In June of 1971, President Richard Nixon of the United States, avowed to address “public enemy number one,” and that it was “necessary to wage a new, all-out offensive.” He wasn’t talking about foreign powers or communists. He was describing the rise of drug abuse, drug users, drug dealers in the United States, and the following policies that criminalized them. Referred to as the “War On Drugs,” the outcomes of this nearly 50-year old struggle have been both good and bad. In recent years, the “war” has been increasingly perceived as a failure.
The continued abuse of illegal drugs continues to worsen globally. In 2016, nearly 6% of the global population was using illegal drugs, and the number has only increased. The world is increasingly in the grip of an unprecedented drug crisis. The number of deaths caused directly by the use of drugs in 2015 increased to 168,000. This represents a staggering 60% increase from 2000 when only 105,000 people died from using drugs.
A disproportionate amount of these deaths happen in the United States, where a staggering amount of money and resources are spent each year waging this war on drugs. Over 70,230 drug overdose deaths occurred in 2017, and the numbers have climbed since. In 2017, the abuse of and “war” against illegal drugs cost over $190 billion annually, representing crime, healthcare, and lost work productivity. In 2016, opioid overdoses resulting in emergency room and hospital stays cost Medicare $3.5 billion, with additional expenses of $2.9 billion. Over 5% of the global encumbrance of drug and alcohol abuse is attributable to the United States.
The American appetite for opioids alone is insatiable. The total population of the United States makes up less than 5% of the world’s total population, yet Americans consume 80% of all opioids produced in the world, and most are taken illegally.
After decades of interdiction-based “fighting,” the U.S. government is now spending more on treatment and recovery services than on law enforcement, interdiction, and international intervention. The state of New York, in particular, designated 17 percent of its budget towards substance-abuse-related spending.
The US War on Drugs
Costing over $1 trillion since it began, the annual expense to United States taxpayers is over $51 billion each year. The government’s spending on federal drug control has increased steadily over the years, with nearly $30 billion spent in 2019.
The United States wages war on the illegal drug trade both at home and abroad. Internationally, the United States works with law enforcement and militaries of other countries to target criminal organizations and drug cartels. These groups often have their own paramilitaries that they fund through the sale of drugs, and they destabilize and harm the economies of the countries where they operate. The United States justifies these operations as waging war on drugs at the source, or the supply.
Domestic programs are supported through federal funding to state, county, and municipal law enforcement departments. Law enforcement has been the primary approach against illegal drugs in the United States for over a hundred years. With the statistics showing poor outcomes from the criminalization of even petty drug-related crimes, the United States has finally admitted that it’s not working. Among the overcrowded populations of incarcerated citizens currently in federal prisons in the United States, only 0.1% were in for possession, and 51.9% were in for trafficking. And while arresting and incarcerating the traffickers is effective, options for treatment and public health programs have for a long time taken a back seat to the criminal justice program.
Research has shown from the very beginning that neglecting public health and treatment for addiction is not a cost-effective way to wage the “war on drugs.” In spite of this research and the increasing data collected, federal spending on the “demand” side vs. the “supply” side is disproportionate.
A Historic Declaration of War
The 1960s saw tremendous change, through social upheaval and cultural shifts. Drug use had become synonymous with political dissension among younger generations and more famously, hippies, and college students. Marijuana was frequently used and had become problematic, but it was heroin that was the insidious problem that was hard to ignore.
In 1969, President Nixon warned Congress that “a new urgency and concerted national policy are needed at the Federal level to begin to cope with this growing menace to the general welfare of the United States.” Between 1960 and 1970, the number of narcotics-related deaths had climbed from 200 to over 1000. The number of heroin addicts was growing at an alarming rate, along with a 100% increase in crime since 1961. The existing Bureau of Narcotics and Dangerous Drugs could not keep up, even with the increasing numbers of arrests, investigations, and seizures of heroin.
In 1971, two congressmen who visited troops in Vietnam discovered and announced to the American public that 35% of servicemembers had tried heroin with over 20% addicted. Servicemembers had turned to heroin when the military began destroying marijuana fields in Vietnam and arresting and court-martialing GIs who were using or possessed it. When Cambodia’s civil war heated up, heroin became cheaper and more plentiful.
The SAODAP (Special Action Office of Drug Abuse Prevention) was created. This agency was headed by Dr. Jerome Jaffe, a drug-abuse specialist pioneering a drug abuse prevention program in Illinois that focused on treating drug addicts. Dr. Jaffe had begun using methadone and detoxification programs as a way to help the recovery process and streamline the various agencies tasked with treating addicts into a national program.
The end of the Vietnam War saw hundreds of American soldiers returning home hopelessly addicted to heroin, which was readily available in Asia. At the recommendation of Dr. Jerome Jaffe, “Operation Golden Flow” was implemented to begin testing urinalysis testing for all servicemembers who were returning home. Those who tested positive for heroin would have to remain overseas for several additional weeks to detox.
Dr. Jaffe had addressed military leadership regarding heroin addiction in the military, urging them to test, treat, and detox soldiers before reintroducing them to society in the United States. The media were reporting that as many as 20% of servicemembers in Vietnam were addicted to heroin. The U.S. Code of Military Justice mandated immediate court-martial for drug use. President Nixon sought an “amnesty” policy that was announced by the Department of Defense to encourage servicemembers to get help for their addiction without risking a court-martial. Dr. Jaffe even sought to reverse past decisions made, resulting in dishonorable discharges. This drug testing had a rapid deterrent effect, and the servicemembers who tested positive on their way home were typically addicted and unable to stop using. Another researcher, Lee Robins, discovered that only 5% of servicemembers who had used heroin returned to addiction, and 12% relapsed over the next three years.
In 1972, in a report to Congress by Senator Harold E. Hughes, studies were referenced where the military had experimented with different treatment “modalities” for drug addicts. These included a therapeutic community run by a civilian “guru,” unit drug counselors, halfway houses, and various other inpatient and outpatient programs. This report was part of the Introduction of Armed Forces Drug Abuse and Drug Dependence Prevention, Treatment, and Rehabilitation Act of 1971. Senator Hughes indicated that he hoped the bill would give the military the authority to treat drug addiction and alcoholism as disease or illness rather than a crime. He asserted that “Until this concept gained some degree of public acceptance, no progress was made in controlling the various forms of chemical addiction in civilian life.”
The studies conducted by Lee Robins showed that these addictions could be successfully overcome by changing the environment the soldiers were in and removing the stigmas surrounding addiction. While many had gone from heroin to other drugs or alcohol, many of these users had used drugs before being deployed.
The Office of Drug Abuse Law Enforcement was established in 1972, to begin fighting drug trade on the streets. In 1973, many other smaller agencies and individuals were consilidated under the Drug Enforcement Administration (DEA). This was was formed as a national agency formed from drug enforcement agents and staff from other government agencies.
In the beginning, the government took a more pragmatic approach. By 1973, over $420 million had been allocated for treatment and rehabilitation programs. For a brief time, treatment was a significant component of the drug initiatives that were part of President Nixon’s programs. Dr. Jaffe sought to make treatment for addiction a major strategy in the war on drugs.
Even though it would be several decades later before the data proved this was a more effective approach, Dr. Jaffe and many of his associates wanted to address the problem from the demand side versus just focusing on the law enforcement aspect. They hoped that by working alongside law enforcement, the trafficking would diminish, and more addicts would seek treatment.
An approach called Law Enforcement Assisted Diversion (LEAD) empowers trained police officers to make fewer arrests and instead send offenders to treatment and public health services. This approach requires considerable training and a different approach, but in cities like Seattle, where it has been widely implemented, it has resulted in an average reduction of$2,100.00 per individual in legal and criminal justice system costs. The city estimated the cost of non-participants to have actually increased by $5,951.00.
The Opioid Epidemic
The number of Americans who died of opioid overdoses in 2017 was larger than the population of many towns, to the tune of nearly 48,000. Dying of an accidental opioid overdose is more common in America than an automobile accident. Most opioid deaths occur between the age of 25 and 55, with 16-22 deaths per 100,000 people. Research suggests the numbers may be much higher as opioid deaths are underreported.
Economic loss due to drug overdose, fatalities, and incarceration in 2016 resulted in a loss of $8.2 billion in federal tax revenues. Overdose fatalities caused financial losses of $31 billion.
The financial benefit for preventing or reducing opioid overdoses and deaths could have exceeded $95 billion in 2016. The opioid crisis costs everyone money. Beyond just medical and treatment costs, there are child and family assistance costs incurred, law enforcement, criminal justice, and legal expenses.
Prescription opioid misuse in 2016 accounted for a $29.4 billion rise in healthcare and substance abuse treatment. Criminal justice costs increased by $7.9 billion, and reduced productivity, unemployment, and other associated issues cost nearly $20.8 billion. The cost for the average 2.4 million severely opioid-addicted individuals who did not die of an overdose was $72.3 billion, which on the low end of estimates comes out to about $30,000 annually per person. Medicaid ends up footing the bill for a disproportionate amount of medical expenses related to opioid overdoses when compared to the actual number of people it’s covering. These costs make up significant portions of the budgets for individual states.
When an individual overdoses on or misuses opioids, there is far more involved than just a hospital visit. First responders, law enforcement who respond, and other medical professionals are usually involved. The time spent responding to drug-related incidents takes up so much time and complicates routine law enforcement tasks. Drug-related violence makes regular stops and checks dangerous for law enforcement officers.
Supply & Demand: The Many Heads of the Drug Trade Hydra
Like the mythological creature with many heads from Greek mythology that would grow two heads each time one was cut off, the overwhelming focus on tackling the supply chain of illegal drugs has proven expensive and in some cases, more damaging down the road. The first attempts to regulate substances like heroin, morphine, cocaine, and cannabis occurred under the Pure Food and Drug Act of 1906, which labeled certain substances as unsafe or addictive. The Harrison Narcotics Act of 1914 took regulation step further to control opiates and cocaine, resulting in an unprecedented surge of drug-related arrests and charges.
After the war on drugs was declared, DEA operations expanded significantly to enforce the new laws, with the focus on drug interdiction activities. As an example, the DEA went after Mexican marijuana in the early 1970s with “Operation Intercept.” While this may have stemmed the flow of marijuana from Mexico, marijuana from other countries began to come from elsewhere to meet the demand. Interdiction and eradication efforts often result in cartels or drug operations merely packing up and relocating elsewhere. Other drugs were rapidly becoming just as popular as marijuana during this time period. Cocaine consumption in the United States increased by nearly 700% between 1978 and the mid-1980s. This is a pattern we’ve seen before.
The prohibition of alcohol in the 1920s resulted in drastic increases in crime as the criminal syndicates that formed to fill the void of legal alcohol sales contributed to the rise of corruption, distribution of dangerous “moonshine” alcohol. This occurred alongside an increasing demand for opiates, cocaine, and other drugs as alcohol users turned to other substances when alcohol was not as readily available.
While the prohibition approach towards illegal drugs is viewed as a way to reduce drug-related violence and the rise of gangs and cartels and keep the prices of drugs high, there continue to be unintended consequences. Some of these effects actually cause more harm and work directly against the efforts to curb drug use. Interdiction efforts by the U.S. government in nations south of our borders are still a significant part of national security and counterdrug operations. They are targeting narco-trafficking and drug crops before they even reach the U.S.
The unquenchable demand for and consumption of illegal drugs in the United States surpasses that of nearly every other country in the world. As long as the demand exists, the drugs will find their way across the borders.
Forcibly limiting the supply of drugs while demand remains relatively constant only increases the profitability of drug trafficking.
While waging war against drug cartels and suppliers overseas is, by nature, extremely costly, the human cost outweighs the trillions that could continue to be spent going after the supply of drugs.
The annual savings on drug law enforcement and mass incarceration costs from the legalization of drugs, like marijuana, would amount to roughly $41.3 billion according to Harvard economist. The decriminalization of drug possession could also have this effect. In 2015, the federal government spent an estimated $9.2 million every day to incarcerate people charged with drug-related offenses. The easiest way for local police to up their numbers and boost their careers is to target low-level or first-time drug offenders.
More than six in ten Americans state that state governments moving away from mandatory prison terms drug offenses is a good thing, while three out of ten Americans say these policy changes are a bad thing. In some states, law enforcement agencies are decreasing the number of arrests and drug charges in the area.
Regardless, The Drug Policy Alliance is working to shift funding away from the same old failed policies and toward effective drug treatment and education programs. The amount of money allocated by the Office of National Drug Control Policy for targeting this health issue has not declined. In fact, in the years since former President Barack Obama took office, it has more than doubled. Rehabilitation and treatment programs are developing all over the country to help make a meaningful difference.
The Human Cost of the War on Drugs
Drug addiction has manifested itself in many different ways within the last few decades. Whether perceived as a moral, public health, or political problem, the practice of dehumanizing drug addicts has only worsened the problem. For most, addictions can be managed or even overcome. There is a fine line that can be trod between enabling and pushing for treatment and recovery. It is less expensive to treat and rehabilitate. While in some cases, incarceration is the only way to facilitate the process of treatment, jail time can be more costly, both short and long term. Lengthy sentences that result in lasting convictions and criminal records for possession make it difficult for rehabilitated individuals to secure employment and reintegrate into society.
Even those individuals in the United States who are not involved in drug use are impacted. The overwhelming costs of healthcare for the overdosing and addicted send the cost of healthcare up for everyone. The sector of the population with private insurance or who are underinsured and paying out of pocket saw increases of $6.3 billion to health care costs overall in the United States. Americans on Medicaid saw costs increase by $8.7 billion.
There is no way to calculate the unthinkable and unquantifiable damage done to families and individuals. There is a decreased quality of life and emotional burdens for those involved and their family members and friends. Drug abuse impacts communities, takes away the feeling of safety in neighborhoods, decreases property values, and affects productivity on many levels, not all of them economic. Many instances of child neglect are closely related to drug abuse, and the opioid disorders in families result in an additional $6.1 billion a year spent on family and child assistance. Children are affected further down the road when exposed and are 25% to 68% more likely to abuse drugs themselves when a parent does. One in thirty-five persons in the United States expresses that they know somebody with drug addiction or disorder. The crisis touches every level of society, and the war costs far more than money.
- Staff Report on Drug Abuse in the Military: Report, Ninety-second Congress, First Session 1972