In the Age of Cocaine: What Is Our Drug Problem?
By Mark Danner
and , Mark Kleiman, Rudolph Giuliani, et al.
December 22, 1985
Last year Americans spent $30 billion on illegal drugs, while their government spent $1.5 billion trying to shut down their sources of supply. Despite stepped, up funding by the Reagan Administration, enough traffickers manage to elude the clutches of Drug Enforcement Adminis, tration agents to maintain the drug market in a state of robust prosperity. Government efforts have come to resemble a perverse price, support program, succeeding mainly in keeping drug prices up and dealers' profits high.
The booming drug market no longer serves only poor junkies and adolescent
pot smokers; during the last decade drug use has become increasingly fashion,
able among the well,to,do. The "drug problem" now means affluent lawyers,
doctors, and investment bankers serving cocaine at parties, offering it
at clubs, even taking a snort or two before an important busi, ness meeting.
Sermons about the dangers of drugs are no more successful in discouraging
wealthy users in their newfound predilections than the DEA's efforts are
in limiting their supply.
Why are Americans using more and more drugs? What should be done about it? Are there better ways to discourage drug use than putting traffickers and dealers in jail? Harper's recently invited a group of legal scholars, medical authorities, and government officials to reflect on America's drug problem.
The following Forum, cosponsored by Harper's and the Manhattan Institute for Policy Research, is based on a discussion held at the University Club in New York City. Mark D. Danner served as moderator.
MARK D. DANNER is senior editor of Harper's.
MARK A. R. KLEIMAN was director of policy and management analysis in the Criminal Division of the Justice Department from 1981 to 1983. He is currently a research fellow at Harvard University's Kennedy School of Government.
ARNOLD S. TREBACH is a professor of justice at American University and director of its Institute on Drugs, Crime, and Justice. He is the author of The Heroin Solution and The War on Us: The Story of the Aerican Anti-Drug Crusade and Its Victims, which will be published next year by Macmillan.
ROBERT M. STUTMAN is special agent in charge of the Drug Enforcement Administration's New York field division. From August 1979 to September 1985 he headed the DEA's Boston field division.
RUDOLPH W. GIULIANI is U. S. Attorney for the Southern District of New York, where he initiated Federal Day-Operation Pressure Point and other major campaigns against drug dealing. From 1981 to 1983 he served as associate attorney general.
LUIS G. GARCIA trafficked in marijuana, Quaaludes, and cocaine in Miami and the Bahamas from 1979 to 1983. He participated in a DEA "sting" operation in 1983 directed at Bahamian politicians and government officials involved in the drug trade, and testified before the Royal Bahamian Commission of Public Inquiry.
LESTER GRINSPOON is an associate professor of psychiatry at Harvard Medical School. He is the author of Marihuana Recon- sidered and, with James B. Bakalar, Cocaine: A Drug and Its Social Evolution.
ERNEST VAN DEN HAAG is John M. Olin Professor of Jurisprudence and Public Policy at Fordham University and a Distinguished Scholar at the Heritage Foundation. His books include Capitalism: Sources of Hostility, Punishing Criminals, and The Death Penalty: A Debate.
HERBERT LONDON is dean of the Gallatin Division of New York University and a senior fellow at the Hudson Institute. His books include Closing the Circle: A Cultural History of the Rock Revolution.
MARK D. DANNER: What is our drug problem? The traditional response might run as follows: Greedy criminals are smuggling increasingly large amounts of illicit and dangerous sub- stances into our country, where Americans, particularly young ones, smoke, snort, and in- ject them into their systems in larger and larger amounts, thereby ruining their health, mud- dling their thinking, and generally debilitating themselves.
But some might offer a different answer: For some reason, our government is inordinately concerned with preventing its citizens from consuming certain substances they very much want to consume, and in so doing has created a huge illicit industry and a large new criminal population. In considering our drug problem, I want to keep these two responses in mind.
Perhaps the best way to start is to divide the monolith we call the drug problem into its con- stituent parts. What drugs in particular are widely used today? Are some drugs becoming more popular and others less so? And who uses drugs? Is it true, for example, that marijuana is favored mostly by young people, that heroin remains the drug of the ghetto, and that cocaine has become fashionable in the suburbs?
Second, why do people use drugs, and why are they using them more and more? Should we talk about poverty? affluence? peer pressure? addiction?
Finally, what should be done about the drug problem? Are the present enforcement policies working? Should other approaches be tried? For example, is legalization of some or all drugs a realistic option?
Mr. Kleiman, perhaps you can give us some idea of the drug problem as
it exists today.
MARK A. R. KLEIMAN: As you mentioned, we have a drug problem not only because some people use drugs but because other people object to them, with the result that the United States now has a huge illicit drug industry. The damage a drug does may result as much from its ille- gality as from its pharmacology.
Americans probably spend between $25 billion and $30 billion annually
on illegal drugs.
Only a small fraction of this money is earned by large criminal organizations. But virtually all of it represents the income of criminals: people who either buy and sell drugs on their own ac- count or work for someone who does. The only significant expenses involve boats and planes; radio equipment; and lawyers' fees, bribes, and the other expenses of getting out of legal trouble. The actual raw-material price is almost always trivial.
DANNER: How many people are paying that money, and for what drugs?
ARNOLD S. TREBACH: In terms of sheer numbers, our worst problem drugs are the legal recreational drugs-alcohol and tobacco. Out of a total population of 240 million Americans, more than 100 million use alcohol, and 10 to 13 million are probably addicted to it. Roughly 56 million Americans are addicted to tobacco; al- most all users are addicts.
Among illegal drugs, marijuana is still the most popular. According to the U.S. govern- ment, 20 million Americans smoke marijuana occasionally. My own studies, based on gover-ment data, suggest that the number of marijuana users - people who smoke it at least once a year - is probably between 35 and 40 million. Of these, perhaps 3 million smoke it every day, which is one definition of an addict. But my guess is that no more than 1.5 million are compulsive users - smokers who would suffer great discomfort if forced suddenly to stop using the drug. So I suspect that roughly one in every twenty pot users is truly addicted, while roughly one in ten alcohol users is.
Cocaine has now become the second most popular illegal drug. Somewhere
between 12 and 15 million Americans probably use cocaine at least once
a year. Of those, perhaps 500,000 to 750,000 use it every day. Another
3 to 5 million may use heroin at least once a year, and about 300,000
to 500,000 are addicts. Finally, a couple of million Americans are addicted
to Valium and to other, more obscure drugs that aren't much talked about.
DANNER: Mr. Stutman, how are these numbers changing? Do you see drug use increasing?
ROBERT M. STUTMAN: The most significant change during the past few years is the surge in cocaine use, accompanied by the increasingly younger age of its users. Like many people, I used'to consider cocaine the drug of the Yuppies; young lawyers, doctors, and investment bankers were the people I expected to snort coke. Today, it's not unusual for me to find thirteen- and fourteen-year-old cocaine users in nice, affluent suburbs. A well-documented study recently published by the state of Massachusetts found that 26 percent of high school seniors use cocaine occasionally or have at least tried it - an astonishing figure. Cocaine is probably the most addictive illegal drug available in this country, and if one in four high school seniors now uses it occasionally, we will have a devastating problem five years down the road.
On the plus side, marijuana use, certainly among young people, seems to have leveled off in the past few years and in some areas to have declined significantly. According to a National Institute of Drug Abuse survey taken last year, 5 percent of high school seniors smoke grass every day, which is down from 10 percent in 1979.
The use of heroin has also declined significantly. Mr. Trebach estimated
there may be 500,000 heroin addicts; fifteen years ago there were probably
800,000 to 900,000. And the use of PCP and Quaaludes, two drugs that were
huge problems a few years ago, is also way down.
RUDOLPH W. GIULIANI: I agree that cocaine has become a gigantic problem; there may be five, even ten times as many users today as there were a decade ago. And there is so much cocaine pouring into the country that the price has actually gone down.
LUIS G. GARCIA: Yes, when I was in the business, you could pick up a kilo of cocaine for about $50,000 in Miami. Today, only three years later, a kilo in south Florida brings $34,000. The government sends all these federal agents down to south Florida and they arrest a lot of dealers and seize a lot of coke. But the cost of growing the leaves in South America and processing them in labs down there is nothing compared with the profits. So the producers and traffickers react to the extra enforcement by flooding the market.
GIULIANI: Exactly. While the price of heroin has increased five times - from $44,000 for a kilo in 1975 to about $200,000 today - cocaine, despite the huge increase in demand, has actually gotten cheaper.
The heroin and cocaine problems are of different orders of magnitude.
When we began arresting heroin dealers on Manhattan's Lower East Side
as part of Operation Pressure Point two years ago, the market was affected
almost immediately: the price went up, and a large number of addicts suddenly
sought entry into methadone and other treatment programs. On the other
hand, the tremendous influx of federal law enforcement officials into
south Florida during the past four years has had very little effect on
the cocaine market.
DANNER: So Operation Pressure Point suggests that heroin use is localized, and relatively easy to target; cocaine use, on the other hand, is more widespread, not just geographically but across social classes.
GIULIANI: That's right. For example, if I wanted to make heroin cases in New York City, I'd concentrate on the Lower East Side, Harlem, the South Bronx, and a few other areas. That's where the great percentage of heroin is sold, and that's where the addicts are. Heroin is still a drug that disproportionately affects the poor, and it is the drug most closely connected with violent crime and property crime.
If I wanted to make cocaine cases, I'd go to the Upper East Side bars,
the after-hours clubs, the suburbs - the more affluent areas. You'd find
a lot of marijuana in those places too, but marijuana can be found everywhere,
especially among young people. It's still a drug of initiation. There's
some overlap, of course, but cocaine is more exclusively a drug of the
middle class and the wealthy.
DANNER: So why do so many fairly wealthy people suddenly begin snorting cocaine?
TREBACH: None of us will ever know why people take certain drugs. Simply put, people take drugs because they like them. Who knows why it suddenly became fashionable to snort coke? It's like fashions in hairdos or clothing.
LESTER GRINSPOON: It's like asking why people go mountain climbing or parachute jumping. They use drugs because they enjoy them and are willing to take certain risks for the thrill or pleasure they get.
STUTMAN: Cocaine has become the marijuana of the eighties for two simple reasons. First, it is a social drug, a drug that is fun to use in groups; it's popular at parties and in bars and clubs and discos, just like grass. Second, many people are still convinced that cocaine can't hurt them, which was widely believed about marijuana until a few years ago. Those two facts suggest our young people are ripe to become seriously debilitated by cocaine.
KLEIMAN: But of the millions of Americans who use cocaine, probably fewer than 10 percent use it daily. In fact, except for tobacco, none of the mass market drugs has more than a 15 percent ratio of chronic intensive use-"addiction"- to occasional use.
GRINSPOON: The loaded word here is addiction. Although some people define an addict as a daily user, many people understand addiction as a debilitating physical dependency on a drug. Such dependency is possible with some drugs. For example, an alcoholic who suddenly stops drinking may experience an array of physiological symptoms which make up the abstinence syndrome known as delirium tremens, or the DT s. A heroin addict also suffers from an abstinence syndrome, although the severity of these par- ticular withdrawal symptoms has been much exaggerated. Withdrawal from barbiturates can be infinitely worse; a person who has been taking 800 milligrams or more of secobarbital a day and suddenly stops may actually die.
According to this definition of addiction, marijuana is not an addictive drug. Neither, really, is cocaine. A heavy cocaine user who suddenly stops will have a few relatively trivial physical symptoms. But he can quit cold turkey and not worry about it, which a Valium addict or an alcoholic cannot do. Yet I have patients who are as fastened to cocaine as others are to heroin. They don't shake or sweat, but they have a very strong psychological craving. A good comparison might be to the craving felt by a compulsive gambler.
ERNEST VAN DEN HAAG: Another comparison might be to being in love. If the object of your love is withdrawn, you will suffer from depression and other psychological problems. In trying to help someone get over his marijuana or coke habit, or his obsessional love, a psychiatrist is dealing with a purely psychological problem, sometimes called a volitional defect. The problem has two parts: Why does this person love this substance, or this person, more than others seem to, even though he realizes that loving it, or her, may be destructive? And why does he find it so hard to get rid of a habit he wants to get rid of? That he does want to is es sential; if he doesn't, no one can do anything for him.
GRINSPOON: It's a good analogy, because we know as little about why people become drug users as we do about why they fall in love. It is a human weakness to fall in love with a person you know is not good for you, just as it is a human weakness to become addicted to drugs.
HERBERT LONDON: We have to look not only at what the drug does to people - the craving it causes, and so on - but at why they feel obliged to use it in the first place. I think cocaine has become fashionable because the middle class in this country was sold a bill of goods; they were told that cocaine is a relatively risk-free drug, so a lot of people who were unwilling to try heroin - because they believed it was dangerous - were willing to try cocaine.
GIULIANI: Most of the people who now snort coke belong to a generation that was presented with a very benign picture of drugs. In the movies they went to see, in the songs they listened to, in the words of their heroes, cocaine and marijuana were depicted as "all right" drugs - not very different from, and certainly no more harmful than, alcohol. A mind-set was created, and it takes more than three or four years to turn it around.
DANNER: Why are you so certain that when people are fully informed about what the drug does, they will decide not to use it? It seems to me that's taking a rather sanguine view of human nature.
LONDON: I am not talking about informing people but about frightening them. The trouble is, people don't fear cocaine as they fear heroin. We relied on our educational institutions to warn people of the dangers of drugs - to frighten them - but they didn't do that at all.
GRINSPOON: We frightened them all right, but the result is that they no longer take us seriously. By lumping all these substances together and pretending that they're all equally harmful, we lose our credibility. Young people hear about reports issued by the National Institute of Drug Abuse and the Drug Enforcement Administration that claim every drug is equally dangerous, every drug is harmful, none of them has any beneficial effect whatever. They know from their own experience with marijuana that it isn't true. So now they don't believe anything the government says - they find out for themselves.
Mr. Stutman mentioned that the use of PCP has declined dramatically.
That's not because of government warnings but because young people, relying
on their drug educators-one an- other-have discovered PCP is a bad drug.
The same thing happened with amphetamines.
TREBACH: Even now, much of the information that NIDA and the DEA put out utterly per- verts scientific findings. Kids know they can use marijuana and not ruin their lives. The overwhelming majority of people who use these drugs do so occasionally, and apparently wit out destroying themselves.
STUTMAN: The point is to convince people that drugs like cocaine are harmful. I think Dr. Lon don is right that it's more a question of frightening people than of giving them medical facts. High school kids I talk to who have quit smoking grass or who never started usually say that they believe the drug will hurt them. And surveys bear this out.
Why Do People Use Drugs?
Wrongs unredressed, and insults unavenged;
that summonest to the chancery of dreams, for the triumphs of
suffering innocence, false wit- nesses, and confoundest perjury,
and dost re-
GRINSPOON: If the diminution in the number of young people who smoke marijuana is a function of the government's fear campaign, the policy will eventually backfire. The government's new argument is that marijuana is the "gateway drug." This is just another version of the long-discredited "stepping-stone" hypothesis, which says that marijuana has inherent psychopharmacological properties that lead its users to take up so-called harder drugs. This is not true. This is not education but miseducation, and it will result in distrust.
GIULIANI: Why is it miseducation to tell people marijuana is bad for them - that it is dangerous, that it doesn't do anything good for them, that they shouldn't use it? Are these things untrue?
GRINSPOON: They are not altogether true.
GIULIANI: So marijuana is good for you? It is a helpful thing for people to smoke marijuana?
GRINSPOON: There are circumstances where it might be.
GIULIANI: That's ridiculous! I have one question for you, Doctor: Should we be telling young people that marijuana really isn't so bad?
DANNER: Now wait, what kind of question is that? Is there really a clear answer that the government mayor may not be distorting? Or are we in fact disagreeing about values, about which truth - that some people become addicted, or that most people don't - is most appropriate to guide public policy?
KLEIMAN: Certainly some scientific facts - the physiological effects of a drug, its effects on learning and development, the probability that someone who uses it will become a compulsive user - are relevant. The problem is that honest answers don't necessarily produce the fear that some people want them to. Marijuana is certainly not a purely benign drug, at least not for the 2 or 3 million Americans who smoke five joints a day. But it's hard to prove that Saturday-night marijuana use does much damage; the scientific evidence is just not that impressive. Assume the worst about the evidence linking it to lung cancer, and the danger is still small compared with that of tobacco smoking. The studies linking marijuana to drops in IQ just don't hold up. Evidence that it weakens the immune system is interesting but inconclusive. Maybe the only way we can control the behavior of kids with respect to marijuana is to tell them all drugs are poison. But we'd be lying.
TREBACH: That's why I don't tell young people that marijuana is something terrible. I say: "Look, compared to tobacco and alcohol, compared to heroin, here are the facts." My hope is that we can be open and honest and help people make up their own minds instead of scaring them to death, as we tried to do in the past.
GIULIANI: In fact, we've done just the opposite: we haven't stressed the dangers enough.
On the consequences of enforcement-and decontrol
DANNER: Is that the basis of our drug policies, Mr. Giuliani? You're very involved in drug enforcement. What do you see yourself as doing?
GIULIANI: Teaching, first of all. The most general purpose of the law is to teach. Laws against the use and sale of drugs say firmly that it is wrong to use these things.
Of course the law also happens to be one of the ways in which society controls people's behavior; it does this through laws that protect the environment, laws that require prescrip- tions to buy most legal drugs, as well as laws that forbid the use of certain drugs. Early in the century, the legislators who drafted the original laws saw that people were being harmed by drugs, and they saw links between the growing
use of drugs and some types of crime. Those remain the practical reasons for our drug laws today.
VAN DEN HAAG: In practice, the purpose of the drug laws is not to educate at all-if it were, I'd be all in favor of them - but to restrict the sale of these substances. And that purpose the law has failed, and must fail, to achieve. Only from 5 to 10 percent of all drugs entering the United States are intercepted. The price of seizing that tiny percentage is enormous, not only in direct law enforcement costs but also in the corruption and social dislocation produced. The time has come to ask ourselves the question we asked about alcohol in the twenties: Wouldn't the money wasted trying to prohibit the stuff be more profitably spent on direct efforts to educate people about the dangers of drugs?
GIULIANI: The percentage of drugs seized is an absolutely meaningless measure of enforcement efforts. In many of the most important drug cases, high-level traffickers are arrested but almost no drugs are seized. And if you define an effective enforcement program as one that is perfect or near-perfect, then you are asking more of drug enforcement than of all.other law enforcement. We are not anywhere near perfect in deterring murder - or income tax evasion, for that matter. Sball we legalize them?
STUTMAN: Enforcement is effective. We've had some striking successes. Dr. Grinspoon attributed the decline in PCP use to the fact that people were frightened of the drug. But it's also true that there is a hell of a lot less PCP available: our tight controls on piperidine, which is needed to produce the drug, made it difficult to find.
TREBACH: Sure, we can curb some of the drug traffic. But we will never be able to prevent those Americans who want to use drugs from doing so - without, that is, massive invasions of our constitutional freedoms. How else can law enforcement officers go after something as easily concealed and as highly profitable as drugs? Look at this tape recorder; it's the size of two packs of cigarettes. How much would that be worth if it were cocaine?
STUTMAN: Maybe $20,000.
TREBACH: When $20,000 worth of illegal substance can be concealed in something this tiny, there will always be 100,000 traffickers. How do you expect the police to find it? The only way is to ignore or skirt restrictions on search and seizure. A quarter of all Fortune 500 companies now test their employees for drugs; in 1982, only 10 percent did. Such tests are already mandatory for competitors in many sporting events, including the Olympics. The mayor of New York City has even proposed that all visitors from Mexico and the Far East be strip-searched at the airport - which, by the way, is quite legal. Pressure is building for invasions of privacy. We are moving toward increasingly revolting methods of preventing people from doing what they want to do. It won't be long before legislators will be required to bring in a warm bottle of urine before every important vote. This is the road we are on; if we continue down it, I see a very bleak future.
Why not look at each drug or group of drugs and devise approaches that make sense. Her- oin? It's a medical problem. I'd be perfectly willing to supply it to addicts through the doctors treating them. Cocaine? This troubles me deeply, because it's such a seductive drug. But there is no evidence that cocaine involves a greater percentage of its users in debilitating abuse than does alcohol, and so I would seriously consider decriminalizing possession. Marijuana? I would allow it to be sold in stores along with alcohol - it is certainly no more harmful - but I would require that labels be put on all packages saying that it may be addicting and explaining in detail how it might endanger the user's health. The same labels should be put on bot tles of liquor and beer.
We've seen that this method can work. Today, about 32 percent of American adults smoke, whereas in 1965, 43 percent did. This reduction was achieved not by prohibiting tobacco but by mounting government education efforts and by limiting advertising. So I'm suggesting new approaches to dealing with drugs.
Otherwise, we'll need greatly increased law enforcement
in the face of constantly increasing demand, and we will inevitably invade
the liberties of our people.
LONDON: Consider the social consequences of your proposal. Warnings do not prevent young people from smoking cigarettes; warnings certainly won't prevent them from smoking marijuana. Ernest argues that we're paying a great price for our current policy, and I agree. But it's obvious to me that if many more people begin using drugs, we'll have to pay a much greater price in terms of family dislocation, hospital costs, in- surance costs, and so on.
VAN DEN HAAG: You assume drug use would go up enormously under Mr. Trebach's plan. I don't think that's correct. After the repeal of Prohibition, alcohol consumption increased, but the increase was too slight to justify the moral, material, and other costs of Prohibition. The in- crease in addiction that would accompany legalization is clearly undesirable. But it has to be weighed against the social cost of the prohibition we now have. After all, anyone who wants to can become addicted today.
And addiction tends to be self-limiting. When American
troops were in Vietnam, her- oin and marijuana were as available as they
could possibly be - and terribly cheap. Most of our soldiers tried them,
and some used them habitually. Only a small percentage became ad- dicts,
and most of them stopped using drugs when they returned to this country.
GRINSPOON: There's no question that prohibition works. While the Volstead Act was in effect, Americans consumed significantly less alcohol.
On the other hand, many people were blinded or killed by drinking methyl alcohol and orga- nized crime and corruption thrived, as did disrespect for the law. Americans finally decided the price was too high, but there is no question that repeal brought more drunkenness, alcoholism, traffic accidents, cirrhosis.
When I visited Texas in 1972, I found that about 800 young
people were in prison on mari- juana charges, mostly simple possession,
with an average sentence of almost ten years. Now, whatever our disagreements
about the psycho-pharmacological effects of marijuana, no one claims it
is as damaging as ten years in the penitentiary. The drug has no psychoactive
properties that can be compared to the harm to careers, family finances,
self-esteem, and respect for the law that result from a long stay in prison.
And more than 4 million Americans have been arrested on marijuana charges
the past decade. On the federal level alone, we're spending $1.5 billion a year to control drugs. Our attorney general runs around the country proclaiming a daily "plant count" when, it seems to me, he should be addressing more important matters.
GIULIANI: The statement that enforcement of our drug laws is costing taxpayers enormous amounts of money just isn't true. By any governmental standard, the cost is minuscule. And those costs are almost entirely offset by the cash and property seized during drug arrests. In Florida, the state enforcement people are exceeding their budget in assets seized.
GRINSPOON: I don't know if that's a good argument or a bad argument. It seems to me that the DEA and the drug dealers are involved in a kind of synergism: the DEA needs the drug dealers, not only to justify its large budget but, as Mr. Giuliani suggests, to provide a good part of that money; and the dealers need the DEA to keep the prices of drugs high. Meanwhile, the courts are clogged with marijuana cases; 25 percent of criminal cases in federal courts are drug cases.
GIULIANI: The vast majority of those are cases against heroin and cocaine dealers and major marijuana traffickers. The courts are certainly not "clogged with marijuana cases." Of course if you get caught in, say, Wyoming with a small amount of marijuana, you very likely will go to prison; the people of Wyoming feel that this is a significant offense. In New York City, we don't have the luxury - enough police offi- cers, judges, or cells - to treat possession of ma- rijuana that way even if we wanted to.
Actually, the Prohibition model is silly, distorted, and irrelevant. I think drugs are extremely dangerous,. and we can do a better job of limiting their use by keeping them illegal. That's not an irrational position, and it happens to be the case that the vast majority of Americans agree with it. Americans are not clamoring to legalize drugs, as they did to legalize alcohol. The idea is clearly unpopular, impractical, and utterly unrealistic. No member of Congress has put forward a bill to legalize marijuana, cocaine, or heroin, because he wouldn't be reelected if he did.
STUTMAN: In 1977, we probably came as close to decriminalizing marijuana as we ever will. Since then, the percentage of Americans who oppose legalization has steadily grown; polls now put it at about 75 percent.
GRINSPOON: But the whole country has turned to the right. I'd bet the situation will be very dif- ferent, at least regarding marijuana, a decade from now. Mr. Giuliani and Mr. Stutman seem to assume we have only two alternatives: strict prohibition of all drugs and absolutely free availability of all drugs. I don't think free availability is the answer. It frightens me to think of cocaine, for example, freely available at the price physicians can get it for medical purposes, which is about $30 an ounce. I think we need to conduct some social experiments to find better ways of dealing with these drugs. Some have already begun. In 1973, Oregon decriminalized marijuana. Many people warned that this would lead to a great increase in marijuana use, even that people would move to Oregon so they could use the drug freely. It didn't happen. When Alaska made it legal for people to culti- vate marijuana on their own property two years later, similar - and similarly mistaken - predictions were made. In neither state did the use of marijuana increase measurably.
KLEIMAN: To some extent, other experiments are proceeding even within the current regime of strict prohibition. As Rudy said, levels of enforcement vary a great deal across the country and from drug to drug. The point he made about Operation Pressure Point's effectiveness against heroin dealers compared with the relative ineffectiveness of the South Florida Task Force against cocaine says a lot about our current enforcement policy. We can enforce the cocaine laws as rigorously as we like, and nothing changes. That's partly because cocaine is an enormously profitable mass-market drug and partly because the enforcement resources of the government are simply not large enough to deal with it. Between 1981 and 1985 federal enforcement efforts against cocaine tripled. This enormous investment bought us, as far as I can
tell, zip. The supply of cocaine wasn't drastical- ly reduced and the price actually fell.
GIULIANI: That's because the market is so huge. I'm not sure the problem wouldn't be significantly worse without that level of enforcement; at least it keeps a finger in the dike. If educational programs can begin to bring the de- mand down, enforcement efforts will start to show real results, just as they did with heroin.
KLEIMAN: But as you pointed out, heroin use is so limited that street-level enforcement can have a large effect; and it's so closely linked to property crime that the cost of enforcement is justified. Street-level enforcement definitely reduces the number of heroin users and provides immediate, measurable benefits to everyone else in the target area.
But street-level enforcement doesn't have the same effect
with marijuana and cocaine- ,
there are just too many dealers. Going after the big importers and distributors may push prices up, but not enough to discourage the users, who are relatively affluent, from buying the drugs.
So the main effect of cocaine and marijuana en- forcement
is to make the remaining traffickers richer by limiting competition. Yet
federal en- forcement currently centers on marijuana and cocaine: 70 percent
of the people convicted in DEA cases last year were convicted for cannabis
- and cocaine offenses, and only 18 percent for heroin offenses. I think
there is a strong argument for moving away from pursuing big co- caine
and marijuana traffickers and toward street-level heroin enforcement.
GARCIA: Boy, that's a mistake if I ever heard one. I think I'm going back in the cocaine business if I keep hearing ideas like that.
KLEIMAN: I wouldn't advise it. Cutting back federal cocaine enforcement would reduce the profitability of the illicit cocaine business. Enforcement keeps prices high. .
DANNER: But doesn't the illicit industry that has arisen as a result of the drug laws create and encourage organized crime?
GIULIANI: The drug laws don't "create organized crime." As a matter of fact, the drug laws are a very effective way to pierce organized crime. Vito Genovese died in prison; he would probably never have been sent there if the DEA hadn't made him on a drug case.
KLEIMAN: Rudy, you've got to concede that those guys wouldn't be in the drug business if they weren't benefiting from it.
GIULIANI: Of course. But the notion that drugs somehow "create" criminals is silly. The United States has a large criminal population, period. Maybe drugs make that problem marginally worse; but we won't solve the crime problem by legalizing drugs. Marijuana has almost nothing to do with organized crime; if we decriminalized it tomorrow, the crime rate in Manhattan would remain virtually the same. And the ma- jor traffickers, the serious entrepreneurs in south Florida, would just switch to coke. If we decriminalized cocaine, those traffickers would move into extortion, labor racketeering, and so on.
GARCIA: Yeah, 95 percent of the people I knew in the drug business would be out doing some oth- er crime if drugs were legalized, even if it came down to holding up the local 7-Eleven or robbing somebody's house.
Diplomacy, education, and the paradox of vice control
GIULIANI: Look, we deal with the crime prob- lem-which goes beyond the resources allo- cated to solve it - by prosecuting individual, representative cases as a means of deterring other crime. That strategy is working in containing our heroin problem, largely because our educational programs have reduced the population of users to a manageable size. Right now, the strategy isn't working as well with cocaine. But wouldn't our cocaine problem be catastrophic if we weren't making any effort at all? The answer is not to legalize cocaine and give people all they want, and at the same time go into schools and tell kids that cocaine is dangerous, don't use it. That's absurd. Give up on our drug laws and it will be almost impossible to mount an educational effort that will truly discourage drug use. And there is a moral question here as well. Do we want to live in a society that says, "Go ahead, pump all the drugs into your body that you want"?
As for marijuana, I don't claim that everyone who uses
it necessarily moves on to other drugs. But if we encourage people to
use marijuana by legalizing it, we will create an even larger drug- using
population, and many of these people are certain to move on to cocaine
and heroin. If the number of marijuana users is kept down, eventually
the number of cocaine and heroin users will decrease.
TREBACH: You say my arguments are absurd. What if! say, O. K., where do you think drug policy will be at the turn of the century? How much drug use will there be - and how many dead po- lice officers and soldiers, how many people locked up in jail?
GIULIANI: If we increase our commitment to our current policy, we can dramatically reduce the drug problem. That policy has five parts. First, the United States must continue to work with - and put pressure on - those countries that produce cocaine, heroin, and marijuana, in order to put the producers out of business.
TREBACH: You want to force other countries to control their drug traffic. That's ridiculous! We can't control drugs on our streets; to suggest that the Bolivians and Peruvians and Colombians can control drugs in their jungles - where no official has the guts to go - is preposterous.
GIULIANI: I'm not saying we can solve the cocaine or heroin problem solely through the exercise of foreign policy. Many countries that produce drugs are not open to our influence. But we can still do a great deal.
The second part of the policy is to make more effective
use of the military, especially in patrolling our coasts and borders.
TREBACH: Sure, there ought to be controls at the border. But think how far we'd have to go to make truly effective searches. At the moment, strip searches are completely legal. Anyone of us may be challenged to submit to a strip search when we enter the country, to give a urine sample at work, to face all sorts of indignities whose real motivation is this obsessive concern with preventing people from taking drugs and whose result is to diminish the personal freedom of us all. If what are now the dominant forces in our society, so ably represented by Mr. Giuliani and Mr. Stutman, have their way, this country may be a very uncomfortable place to live in at the turn of the century, though I doubt drug use will have been reduced.
GIULIANI: I don't advocate strip searches or mandatory urine tests or any of those horrible things that you are using to condemn what is in fact a very reasonable approach to a difficult problem. The third aspect of our drug policy is to strengthen our deterrent at home. The message must be clear: if you deal drugs you go to prison. Today, every drug dealer in this city knows that if he gets arrested for selling drugs he will probably not go to prison. In New York City last year, only one out of nine people arrested for selling drugs was imprisoned.
TREBACH: Are you saying that we have to build more prisons?
GIULIANI: Absolutely. If the message reaching the street was that when you get arrested you go to prison, no excuses, there would be a dramatic drop in drug sales and in the crimes associated with them. During Operation Pressure Point, drug-connected crime in the target areas dropped between 30 and 40 percent.
TREBACH: The thought of many more people in our prisons is appalling. Why don't we make certain now that anyone who deals drugs goes to prison? Because we have practically lost the prison option altogether; our prisons are so overcrowded that we only put people there when we don't know what else to do with them. America is already the largest jailer of its own citizens among the Western democracies.
GIULIANI: Americans commit more violent crimes per capita than other Western people. We don't put people in prison because we like to but because we have no other choice. Do we let them rape and murder in the streets, or do we get them off the streets?
The fourth aspect of our policy is to put more money into treatment programs so that people who want to stop using drugs will have help in doing so. And finally, we have to devise more effective ways to educate young people not to use drugs.
GRINSPOON: Why not educate people about drugs?
GIULIANI: Because our society has made a choice that it is dangerous, and thus illegal, to use certain drugs. Your question proves my argument about how the drug problem became so great. For years, we essentially said to people: "Hey, drugs really aren't much of a problem."
STUTMAN: I would add a number six to Mr. Giu- liani's program: we must change our society's tolerant attitude toward drugs. During the past few years, that attitude has been changing; parents will no longer accept as inevitable that their kids use illegal drugs. They want to fight it.
KLEIMAN: Of Rudy's five-point program, the only point likely to make a dent in marijuana and cocaine consumption is the last - education. Programs directed at countries that export drugs, efforts to increase interdiction at the border, increased domestic enforcement-none of these steps can raise prices high enough, produce sub- stantial enough shortages, or eliminate enough retail dealers to keep drugs out of the hands of customers. In any case, while street-level enforcement may drive a heroin addict into treatment by getting rid of his connection, cocaine users tend to buy enough coke to last for longer periods; and marijuana users, for even longer periods. Finally, treatment programs, as Professor van den Haag pointed out, assume a desire to be cured, which most marijuana and cocaine users lack.
GIULIANI: It is clear that these steps have already worked in decreasing heroin use. That's a good reason to use this approach as a model for dealing with cocaine.
KLEIMAN: It sounds good, but you're comparing heroin, which at its peak of popularity was used on a daily basis by maybe a million people, almost all of whom were poor, to cocaine, which is now used by at least 5 million relatively rich people, many of whom view it as a luxury. The cocaine problem is on a different scale entirely.
GIULIANI: But as you say, use of cocaine tends to be "soft": most people who use it are not daily users and are not antisocial. These people can be persuaded by education, by legal deterrents, by social pressure. It's like the difference between deterring white-collar crime and violent crime; it is much easier to deter white-collar crime. One strong sentence meted out to a middle-class cocaine user would have a heck of a lot more deterrent effect than the same sentence meted out to a heroin user.
VAN DEN HAAG: Unquestionably, the most effective policy would be to sentence every convicted user to five years in prison. The market would disappear in a moment; and if there is no market, a dealer can't deal. But you would have to persuade judges and juries to hand down those sentences, which means convincing them that the social cost would not be greater than the advantage gained.
GIULIANI: In any area of law enforcement, it would not be effective to prosecute every single person who commits a crime. Dealers are even more responsive to deterrence than users, because they are essentially white-collar criminals; if you make the risk high enough, they move on to something else. I could play tapes for you of Ma- fia guys discussing whether they should move their money from one drug to another because the risk of jail has gotten too high.
KLEIMAN: The real problem is that if you increase the pressure on dealers, the price of the drug goes up to cover the heightened risk. Since the users are already there, ready to pay the price, you only increase dealers' earnings. If you put more burglars in prison, you do not increase the profits of burglary, but if you put more dope dealers away, the revenues of dope trafficking go up.
All we can really do on the supply side of the marijuana
and cocaine markets is marginally raise the price of the drug and temporarily
reduce the number of dealers on the street, and it's questionable whether
we can even do that. As for prosecuting users, it would be tough to get
convictions, not to mention severe sentences. The number of users is just
GRINSPOON: Instead of devising ways to arrest everyone, maybe we should encourage people to be more intelligent and prudent in how they handle these substances. If we can't force everyone to stop using drugs, which seems to be the case, perhaps we can develop informal controls that discourage their abuse. Many societies, and even some groups within our society, seem able to do this. For example, there seems to be relatively little alcoholism among Jews, Chinese, and Greeks, yet they have the same access to alcohol that everyone does. The reason for that, many people believe, is that alcohol has been integrated into their subcultures in various ways - through the religious use of wine among Jews, for example.
There are many similar examples that might help us learn
what actually does work in controlling drug use. Formal controls will
not solve this problem. As long as the demand is there - and the profit
- somebody will be happy to take the place of the dealer you've arrested.
TREBACH: The implication is that we must begin teaching people the responsible use of mind-al- tering substances. Such a view is anathema in Washington today.
GIULIANI: Maybe that's because there's a terrible moral and philosophical contradiction in that notion. You are saying: "O.K., we will break down yet another barrier in our effort to become more permissive and liberal, to let people do whatever they please to destroy themselves." Why can't we protect ourselves for a change? Americans only recently became sensitive to the dangers of dirty air. It seems absurd for us to say: "Gee, drugs are really no problem. There is a 'responsible' way to stick cocaine into your nose." That is a dangerous notion and just plain wrong.
TREBACH: But what do you say to kids about drugs when they reach twenty-one?
GIULIANI: Never use them.
STUTMAN: I don't know a good use of any drug we've mentioned today, including alcohol.
TREBACH: What about sex?
LONDON: You say no, and you know full well the kid's going to engage in sex anyway. But it's desirable to say no; the hypocrisy is desirable.
TREBACH: That's it! Dr. London has just defined for us the dominant social position on sex, and drugs.
GIULIANI: What do you say that teaches kids about the "responsible" use of cocaine?
GRINSPOON: The same thing I say about alcohol: some people seem to use this drug without diffi- culty. But a significant number-and we cannot identify them in advance-have serious problems with it. So if you use it, you take some risk. Here is the kind of harm you flirt with if you use this drug.
GIULIANI: We've done a poor job of controlling people's behavior with respect to alcohol. To use it as a model for the cocaine problem is ut- terly irresponsible. Cocaine use is not yet at the level of alcohol use, thank God.
TREBACH: The use of alcohol is going down; people are becoming more conscious of offering their guests nonalcoholic beverages at parties and in other social settings. And smoking has declined steadily. So people can be influenced to use some drugs more responsibly.
KLEIMAN: Some kinds of drug education in schools work, particularly with respect to tobacco, which seems to be the real "gateway drug": 80 percent of high school kids who are tobacco us- ers have tried marijuana, whereas fewer than 25 percent of those kids who are not tobacco users have tried it. We can substantially reduce tobacco use among kids by programs in the sixth and seventh grades.
The basic approach is this: "Look, people are going to
be offering you tobacco. Here are some reasons why you shouldn't use it."
You tell them cigarettes make their breath smell bad and stain their teeth
so that people won't want to kiss them, and that smoking wrecks their
wind so they won't do as well in sports. These are reasons that matter
to kids and that also happen to be true. Finally, you teach them the difficult
social skill - and it is difficult at that age - of gracefully turning
down a cigarette.
LONDON: Would you teach them the same things about marijuana?
KLEIMAN: Absolutely. But in the case of marijuana, it's hard to come up with comparable short- term health problems that would persuade a seventh-grader not to smoke his first joint. Maybe the answer is simply to make fun of what marijuana does to you.
GRINSPOON: I'm concerned not just about marijuana and the other substances we have now but also about those coming out of the laboratory. Some that may have legitimate uses will be kept from people who need them because of the way we respond to drugs.
For example, consider the way the govern- ment has behaved
with respect to 3,4-meth- ylenedioxymethamphetamine, or MDMA- known, unfortunately,
as Ecstasy. Some anecdotal data suggest this drug may have important therapeutic
uses. But we don't know enough about these possibilities or about the
down side of the drug. So what did the DEA do? It took emergency action
and listed it on Schedule 1, putting it in the same category as heroin.
They were worried that kids were trying it, which is a legitimate concern;
but the DEA's action will inhibit us from gathering important data. Again,
we're creating a situation: MDMA is going to be available on the street,
and much of it will be impure. But we will only have street data to give
us some sense of what the substance does, good and bad. Unfortunately,
that is the way we've handled many drugs in the past cou- ple of decades.
KLEIMAN: That experience should have demonstrated the paradox that is at the center of any vice control policy, including drug enforcement. We make something illegal because it's a vice - bad for its devotees and bad for the people around them. But for those who indulge anyway, prohibition and enforcement make the vice more dangerous; they also make these people more dangerous to the rest of us. Think of wood alcohol during Prohibition, the violence and disease associated with prostitution, the gambling debts collected by muscle rather than collection agencies.
That this paradox exists does not mean we should legalize
everything - it seems to me that society is better off with 400,000 very
dangerous heroin addicts obtaining the drug illegally than with 5 million
addicts obtaining the drug from their doctors, even though each of them
would be a little better off and a little less dangerous. It does mean
that we don't get a free shot at drug dealing. Successful drug enforcement
- most of all, street-level heroin enforcement-helps. Unsuccessful drug
enforcement - anything that fails to shrink the market - only makes the