sitting man in jail

We are not losing the war on drugs, we have lost! In many jails, half of the inmates have been incarcerated after being found guilty of drug related crimes. Many of them have been found guilty for minor infractions- not large scale sales. There are lots of young adults who have been jailed for possession of marijuana or for having distributed some to friends and classmates. Our jails are overflowing and private companies are cleaning up by managing and/ or building new jails across the country under contract with state, federal or local governments. We, in the U.S. are the most jailed population in the world. At year-end 2009 it was 743 adults incarcerated per 100,000 population.

Accordinging to the U.S. Bureau of Justice Statistics (BJS) 2,266,800 adults were incarcerated in U.S. federal and state prisons, and county jails at year-end 2010 — about .7% of adults in the U.S. resident population. Additionally, 4,933,667 adults at year-end 2009 were on probation or on parole. In total, 7,225,800 adults were under correctional supervision (probation, parole, jail, or prison) in 2009 — about 3.1% of adults in the U.S. resident population. In addition, there were 86,927 juveniles in juvenile detention in 2007.

On January 1, 2008 more than 1 in 100 adults in the United States were in prison or jail. In 2008 approximately one in every 31 adults (7.3 million) in the United States was behind bars, or being monitored (probation and parole). In 2008 the breakdown for adults under correctional control was as follows: one out of 18 men, one in 89 women, one in 11 African-Americans (9.2 percent), one in 27 Latinos (3.7 percent), and one in 45 Caucasians (2.2 percent). Crime rates have declined by about 25 percent from 1988-2008. 70% of prisoners in the United States are non-whites. In recent decades the U.S. has experienced a surge in its prison population, quadrupling since 1980, partially as a result of mandatory sentencing that came about during the “war on drugs.” Violent crime and property crime have declined since the early 1990s.

In 2006, about $72 billion was spent on corrections. This went up to $74 billion in 2007. In 2005, it cost an average of $23,876 dollars per state prisoner. State prison spending varied widely, from $45,000 a year in Rhode Island to $13,000 in Louisiana. In California in 2009, it cost an average of $47,102 a year to incarcerate an inmate in state prison. From 2001 to 2009, the average annual cost increased by about $19,500.In 2001 among facilities operated by the Federal Bureau of Prisons, it cost $22,632 per inmate, or $62.01 per day.

Housing the approximately 500,000 people in jail in the USA awaiting trial who cannot afford bail costs $9 billion a year.Most jail inmates are petty, nonviolent offenders. Twenty years ago most nonviolent defendants were released on their own recognizance (trusted to show up at trial). Now most are given bail, and most pay a bail bondsman to afford it. 62% of local jail inmates are awaiting trial. To ease jail overcrowding over 10 counties every year consider building new jails. As an example Lubbock County, Texas has decided to build a $110 million mega jail to ease jail overcrowding. Jail costs an average of $60 a day nationally. In Broward County, Florida supervised pre-trial release costs about $7 a day per person while jail costs $115 a day. The jail system costs a quarter of every county tax dollar in Broward County, and is the single largest expense to the county taxpayer.

All of this would be acceptable I suppose except it has made not an iota of difference in the use of illegal drugs or the crime and health issues associated with their distribution and use. It has, in an economy that has failed, added an enormous expense to society with a very poor Return On Investment (ROI).

Estimate of the size of the international drug market range from $300-$500 billion dollars, making up approximately 8% of global trade. The United Nations Office on Drugs and Crime estimated that in 2010, the international drug market has a value of over $300 billion, making it larger than the gross national products of all but twenty-one nations. It is GROWING!!!!!!!

As a physician, I do not want to see kids who experimented in school end up with HIV or Hepatitis B and C as a result of the use of illegal drugs and dirty needles. An adolescent “experiment” could end up in a lifetime of pain and anguish. Likewise, it seems ridiculous to me to criminalize the use of marijuana. The laws have not changed anything! It is readily available across the country in schools, on the street, etc. The only thing is that the illegal marijuana may be laced with anything from cancer causing pesticides to cocaine or crystal meth. Oh yes, and the notion that marijuana is a drug that opens the door to other drugs (a “gateway drug) has never been proven. It is just another piece of worthless conjecture.

Now, I have heard all kinds of opinions about the horror that will occur if we were to decriminalize illegal drugs (including “weed”). These are all opinions and let us not forget that the companies that build and operate jails, those that illegally distribute large quantities of illicit drugs, and those that still are praying that God will perform a miracle and Rick Santorum will become President still hold sway with elected officials. But, let’s take this OUT of conjecture and into reality. Let’s look at Portugal:

The drug policy of Portugal was put in place in 2000, to be legally effective from July 2001. In 1999 Portugal had the highest rate of HIV amongst injecting drug users in the European Union. The number of newly diagnosed HIV cases among drug users has decreased to 13.4 per million population in 2009 but that is still high above the European average (2.85 cases per million). There were 2000 new cases a year, in a country of 10 million people. 45 % of reported AIDS cases recorded in 1997 originated among IV drug users, so targeting drug use was seen as an effective avenue of HIV prevention. The number of heroin users was estimated to between 50,000 and 100,000 in 2000. This led to the adoption of The National Strategy for the Fight Against Drugs in 1999. A vast expansion of harm reduction efforts, doubling the investment of public funds in drug treatment and drug prevention services, and changing the legal framework dealing with petty drug offences were the main elements of the policy thrust. In 2001, Portugal became the first European country to abolish all criminal penalties for personal drug possession. In addition, drug users were to be targeted with therapy rather than prison sentences. Drugs are STILL illegal and big time dealers and distributors are STILL prosecuted but the poor schnook in the street- your son or daughter perhaps?- is not prosecuted. Possession is a civil issue- perhaps they might be fined if anything at all. Individuals found in possession of small quantities of drugs are issued a summons. The drugs are confiscated, and the suspect is interviewed by a “Commission for the Dissuasion of Drug Addiction” (Comissõespara a Dissuasão da Toxicodependência – CDT). These commissions are made up of three people: A social worker, a psychiatrist, and an attorney. The dissuasion commission has powers comparable to an arbitration committee, but restricted to cases involving drug use or possession of small amounts of drugs. There is one CDT in each of Portugal’s 18 districts. Several options are available to the CDT when ruling on the drug use offence, including warnings, banning from certain places, banning from meeting certain people, obligation of periodic visits to a defined place, removal of professional or firearms license. Sanctioning by fine, which may vary by drug involved, is an available option. If the person is addicted to drugs, he or she may be admitted to a drug rehabilitation facility or be given community service, if the dissuasion committee finds that this better serves the purpose of keeping the offender out of trouble. If the offender is not addicted to drugs, or unwilling to submit to treatment or community service, he may be given a fine. Since the start of decriminalization, illegal drug use by teenagers has declined, the rate of HIV infections among drug users has dropped, deaths related to heroin and similar drugs has been cut by more than half, and the number of people seeking treatment for drug addiction has doubled. The number of drug related crimes has dropped as well.

 Let’s look at numbers in a time that we desperately need to cut costs in America:

A Harvard economist, Jeffery Miron, estimated that ending the war on drugs would inject 76.8 billion dollars into the US economy in 2010 alone. He estimates that the government would save $41.3 billion for law enforcement and the government would gain up to $46.7 billion in tax revenue. Since President Nixon began the war on drugs, the federal drug-fighting budget has increased for $100 million in 1970 to $15.1 billion in 2010, with a total cost estimated near 1 trillion dollars over 40 years. In the same time period and estimated 37 million nonviolent drug offenders have been incarcerated. $121 billion was spent to arrest these offenders and $450 billion to incarcerate them.

Holding on to some silly, costly and simply ineffective system of making criminals out of those who possess and use small amounts of illegal drugs is a battle lost with a high price. We cannot afford expensive inaction. It’s time to make a change and quadrupling our policing of drugs and making more jails is NOT the answer. Let’s not be ridiculous!