The Lost War

This article by David Sheff was published at Medium

The war on drugs was lost because the war on addiction was never begun

The death last month of the Glee star Cory Monteith was tragic. All deaths are. But it is even more tragic when it could have been prevented — like Monteith’s.

Because of Monteith’s death from an overdose of heroin and alcohol, addiction is having its latest fifteen minutes of fame. Fifteen minutes, however, are better than none to serve as a reminder of the prevalence and perniciousness of this disease. It’s unfortunate that it takes the death of a TV star—a Canadian in this case, but beloved in America and thought of as one of our own—to talk about a disease that kills three hundred and fifty people every day.

In the ubiquitous coverage of Monteith’s overdose, I haven’t heard any commentator express the fact that this death isn’t merely sad. It is appalling­—because it might have been prevented if it weren’t for failed drug policies.

The so-called war on drugs, which President Nixon launched in 1971, has been a war on millions of addicts, including ones just like Monteith. This approach has treated the problem as though it could be stopped by interdiction, arrests, and incarcerations. Addicts, Monteith among them, have been viewed as weak willed and derelict and treated as criminals rather than what they are: People afflicted with a chronic and potentially fatal illness. (In my last Medium column, I explained the disease of addiction.) If, before his death, Monteith had been caught with drugs and paraphernalia in his possession, he would likely have been arrested. But arresting people who are ill isn’t only inhumane, it’s counterproductive: When addiction isn’t treated, it worsens. If the U.S. hadn’t spent decades and more than a trilliondollars fighting the war and instead spent the time and money to improve prevention and treatment, Monteith might have been healed, and so might every other addict.

As I report in my book Clean, in North America and the rest of the world, the chorus of voices calling for an end to the war on drugs is getting louder. The Global Commission on Drug Policy—members of which include economists, policy experts, and several former world leaders—former Secretary of State George Shultz, former chairman of the U.S. Federal Reserve Paul Volcker, and entrepreneur Richard Branson, among others—have declared that “the global war on drugs has failed, with devastating consequences for individuals and societies around the world.” Speaking at the Brookings Institution last year, New Jersey Governor Chris Christie said, “The war on drugs, while well-intentioned, has been a failure.” Soon thereafter, the NAACP took a stand: “Today the NAACP has taken a major step towards equity, justice and effective law enforcement,” said Benjamin Todd Jealous, the organization’s president and CEO. “These flawed drug policies that have been mostly enforced in African American communities must be stopped and replaced with evidenced-based practices that address the root causes of drug use and abuse in America.” In a New York Timeseditorial, Fernando Henrique Cardoso and Ruth Dreifuss, the former presidents of Brazil and Switzerland, respectively, argued that the war should be ended because of the appalling human-rights violations perpetrated in its name. The chorus now represents a majority of the American people. In a recent poll, only 10 percent of Americans said they considered the War on Drugs a success. Two-thirds of those polled, including the majority of both Democrats and Republicans, said it was a failure.

They’re right. The war has decimated families and communities, encouraging an out-of-control cycle of violence, addiction, and crime; targeted racial minorities; and killed tens of thousands of civilians in Mexico and other countries. It is responsible for America having more people imprisoned than any other country in the world, even China or Russia. And then there’s the money: the trillion-plus dollars that could have been used on social programs, especially ones that would have prevented addiction from flourishing.

The war has also exacerbated the nation’s current number-one drug problem, prescription-pill abuse, which leads to more non-natural deaths in America than any other cause. For these addictive medications, physicians and pharmaceutical companies, not cartels, are the suppliers. Meanwhile, prescription-medication misuse is fueling a new and mounting heroin epidemic. Many OxyContin and Vicodin users grow addicted and turn to heroin because it’s cheaper than pharmaceuticals and much easier to score. So much for the effectiveness of the drug war. It’s by now a familiar refrain: targeting the drug supply doesn’t work.

In Clean, I tell the story of a boy named Luke Gsell, who became addicted at fourteen. Gsell said that his need for drugs was such that when he couldn’t find ecstasy, pot, or cocaine, he’d “take gasoline out of the lawnmower and huff that.” People who want drugs will find them, and as long as people want them, any war that focuses on the supply of drugs is destined to fail.

The drug war has failed, but in this debate, few address a critical question. Can we afford to accept defeat? Drugs kill 120,000 people a year and cost the nation more than four hundred billion dollars, mostly in health care, criminal justice, and lost productivity. Twenty million Americans are addicted. Few of those who have called for an end to the war have offered specific solutions, instead mostly issuing a generic and obvious call to lower demand. But how?

There is a solution, and a model to follow. If we’re finally going to take on America’s drug problem effectively, we must end the war on drugs and instead fight this like we fight other diseases. We must effectively take on the disease of addiction.

Simultaneously with ending the drug war, we must work to cure addiction, just as we have worked to cure other diseases. Cancer. Heart disease. HIV AIDS. More money for addiction research is necessary. It could lead to significant advances in the creation, testing, and dissemination of effective addiction prevention and treatment. If we were to begin dismantling the drug war by budgeting, say, a third of the money currently allotted for curbing the supply, the paltry one-billion-dollar budget of the National Institute on Drug Abuse (NIDA) could be quintupled. Access to more money could allow NIDA and the researchers it funds to improve current prevention strategies and treatments and develop new ones, including addiction vaccines, prevention programs for children and young adults of all ages, medications, and behavioral treatments for the addicted. By starving NIDA and researchers around the nation of the money to improve existing treatments and find new ones, the administration is impeding progress. By failing to work with the states to create a national treatment system based on evidence-based practices, the government is allowing the perpetuation of the current system, which is based on pseudoscience and best guesses and does not work for most addicts who make it into rehab, and only one out of ten ever receive any treatment whatsoever.

It’s too late for Cory Monteith. But when we change our focus and fight the war on the disease of addiction, we’ll save the lives of countless others like him.