THE TWO FACES OF HAWAII'S DRUG WAR
The special police unit, draped in protective white spacesuits bursts through the door of the apartment complex following the distinctive acetone smell that the neighbors had reported. In the kitchen they find the makings of a small time methamphetamine lab: saucepans, bags of white powder, cookie sheets. Nearby sits a rickety highchair. That night's TV news leads with the story of the dramatic bust. It highlights the danger to the child in the apartment, to the nearby neighbors and the courage of the arresting officers. This is the public face of the Drug War in Hawai'i.
The scrawny woman shuffles quietly into the e.r. late on a Thursday night. When someone finally notices her she pulls up her sleeve to reveal an angry festering sore on her upper arm. Her fever's making her dizzy and she can barely explain that her arm's been hurting for weeks but finally got so bad that her boyfriend forced her to come in. Why didn't she come in before? "Hey, I one junky. I scared; they wen treat me like garbage in heah last time." ...Across town, the 72 year old man walks shakily to the ringing phone. He's just finished his second course of chemotherapy. His constant retching has exhausted him and he's already lost 11 pounds. His doctor gave him Marinol, but he can't keep it down long enough to do any good. His daughter in California is telling him he should try smoking some pakalolo. He bristles at her, "I'm a law- abiding citizen; I never broke one law in my life...auwe....I gotta go." This is the private face of the Drug War in Hawai'i.
SENDING A MESSAGE or SYMBOLIC MESSAGES/REAL CONSEQUENCES
Progressive social policy has been a hallmark in Hawai'i since the 60's. The list of firsts is impressive: first to decriminalize abortion, first to require employer-provided insurance; first to pass the ERA.
When it comes to drug policy, however, all bets are off. In this area policy-makers don't deal with costs and benefits, with Legislative Reference Bureau recommendations, in short, with rational, fact-based analysis. They can't. It's a war out there. Or is it an ideological crusade? In both, it's your commitment to the cause that counts. If you question what motivates policy or the outcomes of those policies, then you're a traitor. Or in today's parlance, you're a "legalizer" a "drug user" or perhaps you're "sending the wrong message to our youth". There is one exception: Hawai'i's seven year old state-wide needle exchange program (more on this later).
In a war, of course, anything goes. Civil liberties get in the way so we amend our laws to provide what are called "drug exceptions to the Bill of Rights": if you suspect drugs, you can stop a car; you can enter a house unannounced ...if you find drugs...you can kick a family out of public housing; you can seize a person's property if you think it was acquired with drug based profits.
All this ideology makes for a very narrow consideration of drug policy issues. It is true that on the federal level, the Administration is downplaying the war terminology (although we do have a general - or is he a czar?- in charge of the nation's efforts). But the truth lies in the budget numbers, and, despite the cooling of the rhetoric, spending in the U.S. on efforts to curtail drug use remains skewed at 2/3 for enforcement and 1/3 for prevention and treatment. Those same proportions hold true for Hawai'i according to a 1995 report from the Hawai'i State Substance Abuse Task Force.
In fact when it comes to our policy toward illicit drugs, Hawai'i is pretty much in lockstep with the feds. Our leaders, from the Governor to the Mayors to virtually all of the state legislators, and obviously the police, take an unwavering hard line on drugs. They believe it's primarily a law enforcement issue and that the public wants them to be "hard on crime and hard on drugs".
In other parts of the U.S. there's another battle raging. The successful medical marijuana initiatives in California and Arizona have resulted in an explosion of interest in current drug policies - and how they're working. (Hawai'i, of course, lacks an initiative process; the only way to legalize such use here is through legislation). Increasingly though, intellectuals and journalists are questioning the war on drugs approach - with special attention to its economic and social costs: 16 billion per year in federal spending, 1/3 of all African American young men under the purview of the criminal justice system, and the largest per capita and total prison population in the world, housed for $30,000 per prisoner per year. Not only are the costs astronomical, but they divert needed funding from other areas like education.
LOCK 'EM UP; THROW AWAY THE KEY or IF YOU WANT TO KEEP GETTIN' WHAT YOU'RE GETTIN', KEEP DOIN' WHAT YOU'RE DOIN'
The question is - what are we doing about drug problems in Hawai'i? Are we winning the war on drugs here? Would anyone honestly assert that we are?
Our prisons are overfull; 600 prisoners have been sent to Texas in the past year. But it's not easy to determine how many are locked up for of drug offenses. U.H. sociologist Gene Kassebaum figures that 26% are in for "drug law violations" i.e. drug-specific offenses such as selling, cultivating or manufacturing of drugs. But many others are in prison for parole or probation violations - and these offenses are usually drug-related (for "dirty" urine tests). When these violators are figured in, the estimated percentage of drug-related offenses rises to at least 35%. This does not include the many property crimes, assaults, and robberies that are committed to obtain the money to buy drugs, or because of a turf battle or a drug deal gone sour. Then there's domestic violence.
According to Billy Mills, Substance Abuse Officer for the Department of Public Safety, an estimated "80% of the general felon population needs treatment for underlying substance abuse problems" (including alcohol). So we lock up several hundred prisoners per year, almost all of them with a substance problem, and give them treatment while incarcerated. Right? Not exactly. The KASHBOX Program at Waiawa, a 9-15 month Twelve Step program like Alcoholics Anonymous, has recently been expanded to 84 beds, and will soon increase to 200. Ho'omana, a similar program at the women's facility has just 15 beds for its 6-9 month program. These are the only programs currently available to the hundreds of inmates who could use them.
Nor can every person with a history of substance abuse be helped by a Twelve Step approach. Most treatment professionals agree that a variety of approaches should be available. Despite a growing body of research showing that treatment is at least 7 times more cost effective in treating drug problems than enforcement approaches, funding for treatment in Hawai'i has been static for the past several years. At the same time, says Larry Williams, Executive Director of Salvation Army Addiction Treatment Services, demand is soaring as Hawai'i's sour economy and its stresses drives more people towards substance abuse.
Drug treatment programs here are deluged with applicants, especially for state subsidized spaces. Women's Way, the only in-patient program in the state that will take women with their children, has a waiting list of 20-40 at any time; the wait ranges from 1-3 months. The situation is even worse on the Neighbor Islands where there are very few treatment options. Methadone programs, with a 30 year successful track record of stabilizing users' lives and reducing criminal activity, are currently available only on Oahu, and in Hilo. Efforts are underway to open a facility on Maui. DOH's Alcohol and Drug Abuse Division (ADAD) estimates that there are 12,000 heroin injectors in the state, yet at any one time there are less than 500 people enrolled in methadone programs statewide.
THE THIN BLUE LINE
The police, of course, are the ones who see much of the fall-out from our drug problems. Major Ken Tano, head of HPD's Narcotics and Vice Division, believes that "the users are the victims of the whole cycle". It's those distributing drugs that he sees as the real villains. They are the ones he'd like to "put away".
Crystal methamphetamine or "ice" remains the most problematic drug in Hawai'i with an apparently constant demand. Major Tano estimates that of the 15-18 narcotics search warrants HPD serves each month, 90% of them for ice. Despite clear evidence of its harmfulness, the message is not coming across. Critics of DARE and other prevention education programs with a "no use" philosophy, are concerned that they don't distinguish enough between drugs. When they pass on harsh messages about the dangers of marijuana, which many kids view as exaggerated, it undermines their credibility when they preach against more dangerous drugs like ice or crack. Major Tano believes that one reason for ice's popularity here is that it is smoked like marijuana, a more familiar form of drug-taking and not nearly as stigmatized as injection.
THE WAR ON PAKALOLO
National drug reform organizations contend that without marijuana there could be no War on Drugs. According to the FBI, marijuana arrests have increased every year of the Clinton administration to a record high of 642,000 in 1996. NORML (The National Organization for the Reform of Marijuana Laws) notes that there has been an 80% increase in such arrests since 1990; 85% of these arrests were for simple possession. Arrests for all illicit drugs in 1996 totaled 1.5 million. In Hawai'i, as in the rest of the U.S., marijuana is by far the most widely used illicit drug. The Department of Health and Human Services estimates that nearly 70 million Americans have tried it; of these 18 million smoked it within the last year. In Hawai'i the comparable figures are 33.6% (high school students in 1993) and 28.9% (adults in 1991) for lifetime use. As for the virtually discredited "gateway" theory, the National Institute on Drug Abuse (NIDA) found that 77% of all current illicit drug users report that marijuana and hashish are the only illegal drugs they use.
Despite Hawai'i police officials' assertions that they rarely bust people for simple possession, the 652 individuals who were arrested on this charge statewide during the first six months of 1996 might disagree. A January 1997 report from the A.G. office ("Crime Trend Series") shows that arrests for marijuana possession rose 8.5% in the City and County of Honolulu from 1995 to 1996. They were up a startling 26.1% in Kauai County (although the numbers there were small), but fell in Hawai'i and Maui Counties.
Concerns about marijuana use largely drive the concerns about teen age use. While headlines scream that cocaine use among high school seniors has tripled; a closer look shows that we're talking single digit figures where one or two points can make a dramatic difference. Kids do distinguish between the risks of marijuana and those of harder drugs and their usage figures show this. The University of Michigan "Surveying the Future" report of 1996 showed 4.9 % of seniors admitting use of cocaine, and 1% using heroin while 35.8% said they'd used pot.
Many local observers -especially on the Big Island - believe it's no coincidence that the upsurge in the use of ice and crack cocaine occurred in the late 80s at the same time marijuana eradication campaigns intensified and street prices for pot soared to $7000-9000 per pound. There is a well recognized substitution effect among drug users. When their drug of choice becomes unavailable or too expensive, they switch to another substance. And if both of them happen to be smokeable...that makes the transition easier. The Big Island now has the worst social problems of any county, and the crack-down on marijuana growing has undoubtedly been a factor according to Rep. Robert Herkes and other public officials.
Not to worry though, the Hawai'i County prosecutors are on the case: on September 9th of this year, a 6 year old prosecution ended in a hung jury. The defendant was 60 year old hemp activist Aaron Anderson whose crime was ordering sterile hemp seeds from a legitimate mail order firm. During the trial Deputy Prosecutor Kay Iopa stated that she was only prosecuting the defendant because of his vocal support for marijuana law reform. The case has been beamed all over the Internet; mainlanders must be wondering if this is truly the most urgent drug problem facing our state. Needless to say, anti-marijuana hysteria in Hawai'i has pretty much doomed any rational consideration of growing hemp, its non-psychoactive relative, as a replacement crop for sugar and pineapple.
OTHER PATHS
Police Major Tano sees great promise in Hawai'i's 16th month old Drug Court Program which has just "graduated" its third class. This program, under the leadership of Judge James "Duke" Aiona, Jr., has compiled a good record for keeping its participants out of jail. Essentially the program targets non-violent drug offenders who undergo careful assessment. Those selected are offered the choice of drug court in lieu of prison. If they enter the program, they are subject to intensive monitoring, including routine drug testing and regular appearances before the court, and receive comprehensive counseling. If they are successful at staying clean and adhering to the program requirements, they graduate and their arrest is expunged from their record. To date, of 205 admissions into the program, 41 have graduated; 41 have been terminated (read: sent to prison) and the remaining 123 are still in the program which averages 14 months.
Critics of drug courts contend that they are yet another punitive, abstinence-based law enforcement approach to drug use - and this is true. Yet, even critics admit, that the individuals involved with Hawaii's program, from the judge on down, really care about the clients and bend over backwards to help them succeed.
A THIRD WAY
Opponents of current lock 'em up approaches believe we've spent enough time and money on law enforcement approaches to our drug problems. Other countries and at least one U.S. city are trying alternative approaches known as known as "harm reduction" or "medicalizing" the drug problem. These strategies employ a public health, research-based model using incremental goals. Harm reductionists assume that mind-altering substances are here to stay and, and that a realistic goal is control, not eradication. They put aside ideology and moral/religious language and focus on diminishing harms and improving the quality of life for both individuals and communities. Examples of harm reduction include drug maintenance programs, such as the heroin project recently endorsed by Swiss voters; the "cautioning" and referral system used by Liverpool police; permitting methadone to be dispensed by family physicians minus burdensome over-regulation; expansion of clean needle availability (vending machines are used in some nations: put in a dirty needle; out comes a clean one); and "low threshold" treatment programs which make it easy to get in, not hard.
.Harm reduction is sometimes called "the third way" lying between prohibition and legalization. It attempts to reduce the harms to individuals and society both from drug use AND from the fallout of our current harsh policies. In Hawai'i the rhetoric of harm reduction has made some minor inroads thanks to two successful harm reduction conferences in Honolulu. It remains controversial, however, because it doesn't view abstinence as the only desirable goal for a user; instead, harm reduction applauds any degree of positive change. Proponents, such as those in the fledgling Harm Reduction Hawai'i Project, are sometimes accused of supporting legalization of drugs. Most supporters, however, are non-idealogical, practical people, working in HIV prevention or treatment. Many of them would agree with a recent declaration published by the Federation of American Scientists (FAS) of "Practical Principles for Drug Policy". This report, with a distinguished roster of signatories, recommends a third way between prohibition and outright legalization, based on scientific knowledge, not on symbolic language or moral beliefs. They assert that open discussion is the way to start and urge all sides to refrain from name-calling and further polarizing the difficult issues surrounding drug policy.
Hawai'i's needle exchange program, in place since 1990 and regarded nationally as a model program, is a classic harm reduction program. It draws injection drug users in with the promise of sterile needles in exchange for used ones. Its clients receive health, social service and treatment referrals offered in a non-judgmental, humane and friendly manner. And its yearly evaluations indicate that is seems to be reducing the spread of HIV in Hawai'i among injection drug users - the chief aim of the program.
Hawaii's struggling economy, though, cripples innovation just as it hampers expansion or even maintenance of existing treatment or prevention programs. DOH's Alcohol and Drug Abuse Division is the "single state source" for all federal monies spent on treatment and prevention services in Hawai'i. Following the lead of the Feds, ADAD has been reluctant to embrace, or even consider, treatment or prevention approaches outside of those which are abstinence-based. Understandably, the many programs receiving funding through them are hesitant to explore alternative approaches such as harm reduction.
Public officials also remain hard to convince. In the current climate they are scared of appearing "soft on drugs" and the media is complicit in this. Mayor Harris's solution to pockets of drug dealing in Chinatown is to tear down or seize the building. Governor Cayetano after running on a platform of "no new prisons", has caved to the pressure. Our hard-line Corrections Chief Kaneshiro, through his unbending application of the law, has forced the exportation of hundreds of our prisoners - and thousands of our tax dollars - to Texas.
Other cities, most notably Baltimore, lead by innovative Mayor (and former prosecutor) Kurt Schmoke, are trying the "medicalization" approach. One upshot: billionaire and drug reform advocate George Soros just gave Baltimore $25 million to implement job training, education reforms, and drug treatment on demand. In other words, trying to address some of the underlying problems leading to drug abuse. Will this help the miserable addict waiting in the e.r.? Will it help the old man with cancer get some relief? We can only hope that Hawaii's politicians are paying attention.
Many have noted the parallels between the Vietnam War and the War on Drugs. Respected New York Times reporter James Reston hit it on the head in 1965 when he wrote that "In any war, the first casualty is common sense, and the second is free and open discussion." With Hawaii's past leadership in social programs in mind, open examination of the issue should not be too much to ask. Let us shine some light on our state's drug problems and see if there might not be some common sense solutions revealed.
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