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6. The, question as to precisely where and how drugs would be made available
is not insignificant. Although a part:31 repl: was included in TV response to
question one, further elaboration is necessary.

The response must be framed in terms of toth providing drugs to the public and dealing with the specific problems of addicts.

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Cocaine chewing gum and smoking and edible opium would be available through existing pharmaceutical cutlets. !! would be relative!, easy for such outlets to acquire the equipment to monitor the MOST card system described.

Provision of other forms of cocaine or opiates to addicts would be thrcuch combination clinic and distribution centers similar to methadone programs now is existence. The current methadone clinics could actually be incorporated into the new system. As noted, physicians would be authorized to prescribe maintenance doses.

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Coca containing beverages and coca tea would be treated as foodstuffs
unless the preparation contained an extract of more than a designated amount of
соса. They could be distributed as coffee, tea and calas are now distributed.
The slightly more potent beverages, or coca wine, would be distributed through
liquor stores or other places selling alcohol and regulated similarly,

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Marijuana could be distributed through tobacconists or similar shops devoted
exclusively to marijuara distribution. I do not favor sale of
marijuana through liquor outlets as I think a distinction shoulbe drawn
between the two. While this may appear trivial to some, I believe that both
the danger of additive effects when mi:: ing alcohol and arijuana, and the
fact that mar i juana used alone is less dangerous than alcohol alene mandates
maintaining a separation.

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Due to the unique nature of hallucinogens and the necessity for the screening and testing process described above, it would make sense to establish dispensaries in which a user might also remain to irgest the substance if so desired. The dispensar: es would also serve as the screening and testing centers for those wishing to legally obtain ha!!licinogens.

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The question as to whether or not du? Lise. even :! legal, be proscribed for employees in certain ccausations is one of the most difficult and challenging issues in the debate on regulatory reformi. Marijuara is of particular interest here, since traces may sometimes be identified for weeks following use. The difficulty is deteririning the meaning of such residuals.

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There is one study suçgesting that use of marijuana may cause 1 cairment in piloting ability for up to 24 hours following use. Although there has not been replication of the study, the findings deserve scrutiny because they indicated some degree of impairment even when the pilots no longer perceived themselves as impairec (35).

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The study has been criticized for inadequate nathodology in structuring of
controls. Clearly, the implications are significant, and suggest that
caution must be exercised in making far ranging policy decisions pending
replication (35a).

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It is clear that the mere existence of traces of
cannabinoids in the body days or weeks after use does not indicate
impairment. It is my belief that individuals entrusted with the public safety
must be unimpaired. This need must be balanced against the constitutional
protection provided by the fourth amerdment. All drug testing is intrusive.
and the most effective testing, through blood sampling. is most intrusive.

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Also problematic is the fallibility of even sophisticated testing techniques
(36). While there is no resolution to the constitutional issues raised by
testing, and there is currently no way to correlate traces of cannabinoids with
impairment, there is a partial solution to the problem,

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In lieu of random drug testing among operators of commor carriers and public safety officials, randcm Dscho-motor testing could be performed. This would directly measure the variables involved in sate operation of vehicles ard equipment. where there appeared to be impairment, bic: samples might then be taken. This would avoid interference in personal behavior unless it directly impacted on the job performance.

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Another technolssical desice, the interlock, could be acolied to operators of Common carriers. Indeed, suggestions are being heard that such devices right be employed for first 11,12 CW! (driving while intoxicated) oftenders to prevert them from sperating their vehicles if inpaired. while circumvention of systems could not be totally avoided. a combination et laws making it a felony to tamper with an interlock or or an individual to operate an interlock for an impaired oer son would serve as a deterrent to such tancering and circumvention of intent.

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In the case of common carriers, it would represent an extremely modest
additional expenditure to employ a safety technician responsible for
monitoring interlocks to see that they were both in working order and had not
been tampered with. The advantage of a combination of random psychomotor
testing and interlocks would be that all forms of impairment, including that
caused by illness such as influenza or the common cold would be detected. In
addition, the possibility of sophisticated drug or alcohol abusers
çircumventing accurate drug testing, which has already occurred, would become
a non-issue. The public safety would be better addressed by this system, and
the question of fourth amendment violations would be avoided.

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I do not believe teachers, brokers and other individuals should be subjected
to this regimen.

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It is also important to remember that some forms of substance use do not cause
impairment. No one, for example, believes that a pilot is a menace following
his morning cup of coffee. The use of coca tea or beverages would have to be
viewed in the same light.

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B. in response to Rap. Rangel's question as to what rate of addiction and
use might occur if drugs were legalised and what the accidental drug-related
death rate might be, my response is that one must look to history both here
and abroad for possible answers. Without going into statistical analysis, it
is possible to note that reformed drug policy in Holland has resulted in
decreased use of marijuana, despite its de facto !egalization, and in
decreased use of heroin (37). Use of other opiates and cocaine has risen,
although crack use is virtually non-existent and medical and social indices
of drug use have stabilized. The Dutch system is not similar to my proposals,
however, and does not provide for as much regulation or any generation of
revenues through taxation as to the proposals elaborated above.

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Another clue as to the effects of legalization is available by looking at
nineteenth century America prior to widespread drug prohibition. In brief,
all the historical evidence indicates that despite widespread and
fully legal supplies of marijuana, cocaine and spiate freparations, there were
relatively few social problems associated with their use. There were medical
problems and o. erdose deaths, but even these were minimized by the existence
of orderly and pharmaceutically pure supplies of these substances.

In many
cases, people were unaware of what drugs var:cus patent medicines and remedies
contained and became addicted unwittingly. This was remedied by passage of
the Pure Food and Drug Act of 1905, but drug prohibition and its concomitant
social problems did not begin until 1914 with passage of the Harrison
Narcotics Act (38).

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An extremely important study, which, to my hnowledge, has not teen utilized in
the current debate, was published in December 1967 in the American Journal of
Public Health. Entitled "Epidemioloy of Cirrhosis of the Liver: National
Mortality Data," it provides compelling evidence that while the United States
was experiencing a combination of public health benefits and social discord
under prohibition, the British were able to gain all of the public health
benefits without recourse to prohibition (3a). Not only did the British excee the
Americans in reduction of cirrhosis of the liver linked to alcohol
consumption, they also succeeded in keeping the rate at a relatively low
plateau. This contrasts sharply with the fimerican experience, where alcohol
consumption rose towards pra-Prohibition !evels in the years following repeal,
bringing with it a corresponding increase in cirrhosis.

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This study is crucial in responding to legititate concerns about the impact of
liberalized narcotics laws on public health. The argument now heard in many
quarters is that the trena dous Health costs of legal alcohol provide grounds
for dreading the effects of legalizing another substance. Nowhere do
opponents stop to consider how effective the Eritish combination of taxation.
rationing, and restricted hours were in reducing alcohol abuse without
creating black markets and socia! disruption. Surely those who invoke the
public health success of Frohibition must, in hairness. e.amire data that
indicate there is an alternati. to the polar eytrengs of Corlete prchibition
or laissez faire legalization.

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Another recently released stud, also provides grounds for optimism. The
study, released in June 1925, is entitled "Liver Cirrho3:s mortalit in the
United States, 1971-1955 (35)." The stud, indicates that across virtually
every age group. (with the e..ception of

75. where factors Other than

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alcohol use may significantly contribute to cirrhosis) cirrhosis of the liver
peaked between :93 and 1975. Per capita con su.notion of hard liquor peaked at
about the same time, and beer consumption, al:ttia later. while the reason
for this encouraging development is not certair, a combination of education
and the emphasis on tealth may hare been important factors. I suggests that
our culture may be able to develop a responsib! relationship with
psychoactive substances over time.

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Depending on the assumptions used, it would be possible to paint a: trer i grim or rosy scenario. I think it is important to remember that the mere fact of rug use is not necessarily an evil, and an increase

would not necessarily be a hallmark of failure. The best analogy would be that use of alcohol could rerrain Stable or increase but we would consider i! progress if alcoholism and alcohol related trałti: and other fatalities declined.

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9. There is not unanimity of opinion among so-called medical and drug
experts. It is not difficult to find individuals on both sides of the issue,
although personally I have encountered individuals in a variety of medical and
health related professions who now faror some form of drug legalization.

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10.

In the current climate it is difficult for anyore, physician or otherwise, to suggest that any drug use might be beneficial. It is rele.ant to recall, however, that although aicshoi is the most dainagiis drug cf abusa by many standards (tobacco causes more deaths, but less social tragedy) 39), there are studies indicating that moderate consunction of alccheiic beverages may be beneficial (3a), 1395), (OC),

(290). There are probably physicians who feel that the same thing is true for moderate ---sumst:sncf zome ct-er substances. There are certainl, mental health professionals who feel that use of hallucinogens and related drugs Fisie potentia! Serefits under the right circumstances (40), (40a), (40b). (404), (400).

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The it.plicit suggestion of coen communication with the fanily physician is a good idea, and there is little scub: that most pti, s. cians would suggest abstinence in most cases.

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11.

I believe it is difficult, if not impossible to project the impact of drug regulatory referit, co either medical insurance er overall cost of health care. Perhaps as stat:stics accumulate, insurance companies would offer discounts for abstainers or moderate users as they do now icr non-smokers.

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Assuming the worst--that cwer all health care costs inc: eased--there would be tremendous revenues available both from monies freed up from law enforce.nent and from funds produced through taxation of drugs. These funds would be earmarked for health care. Many solutions to complex problems involve trade offs (41).

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12. I strongly believe tha: bringing the intravenous drug culture within the
legal fold and providing free, sterile needles would greatly reduce the spread
of AIDS. I feel that while the balance of the debate on drug regulatory
reform unfolds, there should be inmediate action to provide sterile needles to
all intravenous drug users. It is encouraging to see New York City embarking
on a pilot program in this regard (August 1988).

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I believe that advertising, cther than simple point of sale tombstones and

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similar ads in the yellow pages, should be prohibited. This reviation should apply equally to alcohol, tetacco and ite other sichoactive agents, witsexception of coffee, tea, coca and mil cosa be orages.

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I believe public use should generally se prohibited and viciatice of this
prohibition should be punishable by a fing similar to a parking ticket.
Intravenous drug Lise and use of crack or PCP in putlic would be punishable by
overnight incarceration similar to that usually employed for public
drunkeness.

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The question of how and by whom psychoactive drugs, both in plant form and other forms would be regulated for purity and content is another issue that must be addressed. ! suggest that we iook to existing mechanisms with an eye to adapting them to regulation of the psychoactive drug market.

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Currently, the United States Department of Agriculture (USDA) and the Eureau of Alcohol, Tobacco and Firearms (BATF) share responsibility for regulating aspects of the comerce in alcohol and tobacco.

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Using these existing regulatory bodies, USDA could be responsible for grading
mari juana for quality, freserce of adulter ants, and pesticide residues. PATF
could function, as it does now for tobacco, to see that interstate commerce
and tax regulations regarding the cannabis trade are complied with. The
question of tar and tetrahydrocannabinol (THC) content in mar i juana, if
modeled on the tobacco industry, would not be problematic, as my suggestion
is that marijuana nct be made available in convenient, pre-packaged forms such
as cigarettes. Currently, the Federal Trade Comission (FTC), which deals
with all aspects of advertising, tas a voluntary agree.nent with tobacco
manufacturers regarding display of tar and nicotine content on some cigarette
packages and advertisements.

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Regulation of plant hallucinogens, such as hallucinogenic mushrcoms, could
also be handled by the USDA. In the case of some of these naturally occurring
substances, the problem of spoilage would be a factor. LISCA, hcwever, has
extensive experience dealing with per: shables such as miili. It would seem
unnecessary to create another bureaucrasy stric:ly for regulating the quality
of naturally occurring psychoactive agents.

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Regulation of raw coca and opili would also be handled by USDA, although once
the coca went into the marletplace, it would be regulates, lile coffee or tea,
by the Food and Drug Administration (FDA) as a fosdstuft. You will recall
that more concentrated coca extract would be regulated lile alcohol, in which
case purity and content would fall under the jurisdiction of EATF.

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No change
Prescription drugs would be regulated as they are toda',, by FDA.
would be necessary.
Objections to this scenario have been raised in regard to the difficulty of

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having FDA involved for Substances that couid prove carcinogenic.
objection is not applicable in this scenar:0, however, since the plant
substances would fall under USDA regulation.

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ADDITIONAL BENEFITS OF REGULATORY SEFGEM

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It has not been my intention here to cover all angles of the debate on legalization.. Nadelmann has done a trilliant job in explaining the costs of

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prohibition and the potential benefits of legalization. Reuter has done a painstaking econometric analysis of why further expenditures for interdiction are unlikely to have any impact 'on retail price and availability of illicit narcotics. Therefore, I will only very briefly recap a few of the benefits I believe would result from reforming the narcotics laws.

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In addition to the clear economic benefits that would accrue from savings on enforcement expenditures, reduced crime, and production of major tax revenues, there are a variety of economic and political benefits that would accrue from the drug regulatory reforms discussed herein.

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First, in the international political arena, the United States would be able
to purchase the bulk of the coca crop now being diverted to illicit cocaine
production. This would provide economic benefits to the South American
producing countries. There would be little incentive to continue illicit
Cocaine production since it would no longer te ó particularly valuable
CC...modity. Similar effe:ts would occur in relationship to the international
opium market. This would reduce, if not eliminate entirely, the correoticr.
and violence now associated with the highly profitable black let.

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Second, the u.s. currently produces a tremendous amount of high quality
mar i Juana, and, ac:ording to the DEA, will probably be the largest producer of
that substance by the 1990's. Therefore, the Srce would te toon à Comas:::
boon to Anerican ar pers and a cash e port roo that would regress, to ne
e tent, our internasional trade falanca

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In addition, regulatory refcrm would overall reduce the tensions that have interfered with the efecciie conduct ci firar:can foreign polis; recentl.. An unfortunate byproduct of current efforts at coca and other drug crop eradication has been the creation of virulent art:-Aimer:canisin in courtries vital to our national interest.

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The benefits would probably be greatest in those third world courtries
currently suffering political dislocation as a resul! of the illicit drug
economy

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It would have been easier to have simply eliminated some of my more
controversial recommandations, such as the suggestion that a non-injectable
form of opium and a cocaine chewing gum benade available through a rationing
system. It would be much easier, for instance, to meraly have suggested
legalizing marijuana and looking at some pilot programa regarding other drugs.
My intention, however, to present a coherent apprcach tc criç policy, and
to allow those joining the debate to see that real ptions are both complex
and plausible. To avoid recommandations dealing with the more controuersial
aspects of drug use and misuse would be to aiciu neaningful debate.

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Another reason for presenting a coherent system, a cc.Tolete vision of one possible landscape after legalization, is to dencastrate that any more in the direction of a policy more crierted toward public health considerations than law enforcement prohibitions is not necessar:ly the first step on the road to laissez faire legalization, I want these examining, and even criticizing this scenario to have a view, nct of what first steps mighit look lile, but rather, what the end of the road couid look lihe.

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As noted in my introduction, no one can clair to have all the answers. The policy options are NCT, emphatically, a choice between perfect and inperiact

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policy, but, as in virtually all tcugh issues, choices between better and worse
policies, or more, iply, the lesser of ev: is. As Foal obseried, goed
ethics are practical ethics. It is my hope that even those most si eptical of
the plausibility of the legalization approach will begin to see tha: :: ::
possible to construct a scenario in which ethical, social, medical and legal
criteria figure into the total equation.

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There is an implicit assu..ption in the scenario whic must now be made
explicit. It is simply tha: there is a continuem strug use, or tra! which
causes no difficulties to that which interferes gravely with an individual's
ability to function. It is truely a disaster to consider any drug polisi
options without understanding the centrality of this eontinuun. My
recommendations are based on the belief that for some current!; illicit drugs,

is so likely to quickly become abuse that these substances should remain proscribed. This fcsits a socially responsible role of law enforcement. Conversely, there are other substances which are far less likely to be used in a dangerous and disruptive manner.

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My considerations include worst possible scenarios. Although the following examples are subjective interpretations, they are based on my knowledge of the medical and social consequences I believe most probable in relation to the use of specific psychoactive substances.

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In a worst case situation, for example, a person is better off being
addicted to marijuana than alcohol or opium. Opium addiction is still
preferable to alcohol addiction. It may be a toss up between whether alcohol
addiction or coca: ne addiction is worse, but both are "better" than habitual
use of PCP.

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Another important distinction I have endeavored to draw is that it is not merely the drug, but the mode of administration of that drug that can have a significant impact са abuse potential. Hence, the continuum from coca to crack is a central concept, not a trivial distinction. This is not mere opinion, for it is supported by both medical research and social obser.ation.

The legal recommendations, of course, would not infringe on the right oi the individual states to remain "dry" of marijuana or other drugs if they so chose. Even within states, different nunicipalities would undoubtedly work out statutes suitable to community standards.

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Those who remain unconvinced can refer to the scrious citations used to
support my conclusions and recor.endations. If Iha.e simpl, ace the reader
pause and consider the evidence, I will feel that I have accomplished
something of importance. It is difficult to break a mind-set, articularl)
a subject so traught with emotion. We are all wrestiing with a social
dilemne, and I telieve it is the Aerican genius to be able to find worlable
solutions to seeningly intrastable problems. Only the drug bar ons stand to
benefit from a continued estensior of the status quo.

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