IV. A Comprehensive Approach
1. A National Strategy
The Strategy is national in scope and purpose. The desired end is to decrease drug abuse and its consequences throughout America. As the data indicate, the problem is not compartmentalized. Illegal drugs permeate the entire country, cutting across socio-economic backgrounds, ethnic groups, educational levels, and metropolitan, suburban, and rural boundaries. Unless we recognize drug abuse as an affliction threatening all our citizens and neighborhoods, we will be unsuccessful in achieving our purpose. Like cancer, drug abuse that is left unchecked will spread to other parts of the body politic.
The United States is not an island disconnected from the rest of the world. Although we grow or manufacture many of the illegal drugs we consume (such as marijuana and methamphetamine), America's demand for drugs and willingness to pay high prices makes us a choice target for international traffickers. We further understand that as we bring down our consumption, drug traffickers will search for markets elsewhere, creating problems for other nations. The Strategy therefore, includes bilateral, multilateral, and international initiatives designed to lessen our own drug problem and help all countries address the illegal drug threat -- a threat that jeopardizes their own well-being and national security.
Domestically, the job of reducing drugs in America cannot be done without coordination at the federal, state, and local level or close cooperation between the public and private sector. Such effort is motivated by the strong concern Americans have for their children in light of the drug threat. In a 1997 poll that asked for a list of the top problems facing children, respondents cited drugs more than twice as often as the second-most-mentioned problem (crime) and almost four times the rate as for basic issues like good education.1 This concern has resulted in a significant commitment from the federal government whose aggregate counterdrug budget has grown from $13.5 billion in fiscal year 1996 to $17.8 billion in 1999. More than fifty federal agencies work together under the guidance of this Strategy to reduce the scope and intensity of the national drug problem.
State and Local Government
The federal government cannot accomplish the objectives laid out in this Strategy without the support of the fifty states and four U.S. territories as well as the thousands of city, county, and local governments threatened by illegal drugs. State governments, for example, have enormous potential for addressing the drug problem. They administer the school systems, exercise far-reaching jurisdictional power, channel money and resources to specific needs, and educate citizens about the dangers of illegal drugs. States' funds account for much of the spending on drug prevention and treatment, providing funds to thousands of community-based treatment programs and prevention providers. Counties and cities, play an equally important role, providing essential services such as emergency medical care, education, and law enforcement. Public officials in municipalities and counties are frequently most attuned to the specific requirements of their communities. State and local government can and should play an important role in integrating federal funding and coordinating statewide responses to the drug threat. All levels of government must become partners with the federal government in countering illegal drugs.
State Drug Laws
State drug laws play a critical role in the effort to reduce drug availability and use. In recognition of this fact, in 1988 Congress mandated the creation of a bipartisan, presidentially-appointed commission to develop model state drug legislation. The resulting President's Commission on Model State Drug Laws developed forty-four exemplary drug laws. Since 1993, the Alliance for Model State Drug Laws has been holding workshops throughout the country to focus attention on state policies and laws concerning drugs. The adoption of the Model State Drug Laws, and the continued efforts of the Alliance, are important to national drug-control efforts.
The Role of Communities
Government response is only a small part of the national effort to counter illegal drugs. Communities are significant partners for local, state and federal agencies working to reduce drug use, especially among young people and deserve continued support. Communities around the country have formed coalitions that coordinate local reactions to the illegal drug problem. Coalitions typically include schools, businesses, law enforcement agencies, social service organizations, faith communities, medical groups, and youth groups, as well as county and local government. Community Anti-Drug Coalitions of America (CADCA) supports these organizations through technical assistance, leadership development, and information dissemination.2 The Corporation for National Service assists coalitions through initiatives like Learn and Serve, AmeriCorps, and SeniorCorps. The National Guard helps communities by providingadministrative help, logistical support, and prevention programs like Adopt-a-School. The Drug-Free Communities Act of 1997 provides vital support to communities. The program's genesis and growth has been fueled by an unprecedented level of bipartisan support. Last year, grants were provided to ninety-two communities, an initial training and technical assistance conference was conducted, and a presidentially appointed Advisory Commission was established. Two-hundred additional grants will be made during fiscal year 1999. CSAP's five regional Centers for the Application of Prevention Technologies (CAPTs) provide communities with effective coalition training and related materials.
Civic and Service Alliance
Civic, service, fraternal, veterans', and women's organizations also contribute to the national counter-drug effort. Since November 1997, there has been a continued effort to bring together leading civic organizations in an alliance to help young people pursue healthy, drug-free lifestyles. To date, forty-seven national and international organizations have signed a resolution and are member organizations of the "Prevention Through Service" Alliance.* Member organizations represent major service clubs, fraternal and veterans organizations, college student service organizations, youth development agencies, and youth sports programs. They represent more than one hundred million volunteers belonging to nearly one million local affiliated chapters across the country. Highlights of the civic alliance include increasing public awareness, promoting communication about effective prevention, networking among organizations and communities, providing leadership and scholarships, and encouraging volunteerism, as well as service to those in need. Member organizations of the civic alliance support the national anti-drug youth media campaign by sponsoring community-based prevention message activities.3
According to the 1997 NHSDA, 6.7 million current illegal drug users were employed full-time. This number represents 6.5 percent of full-time employees aged eighteen and older. Drug-abusing employees affect the productivity of any business; in some industries they pose an obvious threat to the safety and security of Americans.
In the interest of safety, the Omnibus Transportation Employees Testing Act of 1991 requires alcohol and drug testing throughout the transportation industry. The Department of Transportation (DOT), the industry leader in drug-free workplace programs, oversees approximately eight million employees in the United States who work in regulated business within the aviation, motor, carrier, rail, transit, pipeline, and maritime industries. DOT requires workers in safety-sensitive positions who test positive for drugs to be referred to substance-abuse professionals before returning to work. If substance abuse is diagnosed, the employee must receive treatment before resuming duties. This program -- which also requires drug-testing for operators of commercial motor vehicles from Canada and Mexico -- has become a model for non-regulated employers throughout the United States and other countries around the world. The current percentage of positive drug tests in the transportation industry is very low, having dropped considerably since the program started.
As the nation's largest employer, the federal government has set the example for the past eleven years. Currently, 120 federal agencies have drug-free workplace plans certified by the HHS, Office of Personnel Management, and DOJ. These agencies represent about 1.8 million employees -- the vast majority of the federal civilian workforce. As a result, substance-abuse problems and positive drug tests are at record low levels -- .005 percent. The U.S. military is a prime example of how institutional values and leadership can minimize workplace substance-abuse problems. A generation ago, the uniformed ranks were notoriously drug ridden. Today, a minuscule proportion (approximately one per cent) of defense personnel, uniformed and civilian, use illegal drugs. That turn-around was achieved by prevention, education, and drug-testing combined with strong first-line supervisory leadership that made it clear that illegal drug use was unacceptable behavior.
Because of the federal government's example and experience, comprehensive drug-free workplace programs have expanded throughout the nation. Today, over 80 percent of all companies with more than five thousand employees have drug-free workplace programs. Private sector results parallel the federal experience, with rates of positive drug tests decreasing over the past ten years. Clearly, comprehensive workplace programs provide both incentives and models for smaller employers to build upon in coming years. Drug-free employees have fewer work-related accidents and less absenteeism, use fewer health-care benefits, and file fewer workers compensation claims than their drug-abusing colleagues.
Effective workplaces strategies include written anti-drug and substance-abuse policies, education for employees, employee assistance programs, referral to treatment for both employees and family members, drug testing, and training for supervisors so that they can recognize the signs of drug use reflected in jobperformance and refer employees for help. Programs that employ these strategies improve productivity and reduce employers' costs associated with employee recruitment, training, and retention.
Businesses receive information on creating drug-free workplace programs through the Department of Labor's (DOL) Working Partners for an Alcohol- and Drug-Free Workplace initiative, which includes specific outreach to small business and a repository of materials in the Web-based Substance Abuse Information Database (SAID).4 CSAP also assists businesses implement drug-free workplace programs through its telephone help line, supplemental materials, and training programs.5
Recognizing that it is often difficult for small businesses to institute drug-free workplace programs, Congress passed the Drug Free Workplace Act of 1998 that establishes a demonstration program within the Small Business Administration (SBA). Under this program, the SBA will make grants to eligible business development centers to educate businesses on the benefits of a drug-free workplace program, provide technical assistance in establishing programs, and educate working parents on how to keep children drug-free.
Another workplace-related challenge is helping long-term unemployed substance-abusers become employable. The Workforce Investment Act of 1998, administered by DOL, allows administrative funds to be used for drug testing and referral to treatment in programs that target unemployed youth and adults. The Job Corps program, for example, enforces a zero-tolerance policy, and includes drug testing, assessment, and referrals to treatment. DOL also administers the Welfare-to-Work grants to help individuals overcome barriers to employment, like substance abuse and lack of education. These grants target the roughly 20 percent of the adult welfare population who are most at risk of long-term dependency. To date, eighty-eight million dollars worth of grants that specifically address substance abuse have been awarded.
Organized athletic programs can reach young people and engage them in drug-free activities. Each year approximately 2.5 million students play football and basketball in high school and junior high. Millions of children are involved in soccer leagues, among other sports. Studies show that a young person involved in sports is 40 percent less likely to get involved with drugs than an uninvolved peer. Scores of children admire professional athletes, but these stars often convey mixed messages pertaining to drugs, if not outright pro-drug attitudes. In 1998, ONDCP launched an Athletic Initiative to reduce drug use within sports, encourage the athletic world to condemn drug use, and urge youth to get involved with sports.6 ONDCP's "National Coachathon Against Drugs" involves professional and amateur sports leagues. During 1998 one hundred thousand copies of the Coach's Playbook Against Drugs were distributed to coaches around the nation.7 As a result of the athletic initiative, eighteen Major League Baseball clubs and several National Football League teams now show anti-drug messages in their stadiums. In 1999, ONDCP will conduct a national summit to address the full range of sports-related drug issues.
The faith community plays a vital role in building social values, informing the actions of individuals and inculcating life skills that are critical to resisting illegal drugs. The clergy -- rabbis, priests, and ministers -- all serve as civic leaders. Many run programs that provide much-needed counseling and drug treatment for members of their communities. Consequently, ONDCP is expanding its outreach to the faith community. In 1999, ONDCP encourages religious communities to speak out against drugs and further develop faith-based initiatives to prevent and treat drug use.
Countering Attempts to Legalize Drugs
Given the negative impact of drugs on American society, the overwhelming majority of Americans reject illegal drug use. Indeed, millions of Americans who once used drugs have turned their backs on such self-destructive behavior. While most Americans remain steadfast in condemning drugs, small elements at either end of the political spectrum argue that prohibition -- and not drugs -- create problems. These people offer solutions in various guises, but one of the most troublesome is the argument that eliminating the prohibition against dangerous drugs would reduce the harm that results from drug abuse. Such legalization proposals are often presented under the guise of "harm reduction."
All drug policies claim to reduce harm. No reasonable person advocates a position consciously designed to be harmful. The real question is: which policies actually decrease harm and which increase good? The approach advocated by people who say they favor "harm reduction" when they are really advocating drug legalization would in fact harm Americans.
The theory behind what legalization advocates call "harm reduction" is that illegal drugs cannot be controlled by law enforcement, education, public-health interventions, and other methods. Therefore, proponents say, harm should be reduced by decriminalization of drugs, heroin maintenance, and other intermediate measures. The real intent of many harm-reduction supporters is the legalization of drugs,which would be a mistake.
Some people argue that they are not calling for the legalization of all drugs but only for "soft" drugs. Since many users enter treatment every year for help recovering from chronic abuse of marijuana and similar "soft" drugs, this idea overlooks the danger posed by such drugs. Other people support decriminalization of drugs so that drug use would remain against the law but penalties would be minimal. Illegal drug use would become analogous to minor indiscretions like jay-walking. Still others defend the therapeutic value of specific drugs or the economic viability of a drug-related product. By making drug use more acceptable, these people argue, society would reduce the harm associated with drug abuse.
The truth is that drug abuse wrecks lives. It is criminal that more money is spent on illegal drugs than on art or higher education, that crack babies are born addicted and in pain, that thousands of adolescents lose their health and future to drugs. Addictive drugs were criminalized because they are harmful; they are not harmful because they were criminalized. The more a product is available and legitimized, the greater will be its use. If drugs were legalized in the U.S., the cost to the individual and society would grow astronomically.
Many harm reduction partisans consider drug use a part of the human condition that will always be with us. While we agree that crime can never be eliminated entirely, no one is arguing that we legalize other harmful activities. At best, harm reduction is a half-way measure, a half-hearted approach that would accept defeat. Increasing help is better than decreasing harm. Pretending that harmful activity will be reduced if we condone it under the law is foolhardy and irresponsible.
Countering Attempts to Legalize Marijuana
Marijuana is a Schedule I drug under the provisions of the Controlled Substance Act, Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, because of its high potential for abuse and lack of accepted medical use. Federal law prohibits the prescription, distribution, or possession of marijuana and other Schedule I drugs like heroin and LSD and strictly controls Schedule II drugs like cocaine and methamphetamine. Federal law also prohibits the cultivation of Cannabis sativa, the marijuana plant. Marijuana is similarly controlled internationally through inclusion on Schedule I of the U.N. Single Convention on Narcotic Drugs. In the past decade, data regarding the negative impact of marijuana on our youth has accumulated. As described in Chapter II, marijuana use by young people correlates with delinquent and antisocial behavior.
In response to anecdotal claims about marijuana's medical effectiveness, the NIH have sponsored conferences involving leading researchers and is supporting peer-reviewed research on the drug's safety and efficacy. ONDCP is supporting a comprehensive review of existing research on marijuana's potential benefits and harms. This eighteen-month study, conducted by the National Academy of Science's Institute of Medicine, is considering scientific evidence on several topics related to marijuana, including the drug's pharmacological effects; the state of current scientific knowledge; marijuana's ability to produce psychological dependence; risks posed to public health; marijuana's history and current pattern of abuse; and the scope, duration, and significance of abuse.
The U.S. medical-scientific process has not closed the door on marijuana or any other substance that may offer therapeutic benefits. However, both law and common sense dictate that the process for establishing substances as medicine be thorough and science-based. By law, laboratory and clinical trial data are submitted to medical experts in the DHHS, including the FDA, for evaluation of safety and efficacy. If scientific evidence, including results of adequate and well controlled clinical studies demonstrates that the benefits of a drug product outweigh associated risks, the substance can be approved for medical use. This rigorous process protects public health. Allowing marijuana or any other drug to bypass this process is unwise.
Permitting hemp cultivation would result in de facto legalization of marijuana cultivation because both hemp and marijuana come from the same plant -- Cannabis sativa, which contains THC, the active ingredient in marijuana. Chemical analysis is the only way to differentiate between cannabis variants intended for hemp production and hybrids grown for their psychoactive properties.8 In June 1998, a New Hampshire magistrate determined that the Controlled Substances Act unambiguously prohibits the cultivation of hemp. The magistrate found that hemp is marijuana under the statute's definition.
According to a Department of Agriculture review of university studies, hemp is unlikely to be a sustainable, economically viable alternative crop given the uncertainty of demand and market prices. The current U.S. market for hemp products is small, and the potential seems high to reach a situation of oversupply quickly in this niche market. For every proposed use of industrial hemp, competing raw materials and proven manufacturing practices already exist. The ready availability of other lower cost raw materials is a major reason for a 50 percent drop in worldwide hemp production since the early 1980s.
Given concerns about encroaching efforts to justify legalization of harmful psychoactive drugs, the 1999 Strategy outlines specific steps to counter the potential harm such activities pose. Such measures, whichhave been elaborated throughout this document, include:
- Presenting information that demonstrates the harm caused by substance abuse.
- Teaching youth that substance abuse is detrimental to their health and well-being.
- Supporting established scientific procedures to ensure that only safe and effective drugs are used for the treatment of medical ailments.
- Informing state and local government as well as community coalitions and civic organizations about the techniques associated with the drug legalization movement.
- Ensuring the rule of law.
- Working with the international community to reinforce mutual efforts against drug legalization.
* Current member organizations are: 100 Black Men, Inc., AMBUCS, AMVETS, Benevolent and Protective Order of Elks, Big Brothers Big Sisters, Boys and Girls Clubs, Boy Scouts of America, B'nai B'rith Youth Organization, Camp Fire Boys and Girls, Campus Outreach Opportunity League, Civitan International, Fraternal Order of Eagles, General Federation of Women's Clubs, Girls, Inc., Girl Scouts of the U.S.A., Improved Benevolent Order of Elks of the World, Independent Order of Odd Fellows, Jack and Jill of America, Inc., Junior Chamber International, Knights of Columbus, Lions Clubs International, Moose International, Masonic National Foundation for Children, Mothers Against Drunk Driving, National Beta Club, National Council of Negro Women, National Council of Youth Sports, National Exchange Club, National 4-H Council, National FFA Organization, National Panhellenic Conference, National Retired Teachers Association, Optimist International, Pilot International, Quota International, United Native Indian Tribal Youth, Rotary International, Ruritan International, Sertoma International, Soroptimist International, The LINKS, Inc., Veterans of Foreign WArs, YMCA of the USA, Youth Power, Youth to Youth International, YWCA of the USA, and Zeta Phi Beta Sorority, Inc.