Illegal Drugs

In 1979, 14.1 percent of individuals age 12 and older participating in the National Household Survey on Drug Abuse (NHSDA) reported illicit drug use in the month before the question was asked. In 2006, 8.3 percent of individuals age 12 and older said the same, in the National Survey on Drug Use and Health. This apparent trend is underscored by statistics on teen drug abuse, from the University of Michigan's annual nationwide "Monitoring the Future" survey.

Researchers there link peaks and valleys in drug use to changing perceptions of the degree of health or other risk in using or even experimenting with various substances. These perceptions are in turn influenced by factors including parental attitudes, celebrity behavior, the experiences of other teens, high-profile drug-related deaths, cultural trends, such as the now-defunct "heroic chic," and anti-drug advertising campaigns.

Teens and Drugs

Reported teen drug use has dropped significantly since the 1990s. But what is emerging as a concern are the growing numbers of people abusing prescription drugs, now the second-most used drugs among teens, behind marijuana.

Differences between the Monitoring the Future results for 1975 and 2006 show shifting attitudes according to the drug in question, a trend researchers attribute to "generational forgetting" – information about hazards one generation knew about not being passed on to the next.

From 1975 to 2006, the number of high school seniors who said there was "great risk" in smoking marijuana regularly rose from 43 percent to nearly 58 percent. The percent who thought trying cocaine once or twice had "great risk" rose from 42 percent to 52 percent.

In the same time period, as LSD became less available, the sense of risk associated with it seemed to fall. From 1975 to 2006, the number of high school seniors who said there was "great risk" in trying LSD once or twice dropped from 49 percent to 36 percent. The number saying there would be "great risk" in regularly using LSD slid from 81 percent to 69 percent.

The sensations brought on by illegal narcotics can increasingly be found in the pharmacy, in drugs legally approved to treat depression, pain, and anxiety. Of the four drugs showing increased usage in the Michigan survey, only one – ecstasy - is illegal. The use of OxyContin by high school seniors, for example, rose 40 percent nationwide in just three years, to a level five times that for the use of methamphetamine.

The rise in popularity of OxyContin, an addictive prescription pain reliever, illustrates the challenge facing authorities trying to prevent drug use. The drug was first released in 1995, and its use has particularly spiked in the Appalachian states, which are more isolated from traditional illegal drug routes. OxyContin is obtained through fake prescriptions, other people's legal prescriptions , theft, diversion from pharmacies and the practice of "doctor-shopping," in which people go from one doctor to another seeking multiple prescriptions. The problem for officials is how to separate legitimate users and prescription-writing doctors from the addicts and dealers.

Tough Tactics

Federal and state governments have used two strategies to combat drug use: reducing the supply of illegal drugs and curbing the demand.

Americans typically think about efforts to reduce supply in terms of aggressive police investigations, tougher sentences for drug dealers, better detection of drugs crossing U.S. borders, and support for anti-drug efforts by drug-producing nations.

The number of drug offenders in U.S. prisons has risen dramatically over the past two decades and now accounts for over 12 percent of all arrests. Many of the arrested are drug users who some argue should be viewed as victims more than criminals. In some jurisdictions, judges can sentence non-violent first-time drug offenders to rehabilitation programs, instead of jail, on the grounds that justice is best served by helping otherwise law-abiding citizens fight addiction.

Reducing demand has often meant drug education programs in schools, public service messages in the media, treatment programs and drug testing. Despite civil liberties concerns, the courts have generally upheld drug testing programs for employees and students involved in extracurricular activities. Since 1998, the federal government has spent more than $1 billion on anti-drug ad campaigns largely aimed at teens. Federal anti-drug spending is more focused on law enforcement and interdiction than drug prevention and treatment programs.

The term "war on drugs" was first used in 1971 by President Richard Nixon, but nearly 40 years later there is still debate over whether that war is winnable. Critics of the war on drugs approach, including an increasing number of law enforcement officials and even a few public officials, have called for drug legalization. They argue legalization, like the ending of the Prohibition on alcohol, would undercut drug gangs and allow the nation to focus on drug abuse as a medical problem. Those critics are a distinct minority, largely focused on marijuana.

Marijuana As Medicine?

One area in which advocates of legalization have made progress is the medical use of marijuana. A dozen states allow doctors to prescribe marijuana for medicinal purposes, such as treating glaucoma. Federal policy, however, holds marijuana to be a dangerous and addictive drug. A divided U.S. Supreme Court waded into the debate when it ruled in 2005 that federal authorities could ban homegrown marijuana for medicinal purposes. The ruling does not overturn the state laws but instead means that people who try to use marijuana as a medical treatment risk legal action by federal authorities.

The debate over the actual danger posed by marijuana continues to rage. A 1999 study by the federal Institute of Medicine found that marijuana does have legitimate medical uses for treating symptoms of cancer and AIDS patients. The panel found no evidence that marijuana leads to harder drugs like cocaine but researchers warned that in the long term, marijuana smoke is even more toxic than tobacco smoke. And a 2008 report by the White House Office of National Drug Control Policy, focused on teen drug abuse, further warns that marijuana use can worsen depression and lead to more serious mental disorders such as schizophrenia, anxiety and suicidal tendencies.

Surveys show most people favor allowing doctors to prescribe marijuana but two-thirds oppose general legalization of marijuana.

The Public View

For many Americans, drug abuse is a problem that touches their family closely. Surveys show a quarter of the public says drug abuse has touched their family, and roughly half say they worry a family member might become involved with drugs. Half of Americans give the U.S. government a grade of "D" or "F" for its efforts to keep drugs out of the country, and a plurality say they country is losing ground on the problem .

At the same time, three-quarters of the public doubt we'll ever be able to keep drugs out of the country. In general, the public tends to favor a variety of different approaches, mixing what are otherwise considered liberal and conservative attitudes. Besides doing everything possible to intercept drug supplies, half of Americans also support treating drug abuse more like a disease. And most Americans do not support legalization of drugs.

Choicework

For additional perspective on how society could address this issue, visit our Discussion Guide which sets out three alternative approaches. The points of view are drawn both from what the experts say about an issue and from what the public thinks about it, based on surveys and focus groups. We call this section "Choicework." Each point of view comes with the arguments for and against, along with some potential costs and tradeoffs.

• One perspective emphasizes strict enforcement of the drug laws, intercepting drug supplies, and doing whatever is necessary to catch and punish drug dealers.

• A second perspective puts its emphasis on cutting demand by preventing drug use and doing everything possible to change tolerant attitudes toward it.
• A third perspective regards drug abuse primarily as a health problem, and favors stepped-up treatment to help users rather than punishing them. Advocates generally favor legalization of some drugs.