Citation

Des Jarlais D. Addiction 2015; 110(5): 739-740.

Copyright

(Copyright © 2015, John Wiley and Sons)

DOI

10.1111/add.12745

PMID

unavailable

Abstract

In an ideal world, data on illicit drug use, theoretical understanding of the causes of illicit drug use and policies to reduce the health and social problems associated with illicit drug use would be strongly integrated. There would be: (i) multiple sources of data that converged, (ii) strong (falsifiable) theories for interpreting the data and (iii) evidence-based policies. The paper by Caulkins et al. in this issue [1] illustrates how far we currently are from such a utopia. Caulkins and colleagues present a convincing case that, during the last decade, cocaine use has decreased dramatically (approximately a 50% decrease) and marijuana use has increased almost as dramatically in the United States (approximately a 30% increase). Caulkins and colleagues were able to develop a plausible explanation for the decrease in cocaine use. They believe that a decrease in the supply of cocaine to the United States was important, although they are not certain what supply factors, perhaps eradication efforts, perhaps interorganizational warfare among drug trafficking organizations in Mexico, or perhaps in criminal organizations in Columbia switching from smuggling cocaine to smuggling gasoline, are causing this decrease in supply. With respect to the increase in marijuana use, Caulkins and colleagues do not select a most plausible explanation: 'We do not know why there was such a large increase in the number of daily/near daily users'.

It is interesting to note what Caulkins and colleagues did not consider as possible explanations. Our current dominant policy with respect to limiting the use of marijuana and cocaine is criminalization of the sale and use of these drugs. In the most recently available Federal Bureau of Investigation (FBI) arrest data there were 1 552 432 drug-related arrests (12.7% of all arrests in 2012); of the drug-related arrests, 6.1% were for heroin and/or cocaine possession and 42.4%were for marijuana possession. An additional 5.9% were for the sale or manufacture of marijuana. Caulkins and colleagues do not consider the possibility that cocaine use is decreased because arresting people for cocaine possession has been effective in reducing use, nor do they consider the possibility that marijuana use is increased because we are not arresting enough people for marijuana possession. Enough said and not said?

The situation in which we have imperfect but convincing data on important drug use trends has, at best, partial understanding of the trends, and where the trends are clearly not related to our dominant public policy with respect to illicit drug use sounds pretty dire. [more...]

[1] Caulkins J., Kilmer B., Reuter P., Midgette G. Cocaine's fall and marijuana's rise: questions and insights based on new estimates of consumption and expenditures in US drug markets. Addiction 2015; 110: 728-36.

Language: en