Portal de Periódicos da CAPES

There's No Success Like Failure: The Persistence Of Punitive Prohibition

1997; Project HOPE; Volume: 16; Issue: 2 Linguagem: Inglês

10.1377/hlthaff.16.2.258

2694-233X

Craig Reinarman,

Substance Abuse Treatment and Outcomes

Book Review Health AffairsVol. 16, No. 2 There's No Success Like Failure: The Persistence Of Punitive ProhibitionCraig Reinarman AffiliationsUniversity of California, Santa Cruz and the associate editor of the journal Contemporary Drug Problems. His latest book is Crack in America (University of California Press, 1997).PUBLISHED:March/April 1997Free Accesshttps://doi.org/10.1377/hlthaff.16.2.258AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits TOPICSPharmaceuticalsDrug usePublic healthPoliticsDiseasesLegal and regulatory issuesAbstinenceCivil wars, regional wars, and even world wars all eventually end in peace, but the drug war keeps marching along. Since about 1920, when alcohol prohibitionists took charge of drug control, criminal punishment has been the foundation—and the walls and roof—of U.S. drug policy. This policy has never succeeded in substantially reducing drug problems, and it seems increasingly unlikely to do so in a culture that encourages consumption for pleasure and pain relief at every turn. Its costs and negative consequences for public health and civil liberties continue to climb. Yet, our leaders have responded to this history of failure with a refusal to reevaluate and strident calls for more of the same—in short, with a politics of denial.The authors of this important and interesting book were prompted to write in part by this puzzling persistence of what they aptly call the punitive paradigm of drug policy. In Part One they summarize the evidence for the charge that drug wars have failed and conceptualize it under three “fatal flaws": the “profit paradox,” meaning that law enforcement and interdiction artificially increase drug prices, which increases potential profits and thus draws more entrepreneurs into the drug business; the “hydra effect,” whereby a crackdown on drug production or selling in one area only spreads it somewhere else, so that even drug war “successes” are short-lived; and the “punish-to-deter fallacy.” After decades of trying to imprison our way out of drug problems, it is clear that not even a police state could stop illicit drug use. We arrest 350,000 citizens every year for mere possession of marijuana, yet there are nearly seventy million Americans walking around who have used illicit drugs. Nor is there much evidence that even those who get punished are deterred; indeed, punishment often makes them less able to build law-abiding, drug-free lives.Drug warriors have led Americans to believe that illicit drug use is the direct cause of crime and health problems. But the authors demonstrate that most such problems are “collateral damage” from punitive drug policies. By raising prices in an effort to discourage use and sales, punitive policies cause both “addiction-based” property crime and “trade-based” violent crime. Criminalizing syringes ensures that addicts will share them and spread acquired immunodeficiency syndrome (AIDS), hepatitis, and other diseases. Threatening cocaine-using pregnant women with jail and loss of custody deters them from seeking the medical care they and their children need most. Aiming the drug war artillery selectively at street-level use and sales makes the war against drugs into a war against the poor and persons of color. More generally, the authors show how drug wars make a mockery of democratic values and institutions (for example, by enforcing laws unequally).In Part Two the authors tackle the less-explored question of why, in the face of this evidence, drug war politics persist. Across good economic times and bad, during moments of national cultural anxiety and of self-assuredness, in Republican and Democratic administrations, whenever policymakers have been confronted with the failures and collateral damage of “get tough” drug policies, their only answer has been to get tougher. One of the real strengths of this book is that it lays bare the electoral and bureaucratic interests that have made it rational to pursue irrational drug policies. The authors begin with the question of cui bono —who benefits—and quickly come to the symbolic value of demonizing drugs. Politicians gain the perfect enemy; like Satan, the apparition of demon drugs can be denounced without offending anyone or requiring that anyone address the underlying sources of hard drug problems. Such symbolic politics have been aided and abetted by an ever-expanding drug control complex, whose material interests keep it wedded to the punitive paradigm. Many law enforcement officials now privately admit that the drug war is doomed, but few will say this publicly because they have become dependent on drug war funding. The rise of a treatment industry in the 1970s might have raised questions about the punitive paradigm. But the authors show how the growth of drug treatment was predicated on the notion that it was merely an adjunct rather than an alternative to the drug war. Treatment entrepreneurs quickly recognized that their ability to obtain much-needed funding depended upon defining their wares as weapons in the war against drugs and crime rather than as a humane challenge to it.Similarly, official commissions, reform-minded presidents, and all others who have attempted to define drug abuse in health terms were defamed and defeated by an entrenched drug control complex. Checks and balances that should have led to debate and reevaluation of drug policy have led instead to bandwagon effects that only escalated the drug war. When the state is ideologically invested in repressing all drug use—rather than in the less Utopian goal of reducing drug-related harm—then the punitive paradigm becomes a lens that filters out politically inconvenient evidence of failure.In Part Three the authors explore two alternative drug policy models: legalization and public health. They quickly reject legalization by arguing that for all of its potential advantages in undoing the harms of prohibition, it would not by itself address abuse and addiction. They then outline a public health approach that would emphasize prevention, including teaching “safer use” alongside abstinence; expanding the treatment system to offer a continuum of care in which the definition of “success” would be broadened beyond abstinence to include reduced harm and improved social functioning; and changing the social environment in which drug problems grow by rebuilding inner cities, increasing job opportunities, and making health care available to all.At the same time, the authors recognize the ideological and institutional obstacles to such reform. They conclude, reluctantly, that without sustained political struggle for a more rational drug policy, there will only be more war.If there is a flaw in the authors' argument, it is their inclination to speak of illicit drug use as if most of it were pathological. In making the case for shifting to a public health paradigm in drug policy (as most other industrialized democracies are doing), the authors spend most of their time demonstrating how much better off both drug abusers and society would be if treatment and care replaced arrest and imprisonment. This is certainly true, but public health models have little to say about one awkward fact: Most illicit drug use is neither abusive nor addictive and entails neither physical nor psychological pathology. All illicit drug users are defined by the state as deviant, but most do not suffer from disease. They are not, therefore, the sort of “problem” that either treatment or care can solve.A public health approach that treats deviance as if it were a disease risks replicating the totalitarian tendencies of the punitive paradigm, and without the voices and votes of the tens of millions of citizens who have used illicit drugs, the struggle for a public health alternative to the drug war is unlikely to succeed. Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 1 March 1997 InformationCopyright © by Project HOPE: The People-to-People Health Foundation, Inc.PDF download