Coke, Crack, Pot, Speed

 In 1999 illegal drug use resulted in 555,000 emergency room visits, of which 30 percent were for cocaine, 16 percent for marijuana or hashish, 15 percent for heroin or morphine, and 2 percent for amphetamines. Alcohol in combination with other drugs accounted for 35 percent. This is not the first time that the U.S. has suffered a widespread health crisis brought on by drug abuse. In the 1880s (legal) drug companies began selling medications containing cocaine, which had only recently been synthesized from the leaves of the coca plant. Furthermore, pure cocaine could be bought legally at retail stores. Soon there were accounts of addiction and sudden death from cardiac arrest and stroke among users, as well as cocaine-related crime. Much of the blame for crime fell on blacks, although credible proof of the allegations never surfaced. Reports of health and crime problems associated with the drug contributed to rising public pressure for reform, which led in time to a ban on retail sales of cocaine under the Harrison Narcotic Act of 1914. This and later legislation contributed to the near elimination of the drug in the 1920s.

Cocaine use revived in the 1970s, long after its deleterious effects had faded from memory. By the mid-1980s history repeated itself as the U.S. rediscovered the dangers of the drug, including its new form, crack. Crack was cheap and could be smoked, a method of delivery that intensified the pleasure and the risk. Media stories about its evils, sometimes exaggerated, were apparently the key element in turning public sentiment strongly in favor of harsh sentences, even for possession. The result was one of the most important federal laws of recent years, the Anti-Drug Abuse Act of 1986. It was enacted hurriedly without benefit of committee hearings, so great was the pressure to do something about the problem. Because crack was seen as uniquely addictive and destructive, the law specified that the penalty for possession of five grams would be the same as that for possession of 500 grams of powder cocaine.

African-Americans were much more likely than whites to use crack, and so, as in the first drug epidemic, they came under greater obloquy. Because of the powder cocaine/crack penalty differential and other inequities in the justice system, blacks were far more likely to go to prison for drug offenses than whites, even though use of illicit drugs overall was about the same among both races. Blacks account for 13 percent of those who use illegal drugs but 74 percent of those sentenced to prison for possession. In fact, the 1986 federal law and certain state laws led to a substantial rise in the number of people arrested for possession of illegal drugs, at a time when arrests for sale and manufacture had stabilized.

The data in the chart catch the declining phase of the U.S. drug epidemic that started in the 1960s with the growing popularity of marijuana and, later, cocaine. Use of illegal drugs in the U.S. has fallen substantially below the extraordinarily high levels of the mid-1980s and now appears to have steadied, but hidden in the overall figures is a worrisome trend in the number of new users of illegal drugs in the past few years, such as an increase in new cocaine users from 500,000 in 1994 to 900,000 in 1998. In 1999 an estimated 14.8 million Americans were current users of illegal drugs, and of these 3.6 million were drug-dependent.

The decline in overall use occurred for several reasons, including the skittishness of affluent cocaine users, who were made wary by negative media stories. The drop in the number of people in the 18-to-25 age group, in which drug use is greatest, was probably also a factor, and prevention initiatives by the Office of National Drug Control Policy, headed by Gen. Barry McCaffrey, may have had some beneficial effect. The decrease in illegal drug use in the 1980s and early 1990s was part of a broad trend among Americans to use less psychoactive substances of any kind, including alcohol and tobacco.

Even with the decline, the U.S. way of dealing with illegal drugs is widely seen by experts outside the government as unjust, far too punitive and having the potential for involving the country in risky foreign interventions. The system has survived for so many years because the public supports it and has not focused on the defects. Surveys show that most Americans favor the system, despite calls by several national figures for drug legalization, and there is little evidence that support is softening.