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96 Foreign Aff. 130 (2017)
High Stakes: The Future of U.S. Drug Policy

handle is hein.journals/fora96 and id is 374 raw text is: 





High Stakes


The Future of U.S. Drug Policy

Mark A. R. Kleiman

   any people enjoy the psychological effects of various   chemi-

           cals. Any chemical can have unwanted side effects, especially
           when used often, in high doses, or in combination. There is
always the risk that a user will lose control over his or her consumption,
using too much or too often.
   The likelihood of developing what is now called substance use dis-
order varies by person and by drug; except in the case of nicotine, the
victims of this disorder are generally a small minority among users.
Most  people unfortunate enough  to develop a drug problem recover
without formal intervention, although recovery typically comes after
some  struggle and several failed attempts.
   But an even smaller minority faces graver problems. Their attempts
to cut back fail because of withdrawal symptoms or persistent cravings;
they have become addicted. Addicts, although relatively few in number,
account for most of the damage done by drugs.
   Some  potentially habit-forming  chemicals-including   the two
biggest killers, alcohol and tobacco-are legal to use and sell. Others
are illegal or restricted to medical use by prescription. This tends to
reduce the number  of people who develop drug problems, but it also
worsens the problems  of those who do develop them. Making  a drug
illegal creates illicit markets and the need for enforcement, and can
lead to violence.
   The United  States has a variety of legal and illegal drug markets,
and more  than its share of the evils of addiction, illicit trafficking,
and  drug-related incarceration. Two of those  markets-those   for
MARK  A. R. KLEIMAN is Professor of Public Policy and Director of the Crime and Justice
Program at New York University's Marron Institute of Urban Management. He is the author
(with Jonathan Caulkins and Beau Kilmer) of Marijuana Legalization: What Everyone Needs
to Know. He is also Chair of BOTEC Analysis, a consultancy with clients that include the
Washington State Liquor and Cannabis Board. Follow him on Twitter @MarkARKleiman.


130   FOREIGN  AFFAIRS

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