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VOLUME 3, ISSUE 1 PSYCHNEWS INTERNATIONAL March 1997
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SECTION E: THE FIFTH COLUMN
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Note: The Fifth Column is a regular, independent column
written by Jeffrey A. Schaler, PhD
Opinions and comments are invited. Please send them to
the PsychNews Int'l mailboxes at:
psychnews@psychologie.de
and pni@badlands.nodak.edu
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1
THE DRUG _POLICY_ PROBLEM
Jeffrey A. Schaler, PhD
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Policies are based on values and on explanations
for events. To evaluate the efficacy of our federal
drug policy in a comprehensive and responsible way, we
must examine the values and explanations that are
associated with various possible courses of action.
To that end, we must ask and honestly answer a
question that challenges the status quo: What values
and beliefs about illegal drugs and drug addiction are
embraced and acted on by the leading drug
policymakers, and what are the alternatives?
The reasoning behind current drug policies is
often unstated for moral, political, economic, and
even existential reasons. The reticence of
policymakers on this subject is remarkable, given that
the current institutional forms of the "war on drugs"
are justified by the claim that drugs are destroying
the "moral fabric of American society."
Americans tend to take at face value the unproved
theories about drugs that are the foundation of
current drug policy. For example, many Americans
accept as fact the theories that drugs cause
addiction, that they cause crime, and that addiction
is a treatable disease. Most people are not aware of
the existence of conflicting theories based on the
results of empirical research. Yet abundant and
convincing evidence exists to support the view that
illegal drug use has more to do with choice, values,
and expectations than with addiction, compulsion, or
disease (see, for example, Schaler, 1997). With each
new class of students at American University, Johns
Hopkins University, Montgomery College, and Chestnut
Hill College, I am asked, "Why weren't we told about
this before?"
Drug policy is always based on explanations for
drug use. Because there are diverse explanations for
drug use as an event and these explanations differ
_radically_ from one another, drug policy can be
implemented in ways radically different from current
practice. But the average American citizen, like my
numerous college students, has not been exposed to a
range of views on drugs and addiction. The less
people know about the range of theories, the more
likely they are to be influenced by the status of the
individuals who present a particular message
(scientists, doctors, public health officials, law
enforcement professionals, politicians, and so on)
rather than by the rationality or irrationality of the
message itself. In order to exert democratic control
in the drug policy debate--based on what is being
said, not on who is saying it--Americans need to know
the facts about drugs and addiction. Without complete
information they cannot comprehend the meaning and
implications of various proposed policies. Therefore,
they will continue to assume that all qualified
professionals in the field hold essentially the same
views.
The prevailing policies can be faulted not only
for their disregard of research but also for
fundamental logical errors. The contradictory
reasoning of drug policymakers needs to be subjected
to public scrutiny. For example, many policymakers
attribute abstinence from drugs both to the exercise
of free will and to circumstances imposed from outside
the individual, such as drug prohibition. They
overlook the fact that, by definition, self-control
cannot be the result of formal institutional controls
backed by the threat of legal punishment. The same
individuals typically assert that drug addiction is
situational--that it is caused by the addict's
physiological disposition or by the drug itself; thus
they further contradict their avowed belief in free
will.
When confronted with inconsistencies in their
views, people often produce further theories or
beliefs, perhaps to reduce the sense of dissonance and
discomfort, or else they simply minimize the
importance of a contradictory belief or policy. This
simply creates more problems.
QUESTIONS WE NEED TO ASK AND ANSWER
To understand the values and beliefs behind our
federal drug policy, it is necessary to ask some
unpopular questions:
*
Do illegal drugs cause crime? Given that drugs are
inanimate objects, are they capable of causing a human
action? Can drugs "act" in the way that people can?
*
Does drug use in the form of "addiction" encourage
people to commit crimes other than the purchase and
use of the drug itself? And if so, do the crimes stem
from the addiction or from circumstances involved in
the trade in illegal drugs, such as competition
between dealers?
*
Should drug policies that are based on the
relationship between drug use and crime be consistent
with legal precedents? Should drug policies reflect
court opinions regarding the nature of addiction and
criminal responsibility, and vice versa?
For the most part, U.S. drug policies are based
on the assumption that drugs cause addiction. But
many leading researchers and thinkers question the
very existence of addiction as an empirical entity in
the sociological "positivist" sense, viewing it rather
as a social construct.
Does addiction exist? Do drugs cause addiction?
The answers to these questions depend on what we mean
by "addiction." If by addiction we are referring to
_what drugs do to the physical body_, then the answer
to both questions is yes. We know for a fact that
drugs create changes in the body, a physiological
dependency often characterized by tolerance,
withdrawal symptoms, and death. However, if by
addiction we are referring to _how drugs get into the
body_, the answer is less clear. In this sense,
research has produced no empirical evidence for the
belief that drugs can cause drug users to lose control
of their behavior. Furthermore, from a logical point
of view, behavior is by definition a matter of choice.
Do the bodily changes effected by drugs _cause_ people
to ingest more drugs in the same way that epilepsy
causes people to have seizures? Most people would say
no. The two cases are categorically different.
It is important to be clear about the meanings of
words. When applied to human action, the term
"behavior" refers to a mode of conduct or deportment.
Human behavior _is_ moral agency and as such can never
be caused. _Things_ are caused; _people_ make
choices. This difference is what makes us human. To
speak of human behavior as caused makes no more sense
than to speak of things as capable of choosing. Such
confusion of language is inaccurate and irrational.
The English philosopher Gilbert Ryle called this kind
of mistake a "category error."
Shall we then create and implement policy on the
assumption that addiction is simply a metaphor--that
drug use is a moral issue ruled by choice? In that
case, how much policymaking is called for? If we
agree that drug use is a choice--one that harms no one
but the user--should the government make any effort to
control it?
Philosophical as these questions are, they should
not be confined to the ivory tower as some politicians
and academicians may prefer. If the advocates of a
particular drug policy invoke science to justify their
actions, they should be required by a discerning
public to examine all available evidence, not just
that which supports their political, economic, or
moral interests. If they invoke moral principles,
they should be challenged to defend those principles
in a clear and rational manner.
Any meaningful discussion of the values expressed
in drug policies raises large philosophical questions.
We might begin by asking which is more important,
health or liberty? Is it better to be sick and free
from coercion in a society where medicine and state
are separate, or to be healthy under the control of a
therapeutic state? Can we trust our medical guardians
to refrain from the paternalism and the persecution of
"undesirables" exercised by theocracies throughout
history? Who will guard us from the guardians?
The issue might be rephrased this way: Does the
constitutional right to life, liberty, and the pursuit
of happiness include the right to harm oneself? We
accept the need for government to protect us from one
another, and we agree that the exercise of liberty at
the expense of another's freedom constitutes crime.
But should the values of the majority dictate the
personal behaviors of a minority when such actions
harm no one else? Is it constitutionally proper for
the government to protect us from ourselves?
Finally, can institutional methods of social
control such as those advanced by our current federal
drug policies increase responsibility and decrease
liberty simultaneously? Or are these outcomes
logically incompatible? If they are incompatible,
what is actually going on in the field of drug
control--and _cui bono_ (who benefits)? Could it be
that any drug policy short of total repeal of
prohibition is simply a problem masquerading as a
solution? These are questions we rarely hear
discussed in a public forum.
PLAYERS IN THE DRUG POLICY GAME
The principal contenders in the current U.S.
debate represent three perspectives on drug policy in
a free society: the prohibitionist or "drug warrior"
perspective, the public health perspective, and the
classical liberal or "libertarian" perspective.
DRUG WARRIORS
The "drug warrior" perspective is the foundation
of our present drug control policies. The drug
warrior values a paternalistic state, which plays the
role of protective parent in relation to vulnerable
citizen-children. His focus is on strict enforcement
of prohibition and on the regulation of currently
legal drugs (for example, prescription drugs). Many
drug warriors also advocate the expansion of sanctions
to include tobacco and alcohol. General Barry
McCaffrey and William J. Bennett--current and past
"drug czars" respectively, former director of the
National Institute on Drug Abuse Robert J. Dupont, and
Congressman Charles B. Rangel are drug warriors
sharing this point of view. They typically believe
that drugs cause addiction and crime. In their view,
public policies should aim to limit supply and punish
users and dealers. Thus we have the "war on drugs."
Illegal drugs such as heroin, cocaine, crack, LSD,
"speed," and marijuana, and the people who profit by
selling them, are the enemy.
Here are some questions we need to ask in
evaluating the "drug warrior" perspective: Do drugs
cause crime and addiction? Does prohibition itself
create lawlessness? Is it proper for government to
regulate behavior if that behavior harms no one but
the user? Do people have a right to own and use drugs
as personal property? Is drug supply the best
predictor of use? Are social, economic, and
psychological problems related to drug use ignored and
thereby perpetuated when policy focuses on eliminating
supply and punishing drug users and dealers? Is the
war on drugs a scapegoating device to distract
citizens from other social problems which they may
feel helpless to solve? Does prohibition serve the
economic interests of prison builders, policymakers,
and drug dealers? Can drugs ever be controlled? If
drug prohibition can work outside a total police
state, why is the drug trade flourishing in prisons,
the most totalitarian institutions of our society?
LEGALIZERS
The public health perspective on drug policy is
represented by people who advocate the legalization
and medicalization of drug use. They regard addiction
as a disease and criminal sanctions as inhumane and
wasteful of tax money. Hence they advocate treatment
rather than punishment for drug use. As Mayor Kurt
Schmoke of Baltimore put it years ago, "The war on
drugs should be led by the Surgeon General, not the
Attorney General." Today the slogan of medicalization
is "harm reduction." The advocates of medicalization,
e.g. the Drug Policy Foundation in Washington, D.C.
and The Lindesmith Center in New York, generally also
support "medical marijuana" laws such as those passed
recently in California and Arizona. Ironically,
prohibitionists and legalizers both embrace the
medical model of addiction: they believe that drug
addiction exists, that it is a disease, and thus that
it is "treatable" as a disease.
In examining the public health perspective, we
need to raise questions like the following: does
medical treatment of addiction work? Can it ever
work, or is it based on a logical mistake? Will
medical control (e.g., through prescription drugs)
create the same problems of lawlessness that are
associated with prohibition? Does court-ordered and
state-supported treatment violate the drug user's
First Amendment rights? The late American Civil
Liberties Union attorney Ellen M. Luff addressed that
issue in an important case that received national
attention in 1988 (_Maryland v. Norfolk_). Luff
successfully argued that court-ordered attendance in
Alcoholics Anonymous constitutes state entanglement
with religion. Similar cases have emerged since then
(e.g. _Griffin v. Coughlin_, 88 N.Y. 2d 674, New York
Court of Appeals, decided 11 June 1996; _Kerr v.
Farrey_, 95 F.3d 472, 7th Cir. 1996; _Warner v.
Orange County Dept. of Probation_, No. 95-7055, 1997
WL 321553, 2nd Cir., 9 September 1996, amended 14 May
1997). Should public funds be spent on moral
indoctrination in the name of public health? Again,
should the government control behavior that harms no
one but the individual involved?
Calls for state-supported treatment are echoed by
prohibitionists and legalizers alike. An important
point here is that whether treatment for addiction is
voluntary or involuntary, state involvement in _any_
capacity--e.g. court-ordered attendance, state
licensure of treatment facilities, or state subsidies
for treatment programs--violates the invisible wall
separating church and state. This is because _all_
treatment for addiction is essentially a religious
activity. The state has no business inside a person's
head.
LIBERTARIANS
In the classical liberal, or libertarian,
perspective (represented in somewhat different ways by
psychiatrist Thomas Szasz and economist Milton
Friedman), drug use is regarded not as a disease but
as a behavior based on personal values. It is
regarded as an ethical rather than a medical issue.
Classical liberals cite the scientific evidence that
drug use is a function more of mindset and environment
than of chemistry or physiology. They challenge the
notion of "loss of control" that is integral to the
prohibitionist and public health perspectives, basing
their claims on studies of drug users who controlled
their habits when motivated to do so. They do not
believe that drugs or addiction can cause crime. In
their view drugs are property and as such are
protected by the Constitution; drug users need not be
treated as "barbarians at the gate" requiring
exceptions to the constitutional rule of law. The
classical liberals believe that a free-market approach
to the trade of currently illegal drugs would reduce
the crime and lawlessness associated with them under
prohibition. Valuing liberty over health, they
criticize medicalization as paternalistic and statist.
In their view, informal social controls, either
relational or self-imposed, are the appropriate focus
of drug policy.
In judging the classical liberal perspective, we
need to ask questions like the following: If drug
prohibition is repealed, will there be a substantial
increase in drug use? If there is, will the problems
associated with increased drug use pose a greater
threat to freedom than drug prohibition has? Will an
American free market in currently illegal drugs create
international problems in trade with prohibitionist
countries?
WE NEED POLICY BASED IN FACT NOT FICTION
We need new ways of thinking about addiction--
ways of thinking consistent with empirical findings on
addiction and inconsistent with mainstream ideas about
drugs and the policies based on them. There are no
easy answers to the difficult questions I have posed
here. However, they _must_ be addressed in the
academic and policymaking arenas. Too often,
professors are penalized for even asking those
questions. It is important that we choose the right
course in drug policy, based on fact, not fiction--and
even more important that we once again be free to
choose.
FOOTNOTE (to title):
1. This article is excerpted from the introduction to
_Drugs: Should We Legalize, Decriminalize, or
Deregulate?_, an anthology edited by J.A. Schaler,
published by Prometheus Books, Amherst, N.Y. (1998),
part of their Contemporary Issues series. This
excerpt is reprinted here by permission of the
publisher, E-mail: PBooks6205@aol.com, phone orders
(24 hours): Toll free (800) 421-0351
REFERENCE
Schaler, J.A. (1997). The case against alcoholism as
a disease. In W. Shelton & R.B. Edwards (Eds.)
_Values, ethics, and alcoholism_, pp. 21-49,
Greenwich, Ct.: JAI Press Inc.
Jeffrey A. Schaler, Ph.D., a psychologist, is an
adjunct professor of justice, law, and society at
American University's School of Public Affairs in
Washington, D.C. He is currently at work on a similar
book for Prometheus, co-edited with Magda E. Schaler,
M.P.H., on smoking rights and federal regulation, to
be released later this year.
E-mail: jschale@american.edu
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