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 on drug use and drug policy in the United States. It aims to bring those new to drug policy up to speed and provide ideas to researchers and potential research funders about how they could make strong contributions to the field.

The U.S. Drug Policy Landscape

Insights and Opportunities for Improving the View

Beau Kilmer, Jonathan P. Caulkins, Rosalie Liccardo Pacula, Peter Reuter

Expert InsightsPublished Sep 5, 2012

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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 Takeaways

  • 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.

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Kilmer, Beau, Jonathan P. Caulkins, Rosalie Liccardo Pacula, and Peter Reuter, The U.S. Drug Policy Landscape: Insights and Opportunities for Improving the View. Santa Monica, CA: RAND Corporation, 2012. https://www.rand.org/pubs/occasional_papers/OP393.html.
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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.

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