Treatment vs. incarceration: U.S. officials debate handling of drug offenses

By Ana Francisca Vega
El Economista, Mexico City
Friday, December 18, 2009; 2:03 PM

WASHINGTON -- He had agreed to give me a tour of the streets here on the condition that I not reveal his name. To do so could cause problems with his superiors and co-workers at the police department. I consented. No one, I had been told, knew more than he did about how drug dealers operate in the U.S. capital.

It was getting dark when we got into the vehicle and set off on our tour. "Turn at the corner," he said, "and you'll see." As if by magic, a group of people materialized before us. "Dealers," he said. "Heroin, but also cocaine and probably marijuana." That scene played out at least 30 times in the three hours we spent crisscrossing the streets.

"Now turn left on this street. . . . Oh! Look at him. They call him 'Bobo,' and he's a lucky man. He must have just gotten out of prison," he said with a mixture of disbelief and anger.

"Don't you find it frustrating to know that no sooner than are they arrested, most of them are right back on the streets doing exactly the same thing?" I asked.

The officer was silent for a few seconds, as if searching for the right answer. Then, "I'm not Superman," he replied. "They do their job and I do mine. . . . I've known some of them for so long that they respect me. They see me as an authority figure. I've watched a lot of them grow up.

"Look behind you," he said, as we watched the goings-on at one of the open-air drug markets. I turned my head and there, less than five minutes away, was the dome of the Capitol. There were other drug markets near the campus of Howard University Hospital and near Washington's recently built convention center.

A few days later, as I was interviewing Inspector Brian Bray, commanding officer of the D.C. police's Narcotics and Special Investigations Division, one of his officers entered the room. Visibly pleased, the two men shared impressions about the preceding night. "We confiscated eight weapons," Bray said. I repeated my earlier question to the undercover officer: Isn't it frustrating to know that the person you arrested yesterday will soon be released and, true to form, will return to the streets to commit a crime? His answer surprised me.

"You've got liberal judges, liberal juries that don't want to send people to jail," he said. "A lot of times it's a revolving door. They get ridiculously low sentences for hideous crimes."

"But isn't it a matter of the number of people arrested, rather than the ideology of the judges and juries? How many people were arrested in D.C. on drug charges last year?" I asked him.

"Around 10,000," he said, and, after thinking for a moment, added, "yes, I guess you could say that. We don't have enough space for that many people."

Bray's story plays out repeatedly across the United States, where more than 30 percent of those incarcerated are serving sentences for dealing, possessing or using drugs. For years, the authorities have viewed widespread incarceration as the solution to drug trafficking and consumption. Sen. Jim Webb (D-Va.), who recently proposed a criminal justice reform initiative, said the number of people incarcerated in the United States is 13 times higher than it was 25 years ago. The economic and social costs of incarceration -- with many inmates who have no record of violent crime -- are staggering. This situation might be about to change.

Ever since President Ronald Reagan declared the "war on drugs," U.S. policy has focused on combating supply. Most of the country's resources -- more than 60 percent -- have been allocated to strengthen law enforcement, drug interdiction, crop eradication and international cooperation programs such as the Merida Initiative in Mexico and Plan Colombia. The rest is used for the treatment of drug addicts.

The number of addicts in the United States has been estimated at 23 million, with 7.6 million in need of treatment. And yet, "demand has always been an afterthought of U.S. drug policy and its budget," said John Walsh, drug trafficking expert for the liberal Washington Office on Latin America, which promotes democracy and socioeconomic justice in Latin America and the Caribbean.

A shift in emphasis or, to put it another way, the construction of a more balanced drug policy, is taking place slowly but surely. The key is in the cost. "Economic crisis oddly really plays a beneficial role here because all the states are looking at the budgets," said Doug Ierely, an aide to Webb. "It is making state officials reconsider their budget priorities," he said. "They are thinking more about evidence-based practices." The latter are mainly associated with programs to reduce treatment and rehabilitation.

Perhaps inadvertently, budget constraints have revived the debate between two divergent positions, with proponents of incarceration to fight the drug problem on one side, and advocates of investing in programs scientifically proven to be effective in reducing illegal drug use on the other. The current state of the economy is like "the perfect storm," said Bill Piper, Director of National Affairs for the Drug Policy Alliance, one of the nongovernmental organizations most active in promoting addiction treatment and decriminalization.

Because 90 percent of prisoners are held in local and state penitentiaries, it is the states that have most resented the budget crisis. At the state level, people are seeing the costs of a policy "that locks up a lot of people and maybe doesn't do the best in terms of helping provide treatment to people who are committing the crimes or dealing drugs," said Walsh. "There is even bipartisan support for thinking more seriously about it. So that has been a big boost for treatment."

In recent years, 13 states have legalized marijuana for medicinal use and others have reviewed -- and changed -- some of their drug laws, New York, Kansas and Michigan notably among them. The District of Columbia is considering establishing regulations for distributing medical marijuana. And just a few months ago, California, traditionally at the forefront of decriminalization and demand-reduction policy initiatives, directed federal economic stimulus funds -- specifically the Byrne Justice Assistance Grant, an important source of anti-drug funding -- to treatment programs.

In the California case, authorities had first intended to allocate the stimulus money for law enforcement. But the Drug Policy Alliance in California -- part of a network of groups that promote, among other things, emphasis on treatment rather than incarceration -- persuaded state officials to allocate the funds differently. Margaret Dooley-Sammuli, the group's deputy state director, said that if those funds had been spent on law enforcement, the government would had to have generated $160 million in additional revenue in 2010 to cover the costs of incarcerated drug offenders. In the end, the $135 million in grant funds were spent on treatment.

Oregon officials decided to spend most of the stimulus money on a program that offers rehabilitation options to people who have been arrested on drug charges but have no prior records.

The economic crisis has exacerbated the already precarious fiscal situation at the state level. The notion that a drug policy might generate huge additional costs has led some state governments to opt for a less expensive alternative. "For different reasons, some states are coming to the same conclusions," said Dooley-Sammuli of the California Drug Policy Alliance. "We have to spend money differently."

The effects of the economic crisis on state budgets, coupled with discomfort about high incarceration rates and the attendant economic and social consequences, is spurring a change that, while often silent, appears to be gaining momentum.

"There is an increasing unease in this country about the rates of incarceration, and this could be capturing the zeitgeist and succeed. It is hard to think of any other indicator in which we do so badly," said Peter Reuter, a criminology professor at the University of Maryland, in the Washington suburbs.

This is not to say that the obstacles have been surmounted. The U.S. government continues to use various means to pressure states into reversing innovative or more balanced policies.

"In many ways, the federal government still discourages states from trying new approaches. There are limits on what states can do in terms of regulations if a federal law is in place," said Piper of the Drug Policy Alliance. Yet the transformation seems to have begun.

In addition to budgetary pressures on the prison-centered approach, other factors have become increasingly relevant in the search for a more balanced drug policy. It is no coincidence, for example, that four of five early health-reform proposals in Congress included provisions on the right to addiction treatment.

"That is a big change," said Joseph A. Califano Jr., former secretary of Health, Education and Welfare and founder of the National Center on Addiction and Substance Abuse at Columbia University in New York. "The fact that we are recognizing that mental heath and substance abuse treatment deserves to be treated the same way we treat physical health problems is very important. That will have a significant impact in terms of the way we deal with treatment."

More significant is the apparent acceptance of this approach. "It is wonderful that there is no national debate. It means people have come to accept it," said Reuter, the University of Maryland professor. "A long time ago, I argued that drug policy would benefit from benign neglect."

Politicians are finding it less difficult to openly discuss the need for a change as old paradigms begin to crumble. Asked about this in the context of his criminal justice reform initiative, Sen. Webb said, "I believe you should come to government with an eye toward fixing problems. That's what leadership is. It's about thoroughly thinking through the issue, educating and motivating people to care, reaching out and engaging those from across the philosophical spectrum, and be willing to accept accountability for the outcome."

In addition to Webb's initiative, Reps. Eliot Engel (D-N.Y.) and Dan Burton (R-Ind.) have proposed creating a commission to review U.S. drug policy in the Western Hemisphere, including demand reduction. This initiative, which, like Webb's, faces several legislative hurdles, is based on logic: Despite an investment of about $15 billion over the past two decades, the United States has failed to significantly reduce drug supply or demand.

These recent shifts do not mean that ideology and criminalization are no longer an important factor in U.S. policymaking on drugs. "Stigma is a terrible, terrible problem. There is so much stigma and shame attached to this, and many people still think of this as a criminal issue," said Califano. What these shifts do indicate, however, is that policymakers are finding less political risk associated with advocating alternatives to incarceration -- such as addiction treatment.

Recent polls supported this view. According to Lake Research Partners, 72 percent of Republicans, 88 percent of Democrats and 72 percent of independents supported including addiction treatment in any health reform bill. In addition, more than 60 percent of those polled said they would be willing to pay $2 more a month in insurance premiums for better addiction-treatment coverage.

Although not at the center of national debate, public opinion is increasingly focused on the right of addicts to receive treatment rather than a prison sentence. "Public knowledge of the problem has slowly and silently changed. Now we know more about addictions and about the best ways of reducing consumption. . . . We also know that certain hard policies just don't work," said John Carnevale, a former official of the White House Office of National Drug Control Policy.

Although drug policy at the state level has undergone significant, though not always perceptible, changes in recent years, federal drug policy has remained virtually unchanged. "Frozen" is the way Walsh, the Latin affairs office analyst, put it. Since President Obama took office, the White House has been sending positive signals. Early indications will come when the White House Office of National Drug Control Policy presents its first anti-drug strategy in February.

More emphasis on drug demand is forecast. "This Administration is drafting a balanced national drug policy that focuses on law enforcement, prevention and treatment. President Obama believes that all three components are critical to this Administration's efforts to reducing the use of illegal drugs," according to the office. The office has created the Demand Reduction Interagency Working Group and has pledged to expand successful programs such as the drug courts. The president's budget request next year could determine the fate of the programs. We can say that the federal government seems to be gradually buying into the underlying premise of Webb's initiative, and those of Engel, Burton and the thousands of Americans who strive daily to implement a more effective drug policy with a lower social and human cost. In the end, it is not a matter of being "hard" on crime just for the sake of it, but rather one of combating it more intelligently.

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