ONDCP Blog

What Drug Policy Reform Looks Like

President Obama believes in the pursuit of an America built to last – a Nation founded on an educated, skilled workforce with the knowledge, energy, and expertise to succeed in a highly competitive global marketplace. Yet, for too many Americans, this vision is hampered by drug use and addiction, which inhibits their ability to live healthy lives and achieve their full potential.

While the harms caused by substance use and substance use disorders may seem obvious, here’s a reminder of what the data show: According to the CDC, drug overdose deaths are the second leading cause of injury death, surpassed only by suicides. Making matters worse, studies show that among the 22 million Americans who need treatment for substance use disorders, only about 2 million—only about one-in-10—receive it [i]. What has caused this disparity? For a start, not all health insurance plans have been required to cover drug treatment on par with other medical problems. That’s unacceptable.

This week, the Obama Administration announced a major milestone in drug policy reform that builds on our record of treating drug use as a public health, not just a criminal justice issue. Through a new rule made possible by the Affordable Care Act, we are requiring insurers to treat substance use disorders in the same way they would any other chronic disease. Specifically, this new rule expands coverage of mental health and substance use disorder services to 62 million Americans. In today’s heated debate over drug policy, it is worth noting that this is one of the most significant pieces of drug policy reform in a generation. 

Why does this matter?  Practitioners in our health care system historically have not screened for substance use disorders and often have limited knowledge of the nature of addiction.  As a result, significant resources are spent treating the symptoms of Americans with undiagnosed substance use disorders. Research shows that treating substance misuse before it develops into a chronic disease is the best course of action. Implementing screening and brief intervention protocols has shown to be effective in reducing problematic substance use and its consequences.  For those who have already developed an addictive disorder, only 10 percent of the population who need treatment receive it—often because of insufficient insurance coverage.

Like most chronic diseases, a substance use disorder is progressive. As it progresses, it changes the brain, leading to ever more damaging consequences and making the disease more difficult to treat. If we can ward off problematic substance use before an addictive disorder develops, we can prevent the disease’s most serious consequences. Treatment makes good financial sense as well. Because for every dollar we spend on treatment, we realize a benefit of seven dollars as a result of reduced criminal justice system costs and increased employment earnings. [ii]  That means less incarceration, safer communities, healthier citizens, and a stronger workforce.

The most important thing we can do to reform our drug policies is to change the way we think about – and address -- our Nation’s drug problem.  A "war on drugs” should not define how we can make America healthier and safer. We cannot arrest our way out of the drug problem. So while smart law enforcement efforts will always play a vital role in addressing drug related crime in America, we must acknowledge that science shows addiction is a disease of the brain that can be successfully prevented and treated.

That is why equal access to drug treatment programs is a priority for this Administration. After all, treatment should not be a privilege limited to those who can afford it, but a right available to all those who need it. That is what real drug policy reform looks like.  

Toward a Smarter Drug Policy

Please note that this is a co-authored blog post by Gil Kerlikowske, Director, ONDCP and Benjamin Todd Jealous, President and CEO, NAACP. This post also appears on The Huffington Post and the NAACP blog. 

In Los Angeles not long ago, a man named Michael Banyard ran afoul of California’s “three strikes” law. After bouts of homelessness, unemployment, suicidal thoughts, and a criminal record driven by an underlying substance use disorder, Michael faced a mandatory 25-year prison sentence.

Fortunately for Michael, Federal District Court Judge Spencer Letts was put in charge of his final sentence appeal. Judge Letts saw Michael not as a hopeless, drug-using criminal, but as an individual with a disease in need of help. The judge then did something highly unusual. He not only reversed Michael’s sentence, he invited him into his chambers to talk.

Here were two men who could not be more different – a white, Yale- and Harvard-educated judge and former corporate vice president, and a shy African American who had spent most of his adult life in prison. And yet, the men found they had more in common than either could have imagined.  Judge Letts knew that repeatedly incarcerating Michael wasn’t accomplishing much. 

Over the years, Judge Letts became, in Michael’s words, the father he never had. The Judge gained something extraordinary too. Michael, he said, “showed me that my gut feeling was right – that people are basically the same, with the same basic goodness, if you just give them the chance.”  Today, Michael Banyard has received his GED degree and spends his time volunteering at the Los Angeles Dream Center, where he graduated from a faith-based program that he credits for his transition away from substance abuse. 

Stories like this illustrate the kind of thinking needed to reform our nation’s criminal justice and drug control policies. In 2011, about seven million people were under the supervision of the criminal justice system in the United States. Of these, about two million were behind bars. And nearly one quarter - 500,000 - of those behind bars are there for drug related offenses. America’s incarceration rate – 756 per 100,000 population – is the highest in the world. High rates of incarceration have resulted in prison overcrowding and state governments facing the costs of a rapidly expanding penal system.

In addition, our nation’s historical emphasis on incarceration has significantly affected communities of color. African Americans are disproportionately incarcerated for drug offenses, accounting for almost half (45 percent) of all drug offenders in state prison in 2010. (Whites accounted for 29 percent.) Among prisoners age 18 to 19, African American males are imprisoned at more than 9 times the rate of white males, and African American females are imprisoned at between 2 and 3 times the rate of white females.

It is clear that we cannot simply arrest our way out of the drug problem. Instead, we need smarter, results-based criminal justice policies to keep our communities safe, including treatment for people with substance use disorders and mental health issues.

To bring about real, meaningful change, we need a fundamental shift in how our Nation discusses drug policy. This begins with the acknowledgement that our drug problem is a public health issue, not just a law enforcement issue.  It means acknowledging that an ever-growing body of scientific research clearly demonstrates that addiction – the underlying cause of too much crime in this country – is a disease that can be prevented and treated successfully.

Armed with the indisputable fact that preventing and treating addiction is an effective strategy for reducing substance abuse and crime, the Obama Administration and the NAACP are committed to pursuing evidence-based policies that strengthen families and communities across America.

Already, the Administration has worked to expand specialized courts that divert roughly 120,000 non-violent offenders into treatment instead of prison each year. The President has requested that Congress increase its commitment for drug treatment programs for 2013. And in 2010, President Obama signed into law the Fair Sentencing Act, which made progress in reducing the 100-to-1 disparity between sentences for powder and crack cocaine that disproportionately affected minorities and also eliminated the mandatory minimum sentence for simple possession of crack cocaine.

Significant accomplishments all, yet more must be done, particularly at the state level.

Demonstrating how criminal justice reform can be a bipartisan issue, the NAACP has worked tirelessly with elected officials from both parties to achieve sensible reform. With the support of the NAACP, Republican Governor Nathan Deal of Georgia signed into law the most sweeping criminal justice reform legislation in the country. The NAACP also worked to find common ground with Republican Governor Bob McDonnell of Virginia, who shut down prisons and called for more money to be sent to universities. In Texas, the NAACP helped push Republican Governor Rick Perry to sign 12 progressive reforms that led to Texas scheduling the first prison closure in the state’s history.

Actions by the Obama Administration, the NAACP, and others are vital steps toward reshaping and redirecting our nation’s criminal justice system. These are only the first steps, however, and the road ahead is long. It will take still more action, more time, more work, and more innovative thinking to bring about the reforms that are so urgently needed.

The challenge is immense, but America is up to it. Working together, we can reduce the heavy toll of substance use in our cities, neighborhoods, and families.  Combining proven public health and public safety strategies will help break the vicious cycle of drug abuse, crime, and incarceration. This, in turn, will save countless lives and taxpayer dollars, make America stronger and safer, and ensure a more perfect union.

It’s not only the right thing to do—it’s the smart thing to do. 

Are Drugs Today Really Cheaper, Purer, and More Available Than Ever?

You’ve probably heard this claim: Despite decades of effort, we’ve failed to make any significant progress in reducing drug use in this country. Some critics go so far as to say that “illegal drugs are cheaper, purer, and more available today” than ever before. This is a compelling argument and a powerful sound bite, to be sure. There’s just one problem:

It’s not true. 

While gaining a clear picture of the illegal drug market is always a challenge, a vast array of data, research, and surveys reveal long-term trends and shed valuable light on the nature and scope of the drug problem in America. The evidence presented by these sources is vital in our work to meet the President’s mandate of promoting policies grounded in science and research.

So what do the data show?  Simply put, our national drug problem is substantially smaller than it used to be, and progress continues to be made.

Here’s the evidence:

• According to the National Survey on Drug Use and Health – the Nation’s largest, longest-running, and most comprehensive survey on drug use – the overall rate of drug use in America has dropped by roughly 30 percent over the past three decades.
• More recently (since 2006), the number of past month (current) users of any illicit drug other than marijuana has dropped 16 percent. Driving this decline have been decreases in the number of current users of cocaine (44 percent), meth (40 percent), and prescription drugs (14 percent).
• The Monitoring the Future study, the most important youth survey on drug use in America, has shown that the overall rate of illicit drug use among high school seniors has fallen by 35 percent since 1979.
• The same survey of youth drug use reports that the perceived availability of cocaine among high school seniors has dropped by nearly 50 percent since its peak in 1989.
• According to STRIDE (System to Retrieve Information from Drug Evidence) – law enforcement’s largest forensic laboratory database – cocaine purity over the past few years dropped to levels not seen since reporting began in 1981, indicative of a significant disruption in the U.S. cocaine market. In response, the number of current cocaine users in 2011 dropped significantly from levels in 2002 through 2008.
• According to the United Nations, “cocaine consumption has fallen significantly in the United States in the past few years. The retail value of the US cocaine market has declined by about two thirds in the 1990s, and by about one quarter in the past decade.”
• According to the Center for Disease Control and Prevention’s National Center for Health Statistics, unintentional overdose deaths in the U.S. related to cocaine dropped 41% from 6,726 in 2006 to 3,988 in 2009, the year for which the most recent data are available.
• Cocaine production in Colombia – the source of most cocaine consumed in America – has plummeted by over 70 percent since 2001.

Again, these facts are proof that we are not powerless against the drug problem in America.  As the President himself has noted, we have successfully made a difference in other areas, like smoking and drunk driving, so there’s no reason to think we cannot continue to achieve the same success with illegal drugs. Our challenge, it’s worth pointing out, is not that we are unable to reduce drug use; indeed, we have made great strides in that effort. The challenge is that rates of drug use are still too high.

Drug use and its consequences continue to place too many obstacles in the way of young people working to achieve their full potential. It still drives violent crime in our neighborhoods, in our cities, and throughout our hemisphere. It still fosters substance use disorders that tear families apart and end too many lives. This Administration will continue working aggressively to address this challenge in a smart and comprehensive way, and with a clear and realistic goal: to reduce drug use and its consequences by 15 percent over the next five years.

We are energized by the ongoing national debate about drug policy reform in America. That’s why we’ve put forth a National Drug Control Strategy that outlines more than 100 specific drug policy reforms that build on the progress we have made thus far. Still, as we engage in this important national conversation about how best to protect public health and safety in America, we must remain focused on using science and research – not ideology or dogma – as our guide in this national discussion.

This is part of a series of blog posts that address myths about federal drug policy. Related: Independent fact checkers at Politifact dispel claim that marijuana is easier for young people to get than alcohol.

Drug Laws: Why Do We Have them, and Do They Work?

It’s a question often raised in today’s heated discussion about the efficacy of drug policy in America: Do regulations outlawing certain drugs actually work?

Let’s go to the data. Here’s what the Nation’s largest, longest-running, and most comprehensive source on the state of drug use in America shows:

As you can see, the use of legal drugs like alcohol and tobacco far outpaces the use of illegal drugs. It is clear, then, that laws discouraging drug use do have an effect in keeping rates relatively low compared to rates for other drugs that are legal and therefore more available.  Even beyond this one-year snapshot, we know that significant progress has been made in the long term.  Since 1979, there has been a roughly 30 percent decline in the overall use of illicit drugs in America. . (Related: Independent fact checkers at Politifact dispel claim that marijuana is easier for young people to get than alcohol.)

So our challenge is not that we’re powerless against the problem of substance use in America. The challenge is that rates of drug use – a behavior that harms too many of our fellow citizens -- are still too high. That’s why the President’s National Drug Control Strategy supports innovative and proven programs that aim to reduce drug use and its consequences through a combination of public health and public safety interventions.

It boils down to simple arithmetic: The more Americans use drugs, the higher the health, safety, productivity, and criminal justice costs we all have to bear. And if sensible drug laws (in combination with a wide array of prevention, treatment, and other health interventions, of course) help keep those numbers down, then the answer is yes, they are working.

This is part of a series of blog posts that address myths about federal drug policy. Related: Are Drugs Today Really Cheaper, Purer and More Available than Ever?