Overdosing on extremism??

Kevin Sabet wrote an op-ed calling for more attention to centrists in drug policy discussions.

ACCORDING to a recent study by the Centers for Disease Control, drug overdoses have increased almost six-fold in the last 30 years. They now represent the leading cause of accidental death in the United States, having overtaken motor vehicle accidents for the first time on record.

One might expect such news to spur politicians to explore new options for drug abuse treatment, prevention and enforcement. Instead, at precisely the wrong time, extremists on both sides have taken over the conversation. Unless we change the tone of the debate to give drug-policy centrists a voice, America’s drug problem will only get worse.

He goes on to outline past centrist efforts.

Indeed, moderates have historically been key contributors to both the debate and the practice of effective drug policy. In 1914, Representative Francis B. Harrison, a New York Democrat, worked with Republicans and President Woodrow Wilson to pass the first major piece of federal anti-drug legislation, in response to a surge in heroin and cocaine use.

Other moderates, from Theodore Roosevelt to John F. Kennedy, made drug policy an important part of their domestic agendas. President Bill Clinton worked closely with Bob Dole, the Republican Senate majority leader, on sensible measures like drug courts and community policing. And Vice President Joseph R. Biden Jr. is the reason there is a drug czar in the first place, having pushed the idea for years before President Ronald Reagan approved it.

And, the current context and opportunities:

…a few tough-on-crime conservatives and die-hard libertarians dominate news coverage and make it appear as if legalizing drugs and “enforcement only” strategies were the only options, despite the fact that the public supports neither.

This stalemate comes just as a new range of cost-effective, evidence-based approaches to prevention, treatment and the criminal justice system are within our reach. We know much more about addiction than we did 20 years ago; with enough support, we could pursue promising medications and behavioral therapies, even a possible vaccine against some drug addictions.

Meanwhile, smart, innovative law enforcement strategies that employ carrots and sticks — treatment and drug testing complete with swift but modest consequences for continued drug use, or incentives for abstinence — have produced impressive results, through drug courts or closely supervised probation programs.

And drug prevention has moved from a didactic classroom exercise to a science of teaching life skills and changing environmental norms based on local data and community capacity. We now know that recovery from addiction is possible, and that policies that give former addicts a second chance are in everyone’s interest.

Most recently, R. Gil Kerlikowske, President Obama’s top drug policy adviser, introduced a sensible four-point plan to curb prescription drug abuse: educate prescribers, parents and young people about the dangers of overdose; shut down illegitimate “clinics” that freely sell these drugs; establish electronic monitoring at pharmacies; and encourage the proper disposal of unused medications. Yet his plan received little attention from the news media or Capitol Hill.

I like the spirit of the piece. One big difference between this and most drug policy writing is that this offers a starting place for constructive debate and discussion. This stands in stark contrast to the typical  non-negotiable declaration of Truth that frames different points of view as stupid or evil. (Ouch. I hope I’m not guilty of this too often.)

However, there’s something a little tone-deaf about celebrating the Clinton era improvements in policy that, while important, still coincided with still skyrocketing rates of incarceration.

Points has a harsher take on it, picking apart Sabet’s “fuzzy historical examples” and issuing a call for “some actual historical examples of drug policy centrists in action.” All of which is probably fair, but it would have been nice to see him respond to the spirit of the piece and offer some of the historical examples he calls for.

I saw the use of historical examples as secondary to his call to move beyond the drug policy freak show, take action on some of the low-hanging fruit and use this as a foundation to correct errors and improve policy. To me, the piece would have been stronger without the historical references.

He does close with an insightful framing of the challenge:

Which leads me to the second problem with writing the history of drug policy centrism: the center of what?   Drug policy is far too complicated to reduce to a single spectrum anchored by a single pair of policy poles, between which exists some sort of unified “center” of policy making.  Sabet obviously understands this, to the extent that he is frustrated by the manner in which public conversations about drug policy dwell on legalization and law enforcement to the exclusion of much else.  But how real and definable is the centrism he seeks?

I agree that using a binary framework is simplistic and inaccurate. However, I take Sabet as a political pragmatist and I understand that many important political achievements would never have happened without simplistic and sometimes inaccurate framing.

What would be a more accurate framework for discussion? Maybe the competing values? This is wrought with problems, particularly with those who insist that their perspective is based solely on empiricism. What do you think?

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