CONCLUSIONS, RECOMMENDATIONS AND PRINCIPLES
ADOPTED BY THE KCBA BOARD OF TRUSTEES
November 20, 2001
For decades, our society has been prosecuting and incarcerating increasing numbers of people for possessing or selling small amounts of drugs. Today, no country in the world has so large a percentage of its population behind bars for this type of activity. Furthermore, the collateral damage caused by the excessive reliance on such criminal sanctions has been deeply troubling. Since this harsh use of criminal sanctions has been unsuccessful, we have concluded that it is time for a new approach.
We are not advocating the immediate dismantling of our criminal justice system as a means of controlling the flow and use of illegal drugs and the harm they cause unless and until an effective replacement system is securely in position. We are also not advocating that the dealers and distributors be given a free hand to engage in their trade with impunity. However, we do want to spark an open and honest discussion about the current criminal justice system’s inability to achieve the result that we all want: reducing the damage done by drugs while not creating more harm than the use of the drugs themselves.
Instead of relying primarily on criminal sanctions to deal with the problems of possession or distribution of relatively small amounts of drugs, we should be moving decisively towards a public health model for those individuals. There have been some recent efforts in other states to use the public health model, and they appear to be successful. However, this model has not yet been tested over a long period of time, nor do we know what undesirable consequences might arise from the widespread use of the model. Hence, we believe that our society should promptly develop public health programs for these individuals while continuing to use the threat of criminal sanctions for the limited purpose of encouraging the participation of these individuals in the public health programs. It is our hope that, over time, the reliance on the threat of criminal sanctions will diminish as the success of the public health model demonstrates itself.
While we do not claim to have a complete vision of a perfectly formulated drug policy, we are confident that we must move boldly toward the provision of effective treatment, now offered to only a small fraction of those who need it, and away from an excessive use of the criminal sanctions that has caused more harm than good. Of course, the criminal law will always have a role to play to assure public safety. Behavior that puts others at risk, such as violent or other non-drug related criminal behavior where drug abuse was a factor, should not excuse the underlying crime. Moreover, driving under the influence of any mind-altering drug should continue to be prohibited and punished. And, in our view, the distribution of drugs (except by those who deliver small quantities to support their own addiction) and, of course, giving or selling mind-altering drugs to minors should continue to be prohibited and criminally punished.
Finally, it is absolutely crucial that there be adequate funding for any public health model. In order to have long-term success in dealing with the problem of drugs, our society must make a commitment to pay for drug abuse prevention and drug addiction treatment programs. Failure to do so will doom the public health model to the same sad fate as the current criminal sanctions model.
DRUG ABUSE PREVENTION
Washington’s overall drug abuse prevention goals should be:
- a. to prevent or delay the use of alcohol, tobacco and other drugs among young people;
- b. to reduce the harm from and curb the progression of alcohol, tobacco and other drug use among youth who have already begun;
- c. to reduce the other problem behaviors that can co-occur with the use of alcohol, tobacco and other drugs; and
- d. to increase the availability of school- and community-based prevention services, especially for vulnerable groups and high-risk individuals.
To achieve these goals, a working group of statewide experts should be convened to improve on Washington’s comprehensive substance abuse prevention plan. This special statewide panel, composed of state and local educational and health officials, scholars, clinicians, parents, teachers and students, should build on the work already begun by the State Division of Alcohol and Substance Abuse, and would be qualified to make specific recommendations to improve the state’s comprehensive prevention plan. The plan should incorporate state-of-the-art prevention programming that meets Washington’s needs.
As a guide to the experts on the recommended statewide panel, the effort to improve Washington's comprehensive substance abuse prevention plan should conform to the following broad recommendations:
- Any effective drug abuse prevention strategy must address the social and psychological problems underlying drug abuse, so as to help give young people genuine opportunities to lead fulfilling lives. Drug abuse prevention should be part of a broader youth development strategy, reaching beyond mere drug education and helping young people to develop the needed social and self-management skills to make responsible decisions in the broader contexts of their lives.
- To be most cost-effective, prevention programs should focus primarily on those youth who are most at risk of developing a range of problem behaviors, which include substance abuse, but also include poor school performance and low school attachment, delinquency, depression and suicidal behavior.
- The appropriate outcome measure for prevention programming should not be drug use, but rather drug abuse, or more specifically, the harm resulting from excessive drug use. From this perspective, a core feature of Washington’s prevention strategy should be the prevention of alcohol and tobacco use among minors, especially early initiation of use.
- Drug education programs should provide honest and complete information about alcohol and other drugs, carefully distinguishing between the degrees and types of harm and risk associated with the use of different drugs. Such programs should include a discussion of the appeal of drugs, as well as the physiological and psychological effects that can also lead to excessive and harmful use.
- Abstinence-only programs in schools, while generally ineffective or counterproductive in preventing alcohol and other drug use, seem to be effective in preventing tobacco use; therefore, tobacco-only abstinence programs are highly recommended.
- Adequate training and commitment of teachers, counselors and discussion leaders is essential for an effective school-based prevention program, as is commitment and support from administration.
DRUG ADDICTION TREATMENT
AVAILABILITY AND ADEQUACY OF TREATMENT
- Drug addiction treatment should be available on request to every Washington resident who wants and needs it. This will not always mean treatment at public expense. Individuals who can afford to pay privately for treatment may be expected to do so, although it may be in the public interest to offer incentives for pursuing treatment to those who might be influenced by them.
- Drug treatment should be complemented by, and coordinated with, other needed treatment and assistance, including mental health treatment.
- A broad spectrum of drug treatment options should be available.
- Drug treatment capacity, over the broad spectrum of options, should be sufficient so that treatment is available promptly for individuals who need and want it.
- Special efforts should be made to assure that drug treatment, including inpatient treatment, is promptly available to children who need it.
- A coordinated system for the provision of drug treatment should include places where individuals in need of treatment can go (or can be referred) for assessment, to be matched with treatment programs and to get transitional help.
- Treatment should continue to be available for those who need to re-enter it or to start a new program.
- Obstacles to the effective use of opiate-replacement therapies should be removed.
- Needle exchange programs should be available throughout the state, and convenient referral to addiction-treatment programs, including programs offering opiate-replacement therapy, should be available at needle exchange sites.
TREATMENT IN PRISONS AND JAILS
- Drug treatment on request should be available to individuals in prison or jail.
- Opiate-replacement therapies should be available treatment options in correctional settings, to the extent practicable.
FUNDING AND ADMINISTRATION OF TREATMENT
- The people of Washington should make a commitment to, and have a strategy for, the adequate funding of drug addiction treatment.
- An addiction-treatment exception should be made to the federal prohibition against use of Medicaid funds for services provided in institutions for mental diseases with more than 16 beds.
- The Division of Alcohol and Substance Abuse should have enhanced oversight responsibility for state addiction-treatment policy.
- Research-based investigation and reporting on the effectiveness of various approaches to addiction treatment and related issues should have continued support.
- Health insurance plans should provide broad coverage for drug addiction treatment; the Basic Health Plan and plans offered to employers of not more than 25 employees should have benefits at least at the levels required under WAC 284-53-010.
- Drug court programs should be offered as an alternative to trial on criminal charges for individuals with drug addictions whenever this alternative is not inconsistent with important public interests. The issue of what acts should be defined as criminal offenses is addressed elsewhere. If individuals with drug addictions are charged with crimes (including crimes for which the use or sale of drugs is not an element), the option of drug courts should be considered.
EXPANDING TREATMENT CAPACITY
- Drug addiction screening and intervention standards for health professionals should be established and appropriate training should be incorporated in academic curricula and in continuing education programs.
- Programs to attract and train addiction-treatment professionals should be supported and expanded.
THE USE OF CRIMINAL SANCTIONS
Principles regarding the use of criminal sanctions
- The current use of criminal sanctions against those who possess or deliver relatively small amounts of drugs is an ineffective means to discourage drug use or to address the problems arising from drug abuse, and it is extremely costly in both financial and human terms, unduly burdening the taxpayer and causing more harm to people than the use of drugs themselves.
- Rather than criminally punish persons for drug use per se, any state sanction or remedy should be aimed at reducing the harm directly caused to others by persons using drugs. For example, there should be more reliance on civil remedies, supported by a court’s contempt power, which are already available to be imposed on persons who use drugs to the detriment of others.
- Criminal sanctions should continue to be imposed upon persons who commit non-drug criminal offenses, but those offenders should have the opportunity to receive drug treatment, especially if their crimes are related to chemical dependency.
- The state should significantly expand its investment in drug addiction treatment, drug education and drug abuse prevention programs, which have consistently been shown to be much more cost-effective responses to the problems created by drugs in society. Funding for those programs could be obtained from the substantial cost savings that will accrue from no longer relying on the use of criminal sanctions.
Principles for an alternative drug policy
The reform of drug policy should be guided by the following set of principles:
- Any public policy toward drug use should seek to result in no more harm than the use of the drugs themselves;
- Any public policy toward drug use should address the underlying causes and the resulting harms of drug abuse instead of attempting to discourage drug abuse through the use of criminal sanctions;
- The state should regulate the use of drugs in a manner that recognizes a citizen’s individual liberties while answering the need to preserve public health, public safety and public order;
- The state should regulate the use of drugs in a manner that uses scarce public resources as efficiently as possible.
- Federal law should permit the states to develop their own drug control strategies and structures for individuals possessing or selling small quantities of drugs.