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We need to reduce the harm that drug use and abuse cause in our society. This requires that we find solutions to drug abuse that really work. Some important strategies to consider include forming a commission of non-partisan experts to evaluate the effects of the current drug control model and allowing cities and states greater flexibility to experiment with their own approaches to drug control. It is also important that drug policy not be based on clearly erroneous concepts like the 'gateway' theory which have been rejected by prestigious groups such as the World Health Organization. Separating the markets for marijuana and other illegal drugs may also be a wise approach because research shows that it is the black market which introduces youth to more harmful substances.

Reducing drug use and abuse among youth and young adults is another important goal in reducing the harm caused by drugs. An effective drug control strategy would implement Drug Czar Barry McCaffrey's assertion that “The principal component of our drug strategy ought to be based on prevention programs aimed at adolescents.”62 Making this the principal component requires that it receive a principal share of the funding. To carry out this goal, we need to do two things: raise the spending on youth prevention from its current paltry level of 12% of the drug control budget to 34% and spend that 34% of the budget on programs that actually work as demonstrated by science and research. Investments in our youth, such as after school programs, Big Brother/Big Sister programs, and other enrichment activities are effective and the Federal government's research as published by SAMHSA confirms this. Meanwhile, programs like DARE, television ads and other scare-tactics have not been proven effective at reducing drug use. Funding for programs should be competitive and based on results, not politics.

We must also seek to reduce drug use and abuse in all age groups and in all sectors of society, with special emphasis on the needs of women. Since treatment has been shown to be the most effective tool to reduce drug consumption in this country, it should be a serious component of our national drug control strategy. Instead of putting 2/3 of our funding into law enforcement measures, we should fully fund treatment centers so that treatment is available upon request, and enact legislation that provides full-continuum insurance coverage for drug and alcohol addiction. In the struggle against the harms of drug and alcohol addiction, the lack of treatment availability in the United States virtually ensures that we will continue to suffer horrendous social costs from these diseases.

Finally, we must stop the spread of diseases associated with injection drug use. With the high number of new HIV and hepatitis infections, laws against the possession of clean needles are a virtual death sentence. Needle exchange programs do not increase drug use, but do save lives. A ban on federal funding for needle exchange programs is pure folly. Claims that decriminalizing needle possession will lead to increased drug use have been never been proven. Seven reports funded by the U.S. Government between 1991 and 1997 are unanimous in their conclusions that clean needle programs reduce HIV transmission, and none find that clean needle programs cause rates of drug use to increase.63 

62 ONDCP Director
63 National Commission on AIDS, The Twin Epidemics of Substance Abuse and HIV, Washington D.C.: National Commission on AIDS (1991); General Accounting Office, Needle Exchange Programs: Research Suggests Promise as an AIDS Prevention Strategy, Washington D.C.: U.S. Government Printing Office (1993); Lurie, P. & Reingold, A.L., et al., The Public Health Impact of Needle Exchange Programs in the United States and Abroad, San Francisco, CA: University of California (1993); Satcher, D., (Note to Jo Ivey Bouffard), The Clinton Administration's Internal Reviews of Research on Needle Exchange Programs, Atlanta, GA: Centers for Disease Control (1993, December 10); National Research Council and Institute of Medicine, Normand, J., Vlahov, D. & Moses, L. (eds.), Preventing HIV Transmission: The Role of Sterile Needles and Bleach, Washington D.C.: National Academy Press (1995); Office of Technology Assessment of the U.S. Congress, The Effectiveness of AIDS Prevention Efforts, Springfield, VA: National Technology Information Service (1995); National Institutes of Health Consensus Panel, Interventions to Prevent HIV Risk Behaviors, Kensington, MD: National Institutes of Health Consensus Program Information Center (1997, February).

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