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Research Questions

  1. What is the current U.S. drug policy landscape?
  2. How efficacious are U.S. drug policies and programs?
  3. What is the drug policy research funding landscape, and where are the gaps in it?
  4. What are the opportunities to influence the drug policy field?

Abstract

Discussions about reducing the harms associated with drug use and antidrug policies are often politicized, infused with questionable data, and unproductive. This paper provides a nonpartisan primer that should be of interest to those who are new to the field of drug policy, as well as those who have been working in the trenches. It begins with an overview of problems and policies related to illegal drugs in the United States, including the nonmedical use of prescription drugs. It then discusses the efficacy of U.S. drug policies and programs, including long-standing issues that deserve additional attention. Next, the paper lists the major funders of research and analysis in the area and describes their priorities. By highlighting the issues that receive most of the funding, this discussion identifies where gaps remain. Comparing these needs, old and new, to the current funding patterns suggests eight opportunities to improve understanding of drug problems and drug policies in the United States: (1) sponsor young scholars and strengthen the infrastructure of the field, (2) accelerate the diffusion of good ideas and reliable information to decisionmakers, (3) replicate and evaluate cutting-edge programs in an expedited fashion, (4) support nonpartisan research on marijuana policy, (5) investigate ways to reduce drug-related violence in Mexico and Central America, (6) improve understanding of the markets for diverted pharmaceuticals, (7) help build and sustain comprehensive community prevention efforts, and (8) develop more sensible sentencing policies that reduce the excessive levels of incarceration for drug offenses and address the extreme racial disparities. The document offers some specific suggestions for researchers and potential research funders in each of the eight areas.

Key Findings

  • In the last five years, marijuana use — particularly daily use — has increased, and cocaine use has declined. As homicides associated with flagrant street markets for crack have declined, there has been a sharp rise in deaths associated with prescription drugs.
  • The nature of the American drug problem has changed substantially over the last 20 years; it is now less of a crime problem (drug market violence) and more of a health problem (higher rates of morbidity and mortality) and a criminal justice problem (burdensome rates of incarceration).
  • Much of the focus has been on biomedical research, with little-to-no funding for big-picture research — either comprehensive evaluations that look at successful ideas and strategies or novel promising approaches, grounded in the understanding that drug problems do not affect every city, every family, or every nation in the same way.
  • Largely missing from the landscape is analysis and evaluation of the drug control strategy that has dominated government budgets and rhetoric for decades: law enforcement, both domestic and international.
  • There is a need for a new, sustained source for persistent funding of science that objectively and systematically considers overarching policy objectives and/or politically unpopular alternatives.

Recommendations

  • Sponsor young scholars and strengthen the infrastructure of the field.
  • Accelerate the diffusion of good ideas and reliable information to decisionmakers.
  • Replicate and evaluate cutting-edge programs in an expedited fashion.
  • Support nonpartisan research on marijuana policy.
  • Investigate ways to reduce drug-related violence in Mexico and Central America.
  • Improve understanding of the markets for diverted pharmaceuticals.
  • Help build and sustain comprehensive community prevention efforts.
  • Develop more sensible sentencing policies that reduce the excessive levels of incarceration for drug offenses and address the extreme racial disparities.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    The Drug Policy Landscape in the United States

  • Chapter Three

    Efficacy of U.S. Drug Policies and Programs

  • Chapter Four

    The Drug Policy Research Funding Landscape

  • Chapter Five

    Opportunities to Influence the Drug Policy Field

  • Chapter Six

    Concluding Thoughts

This research was sponsored by the John D. and Catherine T. MacArthur Foundation and was conducted within the RAND Drug Policy Research Center, a joint endeavor of RAND Health and RAND Infrastructure, Safety, and Environment.

This report is part of the RAND Corporation occasional paper series. RAND occasional papers may include an informed perspective on a timely policy issue, a discussion of new research methodologies, essays, a paper presented at a conference, or a summary of work in progress. All RAND occasional papers undergo rigorous peer review to help ensure that they meet high standards for research quality and objectivity.

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