Informing America’s Policy on Illegal Drugs

What We Don’t Know Keeps Hurting Us

Committee on Data and Research for Policy on Illegal Drugs

Charles F.Manski, John V.Pepper, and Carol V.Petrie, editors

Committee on Law and Justice and Committee on National Statistics

Commission on Behavioral and Social Sciences and Education

National Research Council

NATIONAL ACADEMY PRESS
Washington, D.C.



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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us Informing America’s Policy on Illegal Drugs What We Don’t Know Keeps Hurting Us Committee on Data and Research for Policy on Illegal Drugs Charles F.Manski, John V.Pepper, and Carol V.Petrie, editors Committee on Law and Justice and Committee on National Statistics Commission on Behavioral and Social Sciences and Education National Research Council NATIONAL ACADEMY PRESS Washington, D.C.

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us NATIONAL ACADEMY PRESS 2101 Constitution Avenue, N.W. Washington, D.C. 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. The study was supported by Contract/Grant No. DC 8C01 between the National Academy of Sciences and the White House Office of National Drug Control Policy. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. Suggested citation: National Research Council (2001), Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us. Committee on Data and Research for Policy on Illegal Drugs. Charles F.Manski, John V.Pepper, and Carol V.Petrie, editors. Committee on Law and Justice and Committee on National Statistics. Commission on Behavioral and Social Sciences and Education. Washington, DC: National Academy Press. Library of Congress Cataloging-in-Publication Data Informing America’s policy on illegal drugs: what we don’t know keeps hurting us/Charles F.Manski, John V.Pepper, and Carol V.Petrie, editors. p. cm. Includes bibliographical references and index. ISBN 0-309-07273-5 (cloth) 1. Narcotics, Control of—United States—Evaluation. 2. Drug traffic—Research—United States. 3. Drug abuse—Research—United States. 4. Drug abuse—United States—Prevention—Evaluation. 5. Evaluation research (Social action programs) —United States. I. Manski, Charles F. II. Pepper, John, 1964– III. Petrie, Carol. HV5825 .I547 2001 363.45'0973–dc21 2001003168 Additional copies of this report are available from National Academy Press, 211 Constitution Avenue, N.W., Lockbox 285, Washington, D.C. 20055. Call (800) 624–6242 or (202) 334–3313 (in the Washington metropolitan area) This report is also available online at http://www.nap.edu Printed in the United States of America Copyright 2001 by the National Academy of Sciences. All rights reserved.

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us THE NATIONAL ACADEMIES National Academy of Sciences National Academy of Engineering Institute of Medicine National Research Council The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M.Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I.Shine is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M.Alberts and Dr. Wm.A.Wulf are chairman and vice chairman, respectively, of the National Research Council.

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us COMMITTEE ON DATA AND RESEARCH FOR POLICY ON ILLEGAL DRUGS CHARLES F.MANSKI (Chair), Department of Economics and Institute for Policy Research, Northwestern University JAMES C.ANTHONY, School of Hygiene and Public Health, Johns Hopkins University ALFRED BLUMSTEIN, H.John Heinz III School of Public Policy and Management, Carnegie Mellon University RICHARD J.BONNIE, School of Law, University of Virginia JEANETTE COVINGTON, Department of Sociology, Rutgers, The State University of New Jersey DENISE C.GOTTFREDSON, Department of Criminology and Criminal Justice, University of Maryland PHILIP B.HEYMANN, Center for Criminal Justice, Harvard Law School JOEL L.HOROWITZ, Department of Economics, The University of Iowa ROBERT J.MACCOUN, School of Law and Richard and Rhoda Goldman School of Public Policy, University of California, Berkeley MARK H.MOORE, Kennedy School of Government, Harvard University WILLIAM NORDHAUS, Department of Economics, Yale University CHARLES O’BRIEN, VA Medical Center, University of Pennsylvania ROBERT H.PORTER, Department of Economics, Northwestern University PAUL R.ROSENBAUM, Department of Statistics, University of Pennsylvania JAMES Q.WILSON, Anderson Graduate School of Management, University of California, Los Angeles DARNELL F.HAWKINS (Liaison, Committee on Law and Justice) Department of African American Studies, University of Illinois at Chicago CAROL V.PETRIE, Study Director JOHN V.PEPPER (Consultant), Department of Economics, University of Virginia KATHLEEN FRYDL, Research Associate RALPH PATTERSON, Senior Project Assistant

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us COMMITTEE ON LAW AND JUSTICE CHARLES F.WELLFORD (Chair), Center for Applied Policy Studies and Department of Criminology and Criminal Justice, University of Maryland ALFRED BLUMSTEIN, H.John Heinz III School of Public Policy and Management, Carnegie Mellon University JEANETTE COVINGTON, Department of Sociology, Rutgers, The State University of New Jersey RUTH DAVIS, The Pymatuning Group, Inc., Alexandria, Virginia JEFFREY FAGAN, Schools of Law and Public Health, Columbia University DARNELL HAWKINS, Department of African American Studies, University of Illinois at Chicago PHILIP HEYMANN, Center for Criminal Justice, Harvard Law School CANDACE KRUTTSCHNITT, Department of Sociology, University of Minnesota MARK LIPSEY, Department of Psychology and Human Development, Vanderbilt University COLIN LOFTIN, School of Criminal Justice, State University of New York at Albany JOHN MONAHAN, School of Law, University of Virginia DANIEL NAGIN, H.John Heinz III School of Public Policy and Management, Carnegie Mellon University JOAN PETERSILIA, School of Social Ecology, University of California, Irvine PETER REUTER, School of Public Policy and Department of Criminology and Criminal Justice, University of Maryland WESLEY SKOGAN, Department of Political Science and Institute for Policy Research, Northwestern University CATHY SPATZ WIDOM, Department of Psychiatry, New Jersey Medical School KATE STITH, School of Law, Yale University MICHAEL TONRY, Institute of Criminology, Cambridge University and University of Minnesota Law School CAROL V.PETRIE, Director

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us COMMITTEE ON NATIONAL STATISTICS JOHN E.ROLPH (Chair), Marshall School of Business, University of Southern California JOSEPH G.ALTONJI, Department of Economics, Northwestern University LAWRENCE D.BROWN, Department of Statistics, University of Pennsylvania JULIE DAVANZO, RAND, Santa Monica, California WILLIAM F.EDDY, Department of Statistics, Carnegie Mellon University ROBERT M.GROVES, Joint Program in Survey Methodology, University of Maryland HERMANN HABERMANN, Statistics Division, United Nations, New York JOEL HOROWITZ, Department of Economics, University of Iowa WILLIAM D.KALSBEEK, Department of Biostatistics, University of North Carolina RODERICK J.A.LITTLE, School of Public Health, University of Michigan THOMAS A.LOUIS, RAND, Arlington, Virginia DARYL PREGIBON, AT&T Laboratories-Research, Florham Park, New Jersey FRANCISCO J.SAMANIEGO, Division of Statistics, University of California, Davis RICHARD L.SCHMALENSEE, Sloan School of Management, Massachusetts Institute of Technology MATTHEW D.SHAPIRO, Department of Economics, University of Michigan ANDREW A.WHITE, Director

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us Contents Preface   xi Executive Summary   1 PART I: INTRODUCTION AND BACKGROUND   13 1   Introduction   15 2   Determinants and Consequences of Drug Use   37 PART II: DATA FOR MONITORING THE NATION’S DRUG PROBLEMS   75 3   Data Needs for Monitoring Drug Problems   77 4   Drug Data Organization   124 PART III: RESEARCH FOR DRUG POLICY   137 5   Supply-Reduction Policy   139

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us 6   Sanctions Against Users of Illegal Drugs   187 7   Preventing Drug Use   208 8   Treatment of Drug Users   241 9   Final Thoughts: Unfinished Business   271 Appendixes     A   Characteristics of STRIDE Cocaine Data   283 B   Data Sources   296 C   Phase I Report Executive Summary   319 D   How Do Response Problems Affect Survey Measurement of Trends in Drug Use? John V.Pepper   321 E   Linking Treatment to Punishment: An Evaluation of Drug Treatment in the Criminal Justice System Jeanette Covington   349 F   Biographical Sketches   382 Index   389

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us Preface This is the final report of the Committee on Data and Research for Policy on Illegal Drugs. Here, and in its earlier Phase I Report, the committee assesses the knowledge available and needed to inform national drug control policy. I believe that our committee has completed its mission in a manner that does credit to the National Research Council consensus committee process, which strives to provide reasoned, scientifically grounded analyses of issues of national significance. Drug control policy is a matter of enormous controversy. Perhaps the hardest challenge that our committee faced throughout its three years of work was to remain dispassionate about a subject that engenders strong views. Committee members had to always be conscious that our charge was to inform drug policy, not to recommend policy. We had to keep in mind that an absence of evidence about the merits of current drug policy implies neither that this policy should be abandoned nor that it should be retained. An absence of evidence implies only uncertainty about the merits of current policy relative to possible alternatives. The absence of evidence came to be the focal concern of the committee, as we gradually concluded that the nation possesses little information about the effectiveness of current drug policy, especially of drug law enforcement. Viewing the unending public debate about drug policy, the committee became painfully aware that what we don’t know keeps hurting us. It troubles the committee that we are not able to offer the nation a conclusive or even suggestive basis for choosing among alternative portfolios of prevention, treatment, and enforcement. Some, believing that

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us present knowledge does support one policy or another, may find this report unpalatable. We hope that Americans will take the report as a call to action to initiate data collection and research that will enable more informed policy making in the years ahead. The committee could not have completed its work without the assistance of many scholars and policy officials who gave unstintingly of their time and shared their resources, their work, and their thinking with us. To gather information on a variety of subjects from a diversity of perspectives, we held four public workshops: Workshop on Cost-Effectiveness Studies, June 23–24, 1998; Workshop on Measuring the Prevalence, Dynamics, and Effects of Illegal Drug Use, November 19–20, 1998; Workshop on Enforcement Activities and the Operation of Drug Markets, May 19– 20, 1999; and Workshop on Drug Data Organization, February 17–18, 2000. We thank all of the individuals who served as presenters and discussants at these meetings. They are listed here alphabetically, and with their affiliations at the time of each workshop: Douglas Anglin, University of California at Los Angeles; Steven Belenko, Columbia University; Jonathan Caulkins, Carnegie Mellon University; Jan Chaiken, Bureau of Justice Statistics; Barry R.Crane, Institute for Defense Analyses; Richard Curtis, John Jay College of Criminal Justice; John Eck, University of Cincinnati; Phyllis Ellickson, RAND Corporation; Susan S.Everingham, RAND Corporation; Jeffrey Fagan, Columbia University; Graham Farrell, Rutgers University; Thomas Feucht, National Institute of Justice; Arthur Fries, Institute for Defense Analyses; John Geweke, University of Minnesota; Meyer Glantz, National Institute on Drug Abuse; Don Goldstone, Substance Abuse and Mental Health Services Administration; Jeffrey T. Grogger, University of California, Los Angeles; Lana Harrison, University of Delaware; Jared Hermalin, U.S. General Accounting Office; Jeff Hill, Office of Management and Budget; Ed Hunter, National Center for Health Statistics; Ram Jain, Drug Enforcement Administration; Bruce Johnson, National Drug Research Institute; Lloyd Johnston, University of Michigan; Robert Kaestner, National Bureau of Economic Research; Mark A.R.Kleiman, University of California at Los Angeles; Mike Klein, Food and Drug Administration; George Koob, Scripps Research Institute; Judith Lessler, Research Triangle Institute; Steven Levitt, University of Chicago; Deborah Liederman, Food and Drug Administration; Robert Moffit, Johns Hopkins University; Daniel Nagin, Carnegie Mellon University; Mangai Natarajan, John Jay College of Criminal Justice; David Nelson, Centers for Disease Control and Prevention; Jacques Normand, National Institute on Drug Abuse; Janet Norwood, formerly, Bureau of Labor Statistics; Rafael Perl, Congressional Research Service; Peter Reuter, University of Maryland; Rex A.Rivolo, Institute for Defense Analyses; Lee Robins, Washington University; Christy Schmidt, U.S. Department of Health and Human

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us Services; Christopher A.Sims, Yale University; Ed Sondik, National Center for Health Statistics; Ken Stark, Washington State; Miron Straf, National Research Council; Patrick Tarr, U.S. Department of Justice; Wendy Taylor, Office of Management and Budget; Jeremy Travis, National Institute of Justice; Craig Uchida, Twenty-first Century Solutions; Tom Vischi, U.S. Department of Health and Human Services; Katherine Wallman, Office of Management and Budget. The committee is especially grateful to John V.Pepper, University of Virginia, whose work as a consultant to the committee throughout its period of operation was truly invaluable. John contributed greatly through his analyses of critical questions and through his participation in the writing and editing of both this final report and the earlier Phase I Report. We are grateful to Dan Melnick, private consultant and formerly at the Substance Abuse and Mental Health Services Administration and the National Science Foundation, who did much to develop the Workshop on Drug Data Organization and who provided expert advice on issues related to the organization of drug data collection in the federal statistical system. We are also grateful to Bobby Charles, Counsel, U.S. House of Representatives, who provided important information on interdiction issues and who wrote a paper for the committee on the potential for linking data from diverse sources. We would like to thank the following National Research Council staff: Barbara Boyle Torrey, executive director, Division on the Behavioral and Social Sciences and Education, and Faith Mitchell, deputy director, for their continuous, sound advice and assistance in support of the committee’s work; Eugenia Grohman, associate director for reports, for her advice on developing the report and for steering this and the Phase I Report through the National Research Council review process; Christine McShane, for her excellent editorial work at several stages of manuscript preparation; Yonette A.Thomas, who served as study director until July 2000; Kathleen Frydl, research associate, who came late into the project but made important contributions to our response to review and managed the review and final manuscripts; Karen Autrey, senior project assistant, who ably managed the logistics from meeting space to food to finances for the project’s first two years; Lecia Quarles, a new project assistant, who proofread the manuscript; and Ralph Patterson, senior project assistant, also new to the project, who managed final travel logistics, project finances, and handled what seemed to be the endless mailing of draft final reports to the committee and reviewers. This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the Report Review Committee of the National Research Council (NRC). The purpose of this independent review is to pro-

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us vide candid and critical comments that will assist the institution in making the published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following individuals for their participation in the review of this report: David S.Cordray, Institute for Public Policy Studies, Vanderbilt University; Dean Gerstein, National Opinion Research Center, Washington, DC; Arthur S.Goldberger, Department of Economics, University of Wisconsin; Adele Harrel, Director, Justice Policy Center, Urban Institute, Washington, DC; Bob Hoffman, New York City Poison Center; Herbert D.Kleber, Department of Psychiatry, Columbia University College of Physicians and Surgeons; Pamela K.Lattimore, Research Triangle Institutes, Research Triangle Park, North Carolina; Lester Lave, Graduate School of Industrial Administration, Carnegie Mellon University; Philip R.Lee, Institute for Health Policy Studies, University of California, San Francisco; Daniel S.Nagin, H.J.Heinz School of Public Policy, Carnegie Mellon University; Irving Piliavin, Institute for Research on Poverty, University of Wisconsin; Thomas C.Schelling, School of Public Affairs, University of Maryland; Richard Schmalensee, Sloan School of Management, Massachusetts Institute of Technology; Fay Taxman, Department of Criminal Justice, University of Maryland; and Larry Wasserman, Department of Statistics, Carnegie Mellon University. Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Stephen Fienberg, Department of Statistics, Carnegie Mellon University, and Henry Riecken, University of Pennsylvania School of Medicine (emeritus). Appointed by the National Research Council, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring panel and the institution. Charles F.Manski, Chair Committee on Data and Research For Policy on Illegal Drugs

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Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us Informing America’s Policy on Illegal Drugs

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