Legalizing drugs may be the way to help addicts, and win the drug war.
AN INTERVIEW WITH MICHAEL S. GAZZANIGA
Dr. Gazzaniga is Director for the Center of Neuroscience at U.C. Davis.
NATIONAL REVIEW: Professor Gazzaniga, thank you for talking with us again [cf. ``The Federal Drugstore,''
NR, Feb. 5, 1990]. We would like to examine the possible consequences of legalizing drugs in America. However, before we take up this controversial issue, perhaps you can sketch a quick picture of drug use today?
DR. MICHAEL S. GAZZANIGA: The current figures suggest that about 10 per cent of Americans use illegal drugs. Of course, the vast majority of these users -- perhaps as many as 90 per cent -- are not addicted to drugs and use them only infrequently. There is also a strong correlation between age and drug use. In surveys, 13 per cent of 18- to 25-year-olds claim to have used drugs in the past thirty days, while a meager 4 per cent of people over age 26 say they have done so. So, while a substantial number of people have experimented with drugs in one way or another, very few become addicted.
NR: Are there any studies that help to explain why people take drugs -- and
why they don't?
MG: Human psychology is very complex; obviously, many factors go into the decision.
Not
surprisingly, the dominant factor seems to be simply the short-term pleasure
of the drug experience. In
other words, drugs make people feel good. This simple fact is what causes people
to take these
substances, sometimes at great medical and social risk. The long-term consequences
are just not present
in their minds at the moment of arousal.
NR: Nevertheless, the fear of being caught -- and the consequences of being
caught, like fines,
confiscation, and jail terms -- must deter drug use to a certain extent?
MG: Again, human psychology is more complex than a basic analysis of reward
and punishment. There
is a large project, near completion, at the Rand Corporation, that is producing
a lot of information and
analysis, including a cross-national analysis of drug policies and outcomes
and a historical analysis of
pharmaceutical records from the period when cocaine was legal in the United
States.
Many of these studies challenge the empirical basis for using deterrence as
a means of controlling drug
use. For example, the Scandinavians imposed a severe penalty for having blood-alcohol
levels above
.08 per cent, regardless of a driver's behavior or demeanor. There was a transitory
drop in road fatalities
but then a return to baseline levels. This pattern is seen over and over again
when severe penalties are
imposed.
In studies that zoom in on individual people's actual beliefs, we also find
that the severity of penalties
plays little or no role in controlling whether or not people prone to using
drugs actually use them. This
disregard for the law is truly remarkable since the cumulative risk of getting
caught over an extended
career of drug use is fairly high.
NR: So, you are saying that potential drug users are not all that sensitive
to the threat of legal sanctions?
MG: Yes. Dozens of studies say exactly that.
NR: In that case, are there any other forces that control -- and could therefore
be manipulated by society
to control -- the decision to use drugs.
MG: There are several other forces at work here. One is the perceived health
risk. If people believe that
drugs are physically harmful to them, they are more likely to resist taking
drugs. Other forces, such as a
person's perception of the morality of the act, and perceptions of the morality
of the law, also have an
effect, as do stigmatization from being caught, shame, and other dimensions
of humiliation. There are
also informal social norms. Professor Robert MacCoun of UC Berkeley, whose
study was part of the
Rand project, makes a strong case for the importance of these factors. However,
on the other side of the
coin there is the forbidden-fruit effect, a process that may attract people
to drug use. As I said, human
psychology is extremely complex.
NR: You've considered drug use in terms of the individual user. Could you tell
us a bit more about what
drug use looks like from society's perspective? For example, what does drug
use ``cost'' society?
MG: In terms of direct financial cost -- money spent on drugs that could have
been spent more
productively -- according to the Office of National Drug Control Policy [ONDCP]
approximately $41
billion was spent in 1990, down from $54 billion in 1988. However, those numbers
are probably highballs.
NR: Why is that?
MG: Drug expenditures aren't tallied accurately like your hotel mini-bar charges.
There's a lot of very
iffy guesswork. ONDCP tries its best by using two different methods. The ``consumption''
method
involves multiplying estimates of the number of drug users by estimates of
the average amount of drugs
used. As you can imagine, neither can be measured very accurately. So they
try to verify these estimates
by what they call the ``supply'' method, which estimates the amount of base
crop raised in producer
countries, reduced by the amounts lost, the amounts seized or consumed in other
countries, and the
amounts seized in our country. The remaining amount is then assessed for value
by considering current
street prices. So the supply estimate is only as accurate as the six other
estimates it is calculated from,
and as ONDCP acknowledges, there are even more uncertainties because much of
drug value is bartered
for sex or for other drugs.
NR: So it's possible that the drug market may not be as large as it is commonly
represented?
MG: Yes. It is likely, in fact. In 1992, Americans spent approximately $44
billion on alcohol and $37
billion on tobacco. The number of Americans using these drugs is vast compared
to those using illegal
drugs. Furthermore, alcohol and tobacco are not only available everywhere,
but are actively promoted.
Taken together, it is hard to imagine that the illegal drug trade produces
an income nearly equal to that of
alcohol or tobacco.
The overall pattern of data collected by government agencies is also at odds
with other common
impressions. For example, how much of the drug business is centered on high-school
and college
students?
NR: Well, you're the one with the data. We'll guess at least half?
MG: According to ONDCP, only $2 billion of the $41 billion spent in 1990 was
spent by high-school and
college students. That is less than 5 per cent of the drug market, if their
figures are correct. So, students
are not the primary drug consumers.
NR: Even if we can't pin down an exact number, it is clear that a substantial
amount of money is wasted
by drug users on purchasing drugs. On the flip side of the coin, how much of
society's resources are being
utilized in the war on drugs?
MG: The cost of the drug war is staggering at every level of government --
local, state, federal. For
example, federal grants to state and local drug-enforcement programs are now
nearly a billion dollars a
year. Federal efforts on international drug control cost more than $800 million
annually. Federal efforts
on drug interdiction are now at least $2.2 billion a year. The total federal
drug control budget is in excess
of $12.5 billion a year, according to the 1992 Bureau of Justice Statistics
Sourcebook. And these
numbers do not take into account the huge amount of money spent by state and
local governments out of
their own tax sources.
NR: What about non-financial costs? Certainly the criminal-justice system must
be heavily burdened
by the war?
MG: No question. In 1989, 1,247,000 people were arrested for drug-related offenses.
Two-thirds of
those arrests were for possession only, and most of those were for marijuana.
As for incarceration, in
1990 there were 930,000 inmates across America in federal, state, and local
prisons. Of these, 50,000
were in federal institutions, and of these, half were in prison for drug offenses.
Of the 684,000 prisoners
in state prisons, no less than 22 per cent were being held for drug offenses.
The courts and jails and
prisons are just jammed with drug offenders.
NR: We've eased toward the issue of legalization, and now we'll ask you straight
out. Why not legalize
drugs?
MG: Adversaries of drug legalization or decriminalization feel that relaxing
drug laws will lead to
increased consumption. They submit that the increase in consumption in turn
will produce an
unacceptable burden on society. This single point, for example, is the basis
for James Q. Wilson's
anti-legalization position. However, there are several reasons to think this
concern is misplaced.
Studies on the decriminalization of marijuana suggest that it leads to no significant
increase in
consumption. Now, these studies have been contested because decriminalization
occurred at a time
when overall drug use was declining for many other reasons. However, recent
re-evaluations of
Prohibition data are consistent with the value of drug legalization.
Furthermore, current surveys indicate that among non-users, only 1.7 per cent
thought that, if drugs
were legal, they would become users. Addicts did say they might use more. But
controlled users thought
their own use would be unaffected.
These answers make sense, if you think about it. As I mentioned before, the
legality of drug use is only
one among many factors that a person considers when deciding whether or not
to use drugs. At least as
important are considerations such as risks to health, costs in terms of lifestyle,
the morality of the act.
NR: But wouldn't lots of people ``try it out'' if it were legalized?
MG: It's possible that there would be a minor bulge in drug use immediately
after legalization -- again,
the forbidden-fruit phenomenon. But think about it. Suppose heroin were legalized
tomorrow and
available everywhere. Would you suddenly become an addict, or even a user?
Probably not. Well, why
not? Because you would decide that the pleasure does not outweigh the risks.
As for current addicts, if they did use a little more, that would not necessarily
increase their inability to
function, or further impair society's efforts to deal with them. Addicts already
cause harm to themselves
and present a danger to others. But there is a limit to the amount of harm
they can inflict on themselves
and to the degree of risk they can present to society. Is a bum on the street
much worse off if he drinks four
bottles of Jack Daniels a day instead of only three? Is society much worse
off?
NR: Then the question, perhaps, is, Would there be more addicts if drugs were
legalized?
MG: If non-users are unlikely to begin using drugs, as we've discussed, new
addicts would have to come
from the ranks of controlled users. As I said, controlled users believe their
drug use would be unaffected
by legalization. Is this a credible belief? Absolutely. Because drugs are already
widely available,
controlled users could use more right now if they wanted to. They choose not
to use more because they
have determined how much they can take and still function. In other words,
they regulate their own
behavior. And for that reason, they would be no more likely to become addicts
post-legalization than
they are right now.
NR: This may be a naive question, but are drugs really that widely available?
MG: National Institutes of Health studies show that perceived availability
has remained consistently
high for marijuana since 1975. As it has for cocaine. Furthermore, from 1988
to 1992 drug availability,
by and large, increased -- despite the war on drugs. There was a 2.5-metric-ton
increase in marijuana,
with a peak in 1989 - 90. Cocaine, according to the Drug Enforcement Administration
as of 1993,
``remained readily available in virtually all major U.S. metropolitan areas.''
Heroin is available, and its
purity has increased. There are some regional variations in this pattern, but
overall, drugs are
everywhere.
NR: So legalization would not affect availability. However, the street price
of drugs is artificially
inflated because drugs are contraband. If the price of drugs dropped precipitously
-- as presumably it
would if they were legalized -- could this lead to increased consumption? Perhaps
controlled users are
controlled partly by the high price of drugs.
MG: Lower prices might mean increased use, but the data on this point are mixed,
and there is some
indication that drug users are insensitive to price. That is, that they use
similar amounts regardless of the
price of drugs. And again, consider alcohol. It is widely available and inexpensive,
but not everyone is a
drunkard. In fact, attitudes have changed markedly as far as drunkenness is
concerned. In the decades
after Prohibition was repealed, drinking hard liquor was a way of showing how
sophisticated you were,
how you were more urbane than the rubes in the Women's Christian Temperance
Union. Think of the
image of cocktail parties, of the Thin Man movies in which much of the humor
revolved around getting
drunk, of Dean Martin's shtik. Nowadays public drinking of hard liquor to the
point of slurring and
dizziness is just tacky. Square, corny old Johnny Carson had a running joke
where he affectionately
teased Ed McMahon for his excessive drinking. Cool, hip Letterman and Leno
wouldn't be caught dead
doing it. These pushes and pulls to alcohol use have nothing to do with jail
or availability or price and
everything to do with social mores. There's no reason to think that the psychology
of drug use is any
simpler.
NR: So is the ``bulge'' you mentioned earlier something like the post-Prohibition
bingeing you just
described?
MG: Yes. But there is an important difference. Just after Prohibition was enacted,
the drinking rate fell
off sharply. However, throughout the Twenties the drinking rate rose, despite
Prohibition, and it was on
the rise when Prohibition was repealed. By contrast, drug use is down in every
age group and across all
sectors of society, and it is continuing to fall. Just as an example, in 1973,
37 per cent of 18- to
25-year-olds said they had used drugs in the previous month. In 1992, only
13 per cent said they had.
NR: That would seem to prove the point of the prohibitionists: it's the war
on drugs that has caused drug
use to go down.
MG: No. The drug war targets three specific factors that affect the drug-use
rate, namely the availability
of drugs, the perceived risk of arrest or legal sanction, and the perceived
risk to personal health. As far as
drug availability is concerned, the drug war has been a total failure. Drugs
are as widely available now as
they ever have been. The risk of arrest has certainly increased -- since 1985
drug arrests have gone up
from 718,000 to 1,247,000 a year. Remember, though, studies indicate that the
perceived risk of arrest is
often ignored by drug users. Finally, health-education programs are widely
promoting the belief that
drugs are bad for bodily and mental health.
So, the war on drugs may be having an effect. But it is important to understand
that that effect is created
through several approaches. I don't know if the risk of arrest reduces drug
use more than education does
-- or even if it reduces drug use at all. However -- and this is an important
point -- if drugs were
legalized, health-education programs would continue to disseminate information.
And they might then
have the resources that now go wastefully toward trying to decrease availability,
and toward arresting
people. If we could have the same level of drug use through simple education
programs, wouldn't we as a
society prefer that to incarcerating millions of our citizens?
NR: Isn't there also a financial dimension? Education might be far less expensive
than our current full
mobilization of the judicial system, would you agree?
MG: I have seen only one attempt at estimating the potential costs and savings
that would accrue to
society from legalization. In a recent book, Prohibition's Second Failure,
Theodore R. Vallance, former
chief of the Planning Branch at the National Institutes of Mental Health, laid
out a proposal based on his
experience and research. His main professional effort for many years was to
come up with estimates and
plans concerning America's drug problem.
Vallance's analysis builds on several sources. First he used the 250-page report
prepared for the NIH by
Dorothy Rice and her colleagues at the University of California. Dr. Rice compared
the direct and
indirect costs of alcohol and drug abuse as well as of mental illness. Direct
costs refer to actual program
expenditures such as those by health professionals, the police, the courts,
and the prison system. Indirect
costs refer to such things as premature mortalities and morbidities due to
substance abuse. These reflect
real losses in terms of productivity and participation in normal society. Not
surprisingly, alcohol costs
society more than illegal drugs: in 1985, $70 billion versus $44 billion. For
alcohol, most of the cost was
for treatment and estimated damage to personal health. For drugs, most of the
cost was for law
enforcement and losses sustained by crime victims.
NR: Could you break those numbers down a little?
MG: Yes. Let me just review the drug-abuse numbers. Again in 1985, the year
that was analyzed in such
detail, $13.5 billion was spent directly on the criminal-justice system --
police, legal adjudication, state
and federal corrections, local corrections, private legal defense, and so on.
There was another $19 billion
in the indirect-costs category: around $1 billion for victims of crime, $4.4
billion in loss of productivity
for those incarcerated, and $14 billion in loss of productivity for those in
crime careers. Throw in around
$10 billion for the costs of treatment, and you have the 1985 estimate of $44
billion. The figures for
direct costs are surely much higher today. For example, totally new moneys
in the amount of $6 billion
were added by the Bush Administration for new task forces, prisons, interdiction
programs, and many,
many other projects. A realistic current figure would be around $100 billion
a year.
Vallance does not, however, simply summarize the past. He uses the Rice data,
combines it with 1993
data on extra expenditures for enforcement, and comes up with the startling
conclusion that legalizing
drugs could save society approximately $37 billion a year! In fact, I am sure
his estimate is low, given the
documented increase in the direct costs already discussed. (See table.)
NR: So the Vallance estimate is about $37 billion, and you say that it is probably
low. How did he
estimate how much of the saving should be reinvested in treatment? And how
do you measure other
dimensions of the problem like reduced suffering that might occur under a legalization
scheme?
MG: He was making best guesses based on his experience, which he writes about
with great verve. For
years he had been pushing alternative plans within the government, only to
be scolded by his superiors
for attempting to question other government agencies' capacity to deal with
the drug problem. But he
emphasizes that the details could all vary a bit, but the overall pattern of
the savings would remain the
same.
It is another matter to find a metric for human suffering. Surely a legalization
scheme ought to find
people less fearful of criminal activity in their neighborhoods. Parents should
feel better knowing the
police could concentrate on those criminal forces that would continue to peddle
drugs to children.
Addicts ought to feel better knowing that society is dealing with their problem
from a health point of
view, and surely there would have to be more programs to assist those who abuse
drugs.
NR: Thank you for your time, Professor Gazzaniga.