Addiction Treatment

Drugs and Drug Policy: What Everyone Needs to Know, by Mark Kleiman, Jonathan Caulkins, and Angela Hawken (2011, Oxford University Press, 234 pp., $16.95 PB)

Mark Kleiman isn't real popular among the drug reform set. The UCLA professor of public policy is no legalizer, and even though he's too much of an evidence-minded academic to be a wild-eyed drug warrior, he still seems to have an unbecoming fondness for the coercive power of the state. Kleiman, who gets top-billing over coauthors Jonathan Caulkins of Carnegie Mellon and Angela Hawken at Pepperdine, also ruffles reformers' feathers with unnecessary snideness and snark.

But I watched Kleiman address Students for Sensible Drug Policy conventions a couple of times, and I thought it was a good thing, a very useful jolt to the group-think that can grip any gathering of congregants committed to a cause. I thought having the students have to hear the arguments of a leading academic thinker on drug policy who, while not "the enemy," was not especially saying what the average SSDPer wanted to hear, was salubrious for their critical thinking skills. I still think so.

In Drugs and Drug Policy, Kleiman and his coauthors continue with the occasional jibes aimed at the drug reform movement, at times reach conclusions at odds with my own, but also serve up a surprisingly chewy work of drug policy wonkery in delicious bite-size chunks. The innovative format, something like a series of FAQs organized within broader chapters -- "Why Have Drug Laws?" "How Does Drug Law Enforcement Work?" "What Treats Drug Abuse?" "Can Problem Drugs Be Dealt With at the Source?" -- allows us to unpack that all-encompassing monster called "drug policy" one subset at a time, and for that achievement alone, is worthy of praise. That it manages to cover so much ground in a paltry 234 pages is all the more laudable.

Overall, Drugs and Drug Policy is smart, reasonable, and thoughtful. It wants policies based on evidence and it advocates for some intelligent alternatives to current policies. It recognizes the utility of needle exchanges, safe injection sites, and opiate maintenance, even as it complains that "harm reduction" has been hijacked by legalizers. It explains that most people who use drugs -- even those diagnosable as suffering from substance abuse disorders -- will quit using drugs themselves without recourse to treatment. And it even allows that drug use can have beneficial effects, even if it doesn't do so until the seventh chapter.

But Kleiman et. al dismiss decriminalization as unlikely to have a big impact on the social fiscal burden of drug law enforcement because, even though it doesn't appear to have much impact on consumption, drug consumers are not, for the most part, filling our prisons -- drug dealers are. While they do concede that not criminalizing otherwise law-abiding citizens could have "significant benefits," they seem to underplay the negative, life-long impact of a criminal drug record on one's life prospects.

In fact, they seem all too comfortable with maintaining the pernicious role of the criminal justice system in drug policy even as they recognize that enforcing the drug laws is "unavoidably an ugly process," with its reliance on snitches, surveillance, and other "intrusive methods" of enforcement. To give them credit, they want smarter drug law enforcement -- concentrating police repression on violent drug dealers while turning a blind eye to discreet dealing, triaging coerced drug treatment spots so they are reserved for the people who could most benefit from them, giving up on interdiction and source country eradication as ineffective -- that might actually reduce the social and fiscal costs of both drug abuse and enforcement, and since drug prohibition isn't going away anytime soon, at least wasting less money on drug war tactics that don't work well should be on the table.

And they reject drug legalization as too scary to experiment with, but seem to imagine it as possible only within a corporate-controlled, heavily-advertised, low-priced scenario similar to that which has accreted around the alcohol industry. Yes, it's probably true that selling cocaine like Coors, would lead (at least initially) to a significant increase in use and problem use, but why does that have to be the only model? A government monopoly similar to the state liquor store model, with reasonable taxes and no corporate pressure to advertise could conceivably allow legalization without the increases in consumption that the authors predict, even though they concede they don't know how large they might be.

Still, when you get to what it is Kleiman et al. would do if they had their druthers, all but the most purist of legalization advocates will find a lot to like. They create three separate lists of recommendations -- a "consensus list" of reforms they think are politically doable now or in the near future, a "pragmatic list" of reforms that would appeal to dispassionate observers but could raise the hackles of moralists, and a "political bridge too far list" of reforms too radical for mainstream politicians to embrace.

The "consensus list" includes expanding opiate maintenance therapy, encouraging evidence-based treatment, early intervention by the health care system, encouraging people to quit on their own (as opposed to being "powerless"), relying less on interdiction, ending the charade that alternative development is drug control, and concentrating drug enforcement on reducing violence and disorder, as well as smarter, more effective coerced treatment in the legal system. If we saw the drug czar's office produce a National Drug Control Strategy with these recommendations, we would consider that a great victory. It ain't legalization, but its headed in a more intelligent, more humane direction.

The "pragmatic list" includes recommendations to lower the number of drug dealers behind bars, not reject harm reduction even if it's been "hijacked," stop punishing former dealers and addicts, reduce barriers to medical research on illegal substances, and be open-minded about less harmful forms of tobacco use.

The authors don't neglect alcohol and tobacco -- the two most widely-used drugs -- and that is really evident in their "political bridge too far" recommendations. The first three items there are aimed squarely at reducing alcohol consumption and its ill effects. They also argue for the legalization of individual or collective marijuana cultivation, a sort of legalization without the market, increased study of the non-medical benefits of drugs, and increasing cigarette taxes in low tax states.

I think Drugs and Drug Policy needs to be read by anyone seriously interested in drug policy reform. It hits almost all the bases, and it's well-informed, provocative, and challenging of dogmatic positions. You don't like the authors' conclusions? Refute them. It'll be good for you.

The National Association for the Advancement of Colored People (NAACP) has now officially broken with the war on drugs. At its 102nd annual convention in Los Angeles Tuesday, the nation's oldest and largest black advocacy group passed an historic resolution calling for an end to the drug war.

The title of the resolution pretty much says it all: "A Call to End the War on Drugs, Allocate Funding to Investigate Substance Abuse Treatment, Education, and Opportunities in Communities of Color for A Better Tomorrow."

"Today the NAACP has taken a major step towards equity, justice and effective law enforcement," said Benjamin Todd Jealous, president and CEO of the NAACP.  "These flawed drug policies that have been mostly enforced in African American communities must be stopped and replaced with evidenced-based practices that address the root causes of drug use and abuse in America."

The resolution noted that the US spends over $40 billion a year to battle against drugs and locks up hundreds of thousands of low-level drug offenders, mostly from communities of color. Blacks are 13 times as likely to be imprisoned for low-level drug offenses as whites, despite using drugs at roughly the same rate as whites, the group noted.

"Studies show that all racial groups abuse drugs at similar rates, but the numbers also show that African Americans, Hispanics and other people of color are stopped, searched, arrested, charged, convicted, and sent to prison for drug-related charges at a much higher rate," said Alice Huffman, President of the California State Conference of the NAACP, which last year endorsed California's Prop 19 marijuana legalization initiative. "This dual system of drug law enforcement that serves to keep African-Americans and other minorities under lock and key and in prison must be exposed and eradicated."

Instead of choking the US criminal justice system with drug offenders, the resolution called for an investment in treatment and prevention programs, including methadone clinics and treatment programs proven effective.

"We know that the war on drugs has been a complete failure because in the forty years that we’ve been waging this war, drug use and abuse has not gone down," said Robert Rooks, director of the NAACP Criminal Justice Program. "The only thing we've accomplished is becoming the world's largest incarcerator, sending people with mental health and addiction issues to prison, and creating a system of racial disparities that rivals Jim Crow policies of the 1960's."

Neill Franklin, an African American former narcotics cop from Baltimore and executive director of Law Enforcement Against Prohibition, made a presentation about ending the war on drugs to the conference Monday, and had more to say Tuesday.   

"The NAACP has been on the forefront of the struggle for civil rights and social justice in this country for over a century. The fact that these leaders are joining others like the National Black Police Association in calling for an end to the 'war on drugs' should be a wake up call to those politicians - including and especially President Obama - who still have not come to terms with the devastation that the 'drug war' causes in our society and especially in communities of color."

Although passed by delegates to the convention, the resolution must be ratified by the NAACP board of directors in October. Once that happens, the NAACP's 1,200 active units across the country will mobilize to conduct campaigns advocating for the end of the war on drugs.

The African-American community has long suffered the brunt of drug law enforcement in this country, but has proven remarkably resistant to calls to reform our drug policies, in part because it has also suffered the effects of drug abuse. That the nation's leading African-American organization has taken a stand against the drug war is a big deal.

Faced with a staggering budget deficit and a prison overcrowding crisis, California Gov. Jerry Brown (D) and the state legislature have approved legislation that would shift responsibility for low-level, nonviolent offenders and parole violators from the state Department of Corrections and Rehabilitation (CDCR) to the state's counties. But sentencing and drug reform advocates say the measure merely shifts the burden of the state's corrections overcrowding from the state to the counties, fails to fund crime prevention services like drug treatment, and fails to include real sentencing reforms.

On Monday, Gov. Brown signed  Assembly Bill 109, the law shifting responsibility for many low-level offenders to the counties.  The law is designed to stop the "revolving door" of low-level offenders cycling and recycling through the prison system, Brown said in a signing statement.

"For too long, the state’s prison system has been a revolving door for lower-level offenders and parole violators who are released within months -- often before they are even transferred out of a reception center," Brown said. "Cycling these offenders through state prisons wastes money, aggravates crowded conditions, thwarts rehabilitation, and impedes local law enforcement supervision."

But the law will not go into effect unless and until the legislature approves and funds a community corrections grant program, something Republicans in the legislature have opposed.

"I will not sign any legislation that would seek to implement this legislation without the necessary funding," Brown said. "In the coming weeks, and for as long as it takes, I will vigorously pursue my plan to balance the state's budget and prevent reductions to public safety through a constitutional guarantee."

The cost of corrections in California is staggering. Gov. Brown's proposed Fiscal Year 2011-2012 budget funds the prison system to the tune of $9.19 billion, nearly 7.2% of the entire state budget. And the war on drugs is responsible for a hefty portion of it.

The state prison system holds a whopping 144,000 inmates, including more than 28,000 drug offenders and more than 1,500 marijuana offenders. Of those 28,000 drug offenders, 9,000 are there for simple drug possession at a cost of $450 million a year, or about $4.5 billion over the past decade. That figure doesn't include the cost of re-incarcerating parole violators who have been returned to prison for administrative violations, such as failing drug tests, so the actual cost of drug law enforcement to the prison system is even higher.

Not only does the prison system face a budgetary crisis, it also faces a looming US Supreme Court decision that, by most predictions, will result in the state being ordered to reduce the prison population to 110,000, which is still about 30,000 over official capacity. The lawsuit before the Supreme Court alleges that California does not provide adequate medical and mental health services to its prisoners.

Gov. Brown's and the legislature's plan to shift low-level offenders out of CDCR and into county facilities does not address the core of the problem, advocates said.

"This plan is a shell game that would simply shift corrections costs from the state to the counties without addressing the real problem: California is locking up too many people for low-level offenses for too long," said Allen Hopper, police practices director with the ACLU of Northern California. "The cost of mass incarceration is robbing the people of California of vitally needed services, including education and healthcare. What we need is real sentencing reform, such as shortening the sentences for simple possession drug crimes. It's time for California to stop wasting hundreds of millions of dollars incarcerating people who pose no threat to public safety."

"This plan would allow people to be locked up in local jails for up to three years, triple the current limit. Research consistently shows that longer sentences do not produce better outcomes. In fact, shorter sentences coupled with re-entry and prevention tactics are both more effective and more cost-effective," said Margaret Dooley-Sammuli, deputy state director in Southern California for the Drug Policy Alliance. "We're talking about people convicted of low-level offenses, like drug possession, prostitution and petty theft, often related to a drug problem. But the plan doesn't include a dime for drug treatment or mental health care. In fact, the governor has proposed reducing funds for those services."

"Any California corrections reform must include sentencing reform," said Kris Lev-Twombly, director of programs at the Ella Baker Center for Human Rights. "A felony conviction is a life-long sentence that should not be applied to low-level offenses. No matter how old the conviction, people with a felony on their record will face significantly diminished employment opportunities and much lower lifetime earnings. They may also be prohibited from accessing student loans, food stamps and other public assistance. This works against individual, family and community well-being and public safety."

The bill signed into law by Gov. Brown is not sentencing reform, but sentencing reform is what is needed, said Dooley-Sammuli. Decriminalization of drug possession is the goal, but legislators aren't ready to embrace that yet, she said. In the meantime, there are other options.

"We want the legislature to reduce the penalty from a felony to a misdemeanor," she said. "We don't think the legislators are at the point where they understand the real harms that come to drug users, their families, and their communities because of the criminal penalties for drug use, but we think they do understand there is no reason why the penalties should be as severe as they are. The common ground is that they cost too much money and they do damage because of the burden of a felony conviction."

Advocates are continuing to push for real sentencing reform in California, said Dooley-Sammuli. "This would be a very good year for it," she said. "The critical thing is for the legislature to understand that there are additional cost savings to be had by reducing these low-level felony offenses to misdemeanors, with no threat to public safety, but with positive advantages for reentry success. They think that this realignment solves the problem, but this is not sentencing reform. Incarcerating people in county jails instead of state prisons is not sentencing reform."

But even as reformers continue to fight for sentencing reform, Gov. Brown and the legislature still have to figure out how to pay for the shift from state prisons to county jails. Brown has been pushing for a special election in June to give voters the chance to approve tax increase extensions, but he needs support from Republicans, and that doesn’t appear to be there. If that doesn't happen, it may appear on the November ballot as an initiative, but the tax extensions expire July 1, and a November vote would require voters to increase taxes, not a popular notion these days.

"Funding is not imminent," said Dooley-Sammuli. "But the deal has been struck. If they can get the Republicans or the voters to agree to tax extensions, this is the plan Democrats want for realignment.

And speaking of funding not being imminent, Gov. Brown has proposed zero increases for community-based drug treatment and actual cuts to drug treatment programs within the CDCR. That would affect treatment for both prisoners and parolees.

"He is talking about reducing access to services even as we face a major shift in how corrections works in this state," said Dooley-Sammuli. "That's really stupid."

It has become increasingly evident that California can't afford its drug war. Gov. Brown and the legislature have attempted to craft a fix, but the fix will leave the system just as broken as ever. Now, the state's political elite has to understand that half-measures won't solve the problem. If they're not ready for decriminalization or legalization, it is at least time for de-felonization.