The Last Drug Czar

In late May the new leader of America's fight against illegal drugs, Gil Kerlikowske, returned to Seattle, the dope-tolerating city where he'd previously served as police chief. As part of the visit, he stopped by a local morning radio talk show, where right off the bat he declared, "I'm ending the phrase, 'the war on drugs.'"

As far as statements from high government officials go, it was a radical declaration. Kerlikowske, and by extension Barack Obama, was rejecting four decades of federal government marching orders -- a bold departure that would have been unthinkable in previous administrations. But even more striking than his announcement was the reaction: crickets. It's not just that Kerlikowske made the statement in liberal Seattle or that he was seated inside the studio of a local National Public Radio affiliate when he spoke the words. The reaction had been similarly muted earlier that month, when he'd made a virtually identical comment to a very different audience, The Wall Street Journal and its readers, telling a reporter, "Regardless of how you try to explain to people it's a 'war on drugs' or a 'war on a product, ' people see a war as a war on them. ... We're not at war with people in this country." There was no immediate outcry, no conservative clamor for Kerlikowske's head, not much of anything except expressions of gratitude from drug-policy-reform advocates.

It's easy to figure out why Kerlikowske's statement has been such a notable nonevent. For a majority of Americans, the failure of our militant anti-drug policy has now become self-evident. Recent polling found that more than 75 percent of people in this country think the drug war has not worked and will not work in the future. "Just say no" long ago morphed from a Nancy Reagan public-service announcement into a national punch line. Pot-smoking pop-culture figures are everywhere, from Woody Harrelson's open advocacy of marijuana legalization to Jennifer Aniston's nonchalant statement that "I enjoy it once in a while." The last three presidents have all admitted to trying drugs. Bill Clinton acknowledged he at least put a joint to his lips, though whether he actually inhaled or not remains fodder for comic speculation. George W. Bush artfully non-denied his past cocaine and marijuana use. And Barack Obama, who on the campaign trail memorably said, "The point was to inhale," wrote in his memoir, Dreams from My Father, that he "tried drugs enthusiastically" as a young man.

The evolution of these three presidential candidate statements on the matter -- from Clinton's unbelievable denial to Bush's tacit admission to Obama's frank acceptance of past drug experimentation -- tracks neatly with the evolution of American attitudes toward the war on drugs. The national mood has shifted from unbelievable denial about the drug war's failure to frank acceptance, from tough-guy bravado about the need to chase down drug traffickers to sensitive instructions to look within ourselves for the sources of the drug problem. That is not to say that America is on the brink of an immediate, Amsterdam-like legalization scheme. Rather, we are moving into an era of new openness to different approaches, an openness that allowed Obama to call the war on drugs an "utter failure" on the campaign trail with decidedly positive results and, once he was president, appoint someone who agrees with his assessment.

The Seattle radio host, Steve Scher, asked Kerlikowske why he wanted the job in the first place. Kerlikowske replied that he was excited by the opportunity to use his experience as a former police chief, in combination with the "bully pulpit" his new position provides, to "change the conversation." After all, he added, "the addiction problem, the drug problem in this country is much more complex than a 40-year-old metaphor for a war on drugs." The situation, he said, should instead be seen as "a public health problem where law enforcement is a big, key player."

Kerlikowske, in other words, sees himself as a credible mouthpiece who can say the things that cops, conservatives, and other longtime drug warriors don't tend to want to hear from doctors who haven't spent time in squad cars. He can say, as Secretary of State Hillary Clinton did in March on a trip to Mexico, that the drug problem is an addiction problem -- a demand problem requiring treatment just as much as it is a supply problem requiring police action. He's fine with Obama having demoted the drug czar post from Cabinet rank before he even got the job; in fact, Kerlikowske said he doesn't even want to be called "drug czar," a term coined back in 1988 by then-Sen. Joe Biden. He prefers "director" -- as in, director of the Office of National Drug Control Policy -- though he jokes that his wife still likes the term "czarina."

Given all this, one gets the distinct impression that Kerlikowske is positioning himself as a caretaker who can put an old model out to pasture while a new discussion is initiated. Scher asked the obvious next question: "Do you have power?" Kerlikowske first gave a short, technical answer about overseeing certain federal budget items. Then he gave a bland answer about having the support of the president and vice president. Later on he circled back to his focus on shifting the way we talk about drugs, which seems to be where he thinks the real power lies: ending the war metaphor, changing the conversation.

***

This rhetoric-shifting strategy is trademark Obama. On everything from race relations to the Middle East mess to the torture debate, the president's style is to lay the foundation for a new discussion first and let that lead to a new policy. On drugs, the data clearly back up the idea that a change is needed -- and not just to the conversation. The United States now boasts the largest prison population on the planet, with some 2.3 million people behind bars. Almost a quarter of them are there for drug offenses, a half million people who make up a group larger than the entire prison population of this country in 1980. This unfortunate distinction is a direct result of the government's long-standing decision to respond to illegal drug use with a strategy that has mainly involved arrest and interdiction -- and, when that hasn't proved sufficient, more arrests and even grander interdiction schemes.

To the dismay of decades of drug warriors, it turns out that the threat of arrest and, in some cases, harsh mandatory sentences has done nothing to halt the public's demand for illegal substances. Nor has it lessened the eagerness of street dealers and drug cartels to deliver those illegal substances to markets large and small. Close to half of all Americans report they have tried illegal drugs. Given this kind of persistent demand, it's no surprise that the targeting of suppliers hasn't succeeded. Take just one example: Under Plan Colombia, the United States spent more than seven years and $6 billion defoliating portions of the country where coca beans, whose leaves form the organic basis for cocaine, are grown. Yet today in Colombia, which supplies most of America's coke, there is more coca being grown than ever before. Nevertheless, the annual sums spent on the drug war have continued to balloon in an almost inverse relationship to its success: from $65 million during one year of the Nixon administration to over $20 billion per year during the second Bush administration.

If, as Kerlikowske is saying, the government now believes that drugs cannot be defeated in a warlike manner, then other, long-neglected tools must be pulled off the shelf. In keeping with what Obama has said about basing federal policy on evidence and sound science, Kerlikowske says he wants to focus more on using proven public-health methods to treat drug addicts, curb the harm they do to themselves and their communities, and combat drug use in general. To make it all politically palatable, this type of change is being presented as a shift in emphasis and being compared -- like everything these days -- to a slow change in the course of an ocean liner, a change that won't really be noticed until a long time in the future. But given the path we've been on for so long, it is potentially something far more significant: a sharp left turn in terms of the perspective from which the drug problem is approached.

The question is, will specific policy changes flow from the new conversation being pushed by Kerlikowske and Obama? Or is it, to reprise a campaign-season attack, "just words"? The only unambiguous (if largely symbolic) action so far has been to demote the drug czar from Cabinet rank. Obama said during the campaign that he supports needle-exchange programs but then failed to allocate funding for them in his proposed budget. The president also promised to end federal raids on legal medical-marijuana dispensaries, but the administration's early record on this is spotty. All of which has reform advocates scratching their heads and waiting to see what Kerlikowske actually does down the road.

"He's the best drug czar we've ever had," said Sanho Tree, an expert on international drug trade at the Institute for Policy Studies. "Which isn't saying a lot. But I'm cautiously optimistic."

***

In one of the grittier sections of downtown Seattle, inside a small storefront on Second Avenue, one gets a sense of how familiar Kerlikowske, 59, is with some of the first-step changes to federal drug policy that reformers have in mind. The storefront is sandwiched between a low-end nail salon and an unfinished high-end condo development, and the blue lettering on its window reads: Seattle Needle Exchange. Since 1989, it has been run by the local health department and funded by local tax dollars.

A skinny white man walks in, pulls out a red cloth wallet, pulls from that wallet two used needle-and-syringe combinations, drops them into the mouth of a see-through container embedded in the counter, and picks up two clean needles and some sanitizing wipes -- all with no questions asked by the staff and few words other than "hello" exchanged between them. Signs hanging on the walls offer depression counseling, enrollment in narcotics anonymous, and advice such as "never lick your point before you shoot." The man leaves without taking much notice. But studies around the world, and statistics connected to this particular program, show that needle-exchange programs help even when they don't serve as portals into addiction counseling and treatment. A 1997 study published in The Lancet found that cities without needle-exchange programs saw a 6 percent increase in HIV infection among intravenous drug users while cities with such programs saw a 6 percent drop among the same population.

The Seattle program exchanged about 3 million needles and placed 426 people in drug treatment last year. King County, in which Seattle sits, runs several similar needle-exchange centers and, consequently, the county has one of the lowest rates of HIV infection among intravenous drug users in the nation: 2 percent, a number that has been stable for the last 15 years. The whole program costs $1.1 million annually and, with the lifetime cost to treat someone with HIV estimated at around $385,000, it more than pays for itself if it prevents infections in just three people each year.

But despite their effectiveness, federal funding for such programs has been prohibited since 1988, on the grounds that they encourage drug use. In fact, needle-exchange programs have proved effective at connecting addicts with treatment and slowing the spread of blood-borne diseases, Kerlikowske told the Senate Judiciary Committee during his confirmation process. He supported needle-exchange programs as Seattle's police chief, and he said that as drug czar he would "strongly consider the current research on the subject" -- research that, he told the committee, speaks favorably of needle-exchange results.

As police chief, Kerlikowske also had to abide by an initiative that Seattle voters passed in 2003 mandating that police make arresting pot smokers their lowest priority. Kerlikowske opposed that measure, though not with incredible gusto, and he told the Judiciary Committee that the new law had "almost no effect on changing law-enforcement practices in Seattle." That could be understood to mean that police ignored the law and still went after low-level pot users, but in fact the reverse is true: the city was tolerant of individual, non-criminal pot smokers before the law passed, and it remained tolerant of them afterward. An annual event called Hempfest, held on the city's waterfront and reliably featuring clouds of pot smoke, always drew a light touch from Kerlikowske's department. (He defended this to the Judiciary Committee by saying he'd directed police not to tolerate open marijuana smoking but to police the event in a manner similar to a rock concert.)

It's impossible to know what the experience in Seattle really taught Kerlikowske. He arrived in the city by way of Florida, where he was raised; the Army, into which he was drafted in 1970; the Nixon administration, where his role was to salute the president as he boarded Marine One; St. Petersburg, Florida, where he began his policing career; and Buffalo, New York, where he was Police Commissioner from 1994 to 1998. But it is clear that no great harm befell Seattle because of his policing practices, or because of his support for needle exchange, or because of the citizens' initiative that de-prioritized pot busts.

In fact, a reasonable person could conclude that living in Seattle during Kerlikowske's tenure might have, at the very least, offered a lesson in favor of the decriminalization of marijuana. It's an idea that about 40 percent of Americans now support, and one that the Republican governor of California, Arnold Schwarzenegger, wants to study as a way of potentially increasing state revenue through possible taxes on the drug. In April, Sen. Jim Webb, a Democrat from Virginia, announced that pot legalization is "on the table" as part of his sweeping reappraisal of the American criminal-justice system. However, Kerlikowske, like Obama, says he opposes marijuana decriminalization and approves of marijuana's current status as a Schedule 1 drug, which places it in the same category as heroin.

When it comes to other drugs, Kerlikowske is in line with Attorney General Eric Holder -- and the president's campaign trail promises -- in wanting to fix the crack-powder sentencing disparity. (Crack possession carries a mandatory minimum prison sentence while powder cocaine possession does not. The result is tremendous racial disparities in drug sentencing.) He's also made a point of publicly noting Americans' abuse of legal pharmaceuticals, a part of the national drug problem that, once recognized, leads easily to discussion of which drugs should really be illegal, and why.

Reformers hoped that Obama would appoint an experienced public-health hand as drug czar and thereby signal a truly stark break with the past. Kerlikowske doesn't fit that description but, as he's been pointing out, his police credentials will allow him to better sell this policy shift. Over the last four decades a lot of people have become accustomed to fighting drugs under the "war" rubric, chief among them law-enforcement agencies whose funding is now tied up in the old metaphor. As the Obama vetters surely realized, it's probably best for a former cop to be the one who stands up and tells them that the drug war needs to end.

It also doesn't hurt that Kerlikowske comes with a personal connection to the demand problem. Earlier this year, after his name was floated as a likely drug czar nominee, it emerged that his son, Jeffrey, had once been arrested on drug-related charges. When he accepted the nomination, Kerlikowske turned the potential source of concern into a valuable personal connection to problems he would be addressing.

"Our nation's drug problem is one of human suffering," he said. "As a police officer, but also in my own family, I have experienced firsthand the devastating effects that drugs can have on our youth, our families, and our communities."

***

What's fascinating about this moment in the drug-reform debate is not just how strongly the tide has turned against the failed war strategy but also how little clarity there is on the ultimate end goal of policy reform. "There is no 18th amendment of drug prohibition that's going to be repealed," says Ethan Nadelmann, executive director of New York's Drug Policy Alliance. "Reform is only going to happen in an incremental way."

Incremental is perhaps too strong a word for describing the actual reforms that have thus far come from Obama's promises to roll back the drug war. Just two days after the president was sworn in, federal drug-enforcement agents raided a medical-marijuana dispensary in South Lake Tahoe, California -- despite Obama's campaign pledge to end federal raids on legal medical-marijuana providers. The administration suggested the raid was a result of crossed wires at the Justice Department at a time when the new attorney general had not yet been approved. This, combined with Obama's failure to propose federal funding for needle-exchange programs, was taken as a worrisome sign by reform advocates, who say that remedying those two problems -- and bringing an end to the crack-powder sentencing disparity -- are important, realistic first-term reforms.

But even if these changes all take place, they will at best represent tentative baby steps. "I don't expect Obama to do anything bold on drug policy in the first term," Nadelmann says. He believes that's the correct approach given the issue's volatile combination of increasing public support and entrenched stay-the-course constituencies. "I see this as a giant wave, and we're surfing that wave, for now. ... But I don't see the drug-war infrastructure crumbling quickly, if only because the old mind-sets have been there for a long time and there are powerful interests vested in the status quo."

Sanho Tree, of the Center for Policy Studies, agrees. "It's very difficult to predict tipping points, and when it happens it's going to happen quickly," he says. "We are already at the tipping point societally in terms of ending the drug war. But the people who have to act on this are in Congress, and they won't do so because they have to face re-election. A lot of these politicians have fairly reptilian brains -- you know, fire, burn, bad. ... They think that because something was toxic a few years ago, it's still toxic today."

Which raises the possibility that the greater policy changes in this arena during the Obama administration may actually come from the states, many of which are in various stages of liberalizing their marijuana laws -- a sort of gateway reform, to borrow a phrase. In April, 56 percent of Californians reported that they favored legalizing marijuana, taxing it, and using the proceeds to pay down the state's budget deficit. And last November, voters in Massachusetts effectively decriminalized marijuana, making possession of less than an ounce punishable by only a civil fine of $100.

If Obama and Kerlikowske sit back, let the states work as laboratories for drug-law changes, and focus simply on changing the tenor of the discussion in D.C. while also achieving a few modest federal policy reforms, it will, in fact, amount to a significant change. And it will be a step toward achieving what Obama, when asked about drug-policy reform during the campaign, said he believes in: "shifting the paradigm."

Correction: This article previously described morphine as a Schedule 1 drug and suggested that coca beans formed the organic basis for cocaine.

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