There are many individuals, organizations, and social movements who are working to address problems associated with harmful drug use. Social science, public health, biomedical, and legal scholars and researchers are diligently producing more evidence-based knowledge to guide societal efforts toward more humane and pragmatic responses to harmful drug use. Strategies to try to deal with this problem generally fall into various categories such as treatment, harm reduction, and other drug policies including those associated with the War on Drugs as discussed on the prior page. We elaborate on these strategies below. Finally, as social problems must be addressed interdependently, using both individual agency and collective action, citizens, lawmakers, health care workers, community advocates, and individuals must act to address drug-related problems. We review some examples of these efforts below.
Treatment
Treatment programs are intended for people who already are using drugs, perceive they have a drug problem, and want to reduce or eliminate their drug use. This strategy is probably familiar to most readers, even if they have not used drugs themselves or at least have not had the benefit of a treatment program. Treatment programs often involve a group setting, but many drug users also receive individual treatment from a psychiatrist, psychologist, or drug counselor.
The video below focuses on the importance of in-person group meetings as part of drug treatment and the struggles faced by those in recovery as they attempted to stay sober during a global health crisis, the COVID-19 pandemic.
Perhaps the most famous treatment program is Alcoholics Anonymous (AA), a program that involves alcoholics meeting in a group setting, acknowledging their drinking problem and its effects on family members and other loved ones, and listening to each other talk about their situations. Narcotics Anonymous shares the AA model. Other group settings are residential settings in which those seeking treatment stay at the facility, sometimes called detox units. In these settings, people check themselves into an organizational facility and may stay there for several weeks.
In addition to or in conjunction with group treatment programs, individual treatment for drug addiction may involve the use of 'good' drugs designed to help wean individuals off the drug to which they are addicted. For example, nicotine gum, patches, and other products are designed to help cigarette smokers stop smoking. Other individuals may ingest cannabis to reduce cravings for other more addictive drugs.
The various forms of treatment can be effective for some individuals and less effective or not effective for others, and most treatment programs do have a high failure rate (Goode 2012). A sociological perspective suggests that however effective treatment might be for some people, the origins of harmful drug use ultimately lie in the larger society – its social structure, social institutions, social interactions, and culture – and that these roots must be addressed for serious reductions in harmful drug use to occur. See the Applying Social Research box below for an example of group-specific structural causes of drug use and how it relates to treatment.
Applying Social Research
Indigenous Communities, Historical Trauma, and Drug Use
Indigenous people report the second highest rate of illicit drug use disorder between 2015 and 2019, at 4.8%. The highest percentage is among people who identify as two or more races or ethnicities. Indigenous people are also the highest percentage of people who sought treatment for illicit drug use disorders and received it (Center for Behavioral Health Statistics and Quality 2021).
The work of researcher and professor Maria Yellow Horse Brave Heart (pictured below) explains how the historically-based trauma experienced by Indigenous communities in the United States may impact substance use. She emphasizes that the traumatic losses suffered across generations by the North American Indigenous populations meet the definition of genocide. She lists massive traumatic group experiences as part of the intergenerational trauma experienced by this community, which may contribute to substance use (2003:8).
This list includes traumas such as massacres, prisoner of war experiences, starvation, displacement, separation of children from families and placement in compulsory and often abusive boarding schools, disease epidemics, forced assimilation, and the loss of language, culture, and spirituality. All of this contributes to the breakdown of family kinship networks.
Brave Heart points to an 1881 US policy outlawing the practice of Native ceremonies, which prohibited traditional mourning practices. This undermined practices of healing and resolution that might improve wellness and potentially lower problematic substance use levels. Urban Indigenous people who use alcohol and/or other illicit substances reported symptoms of historical trauma (Wiechelt et al. 2012). Brave Heart points out that alcohol was not part of Indigenous culture except for in specific ceremonies before colonial contact. If you’d like to listen to Brave Heart herself, watch Historical Trauma in Native American Populations.
Researchers suggest that treatments for substance use disorder among Indigenous peoples should coincide with decolonizing practices. This means that Indigenous communities should be supported in making attempts and achieving control of land and services. Nutton and Fast report that:
"…communities that have made attempts to regain control of land and services have been found to have lower suicide rates, reduced reliance on social assistance, reduced unemployment, the emergence of diverse and viable economic enterprises on reservation lands, more effective management of social services and programs, including language and cultural components, and improved management of natural resources" (2015: 842).
Identity formation can also be a helpful part of drug treatment for Indigenous individuals. Research indicates that increased participation of Indigenous peoples in their culture of origin can decrease the prevalence of substance use disorder (Nutton & Fast 2015).
Finally, all drug treatment interventions should be culturally adapted for Indigenous communities. For example, among Indigenous people inhabiting the Great Plains, the Sun Dance was performed in thanksgiving for a bountiful year and a request for another year of food, health, and success. Today community members pledge to do the Sun Dance to maintain their sobriety from alcohol or drugs.
Researcher Maria Yellow Horse Brave Heart of the Hunkpapa/Oglala Lakota examines drug use. How does her work explore generational trauma you might remember from the ACEs model in the Medicine and Health chapter?
“Photo of Maria Yellow Horse Brave Heart” is all rights reserved and included with permission
To address harmful drug use we must expand access to effective drug treatment. Expanding options takes collaboration by federal, state, and community partners to make a difference. Increasing funding for drug treatment, including drug treatment facilities, community-based drug treatment programs, and harm reduction programs (discussed below) can expand social justice for drug users.
Community-based drug treatment programs serve over 53% of people in recovery (Bowser 1998). They include Twelve Step programs and other peer-led recovery groups. These community-based organizations may serve people with specific social identities, such as recovery groups for firefighters, queer people, or women, as examples. In addition, a recent study found that even when harm reduction or drug treatment services were available, they couldn’t offer enough wrap-around services to their clients. For example, even though many clients were unhoused, most programs didn’t offer housing. Even when clients were parenting, the programs had no funding for childcare services (Krawczyk et al 2022).
Community-based programs may help reduce harmful drug use by increasing social connections and social capital. Social capital is defined as the social networks or connections that an individual has available to them due to group membership. Researchers may measure social capital by looking at voting rates, the number of non-profit and civic organizations in a community, and response rates to the census (Zoorob and Salemi 2017). These are all indicative of one’s engagement with their community, as well as increased social linkages between people through community organizations. In other words, higher levels of social capital within a community might protect it from higher harmful drug use and overdose rates. Research documents the relationship between experiences with racism and illicit drug use among Black women (Ehrmin 2002), and finds that Black women used drugs less if they had a strong ethnic identity and were connected to their communities (Maclin-Akinyemi et al. 2019).
Community partnerships also help address the problem of harmful drug use. Multiple community organizations coming together – nonprofits, hospitals, criminal justice programs, schools, or whatever combination of local organizations – are stronger acting together than in isolation as they pool their resources. Watch the video below to see an example of the success of community partnerships.
In addition, drug treatment programs should take an intersectional approach. Social class and race impact access to drug treatment. Most elective drug treatment programs require some form of payment for services. Those without insurance and without the financial means to pay will be unable to receive treatment. Researchers have also found that racial discrimination has prevented entry for Black and Indigenous people into more desirable forms of drug treatment (Hansen 2015). Thus, quality treatment may be out of reach particularly for individuals who are low-income and of color.
Race and class also play a role in determining which type of opioid use disorder treatment one will receive. Hansen (2015) found that people of color were often only offered the option of the less desirable methadone treatment, which requires near-daily visits to a clinic and a demeaning and constricting practice of surveillance (Bourgois 2000). In contrast, white middle-class individuals were more likely to be given the opportunity to receive buprenorphine treatment for their opioid use disorder. This type of treatment is more private and requires significantly fewer medical interactions. Hansen (2015) sees this systemic discrimination as not only a form of oppression for low-income people of color but also as a mechanism of maintaining the race and class privilege of white middle-class individuals.
Another approach, which overlaps with drug policy strategies, involves the use of drug courts. These began in the 1990s and now number more than 2,500 across the US. In these courts, drug offenders who have been arrested and found guilty are sentenced to drug treatment and counseling rather than to jail or prison. Evaluation studies show that drug courts save money compared to imprisoning drug offenders and that they are more effective than imprisonment in reducing offenders’ drug habits (Stinchcomb 2010). Plainly stated, treatment is more effective at addressing drug use and addiction than is incarceration.
Harm Reduction
Another strategy involves harm reduction. Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use (Harm Reduction Principles N.d.). Harm reduction is both a public health approach to drug use and also a social movement for social justice built on a belief in, and respect for, the rights of people who use drugs. It focuses on providing people who use drugs with the information and material tools to reduce their risks while using drugs. It recognizes that people will use drugs despite efforts to prevent or persuade them from doing so and despite any punishment they might receive for using illegal drugs. Instead, this approach focuses on reducing the harm of substance use rather than requiring abstinence from all drug use. Similar harm reduction strategies are wearing seat belts or providing adolescents with condoms.
The first minute of the video below provides a list of the ways that harm reduction creates a safer environment for everyone. The philosophy behind harm reduction revolutionizes the way we respond to human problems, namely addiction, drug overdose, and HIV. Harm reduction uses a grassroots approach based on advocacy from and for people who use drugs and accept alternatives to abstinence of drug use that reduce harm (Marlatt 1996). According to the National Harm Reduction Coalition (2024), the central harm reduction organization in the US, a core principle of harm reduction philosophy “accepts for better or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them.”
One of the most well-known harm reduction practices is syringe exchange (see the infographic below). This strategy involves the distribution of clean, sterile needles for people who inject heroin, cocaine, or other drugs. Many of these users share needles, and this sharing may spread HIV, hepatitis, and other diseases. If they have a supply of sterile needles, the reasoning goes, the transmission of these diseases will be reduced even if use of the drugs with the aid of the needles does not reduce. This became legal during the HIV epidemic of the 1980s and ’90s to help people who inject drugs avoid infection with the then-deadly virus. The National Harm Reduction Coalition (2024) states that “Syringe service programs (SSPs) distribute sterile syringes, safer drug use supplies, and education to people who inject drugs.”
In this infographic, we see myths about syringe exchange programs and the facts that dispel the myths. Syringe exchange programs reduce harm.
“Syringe Exchange Programs (SEP) Myths vs. Facts” from “Syringe Exchange Toolkit” by AIDS Advocacy Network, American Medical Students Association is included under fair use
Sometimes people oppose syringe service programs because they think it might enable drug use. Research shows the opposite. According to the US Centers for Disease Control and Prevention (2019), new users of syringe service programs are “five times more likely to enter drug treatment and three times more likely to stop using drugs than those who don’t use the programs.”
The current opioid crisis in the US is causing a dramatic increase in infectious diseases associated with injection drug use, such as HIV or hepatitis C. Syringe service programs are known to reduce HIV and hepatitis C infection rates by an estimated 50 percent (Platt et al. 2017). When paired with medication-assisted treatment to treat opioid dependence, syringe service programs can reduce HIV and hepatitis C transmission by over two-thirds (Fernandes et al. 2017; Platt et al. 2017).
Syringe service programs can also prevent opioid overdoses by educating people who use drugs about ways to prevent overdose. Syringe service programs provide training on how to recognize an overdose and how to use naloxone or Narcan, a harmless medication that reverses opioid overdoses. Often syringe service programs will distribute overdose prevention kits that include naloxone (CDC 2019).
Currently, harm reduction is also associated with the distribution of the opioid overdose reversal antidote – Narcan or Naloxone. This harmless medication can almost instantaneously reverse an opioid overdose, saving a person’s life.
The harm-reduction approach to address drug use can be controversial because some believe that it enables drug use. There is no scientific evidence to support this idea. Instead, scientific evidence shows that syringe exchange reduces HIV and hepatitis C rates, and the distribution of Narcan lowers drug overdose mortality rates (Chimbar & Moleta 2018; Fernandes et al. 2017; Platt et al. 2018).
Drug Policy
Many and perhaps most scholars think that the war on drugs has had little, if any, impact on drug use (Walker 2011), and many scholars recognize that this war brought with it many adverse consequences. As Kleiman et al. (2011: xvi) observe, "Our current drug policies allow avoidable harm by their ineffectiveness and create needless suffering by their excesses."
A growing number of people in the political world agree. In 2011, the Global Commission on Drug Policy issued a major report on the world’s antidrug efforts. The commission comprised 19 members, including a former United Nations secretary general, a former US secretary of state, a former chair of the US Federal Reserve, and former presidents or prime ministers of Brazil, Colombia, Greece, Mexico, and Switzerland. The commission’s report called for a drastic rethinking of current drug policy: "The global war on drugs has failed, with devastating consequences for individuals and societies around the world… Fundamental reforms in national and global drug control policies are urgently needed" (Global Commission on Drug Policy 2011: 3). Decriminalization and even legalization of drugs should be seriously considered, the report concluded.
Given this backdrop, many drug experts question whether the nation's current drug policies make sense. They add that the best approach our society could take would be to expand the prevention, treatment, and harm reduction approaches discussed earlier – our society should do what it can to minimize the many harms that drugs can cause. Thus drug education prevention and drug treatment programs should be expanded, sterile needles should be made available for drug addicts who inject their drugs, and drug courts should be used for a greater number of drug offenders.
Lessons from Other Societies
What Happened after the Netherlands and Portugal Decriminalized Drugs?
As the United States ponders its drug policy, the experience of the Netherlands and Portugal provides some provocative lessons.
The Netherlands decriminalized drugs in 1976. Under the Netherlands’ policy, although criminal penalties remain for possessing hard drugs (cocaine, heroin, etc.) and large quantities of cannabis, drug users are not normally arrested for possessing drugs, but they must receive drug treatment if they are arrested for another reason. Drug sellers are not normally arrested for selling small amounts of drugs, but they may be arrested for selling them in large. Cannabis use in the Netherlands dropped in the immediate years after it was decriminalized. Although it increased somewhat since then, as in some other nations, it remains much lower than the US rate. According to the Netherlands Ministry of Foreign Affairs, 23% of Dutch residents ages 15–64 have used cannabis at least once in their lives, compared to 40% of Americans ages 12 and older (2005 figures). Dutch use of cocaine and heroin also remains much lower than American use. Reflecting the Netherlands’ experience, most of the nations in Western Europe have also decriminalized cannabis possession and use, and their rates of cannabis use also remain lower than the US rate.
In 2001, Portugal became the first European nation to remove all criminal penalties for drug possession. Portugal took this step because it reasoned that fear of arrest keeps drug addicts from seeking help and because it recognized that drug treatment costs far less than imprisonment. Anyone convicted of drug possession is sent for drug treatment, but the person may refuse treatment without any penalty.
In the first five years after Portugal decriminalized all drug possession, teenaged illegal drug use declined, new HIV infections from sharing needles declined, and the prison population also declined. Meanwhile, the number of drug users receiving addiction treatment increased by 41%. A researcher who reported these trends commented, “Judging by every metric, decriminalization in Portugal has been a resounding success. It has enabled the Portuguese government to manage and control the drug problem far better than virtually every other Western country does.” A Portuguese drug official agreed, “The impact [of drugs] in the life of families and our society is much lower than it was before decriminalization,” and noted that police are now freer to spend more time and energy on high-level dealers. Adult drug use in Portugal has risen slightly since 2001, but so has adult drug use in other European nations that did not decriminalize drugs. Portugal’s increase has not been higher than these other nations’ increase.
Although the Netherlands, Portugal, and other Western European nations certainly differ from the US in many ways, their experience strongly suggests that decriminalization of drugs may cause more good than harm. If so, the US has important lessons to learn from their experiences.
Sources: Hughes & Stevens 2010; Netherlands Ministry of Foreign Affairs 2008; Reinarman & Hendrien 2004; Szaalavitz 2009; Tracey & Jahromi 2010
Some experts say that cannabis use should be decriminalized and that decriminalization of other drugs should be seriously considered. If cannabis were not only decriminalized but also legalized and taxed, it was estimated (in 2010 dollars) that this new tax revenue would amount to $8.7 billion annually and that about as much would also be saved in reduced law enforcement costs, for a total of more than $17 billion in new funds that could be used for drug prevention, treatment, and other needs (Kristof 2010). The great majority of US adults agree: Nearly 9 out of 10 believe that cannabis should be legalized for either medicinal or recreational purposes, with well over half feeling that it should be legal for both purposes. Conversely, only 1 in 10 are against its legalization (Pew Research Center 2024). We discuss legalization and decriminalization policies in more detail next.
Decriminalization and Legalization
Individuals who seek to decriminalize or legalize cannabis and the social movements they're involved in are often motivated by the nation's long history of systemic racism and the war on drugs. National social justice advocates recommend decriminalizing low-level drug offenses as a way to decrease oppression in our criminal justice system. Decriminalization is the act of reducing penalties for possession/use of small amounts from criminal sanctions to fines or civil penalties (Galvin 2014). For example, in order to address the racial and ethnic disparities in criminal justice systems, Ashley Nellis (2021) from the Sentencing Project recommends that we "discontinue arrest and prosecutions for low-level drug offenses which often lead to the accumulation of prior convictions which accumulate disproportionately in communities of color. These convictions generally drive further and deeper involvement in the criminal legal system."
Legalization means to make the possession and use of a drug legal (Galvin 2014a). In the decade after 2012, 24 states and Washington, DC legalized cannabis for adults over the age of 21. Legalizing cannabis has meant fewer arrests and jail time. For instance, in Oregon, the number of cannabis arrests decreased by 96% from 2013-2016, the year cannabis was legalized there for adult recreational use (Drug Policy Alliance 2022). Further, another seven states have decriminalized cannabis, as of summer 2024 (National Conference of State Legislatures 2024).
This map, from the National Conference of State Legislatures, indicates which states have regulatory programs regarding the use of cannabis as of 2024.
Source: National Conference of State Legislatures 2024
The Drug Policy Alliance, a nonprofit organization that advocates for the decriminalization of drugs, examined rates of youth cannabis use. They found that since the legalization of cannabis use in some states, youth use rates have remained stable and, in some cases, gone down. They have also found that legalization has not made roadways less safe due to driving under the influence of cannabis. Finally, they show that states are using the money generated through taxes on legal cannabis for social good (The Drug Policy Alliance 2022). For instance, in Oregon, 40% of the cannabis tax revenue goes to the state school fund, and 20% goes to alcohol and drug treatment.
However, health researchers remain concerned about the impacts of cannabis legalization. Hammond et al. (2020) point out that we must balance the negative impacts with the positive effect of decriminalization, reducing youth juvenile justice involvement. Youth involvement in the juvenile justice system can have long-lasting negative impacts on the life outcomes of youth. For example, involvement in the juvenile justice system may disrupt education or cause long-lasting mental health problems. We must consider the reduction of these types of issues alongside the known negative impacts of youth cannabis use.
Another equity issue arises with the legalization of cannabis and the rise of a money-making industry. A drug-related felony on an individual’s record may be a barrier to gaining a license to sell cannabis through a dispensary. As we’ve discussed in this chapter, due to systemic racism within drug policy enforcement, those with drug-related felonies on their record are disproportionately Black. This means that Black entrepreneurs may be disproportionately blocked from entering the cannabis industry. Several states and cities have implemented equity programs to address this issue. In California, a prior drug felony cannot be the sole basis for denying a cannabis license. In Portland, Oregon a portion of cannabis sales tax revenue is spent on funding women-owned and minority-owned cannabis businesses (DPA).
Other Drug Policies
In addition to the measures discussed above, several other policies might well reduce certain kinds of harmful drug use or at least reduce the harm that both drugs and our current drug policies cause (Kleiman et al. 2011). These policies include, but aren't limited to, the following:
- Encouraging primary care physicians and other health-care providers to screen more carefully for harmful drug use. Incorporating more careful screening could help identify harmful drug users and individuals at risk of engaging in harmful drug use, such as those experiencing mental health challenges, so that they may be referred to prevention or treatment programs and other resources.
- Providing legally prescribed heroin and/or substitute opiates, including methadone, for heroin users. This method helps monitor and reduce levels of harmful drug use, particularly for drugs with severe health consequences. Its provision has proven effective in several other nations.
- Preventing harmful drug use through education-based prevention programs focusing on children and adolescents. This focus reflects the fact that use of most drugs begins during adolescence, and that if adolescents do not begin using drugs during this period of their lives, they are less likely to do so when they become adults. Some education strategies follow an informational model, involving public-service advertising, the distribution of drug pamphlets in medical offices, and other such efforts. However, some studies question the effectiveness of strategies based on this model (Faupel et al. 2010).
- Abandoning DARE and similar programs in favor of school-based prevention programs. DARE programs have been carried out in more than 7,000 schools across the nation; however, several studies find that DARE programs do not generally reduce subsequent drug use among the children who attend them compared to children who do not attend them (Faupel et al. 2010). According to Kleiman et al. (2011: 201), "the continued dominance in school-based drug education of DARE – a program that has never been shown to actually reduce drug use – is a scandal." They instead recommend school-based programs that help children develop self-control and prosocial behavior, as these programs have also been shown to reduce children’s subsequent drug use.
- Following the psychological principle of operant conditioning. This method would involve providing those struggling with drug addiction or SUD with small cash payments for clean drug tests, as these rewards have been shown to be effective.
- Raising alcohol taxes. According to Kleiman et al., tripling the alcohol tax would especially reduce drinking by heavy drinkers and by minors, and it would reduce the number of homicides by 1,000 annually and the number of motor vehicle accidents by 2,000 annually. The new tax money could also help fund alcohol treatment and prevention programs. “In the entire field of drug-abuse control,” they write, “there is no bargain as attractive as a higher alcohol tax" (2011: 204).
- Raising the tobacco cigarette tax. Government data indicate that every 10% increase in the price of cigarettes reduces cigarette consumption among young people by four-fifths (CDC 2011). Raising taxes on cigarettes in the low-tax states may reduce cigarette smoking in these states. The new tax revenue could be used to fund treatment programs that help reduce smoking.
- Fully reintegrating former drug dealers and users in recovery into society. This is the idea that former dealers and those in recovery should have full access to public housing, educational loans, and other benefits, and they should be allowed to vote in states that now do not let them vote.
No matter the approach, reducing harmful drug use and revising harmful drug policy is social justice. It helps address social inequalities including by reducing the disproportionate consequences of harmful drug use and policy for people of marginalized groups.
Individual Agency and Collective Action
We have already offered some examples of individual agency and collective action in reducing the problem of harmful drug use. For instance, harm reduction is both a public health approach and a social movement, the latter of which inherently involves individual agency and collective action as individuals decide to take action and collaborate with others to create social change. Here we will discuss a couple more examples of efforts to address harmful drug use and the consequences of the war on drugs.
Perhaps the most famous residential treatment program is the Betty Ford Center in Rancho Mirage, California. Betty Ford, the wife of President Gerald Ford, used her individual agency to publicly acknowledge and discuss her own alcoholism at a time when discussing those issues publicly was taboo, especially for women. Moreover, she used her privilege and standing to establish the Betty Ford Center, a residential rehabilitation treatment center in 1982. Mrs. Ford modeled the center's treatment program after the Hazelden Foundation's model of care, which dates back to 1949. The foundation's approach was revolutionary at the time, as a pamphlet from its early days makes clear: "Alcoholism is recognized at Hazelden for what it is—a disease—and not a moral deficiency."
This image is of Betty Ford, who used her individual agency and standing to establish the Betty Ford Center, a residential treatment program for people in need of alcohol and drug treatment.
Image courtesy of Betty Ford Center, http://commons.wikimedia.org/wiki/File:BETTYFORD.jpg
In 2014, the two organizations merged into the Hazelden Betty Ford Foundation, now the largest nonprofit addiction treatment center in the US. As the organization's website (2025) explains: "Today, in harnessing science, love and the wisdom of lived experience, the Hazelden Betty Ford Foundation is a force of healing and hope across the country and around the world for families and communities affected by substance use and mental health conditions" (Gerald R. Ford Presidential Library and Museum n.d.; Hazelden Betty Ford Foundation 2025). This successful nonprofit organization is a result of individuals acting on their own agency.
Other individuals have engaged in individual agency and collective action efforts to help address drug-related problems. Cops likely do not come to mind when you think of who collectively fights against the war on drugs and racialized social control it involves. In fact, a group of police officers and other officials and professionals in the criminal justice system came together to establish an organization working toward the legalization of drugs. Now known as the Law Enforcement Action Partnership, the nonprofit organization advocates for policy that views harmful drug use as a public health problem, rather than a criminal justice problem. Read more about the organization and its members below.
People Making a Difference
Law Enforcement Against Prohibition
Law Enforcement Against Prohibition (LEAP), now known as Law Enforcement Action Partnership, is an organization of current and former police and other criminal justice professionals, including prosecutors, judges, and FBI agents, who advocate for the legalization of illegal drugs. Many of these professionals were on the front lines in the war on drugs and have a unique perspective that should be considered in drug policy.
One of their members is MacKenzie Allen, a deputy sheriff who worked in Los Angeles and Seattle, including time as an undercover agent who bought illegal drugs and made countless arrests for drug offenses. Although Allen strongly disapproves of drug use, his many years in law enforcement led him to realize that the drug problem is best understood as a public health problem, not a legal problem. He notes that the United States has lowered cigarette use through public education and without outlawing cigarettes. "Can you imagine the mayhem had we outlawed cigarettes?" he writes. "Can you envision the ‘cigarette cartels’ and the bloodbath that would follow? Yet, thanks to a public awareness campaign we’ve made a huge dent in tobacco use without arresting a single cigarette smoker."
Allen adds that most of the problems associated with illegal drug use are actually the result of the laws against drugs. These laws create a huge illegal market, much of it involving violent cartels, he says, that promises strong profits for the manufacturers and sellers of illegal drugs. He is also critical of other aspects of the war on drugs: "If the colloquial definition of insanity is doing the same thing over and over, expecting a different result, what does that say about our 'war on drugs?' We’ve been pursuing this strategy for forty years. It has cost a trillion taxpayer dollars, thousands of lives (both law enforcement and civilians) and destroyed hundreds of thousands more by incarceration. Moreover, it undermines the safety of our communities by overcrowding our jails and prisons, forcing them to give early release to truly violent offenders."
Another LEAP member is Joseph D. McNamara, the former police chief of San Jose, California. McNamara also criticizes the violence resulting from the laws against drugs. “Like an increasing number of law enforcers,” he writes specifically about marijuana, “I have learned that most bad things about marijuana—especially the violence made inevitable by an obscenely profitable black market—are caused by the prohibition, not by the plant.” He continues, “Al Capone and his rivals made machine-gun battles a staple of 1920s city street life when they fought to control the illegal alcohol market. No one today shoots up the local neighborhood to compete in the beer market… How much did the cartels make last year dealing in Budweiser, Corona, or Dos Equis? Legalization would seriously cripple their operations.”
As these statements indicate, the legal war on drugs has had many costs. It is difficult to know what to do about illegal drugs, but in bringing these costs to the attention of elected officials and the American public, the Law Enforcement Action Partnership is making a difference. In the image below, they identify the war on drugs as the root cause of other social problems. Read more about their perspectives on drug policy at their Drug Policy website.
This image, created by LEAP, illustrates that the war on drugs is the root cause of "a staggering array of problems in today's society," including racial disparities, overincarceration, violence, homelessness, human rights abuses, and more.
Sources: Allen 2001; Law Enforcement Against Prohibition 2011; Law Enforcement Action Partnership 2025; McNamara 2010
