President Obama’s newest strategy of fighting the so-called “war on drugs” was revealed Wednesday by the director of the National Drug Control Policy, Gil Kerlikowske, at the John Hopkins School of Medicine in Baltimore. The new policy will place a greater emphasis diverting non-violent drug offenders into substance abuse rehabilitation instead of prisons and on using public health tools and education toward battling addiction.
Under the Affordable Care Act (ACA), millions of Americans will receive health insurance coverage for substance abuse and other mental health treatments when the bill come into full effect in 2014. The Department of Health and Human Services (HHS) states that approximately 5.1 million insured Americans currently do not have access to insured care for drug addiction or serious mental health concerns. Medicaid does not currently offer coverage for substance abuse treatment, but will beginning in 2014.
According to the 2008 Mental Health Parity and Affordable Equity Act, all employer-sponsored insurance policies that offer mental health coverage are required to do so without charging a higher copay or deductible, restricting access to available doctors or care providers, or setting lower coverage limits. Mental health care coverage was not mandated prior to the ACA.
In addition, the bill’s “parity” protection will expand coverage for the 30.4 million Americans who have limited mental health coverage on their health insurance. “This is probably the most profound change we’ve had in drug policy ever,” Michael Botticelli, deputy director of the Office of National Drug Control Policy, told The Associated Press (AP). “We know one of the most significant reasons for the treatment gap is folks who don’t have insurance or who have an inadequate coverage package for substance use disorders.”
This new availability of treatment is thought to be an essential component in the continuing war on drugs. “We know that if drug treatment is done early it is usually more effective, and it’s usually less costly than longer term, because drug addiction is a progressive disease,” Kerlikowske told the AP in an interview ahead of Wednesday’s announcement.
The new policy will also include an emphasis on reforms to reduce incarceration rates, including the establishment of drug courts and probation programs. The program will also focus on community-based policing in an attempt to sever the cycle of drug use and crime.
“I think the important part is that a lot of criminal justice experts and police chiefs and sheriffs – my colleagues for many years and myself included – recognize that with a drug problem you can’t arrest your way out of the problem, and so we really need to be smart on the drug problem,” Kerlikowske said.
On the question of marijuana legislation
Despite assurances that the administration is not interested in the arrest of marijuana users in Colorado and Washington — states where recreational marijuana use was legalized in November — the drug czar has indicated that the position of his office on the issue has not changed.
“The legal issue of Washington and Colorado is really a question you have to go back to the Department of Justice,” Kerlikowske said. The Department of Justice has yet to announce its position on enforcing federal law supremacy in regard to the states’ marijuana legalization laws.
Kerlikowske believes that the solution to the nation’s drug problems lies between indiscriminate drug arrests and legalization.
“We’re not going to solve it by drug legalization, and we’re certainly not in my career going to arrest our way out of this problem, either, and these two extreme approaches really aren’t guided by the experience, the compassion or the knowledge that’s needed,” Kerlikowske said.
Marijuana is the most commonly-used illicit drug in America, with 15.2 million users, as of 2008. Additionally, 53.3 percent of all drug users use marijuana exclusively, with another 22.3 percent using marijuana in conjunction with another drug.
Per capita, the U.S. uses more illicit drugs than any other nation. As of 2011, more than 22 million Americans use illegal drugs. According to the National Institutes of Health’s (NIH) National Institute on Drug Abuse, the estimated total cost to society for substance abuse — including treatment, productivity loss, crime, incarceration and drug enforcement — is $559 billion per year. Only the military costs more in American society.
20th-century priorities in a 21st-century world
The 2014 drug policy calls for a ratio of 58 percent spending on drug enforcement to 42 percent on treatment and prevention. This budget marks the first in recent memory that moved away from the historic 2:1 ratio of enforcement to treatment. However, many drug activists feel that the president’s approach — particularly his commitment to making drug seizures and arrests in Latin America — echoes Reagan-era drug policies.
This comes despite recent reports from the United Nations Office on Drugs and Crime indicating that while production of cocaine has decreased, global consumption has remained stable. In Latin America, there has been a push toward drug legalization to mitigate the damage the drug cartels are causing. In high-level talks at the Summit of the Americas in Colombia in 2012, President Obama declined an invitation to discuss drug legalization with the presidents of Guatemala, Costa Rica and El Salvador. Instead, the president pledged more than $130 million in aid to increase security and to pursue the drug cartels.
“The chorus of voices calling for a real debate on ending prohibition is growing louder all the time,” said Neill Franklin, a former Boston police officer and the executive director of Law Enforcement Against Prohibition (LEAP). “The time for real change is now, but at the Summit of the Americas President Obama announced more than $130 million in aid to fund the continued effort to arrest drug traffickers in Latin America. This prohibition strategy hasn’t worked in the past and it cannot work in the future. Latin American leaders know it, and President Obama must know it.”
“This strategy is nearly identical to previous national drug strategies,” said Bill Piper, director of national affairs for the Drug Policy Alliance. “While the rhetoric is new — reflecting the fact that three-quarters of Americans consider the drug war a failure — the substance of the actual policies is the same. In reality, the administration is prioritizing low-level drug arrests, trampling on state medical marijuana laws and expanding supply-side interdiction approaches — while not doing enough to actually reduce the harms of drug addiction and misuse, such as the escalating overdose epidemic.”