Volume 97 Issue 11 Page 1477 - November 2002
Drug War Heresies: Learning from Other Vices, Times and Places
ROBERT J. MacCOUN & PETER REUTER
Cambridge and New York, Cambridge University Press, 2001, xvi + 479 pp, US$75.00, ISBN 0521 57263 0 (cloth) / US$25.00, ISBN 0521 79997 X (paper)
Psychologist Robert MacCoun and economist Peter Reuter have collaborated on several drug-policy studies. Drug War Heresies combines their previous research with wide reading in the American and European drug literature. The result is a big, timely book focused on a vexing problem: the imperviousness of the US drug war to rational analysis. Given the poor results and high costs of the current regime, the unwillingness to consider even modest alternatives strikes the authors as intellectually irresponsible.
Their comparative analysis highlights two alternatives: marijuana 'depenalization' and heroin maintenance. The Dutch cannabis experience and other decriminalization experiments suggest that repealing penalties for, or simply not prosecuting, the possession of small amounts of marijuana would have little effect on the prevalence and intensity of use, while eliminating such harms as criminal records for casual smokers. The Swiss heroin maintenance trials indicate that more users could be drawn into sanitary injection settings, diminishing HIV exposure without appreciably increasing diversion or prevalence. However, the authors concede that those who oppose non-medical drug use on absolute moral grounds will be unmoved by such utilitarian arguments.
As heretics go, MacCoun and Reuter are polite and circumspect. They oppose legalization of illicit drugs because it would inevitably lead to commercialization and pressure to sacrifice public health for sales volume, as the history of alcohol and tobacco regulation attest. The under-regulation of those substances is mainly due to the economic and political clout of their manufacturers. The government's own thirst for revenue can also cause problems. Legal gaming has expanded rapidly despite adverse consequences for the poor and habitual gamblers.
So MacCoun and Reuter content themselves with harm-reduction proposals that stop well short of legalization. Of the two, marijuana depenalization seems the better bet in the American context. Heroin clinics would pose formidable logistical and political problems, including the NIMBY (not in my back yard) reaction of outraged neighbors. US addicts, in contrast to those in Switzerland, also tend to be heavy consumers of cocaine. Their cocaine use would hardly disappear if heroin were available legally. It might even intensify, given that addicts in maintenance would have more to spend on other drugs.
The authors mean to provoke just this sort of reasoned speculation.
They want us to think and argue in consequentialist terms about particular
policy scenarios, which they present in a scrupulously even-handed fashion.
The book's chief limitation, apart from the self-imposed one of relating
everything back to US policy, is its Eurocentrism. Prohibition experiments
in Indian states and shifting opium policy in Hong Kong, to name two Asian
examples, seem as instructive as several of the ambiguous Western cases.
But there is still ample material to provoke debate about past experiences
and alternative futures, especially for cannabis, heroin and cocaine
the substances with which Drug War Heresies is chiefly concerned.
DAVID T. COURTWRIGHT
University of North Florida
Jacksonville, FL
USA