Dr. Steven Jonas

The “Drug War” in the United States has been underway for about 45 years and there has been no significant reduction in the use of the recreational drugs at which it is ostensibly aimed.  Dr. Steven Jonas is a Professor Emeritus of Preventive Medicine at StonyBrookMedicine in New York State who has written quite extensively on various aspects of the US health care system going back to the 1970s. For example, he created the first textbook on the US health care delivery system, published in 1977.   In his latest book, “Ending the ‘Drug War;’ Solving the Drug Problem” (http://www.puntopress.com/2016/02/27/drug-war-solving-the-drug-problem-by-steven-jonas-scheduled-for-early-spring-release/), Dr. Jonas has taken on both the politics of the War on Drugs in the United States, as well as presenting what he calls the Public Health Approach to the Drug Problem (PHADP), designed to finally deal with that problem in a positive way.  

The PHADP is modeled on the great success that has been achieved in the United States since 1965 in reducing cigarette smoking among adults from 45% to 18%, without — guess what? — locking up one cigarette smoker.  Dr. Jonas is addressing both people broadly interested in public policy in general and the public’s health in particular, as well as people who are active in the drug policy reform movement.

Dr. Jonas first became interested in the problems surrounding heroin addiction when he was the director of out-patient services at the Morrisania City Hospital in the Bronx, N.Y.  In the early 1970s.  Since that time, he has published over 20 academic papers and book chapters on the subject, including two articles in law reviews.  He became active in the national drug policy reform movement in the late 1980s. His forthcoming book both reviews and expands upon the academic work he has been doing on the subject since that time.

The doctor originally developed the PHADP in the early 1990s, when it was published in the standard textbook, Substance Abuse.  It presented a viewpoint on the drug problem rather different from that of the bulk of the Drug Policy Reform Movement — the DPRM — (and still is).  It recognizes that the U.S. drug problem is a unity, not a duality.  The distinction between the “licit” and the “illicit” drugs was invented by the original Drug Warriors.  

Unfortunately, from Dr. Jonas’ perspective, the DPRM has accepted this distinction, which vastly limits what it can propose to do about the drug problem, a problem that begins with the negative health effects of the licit tobacco products and alcoholic beverages, which far outweigh those caused by the illicits.   At the same time, before us is the public health-based National Smoking Cessation Program, referenced above.   “Its success means that over time the tobacco-use-related death rates will decline steadily.  At the same time locking people up accomplishes nothing in dealing with the use-rates for the ‘illicits.’ ”  At the same time, the mass incarceration for “illicit” drug-use-related offenses, is one of the Drug War’s greatest negatives.  Of course, if the US did not have the Drug War, which focuses primarily on African-Americans and other non-whites, the mass incarceration problem would not exist.

There is a wide variety of substances, that Dr. Jonas calls the Recreational Mood Altering Drugs, the RMADs, available in the United States.  But the two major killer drugs are tobacco products and the alcoholic beverages, both, of course, “licit.”  In 2014, approximately 488,000 deaths were related to cigarette smoking (including 49,000 from second-hand smoke), while approximately 85,000 deaths were linked to the use of alcohol. Marijuana results in very few deaths. In 2014, heroin overdose deaths came to about 28,000. (A certain number of those would not have occurred if heroin were legal, and available in known dosages, from, say, state-operated “package stores” of the type that in many states used to sell alcoholic beverages.)   Cocaine does not kill many people either. But the two major killer drugs are not targets of the “Drug War.”

Dr. Jonas deals extensively with the U.S. Drug Culture, which underlies all RMAD as well as medication-use: “have a problem, take this pill, gel, dietary supplement, what-have-you — and it will go away.”  He also notes that the same state governments that spend so much criminal-“justice” system money dealing with the illicits and the addictions they cause, depend for major chunks of their annual revenues on one or another aspect of gambling, a highly addictive behavior.

The PHADP begins with using approaches that have been employed to reduce tobacco use include advertising, taxing policy, and limiting availability. In other countries, the requirement that tobacco firms print a simple “Smoking Kills” warning on tobacco packs has certainly been helpful in reducing cigarette smoking.  There are messages on US cigarette packs, but due to the pressure of the tobacco industry hey have not been nearly as stark.

There are several reasons why the Drug War should be brought to a quick end.  Among the principal ones are;

• It doesn’t work – it doesn’t help to reduce drug use.
• It is extremely expensive.
• It has resulted in the imprisonment of many people who are not criminals except that the use of the substances that have been arbitrarily defined as criminal.
• It corrupts the criminal justice system, has created a private, for-profit, prison-industrial complex, and has vastly distorted law enforcement
• It has created a hugely profitable and highly destructive set of “drug cartels” which would not exist without it.

Dr. Jonas notes that while about 75% of the use of the illicit substances is among whites, about 75% of the people who are in prison on drug-related charges are non-white. This is why he calls the Drug War a racist enterprise.

According to Dr. Jonas, the use of tobacco products and alcoholic beverages in children becomes a gateway to use of the illicit drugs later in life.  “A person is much more likely to become a user of marijuana as a teenager if they first started with tobacco and alcohol,” he adds.  An important part of the PHADP consists of educational programs focusing on presently licit RMAD-use, aimed at parents. He says such a campaign can expose the connections between childhood use of alcohol and tobacco and later use. It is very important to note that most people who become substance users/abusers as adults begin with the use of one of the licits when they are children and teenagers.

Once again, the doctor insists, “If we really want to deal with the drug problem, then we have to deal with the recreational, mood-altering drugs as a unity, not a duality, we have to begin with both tobacco and alcohol  and, more broadly, the U.S. Drug Culture.” The book, again Ending the ‘Drug War;’ Solving the Drug Problem, is now available on Amazon.