The Illicit Drug Landscape in the U.S and Paths for Future Efforts

A new RAND Corporation report outlines the illicit drug landscape in the United States, providing insights about how some of the challenges might be addressed and highlighting other problems that need further study.

Researchers say three issues currently dominate national drug policy discussions—marijuana and the push in some states to legalize its use; violence in Mexico linked to the U.S. demand for illegal drugs; and an increase in deaths associated with the use of prescription drugs such as Oxycontin.

"The diversity of these topics highlights how complex drug policy is in the United States and elsewhere around the world," said Beau Kilmer, the report's lead author and co-director of the RAND Drug Policy Research Center. "This report is intended to create a knowledge base that will help ground discussions about U.S. drug policy and help set future research priorities."

More than 40 million Americans used cocaine, heroin, marijuana, methamphetamine, hallucinogens or prescription drugs for nonmedical purposes in 2010, with about half consuming only marijuana, according to federal estimates.

During the past five years, marijuana use—particularly daily use—has increased, although the use of cocaine has declined. While violence associated with street markets for crack and cocaine have declined, there has been a sharp rise in deaths associated with prescription drug abuse.

"The nature of the American drug problem has changed substantially over the last 20 years," said Peter Reuter, a study co-author and a professor at University of Maryland. "It is now less of a crime problem illustrated by drug market violence and more of a public health and incarceration problem."

Researchers note that two important changes at the federal level may impact national drug policy in the future.

First, the federal Affordable Care Act will expand health insurance coverage for millions of Americans, providing them with access to drug treatment and intervention services. Second, federal authorities are increasing their enforcement efforts against medical marijuana suppliers.

While about half of the nation's 1.6 million annual drug arrests have been for possession of marijuana, few people receive prison or jail sentences for such offenses. Most people incarcerated for drugs were involved in distributing substances other than marijuana. Indeed, estimates from other studies show that the total number of people incarcerated for drug offenses increased from 40,000 nationally in 1980 to 500,000 in 2010.

While this increase is striking, the massive racial and ethnic disparities in the incarceration rates merit special attention, researchers say. There were 64 whites sentenced to prison under state jurisdiction for a drug offense for every 100,000 whites aged 18 to 59 in 2009. Meanwhile, the comparable rates for Hispanics and blacks were 150 and 523 per 100,000.

Among the recommendations made in the report are encouraging efforts to help build and sustain comprehensive community prevention efforts, and creation of sensible sentencing policies that reduce the excessive levels of incarceration for drug offenses and address the extreme racial disparities.

Support for the project was provided by the John D. and Catherine T. MacArthur Foundation. The report, "The U.S. Drug Policy Landscape: Insights and Opportunities for Improving the View," is available at www.rand.org. Other authors of the report are Jonathan P. Caulkins of Carnegie Mellon University and Rosalie Liccardo Pacula of RAND.

Since 1989, the RAND Drug Policy Research Center has conducted research to help policymakers in the United States and throughout the world address issues involving alcohol and other drugs. In doing so, the center brings an objective and data-driven perspective to an often emotional and fractious policy arena.