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America's war on drugs: 40 years, a trillion dollars, and debatable results

Under CC License from Thomas Marthinsen. http://www.flickr.com/photos/thomma/4906491235/
Under CC License from Thomas Marthinsen. http://www.flickr.com/photos/thomma/4906491235/

In 1971, President Richard Nixon declared drug users public enemy number one. Young, white, middle-class kids were openly using recreational drugs, and long-held stigmas about drug use were shrinking, especially in the Bay Area. Public perception typically connected drugs with protest culture and the social rebellion of the '60s and '70s. To then-president Richard Nixon, and many others, it was a sign of society coming apart at the seams.

PRESIDENT RICHARD NIXON: We must wage total war on what I have called public enemy number one: the problem of dangerous drugs.

So Nixon began a grand campaign to strike back. He wanted nothing less than a full-scale “war on drugs” that would be waged against the dealers and users of drugs at home, as well as the cultivators and suppliers abroad. It would be carried out through aggressive policing and military intervention. And it would set a trend for decades to come.

PRESIDENT NIXON: We’ve turned the corner on drug addiction in the United States. Drug addiction is under control. REPORTER: The president allocated another $462 million for the drug war in 1974, almost eight times the amount spent four years earlier. ABC NEWS REPORTER: In Washington today President Reagan signed into law a new anti-drug bill passed in the last days of an election year Congress. It provides an additional $2.8 billion to the war against drugs… PRESIDENT RONALD REAGAN: It’s time, as Nancy said, to just say “no” to drugs. PRESIDENT GEORGE H. W. BUSH: It is imperative to put more resources into our fight, so I am asking Congress to put $12.7 billion to wage this war on drugs. If Congress approves my request, funding for the war on drugs will have increased by 93% to nearly double the rate just three years ago when I took office. PRESIDENT BILL CLINTON: If we ever expect to reduce crime and violence in our country to the low level that would make it the exception rather than the rule, we have to reduce the drug problem. We know it is a difficult battle. We know that overall drug use and crime are down in all segments of society but one: young people. And that makes the battle more difficult and more important. PRESIDENT GEORGE W. BUSH: Drugs help supply the deadly work of terrorists, that’s so important for people of our country to understand … which is why the budget I submitted to Congress calls for $19 billion to fight drug use.

How has the drug war changed America, 40 years on? We start with this story:

YEMA LEE: I've been to jail so much it's hard to even keep track. And you know, the drugs just blew my head back. You know what I’m saying. And so some of my gears are stripped. I spent more time in jail than I spent with my children in their actual real life. You know what I'm saying? So that's really depressing to me. And they never really offered me the opportunity, you know what I'm saying, to try and do something different.

San Leandro resident Yema Lee was arrested for drug possession in 2009 – a year in which more than 1.6 million people across the U.S. were arrested for drug violations. She told her story to KALW’s Christopher Connelly.

YEMA LEE: I grew up in West Oakland and as a child. It was normal in our family to drink alcohol and use drugs and sell drugs. We lived in a bad neighborhood so it was like an inherited type of thing. I started out smoking marijuana when I was maybe about four or five with my brothers. They sold marijuana. My aunts and cousins sold marijuana. That’s what we did, you know and later on in life I got around to using crack cocaine after I had been married. I had gotten married when I think I was about 18 years old. What happened was I had walked in on my husband. My husband was using and I didn’t know. And I had been selling the crack, and he was using. And when I walked in, he was using and he said, “Well why don’t you just go ahead and try it.” And it worked – I got hooked. But crack cocaine is not something that you can use and sell. You know what I’m saying? So, well, now we were out the dope game. Now we were just drug addicts. I lost my kids, my job, everything. Crack releases dopamine into your head, you know, so it’s like orgasmic bliss every time you take a hit, you know what I’m saying? So the thing was I’d take this hit, right, and smoke a cigarette and then I’d go rob something. So that’s where my criminal addictive behavior broke in. I started using crack every day. And it took me like less than three months using crack where I just lost everything. I went from a big drug dealer and, you know what I’m saying, the head honcho on my block to just this skinny, emaciated crack head on the corner with no kids, no job, and no house. It took them a while, I guess about ’99 when I actually got my first possession case of actual narcotic. So I had been in and out of jail more than 37 times before I actually went to prison. Once you get tin there, and you see the fences and the cyclone, and all the doors go crash! You got to shut yourself down and create about 50 different masks just to be there. Most parolees know, if they’re in the life, that they’re gonna go, and they get arrested, they already pack ahead of time, like I was packing ahead of time: the last time I went to prison I already knew. So I had tobacco, I had jewelry, and I had drugs, all in my genitalia. Bend over and cough? If you tell ‘em you’re pregnant, they don’t make you cough. There’s no opportunity to change in there. It’s a joke when they say prisons are rehabilitation centers. There ain’t no rehabilitation in there – none. I didn’t use because it was convenient. I used because it was raining. I used because the sun was shining. I used because I had new shoes. I used because I had no shoes. You know what I’m saying? It didn’t need to be a reason. I would start arguments with people just so I had a reason to use. And some days I didn’t need no excuse to use. It made no difference. I used because I liked it. And you’re selfish, and you don’t realize the people that you hurt. When you’re using, I remember the mentality that I had – it was, “Nobody gives a fuck about me anyway.” Excuse me for cursing. But that is it. Nobody cares about me anyway; nobody gives a damn. I’m only hurting me.

CHRISTOPHER CONNELLY: The drug war is such a big, complicated, multinational, multifaceted story. At this point, whether you’re directly affected by drugs or not, whether or not you know a user, or someone who’s been hurt, or someone who’s in prison, it’s impacting your life, every day.

UC Berkeley professor Barry Krisberg is generally considered to be one of the country’s foremost criminal justice experts. Krisberg is a criminologist and the policy director at the Warren Institute at UC Berkeley's Boalt School of Law.

BARRY KRISBERG: The basic logic of the war on drugs was a deterrence argument. You know that we were going to basically deal with this problem by scaring people into stop using drugs. Or by taking out of circulation people who were trafficking in drugs.

And the net result, he says: It failed. Big time.

KRISBERG: I mean on a national level it's seven or eight times larger it was than when we started this.

Yet, he says, the data shows drug use hasn’t changed much.

KRISBERG: The average price of drugs is about the same. Some would argue that the purity and potency of drugs is worse than it used to be. So by any objective measure the drug war has failed miserably.

Krisberg says that after 40 years of drug war, prioritizing the criminal justice system as a deterrent has become a self-perpetuating cycle.

KRISBERG: The police have by and large until very recently dealt with this as a numbers issue. How many arrests can we make? If you look for example at the substantial decline in arrest in juveniles in the last 10 years in California, arrests for drug offenses have gone up. So, part of what's happening is that as crime is going down, police are making a lot of minor drug arrests just to keep their quota.

The result, he says, is an overflowing prison population and an inflated budget for law enforcement. Nationally, more than half of the prisoners in federal penitentiaries are there for drug offenses. In California state prisons, it’s a little less: about one in five inmates are locked up for drug offenses, or roughly 32,000 people. And, of course, if you follow the news, you know prison overpopulation causes plenty of problems.

ROBERT SIEGEL (from NPR’s “All Things Considered”): A bitterly divided supreme court has upheld a lower court’s ruling that requires the California prison system to reduce it’s prison population by some 33,000 prisoners… KRISBERG: As you focus enforcement on the drug industry, what you're gonna do is you may drive out the kind of marginal low end people. But who's gonna stay behind are the really hard characters. And they don't see themselves … they're not deterred. They don't imagine they're going to get caught. And very few of them in fact get caught. We're looking for the easy targets, and the easy targets are not making this problem go away.

So, in the end, Barry Krisberg says the war on drugs has been worse than a zero sum game. And the cost, he says, weighs heavily on poor communities around the country, the state, and in the Bay Area. So Krisberg is calling for a complete change of tactics.

KRISBERG: I think the emerging consensus at this point, not only among the academics but among law enforcement community is that we need to shift to a public health model rather than a criminal justice focus.

Dr. Diana Sylvestre is working towards the public health model of understanding and treating drug addiction at the hepatitis C clinic at Highland Hospital in San Francisco. She also founded and runs the O.A.S.I.S. Clinic in West Oakland, where she specializes in addiction medicine.

DIANA SYLVESTRE: I always like to liken this whole strategy that we have, you know our strategy of building more prisons because of drug use is just like building more cemeteries as a means of dealing with cancer. It is a strategy, but it's not the right strategy.

Still it’s been the country’s primary strategy to combat drugs for four decades now – with dubious results.

I first met Dr. Sylvestre at Highland, where she sees hep C patients. It’s your standard sterile hospital. But when I caught up with her at O.A.S.I.S., I found a different scene. O.A.S.I.S. stands for Organization to Achieve Solutions in Substance Abuse.

SYLVESTRE: We provide a whole range of services. I think it would generally fall under the description of providing medical care for marginalized persons, especially drug users.

Activist posters line the walls. On the day that I visit, patients and workers are making signs for a protest in San Francisco. Sylvestre founded the clinic on the last day of 1998. It now has a thousand patient visits a year.

SYLVESTRE: We're known for our work in hepatitis C, because we've developed some of the successful models of care for treating hepatitis C in persons that weren't supposed to be treatable.

Sylvestre says that 40 years ago, when the foundation for the war on drugs was laid, people didn’t understand how addiction worked.

SYLVESTRE: You know in 1971, we didn't have things like CAT scans and MRIs and cloning. And now we recognize that addiction is a neuro-chemical illness, we know where it is in the brain, and we know that it can be treated when it is put in the context of a medical model.

By the early ‘70s, methadone treatment was gaining popularity. The idea was to give heroin users a way to regulate their addiction by giving them a low dose of a controlled long-acting cousin to heroin, so they could stop shooting up and break the cycle of addiction. Sylvestre says it’s like using insulin to help diabetics maintain their blood sugar and control their disease.

SYLVESTRE: And isn't that what it's all about: treating people so they don't use drugs?

Sylvestre says the reason people take drugs has to do with the part of the brain that feeds addiction: it’s called the nucleus accumbens, and it’s the brain’s pleasure center.

SYLVESTRE: For some people who may not feel particularly good on a day-to-day basis, using the right drug makes them feel better than maybe they've ever felt in their entire lives. And when you’re that kind of person and you have that kind of reaction, your approach would probably reasonably be to try to use it again.

When heroin is injected, it travels through the blood stream and binds with opiate receptors in the brain. A warm, euphoric feeling takes over as pain messages are blocked and the pleasure center is stimulated.

SYLVESTRE: Unfortunately, drugs are addictive. And so a person has to use more and more to get the same, to get the same effect.

When the drug is stopped, the brain sends a warning signal in the form of withdrawal. In the case of heroin it starts just a few hours after the last dose and involves a range of uncomfortable, even painful, symptoms.

SYLVESTRE: And people have the idea, “Well if you just stop using drugs for a period of time you're done with it.” But the neuro-chemical abnormalities are still there. It is as if a diabetic loses weight. Well marvelous – you don't need insulin and that would be a good thing…

But put the weight back on...

SYLVESTRE: And you need insulin again. And so we sort of castigate people with addictions for relapsing when it's actually characteristic of the illness.

A lot of Sylvestre’s patients come to the O.A.S.I.S. Clinic for drug treatment. But she treats them for a variety of issues. Hepatitis C is incredibly common in intravenous drug users – in the Bay Area, up to 85% carry the liver disease.

The hep C treatment that Sylvestre pioneered at O.A.S.I.S. is very effective, but it is also intensive. She says it takes months to lay the groundwork for successful treatment, to get the patient stable and healthy. Her therapy uses weekly shots of Interferon and Ribavirin pills administered twice a day for a year. The whole process costs about $25,000. Most of her patients are covered by Medi-Cal, and Sylvestre has some grant money to help cover the costs as well.

SYLVESTRE: It's an expensive proposition and a challenging proposition because really it's akin to chemotherapy. But on the other hand people are cured at about the rate of about 55%, and it's a fabulous public health opportunity to get this disease off of the streets, because then it's not going to spread.

Diana Sylvestre is not just a physician. She’s also a researcher and a crusader.

Since 1971, the Drug Policy Alliance estimates the war on drugs has cost the U.S. about a trillion dollars – and that’s just measuring enforcement, the courts, and corrections. It doesn’t account for unemployment, medical costs, and the need for foster care.

So, with those things in mind, Dr. Sylvestre helped found a new organization called United for Drug Policy Reform – a drug users union. The members leverage their own experiences to push for more thoughtful drug policies. Dr. Sylvestre doesn’t lump drug users altogether into some criminalized category. She told me that the people she’s worked with are unique, and they’ve inspired her to take action.

People like Larry Galindo – a former heroin addict, a member of the drug users’ union, an ex-convict, and one of Dr. Sylvestre’s employees.

LARRY GALINDO: Tell you the truth I've been to jail so many times that they all start blending together after a while, and I can't really remember them.

Galindo spent about 20 years going in and out of the prison system. His rap sheet is 27 pages long, and includes a variety of crimes including simple possession. It also reports violent crimes that he says are associated with his drug use.

GALINDO: I've got two attempted murders, four assaults with a deadly weapon, great bodily injury, and a bunch of assaults. I've got 13 felony convictions.

Most of Galindo’s criminal activities were done before three-strikes laws. He says that if he were to be arrested for a crime now, he’d probably face a life sentence. He’s clean and working now, but his criminal past still weighs on him. 

GALINDO: The personal toll that drugs took on me … I was shot five times, stabbed twice, in an explosion once, my job was actually robbing drug dealers…

Galindo says that he deserved to be imprisoned for the violent crimes he committed. But, he says, locking up non-violent drug offenders only makes things worse.

GALINDO: You put a person that smokes a little pot or got a little drugs and they never been in a violent environment like that, and you're either going to harden them or break them. He's gonna be affected for the rest of his life; he's not gonna be the same person.

Beat up, Galindo says, or raped by other inmates, or drawn into a more felonious culture.

GALINDO: You might turn a pothead into a cold vicious killer. I've seen it happen.

Although prisons offer addiction treatment, he says the resources are too few and ineffective. 

GALINDO: You can't put me in jail and expect me to quit using drugs under threat of jail. You can get drugs in jail.

Galindo says that he had to make the decision to get clean on his own. After his last prison stint in the early ‘90s, he came back to Oakland and started methadone treatments. He kicked heroin, but found out he had contracted hep C. That’s when he met Dr. Sylvestre. Eventually, she offered him a job. And for the last 12 years, Galindo has worked at War on drugs.

GALINDO: This is actually the first legitimate job that I’ve ever had working for Diana.

Now, as a man who can relate to addicts, to ex-cons, to rehabbing users, Galindo has a uniquely experienced perspective on America’s struggle with illegal drugs.

GALINDO: Well I'd like to see treatment. I'd like to see access to treatment. I'd like to see more education. You know, the budget that we've got from prisons, we're spending so much money that we could be doing a lot of solutions if we cut that budget in half. I mean we could do education, treatment, prevention, all these things and they're all effective if they're done right. PRESIDENT NIXON: I am glad that in this administration we have increased the amount of money for handling dangerous drugs seven fold, to $600 million. More money will be needed in the future. I want to say, however, that despite our budget problems that to the extent that money can help in beating the problem of dangerous drugs, it will be available. This is one area that we cannot have budget cuts.

That’s former President Richard Nixon in 1972, a year after he declared the war on drugs. Forty years later, UC Berkeley criminologist Barry Krisberg has a different perspective.

BARRY KRISBERG: You gotta ask yourself the question: Why are the tax payers spending money for this? Because it's not really having any big effect.

Krisberg’s point is that we know the best way to deal with addiction is by treating it like we would treat any disease, rather than using the criminal justice approach he says has failed.

KRISBERG: And I always like to remind people that we used to treat tuberculosis as a crime and we'd incarcerate people for having tuberculosis. We used to believe that mental illness was criminal and we would incarcerate and use the criminal justice system for mentally ill.

A lot of the folks I talked to at the O.A.S.I.S. Clinic were hopeful that things are moving in that direction. On a national level, President Obama seems to be backing away from the rhetoric of the war on drugs. His administration has reduced some of the sentencing disparity between crack and powder cocaine, and it’s increased funding for public health responses to drug abuse.

But Krisberg isn’t really convinced. He says on a national level there has yet to be a substantive reduction in drug enforcement budgets.

KRISBERG: We used to talk about a military-industrial complex. There's a drug war-industrial complex that's out there too.

Still, Krisberg says polling he’s done shows a vast majority of Californians want to change the way society deals with drug use and drug addiction.

KRISBERG: I think people need to understand that the drug war has failed utterly, in terms of reducing the problem of addiction. It's driven down the cost of drugs. On the street today, drugs are cheaper than they were 40 years ago and more plentiful and of much higher potency. That doesn't sound like a victory.

Krisberg says, until the politicians connect the dots and start making changes, the drug war will go on.

Christopher Connelly is a reporting fellow at KALW and a student at the UC Berkeley Graduate School of Journalism. This story originally aired on August 24, 2011.

Chris Connelly is a reporter with the UC Berkeley Graduate School of Journalism.