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Winter 1998
Middle Ground
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Using this approach to evaluating drug policies and programs would have two key consequences. First, applying a damage standard would expand our focus to include licit drugs such as alcohol and tobacco, which precisely because they are more widely used cause much more damage than any illicit drug. Second, thinking about damage would prompt us to concentrate our efforts on frequent, high-dose users, especially those whose addiction to expensive illicit drugs leads them into criminal activity. A damage standard would also direct our attention to reducing the side effects of drug trafficking, especially violence and the enticement of juveniles into illicit activity, and to start to count the financial and social costs of enforcement and imprisonment.

If our goal is to protect children from the damage they can do to themselves by abusing psychoactive chemicals, we need to concentrate on the licit drugs, by far the greatest threats. About a quarter of high school seniors smoke, and most go on to heavy daily smoking. Heavy smoking, in turn, roughly doubles the mortality rate at any given age. As for alcohol, binge drinking is more common among adolescents than is the use of any illicit drug. The total damage done to adolescents by marijuana does not approach that done by alcohol and nicotine.

Societywide, drinking and drunken behavior exact a terrible toll. Surveys of offenders under criminal-justice supervision show that 40 percent had been drinking at the time they committed the offense that led to their convictions, and alcohol involvement in some categories of violent offenses is even higher.

Fortunately, we know exactly how to reduce smoking and drinking: Make tobacco and alcoholic beverages more expensive. The $1.10 cigarette tax increase rejected by Congress this year, for example, would have reduced the prevalence of juvenile smoking by about a third. The ideal tax on alcohol would be several times its current level of about a dime a drink.

The key to controlling the illicit drugs is to focus on the fewer than 4 million hard-drug addicts. This relatively small group accounts for about 80 percent of the total consumption of cocaine, heroin and methamphetamine. They create problems out of any proportion to their numbers. They suffer enormously and cause suffering around themselves.

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