Fight for reform of U.S. drug policies slowly making headway: Treatment favored over harsh sentences
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* Kim Krisberg

When President Barack Obama issued a memorandum in March affirming that science would reclaim its standing in policy decisions, public health advocates let out a collective sigh of relief, warmly welcoming the change in direction.

To drug reform advocate Ethan Nadelmann, the president’s announcement may have signaled a willingness to put science before politics, but in Nadelmann’s line of work, bridging the gulf between science and policy remains a daunting task, paved with deep-seated opinions and political pitfalls. As executive director of the Drug Policy Alliance, a network of advocates working to promote evidence-based alternatives to the so-called war on drugs, Nadelmann said that while the new administration is showing signs of progress on issues such as needle exchange and medical marijuana, change so far remains a “mixed story.”

“It’s a bit like turning an ocean liner,” Nadelmann told *The Nation’s Health.* “Obama has pointed things in a new direction, but it has to be more than just rhetoric. You have career bureaucrats committed to thinking about this in one way and it doesn’t change easily.”

Nadelmann is just one of many advocates hoping a new presidential administration will also mean a new openness toward real drug policy reform — and, fortunately, there are already some signs of movement in that direction, both in words and in action. Rhetorically speaking, U.S. Attorney General Eric Holder in February said federal officials will stop raiding state-approved medicinal marijuana clinics, and in May, new U.S. drug czar Gil Kerlikowske told reporters that he would work toward policies that favor treating people coping with substance abuse rather than incarcerating them.

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Protestors denounce Bush-era Drug Enforcement Agency raids of medical marijuana clinics in Los Angeles in 2007. The U.S. attorney general said this year that such federal raids would stop.

Photo by David McNew, courtesy Getty Images

Progress is being made legislatively on the federal level as well, with bills making their way through Congress that would lift the ban on using federal funds for needle exchange programs, allow the District of Columbia to implement a voter-approved medical marijuana initiative, and eliminate the sentencing disparity between crack and powder cocaine, which are two forms of the same drug. The U.S. Sentencing Commission found that “sentences appear to be harsher and more severe for racial minorities than others” because of the disparity.

“Certainly on the subject of marijuana…I think there’s been a pretty big shift in public sentiment,” said Bruce Mirken, director of communications for the Marijuana Policy Project, which works on marijuana and medicinal marijuana policy reform.

As of late August, 13 states had legalized marijuana for medicinal purposes, and several more states are considering such measures, Mirken said. And because of a new federal willingness to respect state medical marijuana measures, “there will be less hesitation on the part of state legislators now knowing that they’re not putting their own citizens at risk (of federal prosecution),” said Aaron Houston, director of government relations at the Marijuana Policy Project. In regard to re-examining legal enforcement against personal marijuana possession, Houston said the debate is not only being driven by economics, but by public safety, with “more and more people seeing the violence tied to a black market.”

“We’re starting to see a broader discussion on whether this is really worth it,” Houston said.

Though federal drug policy sentiment seems to be moving in a more evidence-based direction, many advocates agree that states will continue their roles as reform pioneers and laboratories for change. In New Jersey, Roseanne Scotti, director of Drug Policy Alliance New Jersey, has been working and seeing success in three major areas: medical marijuana, needle exchange and sentencing reform. With the help of patient advocates, the New Jersey Senate passed a medical marijuana bill earlier this year, and Scotti predicted it would reach the governor’s desk this fall, noting that the measure garnered support from more than 80 percent of New Jersey residents. In terms of needle exchange, which studies have shown reduce disease and HIV transmission without increasing substance abuse, New Jersey policy-makers had approved such an initiative in 2006, but with strained state budgets and many needle exchange programs depending on grants, the possible lifting of the federal funding ban could mean a significant boost, Scotti said.

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Photo courtesy Jacom Stephens, iStockphoto

“The lifetime cost of (HIV/AIDS) for one person can be more than $600,000, whereas a clean needle costs 10 cents,” she told *The Nation’s Health.* “If we had based our public health policy on facts rather than fear, we could have saved thousands of lives.”

Scotti is also working to push through a state bill giving judges discretion to not impose mandatory minimum drug sentences, which Scotti described as helping to “create a whole caste of people who are permanent economic and labor market outsiders — they can never be part of the system.” She noted that in New Jersey, the state correctional system spends almost $47,000 per person per year, even though treatment has been proven, time and again, to be a more effective route.

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New York State Sen. Eric Schneiderman speaks at a 2008 rally in New York City protesting the state’s drug sentencing laws.

Photo courtesy Correctional Association of New York

“Going to prison in many urban areas is not a deterrent anymore, it’s becoming an accepted life path and that’s just horrible,” Scotti said. “And we know that for kids that have one or more parent incarcerated, they’re more likely to end up in prison too. This is not an effective strategy.”

Reforming drug policy in favor of treatment versus incarceration has long been a public health goal, not only in treating substance abuse but in treating the mental illness such abuse often masks. And the nation’s economic woes have made some policy-makers realize that funds used to imprison non-violent drug offenders could be more effectively spent supporting a public health treatment approach.

“The prison population has continued to go up even as crime went down, and it’s mostly for drug offenses,” said Natassia Walsh, research associate with the Justice Policy Institute, who noted that the United States spends about $67 billion annually on corrections. “What we need is a return to treating substance abuse as a public health problem.”

From a public health and safety standpoint, there is more benefit to treating people in the community rather than inside prisons, Walsh said, and research shows that community-based treatment is more effective in reducing recidivism rates as well as more cost-effective. Walsh noted that while she is “encouraged” by statements from the Obama administration, she hopes additional federal prevention and treatment funds will follow.

One state leading the way in the field is New York, which in April enacted sweeping reforms to its drugs laws, known commonly as the Rockefeller drug laws and often described as the strictest drug laws in the country. The new reforms eliminate mandatory harsh sentences, give judges authority to divert non-violent offenders to treatment, and expand and fund drug treatment programs. Karen Carpenter-Palumbo, commissioner of the state’s Office of Alcoholism and Substance Abuse Services, described the reform as “historic and landmark,” noting that the state that “probably had the most draconian drug laws in the United States, is now leading in reform.”

“We will treat addiction in New York state and not incarcerate,” she told *The Nation’s Health.* “What we see is an identification in the statute that drug addiction is a chronic and relapsing condition…and will be treated as a public health problem.”

Carpenter-Palumbo said the reform means an expansion of the current prevention and treatment system, with enough funds to ensure that 3,000 people a year will have the chance to receive treatment instead of a prison sentence.

For Bob Gangi, executive director of the Correctional Association of New York, the reform was a longstanding goal. A longtime prison reform advocate, Gangi’s association launched the Drop the Rock campaign to repeal the Rockefeller drug laws in 2000, bringing together thousands of residents on behalf of the cause, including New York Gov. David Paterson, who in 2002 was arrested while taking part in a protest against the Rockefeller laws. Gangi said his organization is watching the reform implementation process closely, while continuing to press for full repeal of mandatory sentencing and prison downsizing. He noted that New York’s reforms present a opportunity to improve community health, connect people with meaningful employment, keep more families intact and could save the state more than $250 million a year.

“We’ve become hopeful,” Gangi said. “We see the change that took place in New York without any damage or fallout and that makes us hopeful not only for New York, but for the country that the pendulum is swinging back to a more sane and humane approach.”

For more information on drug policy reform, visit [www.drugpolicy.org](http://www.drugpolicy.org) or [www.mpp.org](http://www.mpp.org).

*   Copyright The Nation’s Health, American Public Health Association