, but anyone who looks at these numbers and thinks they represent change is grasping at straws."
Drug prohibition mindlessly grinds on, chewing up and spitting out more than a million and a half Americans each year. It may have suffered a few hiccups because of the country's financial woes, but there is as yet no sign that anything has really changed.

PERMISSION to reprint or redistribute any or all of the contents of Drug War Chronicle (formerly The Week Online with DRCNet) is hereby granted. We ask that any use of these materials include proper credit and, where appropriate, a link to one or more of our web sites. If your publication customarily pays for publication, DRCNet requests checks payable to the organization. If your publication does not pay for materials, you are free to use the materials gratis. In all cases, we request notification for our records, including physical copies where material has appeared in print. Contact: StoptheDrugWar.org: the Drug Reform Coordination Network, P.O. Box 18402, Washington, DC 20036, (202) 293-8340 (voice), (202) 293-8344 (fax), e-mail drcnet@drcnet.org. Thank you.Articles of a purely educational nature in Drug War Chronicle appear courtesy of the DRCNet Foundation, unless otherwise noted.

The Epidemic That Wasn’t from the New York Times

January 27, 2009
The Epidemic That Wasn’t
By SUSAN OKIE
BALTIMORE — One sister is 14; the other is 9. They are a vibrant pair: the older girl is high-spirited but responsible, a solid student and a devoted helper at home; her sister loves to read and watch cooking shows, and she recently scored well above average on citywide standardized tests.
There would be nothing remarkable about these two happy, normal girls if it were not for their mother’s history. Yvette H., now 38, admits that she used cocaine (along with heroin and alcohol) while she was pregnant with each girl. “A drug addict,” she now says ruefully, “isn’t really concerned about the baby she’s carrying.”
When the use of crack cocaine became a nationwide epidemic in the 1980s and ’90s, there were widespread fears that prenatal exposure to the drug would produce a generation of severely damaged children. Newspapers carried headlines like “Cocaine: A Vicious Assault on a Child,” “Crack’s Toll Among Babies: A Joyless View” and “Studies: Future Bleak for Crack Babies.”
But now researchers are systematically following children who were exposed to cocaine before birth, and their findings suggest that the encouraging stories of Ms. H.’s daughters are anything but unusual. So far, these scientists say, the long-term effects of such exposure on children’s brain development and behavior appear relatively small.
“Are there differences? Yes,” said Barry M. Lester, a professor of psychiatry at Brown University who directs the Maternal Lifestyle Study, a large federally financed study of children exposed to cocaine in the womb. “Are they reliable and persistent? Yes. Are they big? No.”
Cocaine is undoubtedly bad for the fetus. But experts say its effects are less severe than those of alcohol and are comparable to those of tobacco — two legal substances that are used much more often by pregnant women, despite health warnings.
Surveys by the Department of Health and Human Services in 2006 and 2007 found that 5.2 percent of pregnant women reported using any illicit drug, compared with 11.6 percent for alcohol and 16.4 percent for tobacco.
“The argument is not that it’s O.K. to use cocaine in pregnancy, any more than it’s O.K. to smoke cigarettes in pregnancy,” said Dr. Deborah A. Frank, a pediatrician at Boston University. “Neither drug is good for anybody.”
But cocaine use in pregnancy has been treated as a moral issue rather than a health problem, Dr. Frank said. Pregnant women who use illegal drugs commonly lose custody of their children, and during the 1990s many were prosecuted and jailed.
Cocaine slows fetal growth, and exposed infants tend to be born smaller than unexposed ones, with smaller heads. But as these children grow, brain and body size catch up.
At a scientific conference in November, Dr. Lester presented an analysis of a pool of studies of 14 groups of cocaine-exposed children — 4,419 in all, ranging in age from 4 to 13. The analysis failed to show a statistically significant effect on I.Q. or language development. In the largest of the studies, I.Q. scores of exposed children averaged about 4 points lower at age 7 than those of unexposed children.
In tests that measure specific brain functions, there is evidence that cocaine-exposed children are more likely than others to have difficulty with tasks that require visual attention and “executive function” — the brain’s ability to set priorities and pay selective attention, enabling the child to focus on the task at hand.
Cocaine exposure may also increase the frequency of defiant behavior and poor conduct, according to Dr. Lester’s analysis. There is also some evidence that boys may be more vulnerable than girls to behavior problems.
But experts say these findings are quite subtle and hard to generalize. “Just because it is statistically significant doesn’t mean that it is a huge public health impact,” said Dr. Harolyn M. Belcher, a neurodevelopmental pediatrician who is director of research at the Kennedy Krieger Institute’s Family Center in Baltimore.
And Michael Lewis, a professor of pediatrics and psychiatry at the Robert Wood Johnson Medical School in New Brunswick, N.J., said that in a doctor’s office or a classroom, “you cannot tell” which children were exposed to cocaine before birth.
He added that factors like poor parenting, poverty and stresses like exposure to violence were far more likely to damage a child’s intellectual and emotional development — and by the same token, growing up in a stable household, with parents who do not abuse alcohol or drugs, can do much to ease any harmful effects of prenatal drug exposure.
Possession of crack cocaine, the form of the drug that was widely sold in inner-city, predominantly black neighborhoods, has long been punished with tougher sentences than possession of powdered cocaine, although both forms are identically metabolized by the body and have the same pharmacological effects.
Dr. Frank, the pediatrician in Boston, says cocaine-exposed children are often teased or stigmatized if others are aware of their exposure. If they develop physical symptoms or behavioral problems, doctors or teachers are sometimes too quick to blame the drug exposure and miss the real cause, like illness or abuse.
“Society’s expectations of the children,” she said, “and reaction to the mothers are completely guided not by the toxicity, but by the social meaning” of the drug.
Research on the health effects of illegal drugs, especially on unborn children, is politically loaded. Researchers studying children exposed to cocaine say they struggle to interpret their findings for the public without exaggerating their significance — or minimizing it, either.
Dr. Lester, the leader of the Maternal Lifestyle Study, noted that the evidence for behavioral problems strengthened as the children in his study and others approached adolescence. Researchers in the study are collecting data on 14-year-olds, he said, adding: “Absolutely, we need to continue to follow these kids. For the M.L.S., the main thing we’re interested in is whether or not prenatal cocaine exposure predisposes you to early-onset drug use in adolescence” or other mental health problems.
Researchers have long theorized that prenatal exposure to a drug may make it more likely that the child will go on to use it. But so far, such a link has been scientifically reported only in the case of tobacco exposure.
Teasing out the effects of cocaine exposure is complicated by the fact that like Yvette H., almost all of the women in the studies who used cocaine while pregnant were also using other substances.
Moreover, most of the children in the studies are poor, and many have other risk factors known to affect cognitive development and behavior — inadequate health care, substandard schools, unstable family situations and exposure to high levels of lead. Dr. Lester said his group’s study was large enough to take such factors into account.
Ms. H., who agreed to be interviewed only on the condition that her last name and her children’s first names not be used, said she entered a drug and alcohol treatment program about six years ago, after losing custody of her children.
Another daughter, born after Ms. H. recovered from drug and alcohol abuse, is thriving now at 3. Her oldest, a 17-year-old boy, is the only one with developmental problems: he is autistic. But Ms. H. said she did not use cocaine, alcohol or other substances while pregnant with him.
After 15 months without using drugs or alcohol, Ms. H. regained custody and moved into Dayspring House, a residential program in Baltimore for women recovering from drug abuse, and their children.
There she received psychological counseling, parenting classes, job training and coaching on how to manage her finances. Her youngest attended Head Start, the older children went to local schools and were assigned household chores, and the family learned how to talk about their problems.
Now Ms. H. works at a local grocery, has paid off her debts, has her own house and is actively involved in her children’s schooling and health care. She said regaining her children’s trust took a long time. “It’s something you have to constantly keep working on,” she said.
Dr. Belcher, who is president of Dayspring’s board of directors, said such programs offered evidence-based interventions for the children of drug abusers that can help minimize the chances of harm from past exposure to cocaine or other drugs.
“I think we can say this is an at-risk group,” Dr. Belcher said. “But they have great potential to do well if we can mobilize resources around the family.”