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Drug Policy in Principle, and in Practice

I should start where Earth and Fire Erowid ended: by declaring my conflicts of interest. Earth and Fire are my longtime friends, and I greatly admire the erowid.org project of conveying accurate information about psychoactives to people facing real choices about their own behavior. Jonathan Caulkins has been my friend for even longer, and I have been learning from him ever since he was a graduate student and I was an outside reader of his Ph.D. thesis. Jacob Sullum I don’t know personally, but I have benefited from his writing even when (as I usually do) I disagreed with it. Cato Unbound is to be commended for having assembled a symposium free both of the usual drug war rant and of the usual “drug policy reform” rant.

It seems to me that to some extent Jon Caulkins on the one hand and the Erowids and Jacob Sullum on the other are talking past one another. Earth and Fire, and Jacob, are thinking primarily about drugs from which people often derive, or at least think they derive, lasting benefit: cannabis and the hallucinogens. Jon is thinking primarily about drugs from which people often derive damage, and as a result of which they damage others: cocaine and heroin and smoked, snorted, or injected methamphetamine.

In making that differentiation, I am relying neither on pharmacology nor on my own subjective impressions, but on user self-reports. I have both read and heard many accounts in which people described in some detail the benefits they think they have received, and what they think they have learned about themselves, other people, and the world they live in, from the use of cannabis and the hallucinogens, and argued that others should at least consider their use. But although I have heard and read many accounts of the pleasures of heroin, methamphetamine, and cocaine use (and, for that matter, alcohol and tobacco use) I have never heard or read anyone explain what he or she purports to have learned from the use of those drugs, or any other sort of lasting benefit. (Put aside for the moment the benefits of moderate alcohol consumption in reducing “bad” cholesterol.) That is not to deny that cannabis and the hallucinogens can do damage; of course they can. But (and this is scientifically demonstrable) the rates of damage are much, much lower for cannabis than for the heroin, cocaine, methamphetamine, alcohol, and tobacco, and so much lower for the hallucinogens as to constitute them a separate topic.

So Jonathan and the others are feeling different parts of the elephant. No surprise that they offer different reports about its nature. Caulkins can reasonably dismiss the benefits forgone in obeying the current drug laws as mere “pleasure,” because he is concentrating on drugs that merely give pleasure. The Erowids and Sullum aren’t prepared to concede that point, because they’re thinking about a different group of drugs. Banning “magic” mushrooms has more in common with religious persecution than it does with sound policy to protect public health and safety. [Gable 2008; Griffiths et al. 2006]

The abuse statistics quoted by Caulkins are correct so far as they go, but require handling with caution. Even fairly severe drug abuse is, more often than not, a transient phenomenon. About two-thirds of those who meet diagnostic criteria for substance abuse disorder now will not meet those criteria three years from now, with only a negligible fraction having had any formal treatment. [Heyman 1996] We think of drug abuse as a “chronic, relapsing disorder” because only those with the chronic, relapsing form of drug abuse disorder come in for treatment, and primarily the same people show up in the criminal justice system. This proposition is true about alcohol abuse as well as about the abuse of the currently illicit substances.

Still, I think Caulkins could make a plausible case that the decision to start to use alcohol or tobacco or cocaine or heroin or methamphetamine (in other than pill form) is an ex ante bad decision, because the relatively modest gain from successfully controlled use, multiplied by the probability of achieving controlled use, is outweighed by the very heavy losses from falling into even relatively transient abuse and the extreme losses from falling into chronic abuse, multiplied by those probabilities. The expected value of the gamble may well be negative, even if most people who take the gamble come out somewhat ahead of the game, because the average loser loses more than the average winner gains.

Thus Caulkins has a reasonable argument that voters might reasonably decide to protect their fellow citizens from the risk of falling into substance abuse disorder, even at the expense of missing the pleasures of moderate use. But that argument applies with much less force to cannabis, where the risks of falling into abuse are comparable (somewhat lower, but still in the range of 10%) but the losses are much smaller than is the case for the other “big three” illicit drugs or for alcohol. And it would be extraordinarily hard to make out a comparable case for, e.g., psilocybin. At the same time, alcohol is much closer in its risks to snorted cocaine than it is to cannabis. So I am less willing than Jonathan is to attribute even a workable level of rationality to the electorate, as influenced by various sorts of opinion leaders and public officials, and therefore less willing to give those political outcomes great moral weight.

It seems to me that Jacob Sullum is right to say that Caulkins takes away with one hand what he gives with the other: First he claims that he would not deny anyone the choice of trying to achieve moderation in drug use, but he goes on to argue that, under legal prohibition, the only moderate course is complete abstinence. Again, that seems to me largely true about the drugs Caulkins has most in mind (though I would differ with him on cannabis) but not true for a range of other drugs.

And while it is arguably the duty of a good citizen not to support illicit enterprise, it should be noted that if everyone followed the Caulkins rule there would be little opportunity to accumulate new information about whatever drugs are currently illicit, and thus no chance to revise the laws in light of new experience, especially given the pressures to conform science to policy in the name of “drug abuse prevention.” Here John Stuart Mill’s argument for the value of deviation from social norms in adding to the stock of knowledge seems to me to deserve considerable weight.

Still, having thus far largely disagreed with Caulkins in principle, I largely agree with him in practice. The damage done to users and others by heroin, cocaine, and methamphetamine dwarfs in social importance the gains and losses, actual and potential, from cannabis and the hallucinogens. So given a straight-up choice between the current drug laws and a libertarian regime under which all drugs would be treated as more or less ordinary articles of commerce, I think about what the brewing and cigarette industries, and their marketing (and lobbying) arms, could do if given cocaine to play with, and recoil in horror toward the current state of affairs.

The argument “Crack is bad; therefore psilocybin should remain illegal” is transparently false. But so is the corollary “Psilocybin has moderate risks and great potential in facilitating personal growth; therefore crack should be sold at the 7-11.”

Caulkins and I could probably go on at length about all the ways in which the costs of the current prohibitions, especially in the forms of violence, incarceration, and infectious disease, could be reduced without allowing the massive increases in abuse levels that would surely result from commercialization. [Boyum and Reuter 2005; MacCoun and Reuter 2001] To offer three specifics: We could reduce violence and drunken driving by raising alcohol taxes [Cook 2007, Cook forthcoming], we could shrink the illicit drug markets and reduce recidivism by using drug testing and swift, automatic, and mild sanctions to force probationers to stop using expensive illicit drugs [Kleiman 1998, Hawken and Kleiman 2007, Schoofs 2008], and we could break up street drug markets, thus protecting neighborhoods, with low-arrest drug crackdowns [Kennedy 2008, Schoofs 2008]. I would far rather discuss those opportunities for practical improvement than debate the largely academic question about whether the regulation of abusable psychoactives is a legitimate function of the state.

Surely Earth and Fire are right that achieving the optimal level of use for the wide and widening variety of available psychoactives is a challenge that faces contemporary individuals. Surely Jon is right that for many of those psychoactives the optimum is zero. But I doubt that the line between drugs that might responsibly be tried and those best left entirely alone follows the line between currently licit and currently illicit substances.

Mark Kleiman is professor of public policy at the UCLA School of Public Affairs. He is the editor of the Journal of Drug Policy Analysis. His book When Brute Force Fails: Strategy and Crime Control will be out from Princeton University Press next summer.

REFERENCES

Boyum, D. and P. Reuter (2005) An Analytic Assessment of U.S. Drug Policy. Washington: AEI Press.

Cook, P. J. (2007) Paying the Tab: The Costs and Benefits of Alcohol Control. Princeton: Princeton University Press.

————— (2008) “A Free Lunch.” Journal of Drug Policy Analysis (forthcoming).

Gable„ R. S. (2008) “Regulatory Risk Management of Psychoactive Substances.” Law & Policy 14(4):257-276.

Griffiths, R.R., W. A. Richards, U. McCann and R. Jesse(2006) “Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance.” Psychopharmacology 187:268–283.

Hawken, A. and M. Kleiman (2007) “H.O.P.E. for Reform: What a novel probation program in Hawaii might teach other states.” American Prospect Online, April 10.

Heyman, G.M. (1996). “Resolving the contradictions of addiction.” Behavioral and Brain Sciences 19(4): 561-610.

Kleiman, M. (2001) “Controlling drug use and crime with testing, sanctions and treatment” in Heymann, P. & Brownsberger, W., Drug Addiction and Drug Policy: the Struggle to Control Dependence, pp. 168–192. Cambridge, MA: Harvard University Press.

MacCoun R. J. and P. Reuter (2001) Drug War Heresies: Learning from Other Vices, Times, and Places. Cambridge: Cambridge University Press.

Schoofs, M. (2006) “Novel Police Tactic Puts Drug Markets Out of Business.” Wall Street Journal September 27, p. A1.

——–. (2008) “Scared Straight…by Probation.” Wall Street Journal, July 24, Page A11.

Also from This Issue

Lead Essay

  • Towards a Culture of Responsible Psychoactive Drug Use by Earth and Fire Erowid

    In their lead essay, Earth and Fire Erowid stress the importance of developing responsible, fully informed relationships toward psychoactive drugs. Although drug prohibition has persisted for decades, the overwhelming majority of adults have tried at least one illegal drug, and these substances aren’t going away any time soon. Sadly, prohibition itself has stunted our knowledge of these substances, and, as in so many things, ignorance is both dangerous and irresponsible. Provocatively, they criticize even the word “drugs” as a tag for illegal psychoactives: Lumping them all together, they write, betrays a lack of understanding of their vastly different effects, risk profiles and – yes – benefits.

Response Essays

  • Is Responsible Drug Use Possible? by Jonathan Caulkins

    Jonathan Caulkins argues that the responsible use of psychoactive drugs is an overstretched concept, if by “psychoactive drugs” we mean everything from caffeine to heroin. In many cases, he argues, temperance may be the only responsible “use” of a given substance.

    Further, state prohibitions on pleasurable but risky acts are hardly confined to this area of law; their violation is not a genuine form of civil disobedience as long as pleasure itself is the real goal of the act. And the risks remain regardless. Duly enacted laws in a democracy deserve far more respect than this, and following the law is a part of the responsibility of all citizens.

  • True Temperance by Jacob Sullum

    Jacob Sullum notes that temperance and abstinence have been wrongly conflated, and that the Aristotelian view of temperance encompassed all of the moderate, reasoned, and honorable pleasures of life. He reiterates that virtually everyone uses psychoactive drugs of one kind or another, and that the overwhelming majority of use is responsible. He challenges the notion that the state has any interest in the private actions of individuals that do not harm anyone else, and he terms the impulse to protect people from themselves “unethical” and “an open-ended rationale for government intervention that logically leads to totalitarianism.”

The Conversation