The Quest for Drug Control: Politics and Federal Policy in a Period of Increasing Substance Abuse (1963-1981) (Hardcover)

by David F. Musto (Author), Pamela Korsmeyer (Author), David Musto (Author)
Key Phrases: narcotics control policy, drug policy office, opium ban, White House, United States, Drug Abuse (more...)

Editorial Reviews

From The New England Journal of Medicine
Musto and Korsmeyer have written a valuable, albeit somewhat problematic, account of how U.S. policymakers responded as an unprecedented flood of drug abuse inundated the country. The authors outline well the essential themes that permeated debates over how to react to the massive surge in drug use. The policy clashes detailed in the book turned on fundamental questions of value that became polarized when broached in a political context. Should society accept a certain level of drug abuse (thereby implying a tolerance for illicit activity) or, alternatively, should it espouse the elimination of illicit-drug use altogether (even if complete realization of that goal is not feasible)? Should illicit-drug use be criminalized or medicalized? How does an open society balance civil liberties, public health, and the rule of law when considering such a complex, inflammatory issue? Which branches of government should assume primary responsibility for dealing with the "drug problem," and who decides how to define that problem? Perhaps most important for the central actors in this drama, what is the politically feasible course to take? The authors rightly point out that such calculations are made with an eye to the ramifications on one's prospects for reelection or bureaucratic advancement. Within a straightforward chronologic narrative, Musto and Korsmeyer offer a variety of useful insights and interpretations. During the 1960s and 1970s, four successive presidential administrations attempted to foster a holistic approach to drug policy by implementing a three-pronged response: proffer domestic legislative reform that recognizes both the criminal and medical aspects of drug abuse; pursue diplomatic initiatives to curb the flow of illicit supplies from overseas; and reorganize and rationalize the federal bureaucracy to implement drug policy. Yet those plans repeatedly ran afoul of myriad complexities. The federal bureaucracy could not overcome internal dissension. What often appeared as turf battles resulted from administrators' differing answers to the fundamental questions. The moving target of the drug problem (with a focus that shifted often, primarily among heroin, lysergic acid diethylamide, marijuana, and cocaine), as well as users' polypharmaceutical propensities, caused policymakers to play catch-up repeatedly. Gauging public opinion about what initiatives to pursue also proved difficult. At times it appeared that there was support for methadone maintenance, marijuana decriminalization, or interdiction at the border, but that support often evaporated when put to the test. Perhaps most provocative is the authors' interpretation of the drug-control policies of the Nixon administration, which receives due credit for implementing the first well-rounded federal approach to the drug question, one that featured prevention and treatment initiatives to complement the traditional approach of control of supply and criminalization. Musto and Korsmeyer note, however, that the Nixon team viewed its actions from a purely law-enforcement perspective: curing addicts would reduce crime, thereby enhancing prospects for victory in the 1972 elections. The Quest for Drug Control points out that policymakers, regardless of political party, repeatedly eschewed nuanced, thoughtful approaches in favor of simpler, cause-and-effect "solutions" intended to impress upon voters that the government was doing something. Certain limitations permeate the book. It is a top-down history, viewed primarily from the perspective of White House staffers and executive branch officials vying for the President's ear. The authors recognize that the available sources (primarily public documents in addition to papers from presidential libraries) render an incomplete view of the workings of government. More vexing, however, is the half-digested nature of the narrative. A large proportion of the book is given over to quotations taken directly from primary documents. The authors' commendable desire to represent the record accurately nevertheless renders it difficult to divine the significance of multiple twists in policy recommendations, proffered by a parade of figures and emanating from an alphabet soup of agencies. At times, the book loses track of important issues amid the Byzantine maneuvering. For example, readers discover much about the debates concerning criminal penalties in the landmark Comprehensive Drug Abuse Prevention and Control Act of 1970 but may find themselves unclear about what provisions were included in the final version. The book also largely neglects the implementation of policies and legislation. Instead, the narrative often moves directly to the next attempt at bureaucratic reorganization or reshuffling of priorities. Finally, as with many works in this genre, the authors do not define terms such as "drugs" or "abuse" and therefore remain within the self-referential world view of the policymakers they study. Officials have often turned a blind eye to multiple aspects of the problem (such as burgeoning problems with central nervous system stimulants and depressants that remained little recognized for decades). The analytic power of the book would have been enhanced by consideration of relevant factors that failed to register with the policy-making apparatus and by explanations of why such oversights occurred. The book leaves the reader with much to ponder. Why have policymakers turned repeatedly to solutions that failed their predecessors? Considering the political realities so expertly outlined by Musto and Korsmeyer, what politically realistic alternatives could politicians and their advisers enact? Why respond with massive programs whose efficacy cannot be evaluated if, as the narrative suggests, drug abuse undulates largely independently of governmental action? Such musings provide a measure of the success of The Quest for Drug Control: readers are likely to find themselves both informed and baffled by the complexities that surround this perplexing issue. William B. McAllister, Ph.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review
This eye-opening, factual story is for readers who will appreciate history and detail about how drug policy is created. -- (Choice)

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Product Details

• Hardcover: 256 pages
• Publisher: Yale University Press (July 1, 2002)
• Language: English
• ISBN-10: 0300090366
• ISBN-13: 978-0300090369
• Product Dimensions: 9.6 x 6.4 x 1 inches
• Shipping Weight: 1.4 pounds (View shipping rates and policies)
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• Amazon.com Sales Rank: #421,975 in Books (See Bestsellers in Books)