Punitive & Rehabilitative Approaches to Drug Policy

In 1989, amid great public fanfare, a newly intensified federal "War on Drug" was proclaimed. Federal antidrug spending was sharply increased. A debate then arose about how this money should be spent; particularly, whether the emphasis should be heavily in favor of lawenforcement and punitive approaches, as in fact it was, or whether a greater emphasis on treatment and rehabilitation of harddrug abusers would be a more productive approach to an antidrug strategy. This debate is not new, but goes back to the earliest days of Federal action against drugs, in the World War I era. Since that time, as we shall see, the public response to the "drug problem" has followed a generally predictable pattern. It is a pattern which has consistantly favored punishment over rehabilitation for drug users; which has persisted in treating drugs and drug addiction as essentially criminal vice matters, roughly parallel to gambling and prostitution, rather than as medical matters. This study traces the history of the conflict between punitive and rehabilitative approaches in American federal antidrug policy, and examines some of the major factors which have driven policy so persistantly in a punitive direction. Roughly, we may say that the driving force is political in the broad sense, cultural politics. The American public regards "drugs" essentially not as a phenomenon in their own right, but as a manifestation and symbol of what it most fears in society: crime, deviant behavior,

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the doctors convicted were often abusing their prescription powers, prescribing to "street" addicts as a profitable sideline business. However, a conflict was built into this policy, since at this same time the medical profession was establishing its prestige and virtual independence of outside authority in professional matters. A powerful medical establishment was emerging, at least potentially dedicated to the proposition that no one but doctors was qualified to pass judgement on medical prescriptions. A 1925 court case might well have established the medical model of drug control in the United States. A doctor named Linder was convicted of prescribing maintenancelevel quantities of opiates to an elderly patient. In a decision throwing out this conviction, the Supreme Court accepted the proposition that opiate addiction was a disease, and that "maintenance" of an addict was a treatment program which a doctor might rightfully apply. Earlier in the 1920s, as the legal ability of individual doctors to prescribe opiates was effectively removed by the application of the Harrison Act, drugmaintenance "clinics" grew up in a number of cities around the countries. The clinics were subjected to official

Category: Government - P