Harry G. Levine and Craig Reinarman (2004), Alcohol prohibition and drug prohibition. Lessons from alcohol policy for drug policy. Amsterdam: CEDRO.
© Copyright 2004 Harry G. Levine & Craig Reinarman. All rights reserved.


Alcohol Prohibition and Drug Prohibition

Lessons from Alcohol Policy for Drug Policy

Harry G. Levine and Craig Reinarman

Since the mid 1980s, growing numbers of Americans have come to recognize the harshness, expense, and ineffectiveness of U.S. drug prohibition, and they have advocated alternative approaches including harm reduction, drug decriminalization and even outright drug legalization. They have also looked for lessons in America 's own experiences with alcohol prohibition, and with how the U.S. turned from nation-wide alcohol prohibition to various forms of local alcohol regulation.

In the first part of this essay we review the rise, effects and fall of national alcohol prohibition in the U.S. , and we examine the rationale and organization of the system of alcohol regulation instituted after repeal. We focus on lessons from the American experience with alcohol prohibition and alcohol regulation that might be useful for understanding drug prohibition and drug regulation.

In the second part, we discuss the current world-wide system of drug prohibition. We focus on three crises or dilemmas that global drug prohibition now faces: the international harm reduction movement; the growing opposition, especially in Europe , to harsh drug policies; and the unstoppable use of cannabis throughout the world.

Historical studies cannot provide simple and straightforward answers to the complex drug policy questions now confronting Americans. However, closer attention to the history of alcohol prohibition and regulation, and to the character and scope of global drug prohibition, can help us better understand the situation we face in the early twenty-first century and help move us to less costly and more humane and effective drug policies.

From temperance to prohibition to alcohol control

The anti-alcohol (or temperance) movement was created in early nineteenth century America by physicians, ministers, and large employers concerned about the drunkenness of workers and servants. By the mid-1830s temperance had become a mass movement of the middle class. Temperance was not, as is sometimes thought, the campaign of rural backwaters; rather, temperance was on the cutting edge of social reform and was closely allied with the anti-slavery and women's rights movements. Always very popular, the anti-alcohol crusade remained largest enduring middle-class movement of the nineteenth century. (Levine, 1978, 1984; Tyrell, 1979; Gusfield, 1986; Rumbarger 1989; Blocker 1989).

The anti-alcohol movement was devoted to convincing people that alcoholic drink in any form was dangerous and destructive. Throughout the nineteenth century, temperance supporters insisted that alcohol slowly but inevitably destroyed the moral character and the physical and mental health of all who drank it. Temperance supporters regarded alcohol the way people today view heroin: as an inherently addicting substance. Moderate consumption of alcohol, they maintained, naturally led to compulsive use--to addiction.

From the beginning, temperance ideology contained a powerful strand of fantasy. It held that alcohol was the major cause of nearly all social problems: unemployment, poverty, business failure, slums, insanity, crime, and violence (especially against women and children). For the very real social and economic problems of industrializing America , the anti-alcohol movement offered universal abstinence as the panacea.

From roughly the 1850s on, many temperance supporters endorsed the idea of prohibition. After the Civil War the Prohibition Party, modeled on the Republican Party, championed the cause. Nineteenth-century prohibitionists believed that only when sufficient numbers of their party members held office would prohibition be practical, because only then would it be fully enforced.

In the twentieth century a new prohibitionist organization -- the Anti-Saloon League -- came to dominate the movement (Odegard, 1928; Timberlake, 1963; Sinclair, 1965; Gusfield, 1968; Kerr, 1985; Rumbarger, 1989). The League patterned itself on the modern corporation, hiring lawyers to write model laws and organizers to raise funds and collect political debts. The League put its considerable resources behind candidates of any party who would vote as it directed on the single issue of liquor. By expanding the numbers of elected officials beholden to it, and by writing laws for those legislators to enact, the League pushed through many local prohibition laws and some state measures. In 1913 the League finally declared itself in favor of constitutional prohibition. Increasing numbers of large corporations joined the many Protestant churches that had long supported the League. Prohibitionists mobilized the final support for prohibition during the hyper patriotic fervor of the first world war.

By December 1917, both houses of Congress had voted the required two-thirds majority to send to the states for ratification a constitutional amendment prohibiting the manufacture, sale, transportation, import, or export of intoxicating liquor. In November 1918 Congress passed the War Prohibition Act banning the manufacture and sale of all beverages with more than 2.75 percent alcohol. On January 16th, 1919 , Nebraska became the thirty-sixth state to ratify the Eighteenth Amendment, which was to go into effect in one year. In October 1919 Congress overrode President Wilson's veto to pass a strict prohibition enforcement act known by the name of its sponsor, Andrew Volstead of Minnesota , chair of the House Judiciary Committee. The Volstead Act defined as "intoxicating liquor" any beverage containing more 0.5% alcohol.

At midnight on January 16, 1920 , the Eighteenth Amendment took effect. The famous minister Billy Sunday celebrated by preaching a sermon to 10,000 people in which he repeated the fantasy at the heart of the temperance and prohibition crusades:

The reign of tears is over. The slums will soon be a memory. We will turn our prisons into factories and our jails into storehouses and corncribs. Men will walk upright now, women will smile, and the children will laugh. Hell will be forever for rent. (quoted in Kohler, 1973, 12)

Prohibitionism was not, as is sometimes implied, a public health campaign to reduce mortality from cirrhosis of the liver or alcoholic admissions to state hospitals. As Joseph Gusfield (1968) has pointed out, prohibitionists were utopian moralists; they believed that eliminating the legal manufacture and sale of alcoholic drink would solve the major social and economic problems of American society.

National Alcohol Prohibition, 1920-1933

The many literary, photographic, and cinematic images of the prohibition era capture some of the essential features of the period. Prohibition was massively and openly violated, and alcohol was readily available in most of the United States . New institutions and cultural practices appeared: bootleggers and speakeasies, hip flasks and bathtub gin, rum runners smuggling in liquor, and prohibition agents like Elliott Ness smashing down doors. Adulterated and even poisonous alcohol was sold and many people were locked up for violating prohibition laws. (For rich descriptions of the prohibition era, see Allen 1931; Lyle 1960; Allsop 1961; Sinclair, 1964; Mertz, 1970; Kohler, 1973; Everest, 1978; and Cashman 1981. Burnham, 1968 offers perhaps the only serious scholarly case for the success of prohibition. For the most recent evidence and discussions of its failures, see Miron and Zwiebel, 1991; Morgan, 1991; and Thornton 1991.)

Public opposition to prohibition began even before the Volstead Act passed, especially among labor unions, but organized opposition remained small and fragmented until 1926. Then one organization, the Association Against the Prohibition Amendment (AAPA), took over the campaign for repeal. Headed by Pierre DuPont and other powerful corporate leaders, the AAPA gathered increasing numbers of wealthy and prominent supporters, including many former prohibitionists. Although prohibition would have been repealed eventually, the AAPA unquestionably accelerated the process (Kyvig, 1979; Levine, 1985; Rumbarger, 1989).

Just as World War I had provided the necessary context for rallying popular support to pass prohibition, the Great Depression provided the necessary context for repeal. Prohibition's supporters had long argued that banning alcohol would ensure prosperity and increase law and order. In the late 1920s and early 1930s, prohibition's opponents made exactly the same argument. Repeal, they promised, would provide jobs, stimulate the economy, increase tax revenue, and reduce the "lawlessness" stimulated by and characteristic of the illegal liquor industry.

The Depression also played a crucial role in undermining elite support for prohibition. To some extent, alcohol prohibition had originally gained the support of large employers because they believed it would increase worker discipline and productivity and reduce other social problems. The mass violations of national prohibition in the 1920s, followed by the economic depression of the 1930s, raised a new specter: prohibition, many came to believe, undermined respect for all law, including property law. This "lawlessness," as people then termed it, frightened many of the rich and powerful, like Pierre DuPont and John D. Rockefeller, Jr. far more than problems with worker efficiency (Leuchtenburg, 1958; Kyvig, 1979; Levine, 1985). In addition, in the early 1930s the threat of revolt and revolution was in the air. There were food riots in many cities, unemployed people formed militant organizations, mobs stopped trains and took over warehouses of food. Socialists and communists held rallies of tens of thousands, angry armies of marchers camped in front of the White House, and some wealthy people had machine guns mounted on the roofs of their estates (Leuchtenburg, 1958; Piven and Cloward, 1971, 1977; Manchester, 1974).

Those with wealth and power increasingly supported repeal, in part because they felt the need to do something to raise public morale and show that the government was in some way responsive to popular pressure in a terrible depression. In 1931, Matthew Woll, vice-president of the American Federation of Labor and the sole labor member of the AAPA board, told President Hoover's National Commission on Law Observance and Enforcement (the Wickersham Commission) that workers were losing faith in the government's willingness to help them, and that prohibition was causing them further to distrust and resent government. By 1932 a number of influential leaders and commentators also had concluded that legalizing beer would make workers feel better about government and take their minds off their troubles. Senators were told, "Beer would have a decidedly soothing tendency on the present mental attitude of the working men.... It would do a great deal to change their mental attitude on economic conditions." Walter Lippman argued, "Beer would be a great help in fighting off the mental depression which afflicts great multitudes" (quotes from Gordon, 1943, 104). The Wickersham Commission explicitly pointed to the class resentment and lawlessness engendered by prohibition in its report to Congress:

Naturally ... laboring men resent the insistence of employers who drink that their employees be kept from temptation. Thus the law may be made to appear aimed at and enforced against the insignificant while the wealthy enjoy immunity. This feeling is reinforced when it is seen that the wealthy are generally able to procure pure liquors, while those with less means may run the risk of poisoning. Moreover, searches of homes ... have necessarily seemed to bear more upon people of moderate means than upon those of wealth or influence. (1931, 54-5)

On November 16, 1932 , the Senate voted to submit the Twenty-first Amendment to the states for ratification. It would repeal the Eighteenth Amendment and return to the states the power to regulate alcohol. On March 13, 1933 , a few days after he was sworn in as president, Franklin Roosevelt asked Congress to modify the Volstead Act to legalize 3.2 percent alcohol beer to provide needed tax revenue. By April 7, beer was legal in most of the country. On December 5, 1933 , Utah became the thirty-sixth state to ratify the Twenty-first Amendment. National alcohol prohibition was repealed, effective immediately.

In late 1933 and in 1934, bills creating state alcohol control agencies sped through state legislatures. The model for most of the legislation had been written by a group of policy-oriented researchers and attorneys associated with John D. Rockefeller, Jr., and with policy institutes he had created or financially supported (Levine 1985). Within two years of repeal nearly every state had an agency to supervise the sale and distribution of alcoholic beverages, and alcohol had ceased to be a controversial and politically charged issue. The production, sale, and distribution of alcoholic beverages today is still largely governed by the alcohol control structures designed and implemented at that time.

Effects of Prohibition on Consumption and Public Health

It has frequently been observed that drug prohibition tends to drive out the weaker and milder forms of drugs, and to increase the availability and use of stronger and more dangerous drugs (see, e.g., Brecher, 1972). This has been so often reported that many analysts speak of it as an "iron law" of drug prohibition. This "law" holds because milder drugs are usually bulkier, harder to hide and smuggle, and less remunerative. People involved in the illicit drug business therefore frequently find it in their interest to do business in the more compact and potent substances. For example, current interdiction efforts are most successful at capturing boats carrying many large bales of marijuana; therefore, many drug smugglers have turned to smuggling cocaine or heroin because it is easier and far more lucrative than smuggling marijuana. (see Murphy, Waldorf, and Reinarman, 1991).

This "law" of drug prohibition captures what happened during alcohol prohibition. The major effect of the Eighteenth Amendment was to dramatically reduce beer drinking (and therefore total alcohol consumption). At the same time, prohibition increased consumption of hard liquor (especially among the middle class). The fashionableness of the martini and other mixed drinks among the middle class is in part a historical legacy of prohibition, when criminalization made hard liquor the most available form of beverage alcohol.

From 1890 to 1915, beer accounted for more of the total alcohol consumed than did hard liquor. In 1915, for example, beer drinking accounted for nearly twice the total alcohol consumed as spirits did. Warburton compared alcohol consumption in the period of 1911 to 1914 with that during the prohibition years 1927-1930 and concluded that "the per capita consumption of beer has been reduced about 70 per cent....the per capita consumption of wine has increased about 65 per cent...[and] the per capita consumption of spirits has increased about 10 per cent" (Warburton, 1932, p. 260). This change was not permanent -- after repeal, spirits consumption fell while beer consumption rose. By 1935 the alcohol consumed from beer equaled that from spirits, and by 1945 Americans were getting 50 percent more of their total alcohol from beer than from hard liquor (Levine and Reinarman, 1993, 1998; Rorabaugh,1979; Miron and Zwiebel, 1991).

The recent public debate about drug laws has increased interest in the effects of prohibition on public health, the economy, and social problems. These were very lively questions during the prohibition period but have been largely ignored since. However, in the last two decades alcohol researchers in a number of countries have investigated at length the relationship between total per capita alcohol consumption and specific illnesses, especially cirrhosis of the liver. The data available for the prohibition years in the United States will always be poor because it is impossible to get accurate consumption figures for an illegal substance. However, changes over many decades in countries that have kept accurate consumption and health statistics do allow some inferences about the relationship between overall alcohol consumption and liver cirrhosis. Although not all liver cirrhosis is caused by heavy drinking, much is. Furthermore, cirrhosis rates generally follow overall per capita consumption rates. These effects are mediated by dietary patterns, by type of alcoholic beverages consumed, and by when they are consumed. The level of health care people receive also affects cirrhosis death rates. In general, however, the positive relationship between alcohol consumption and cirrhosis holds: when consumption increases, liver cirrhosis increases (Bruun et al., 1975; Mäkelaä et al., 1981; Moore and Gerstein, 1981; Single et al. 1981).

One important way to evaluate the public health consequences of alcohol policies, then, is in terms of how they affect consumption. In 1932 Warburton pointed out that "except for the first three years, the per capita consumption of alcohol has been greater under prohibition than during the war period [1917-1919], with high taxation and restricted production and sale" (260). Both prohibition and post-prohibition alcohol regulation kept overall consumption down compared with the decades prior to prohibition Indeed, post-prohibition regulatory policies kept alcohol use sufficiently low that it was not until the end of the 1960s, 35 years after repeal, that per capita alcohol consumption rose to the levels of 1915 (Levine and Reinarman, 1993, 1998). Whatever public health benefits prohibition achieved in terms of reducing consumption, alcohol regulation in the 1930s and early 1940s accomplished them as well. Further, this occurred despite the fact that the post-prohibition regulatory system had little or no public health focus, and despite the fact that the liquor industry (like most other U.S. industries) gained increasing influence over the agencies that were supposed to regulate it. In short, alcohol control worked almost as well as prohibition in limiting alcohol consumption, and more effectively than pre-prohibition policies.

It is also important to note that other nations achieved even greater reductions in per capita consumption than the United States -- without the negative consequences of prohibition. Robin Room (1988) says that in Australia a series of alcohol control measures instituted in the early twentieth century substantially reduced spirits consumption. More important, Australia 's regulatory policies significantly reduced total alcohol consumption as well as the incidence of alcohol-related health problems, notably cirrhosis mortality and alcoholic psychosis. All of this happened under regulated sale, not prohibition.

Great Britain 's experience parallels that of Australia . England reduced overall consumption by instituting fairly stringent alcohol regulation at about the same time as the United States instituted prohibition. Moreover, as Nadelmann notes, it reduced "the negative consequences of alcohol consumption more effectively than did the United States , but it did so in a manner that raised substantial government revenues." By contrast, the U.S. government not only spent large sums attempting to enforce its prohibition laws, but it was also unable to prevent the flow of money into criminal enterprises (1989b, 1102-3).

As Nadelmann's puts it, "British experience [and the Australian experience] strongly indicates that the national prohibition of alcohol in the United States was, on balance, not successful." Prohibition of course failed to fulfill the fantasies of prohibitionists about eliminating major social problems like poverty, unemployment, crime, and so on. Yet even in the less utopian terms of reducing total alcohol consumption, U.S. prohibition was no more effective than regulated sale in the 1930s and early 1940s. Prohibition, however, produced far more substantial negative side effects than did regulation.

Few other nations had local alcohol prohibition laws, and only Finland instituted constitutional prohibition (repealing it before the United States and for many of the same reasons). Although there are today movements in some Nordic and English-speaking counties ( Canada , Australia , New Zealand , Great Britain ) focusing on the public health dangers of alcohol, these are not prohibitionist groups. In the United States , even many local prohibition laws have been replaced by regulation of some kind. Long after repeal, the consensus remains that national alcohol prohibition was bad public policy.

Alcohol Production and Distribution During Prohibition

During constitutional alcohol prohibition, consumption was shaped by the requirements of illicit production. It was much more profitable and cost effective to make and distribute distilled spirits (gin, vodka, whiskey, or rum) than beer. Beer is mostly water -- only 3 to 6 percent alcohol. Production and storage of beer require enormous tanks, many barrels, huge trucks, and a substantial investment in equipment. Hard liquor is 40 to 50 percent alcohol; it contains up to 15 times more pure alcohol than beer. Because alcohol content was the main determinant of price, spirits were much more valuable than beer and also could be hidden and transported more easily. Furthermore, spirits could be preserved indefinitely, whereas beer spoiled very quickly. Large-scale beer bottling and refrigeration only developed in the 1930s, after repeal (Baron 1962; Kyvig 1979).

The rising supply of hard liquor came from many sources. Tens of thousands of people produced it in small, compact stills in sheds, basements, attics, and in the woods. It was also smuggled from Canada , Mexico and Europe . Some of the largest names in distilling today entered the business or grew wealthy during the prohibition era -- notably the Bronfmans of Canada, who owned Seagrams. A considerable amount of alcohol was also diverted from purported industrial or medical uses (Baum, 2004).

Wine consumption also increased during prohibition, to about 65 per cent more than the pre-World War I period, according to Warburton (1932). Standard table wine contains 10 to 14 percent alcohol. Much of the wine was made for personal consumption and as a profitable side-business by immigrants from wine countries, especially Italy . After the first few years of prohibition, the California wine-grape industry experienced a boom and vineyard prices increased substantially. California grape growers planted hearty, thick-skinned grapes that could be shipped easily and used for small-scale and home wine making. Much of the California wine-grape crop was shipped to Chicago and New York in newly developed refrigerated boxcars. The grapes were bought right off the train by wholesalers, who resold them in immigrant neighborhoods. The home-made wine was then distributed to smaller cities and towns. (Muscatine, Amerine, and Thompson 1984).

Although it is true that prohibition provided a major boost for organized crime, it is not true (although widely believed today) that gangsters and large criminal organizations supplied most prohibition-era alcohol. In Chicago and a few other large cities, large criminal gangs indeed dominated alcohol distribution, especially by the end of the 1920s.

Most of the alcohol production and distribution, however, was on a smaller scale. In addition to home-made wines and family stills, people drive cars and trucks to Canada and returned with a load of liquor. Fishing boats and pleasure boats did the same. Spirits and wine were also prescribed by physicians and available at pharmacies. Many people certified themselves as ministers and rabbis and distributed large quantities of "sacramental wine." Alcoholic beverages were made and sold to supplement other income during hard times. Prohibition thus shaped the structure of the alcohol industry in a distinctive way: it decentralized and democratized production and distribution (Lyle, 1960; Allsop, 1961; Sinclair, 1965; Everest, 1978; Cashman, 1981).

Today as well, most people in the illicit drug business are small-scale entrepreneurs. Supporters of the drug war frequently suggest that elimination of the currently large-scale producers and distributors would have a lasting effect on drug production and distribution. There is no more evidence supporting this now than there was during alcohol prohibition. Much illicit drug production today is also decentralized and democratized. There is no criminal syndicate that, when eliminated, would stop the distribution of any currently illicit drug, or even reduce the supply for very long. Today some groups, families, and business organizations (like the so-called Medellin cocaine cartel) have grown very rich in the illicit drug business. However, just as Al Capone was quickly replaced, so have new producers taken the place of those cocaine "king-pins" who have been arrested. Indeed, after billions of dollars on interdiction have been spent by Customs, the Drug Enforcement Agency, and even the Armed Forces, both heroin and cocaine are more plentiful, cheaper and purer than they were in the 1970s. Even when interdiction does affect the supply of a criminalized substance, the effects are often ironic. The partial success of the Nixon administration's "Operation Intercept," for example, gave rise to what is now a huge domestic marijuana industry (Brecher, 1972) that has become ever more decentralized and democratic as armed helicopter raids have increased.

In short, whereas prohibition regimes tend to be a boon to organized crime, they also increase the number and types of people involved in illicit production and distribution (Williams 1989; Murphy, Waldorf, and Reinarman 1991). Whether production occurs in a mob syndicate or a family marijuana patch, the result tends to be a shift toward production and sale of more concentrated forms of intoxicating substances. Recognition of such tendencies in the prohibition era accelerated the process of repeal and informed the search for alternative regulatory systems.

Establishing an Alcohol Control System

In 1933, at the very end of constitutional prohibition, the difficulties of creating an alcohol control system seemed formidable. In the years before constitutional prohibition in the United States , there had been little systematic control of the alcohol industry. The Eighteenth Amendment had not eliminated the business, but rather had profoundly altered its shape. In 1933 a sprawling illegal industry for producing and distributing alcoholic beverages was in place, composed of uncountable numbers of small independent distributors and producers, and some larger ones. For 14 years this industry had kept the United States well supplied with alcohol. The mass patronage of this illicit industry -- and the political and economic implications of such a popular display of disrespect for law -- was a major factor in convincing Rockefeller and other prominent supporters of prohibition to reverse field and press for repeal.

During prohibition the liquor business was wide open. In most cities and many towns, speakeasies closed when they wished or not at all; they sold whatever they wanted, to whomever they cared to, at whatever price they chose. They decorated as they wished and had a free hand in providing food and entertainment. Producers completely controlled alcohol production, used whatever ingredients they wished and manufactured alcohol of whatever strength they wished. Neither producers nor distributors paid any taxes (except for payoffs to police and politicians) and they were not regulated by any government agency. During prohibition, the liquor industry was probably the freest large industry in America .

Alcohol control, on the other hand was premised on government intervention into every aspect of the liquor business. Controversial issues such as whether food must be served, women admitted, music and games banned, bars and bar stools allowed, all had to be settled. The number, types, and locations of on- and off-premises outlets and their hours of sale had to be determined. Producers had to be regulated to ensure that products were safe and of a uniform alcohol content. In order to eliminate untrustworthy or disreputable persons, both producers and distributors had to be screened, licensed, and made to pay taxes. Legal drinking had to be socially organized in a way that would not be an affront to the abstaining half of the population. Conversely, the control system could not make regulation so tight, or taxes so high, that drinkers would prefer to patronize illicit bootleggers or speakeasies. Americans, after all, were by then quite used to disobeying liquor laws.

Prohibitionists had always argued that the liquor business was inherently unregulatable. The onus was now on reformers to show that this was not true and that they could create structures to make the industry obey laws and yield taxes. The task, as expressed in the catchall title for alternatives to prohibition, was "liquor control" or "alcohol control" in the fullest sense of the term. In short, repeal posed an enormous problem of social engineering. Constructing alcohol control involved problems of government regulation so large and complex as to make some of the classic Progressive-era reforms -- regulating meat packing, for example -- seem paltry. Except for national prohibition, post-repeal alcohol regulation is probably the most striking twentieth-century example of government power used to directly reshape both an entire industry and the conditions under which its product are consumed.

The Rockefeller Report

Prior to the passage of the Eighteenth Amendment, alcohol was regulated by cities, towns, and sometimes counties. State governments were rarely involved in regulating production or distribution. Prohibition then shifted control to the federal government. Post-repeal policy, however, made state governments chiefly responsible for devising and implementing a regulatory system. States could, and often did, then allow for considerable local option and variation.

By the end of the 1920s, the Association Against the Prohibition Amendment had outlined some rough plans for alternatives to prohibition, but they had not been well worked out. The central principles of post-prohibition alcohol control systems adopted by almost every state legislature were first fully laid out in a report sponsored by John D. Rockefeller, Jr. and issued in October 1933, shortly before repeal was ratified. Rockefeller's long-time adviser, Raymond Fosdick, was the senior author. Fosdick supervised the group of attorneys and policy analysts, most of whom worked with or for the Institute of Public Administration -- a Progressive Era policy institute in New York that Rockefeller had funded for a number of years. The report was issued in press releases to newspapers and magazines over several weeks. Finally the Rockefeller Report (as it was called at the time) was released as a book, Toward Liquor Control by Raymond Fosdick and Albert Scott.

Although few at the time recognized it, Toward Liquor Control had taken as its basic conclusions virtually all of the central recommendations made 30 years earlier by another elite-sponsored alcohol policy group called the Committee of Fifty. The Committee of Fifty, which was generally opposed to alcohol prohibition, had produced five books on various aspects of the "alcohol problem" around the turn of the century. Fosdick and the other study members had read the Committee of Fifty's reports and quoted them on the corruption and lawlessness resulting from earlier forms of local prohibition. The Rockefeller Report echoed the Committee of Fifty's conclusion that the legitimacy of the law must be of primary concern in liquor regulation. Both reports agreed that the specific content of the law mattered less than that the laws be obeyed. Both reports argued that alcohol regulation required a flexible system that could be continually monitored and adjusted. Further, both reports advised that, if possible, government should take over the selling of alcoholic beverages (Billings 1905; Levine 1983; Rumbarger, 1989).

The specific plan for alcohol control suggested by Toward Liquor Control, and the Rockefeller Report's most controversial proposal, was that each state take over as a public monopoly the retail sale for off-premises consumption of spirits, wine, and beer above 3.2 percent alcohol. As Fosdick and Scott explained: "The primary task of the [State Alcohol] Authority would be the establishment of a chain of its own retail stores for the sale of the heavier alcoholic beverages by package only." This is the source of the term "package stores" still used today for liquor outlets in many states where people buy alcohol beverages in a bottle to be consumed off premises. The state-run outlets of Canadian provinces, and of Sweden , Norway , and Finland , were cited as working examples of such a plan. This quickly became known as the "monopoly plan" and at the time was usually called "the Rockefeller plan."

For those states not willing to establish government liquor stores, Fosdick and Scott proposed an alternative system: "regulation by license." They cited England as the best example of a working license system. A nonpartisan board appointed by the governor would have statewide authority to issue liquor licenses and regulate the industry. "Tied houses" would not be permitted -- that is, no retail establishments could be owned directly by or under exclusive contract to a distiller or brewer.

Although it offered guidelines for a licensing system, Toward Liquor Control favored the monopoly plan. The possibility of increasing profits, they said, would encourage private businesses to sell more alcohol, to buy political influence and lax enforcement, and to violate laws. Rockefeller explained the chief advantage of government-owned liquor stores in his foreword to the book: "Only as the profit motive is eliminated is there any hope of controlling the liquor traffic in the interests of a decent society. To approach the problem from any other angle is only to tinker with it and to ensure failure." The irony of a Rockefeller warning about the dangers of the profit motive was not lost on observers in 1933. Like others at the time, Rockefeller had concluded, probably correctly, that government ownership brought greater powers than licensed businesses to regulate and control behavior, and ensure obedience to the law.

For both the licensing plan and the monoply plan, Toward Liquor Control outlined a detailed set of matters over which the state agency would have jurisdiction. These included the power to acquire real estate and other capital by purchase, lease, or condemnation; determine and change prices at will; establish a system of personal identification of purchasers; issue permits for and regulate the use of beer and wine for off-premises consumption and for on-premises consumption in hotels, restaurants, clubs, railway dining cars, and passenger boats; require alcohol manufacturers and importers to report on quantities produced and shipped; regulate or eliminate alcohol beverage advertising; determine the internal design, visibility from the street, hours and days of sale, number and locations of alcohol outlets.

In January 1934, a model law based on the guidelines of Toward Liquor Control and written by the staff of the Institute for Public Administration was published as a supplement to the National Municipal Review. The Review was the official journal of the National Municipal League, another Progressive Era policy organization supported by the Rockefellers. The model law and other supporting documents were widely circulated to legislators throughout the country in the months following repeal. State legislators, faced with difficult political choices, and with little personal expertise in the complexities of liquor regulation, turned to the authoritative and virtually unchallenged plans of the Rockefeller commission and the National Municipal League. In a letter in the Rockefeller Archives, one of the model law's authors estimated that the monopoly law was taken almost verbatim by 15 states, and the licensing law served as the text or draft for many more (Gulick, 1977; Levine, 1985).

Alcohol Control in Operation

Post-repeal regulation transformed the alcohol beverage industry. Finland , the only other nation to have experimented with constitutional prohibition, had nationalized production of spirits. However, such proposals were not seriously discussed in the United States . Instead, production took the form of an oligopoly of relatively few corporations. By the end of the 1930s, about 80 percent of all distilled liquor made in the United States was manufactured by four corporations. The beer industry, although more diverse nationally because beer required quick and local distribution, was monopolized by region or area. Regulatory agencies preferred to deal with a few large corporations -- they were easier to police and to make agreements with, and more likely to be concerned with keeping the image of the industry clean and respectable. This pattern of monopolization was not unique of course; most major American industries -- steel, automobiles, soft drinks, chemicals, for example -- were increasingly dominated by a few large corporations. (From at least the time of the National Recovery Act at the start of the New Deal, federal government policy often encouraged such concentration. The alcohol industry was exceptional only in how quickly many small producers were overtaken by a few dominant ones.)

Although production became oligopolistic, distribution was splintered and scattered. Perhaps the most important long-term innovation in post-prohibition alcohol regulation was that it permitted the legal sale of alcohol at a wide variety of sites. Before prohibition, the saloon had been a single, all-purpose institution -- there one drank beer, wine, or spirits, and there one purchased for off-premises consumption a bottle of spirits or a bucket of beer. After repeal, alcohol control created several different types of establishments to sell alcoholic beverages. In most states special stores were designated for selling distilled liquor and wine -- often they could not sell any food at all, or even cigarettes. Beer, on the other hand, was made relatively widely available in bottles and cans -- with grocery stores and small markets licensed to sell it. In other words, after prohibition, sale of bottled alcohol was increasingly separated from the public drinking place. This encouraged the privatization of drinking. Whether alone or with others, drinking became something more commonly done at home -- where, it should be noted, drinking patterns were often moderated by family norms (see Zinberg 1984). By 1941, off-premises consumption accounted for the majority of alcohol sales (Harrison and Laine 1936; Kyvig 1979, 189).

The character of public drinking was significantly altered by these regulatory changes. A new class of licenses for on-premises consumption of beer only, or of beer and wine, was established and liberally issued to restaurants and cafeterias where eating moderated the character and effects of drinking. This separated the barroom selling distilled liquor and beer as a distinct institution. Many state alcohol control laws made provision for a local option whereby a county government could prohibit specific kinds of liquor selling within its borders. This option has been widely exercised. As late as 1973, of the 3,073 counties in the United States, 672 prohibited sales of distilled liquor by the drink for on-premises consumption, and 545 totally prohibited sales of distilled spirits (Alcohol Beverage Control Administration 1973).

Under alcohol control, all establishments licensed for on-premises consumption of spirits were specifically restricted in ways that shaped the cultural practice of drinking. In some areas, control laws attempted to moderate the effects of drinking by encouraging food consumption. For example, spirit sales often were limited to bona fide restaurants with laws specifying how many feet of kitchen space and how many food preparation workers there must be. Most states established restrictions on the number of entrances and their locations (back entrances are usually prohibited); the times of day and days of the week when sales may occur; permissible decorations; degree of visibility of the interior from the street; numbers and uses of other rooms; distance of the establishment from churches, schools, and other alcohol outlets; whether customers may sit at a long bar -- a counter in close proximity to the source of alcohol -- or whether they must sit at tables and order drinks as one orders food; and the ratio of chair seating to bar seating.

The public character of drinkers' comportment was also regulated. Many states, for example, prohibit dancing or live music except under special license. Most gambling or betting is prohibited, and other games are restricted as well. For many years, New York and other states did not allow barrooms to have pinball machines. Many states specifically ban the use of the word "saloon," others ban the use of the word "bar," and some forbid all words to indicate a drinking place. Until about 1980, most drinking establishments in California displayed only a name and a symbol: a tilted cocktail glass with a stirrer.

From a pre-prohibition or prohibition-era perspective, there are two surprising characteristics of post-repeal alcohol controls. First, most laws and regulations are obeyed. Almost all drinking places, for example, stop serving and collect glasses at the required hours; and they observe the regulations about tables, dancing, decorations, signs, entrances, and so on. By and large, this obedience has been relatively easily achieved through careful policing, coupled with the power to revoke or suspend licenses. Operating a liquor-selling business is usually quite profitable compared to other kinds of retail establishments, so owners tend to guard their licenses carefully. Unlike prohibition, alcohol control uses the profit motive to encourage lawful business practices. Minimum-age drinking laws constitute the one obvious exception to this regulatory success as well as being one of the few remaining forms of prohibition. Second, post-repeal alcohol regulation is usually not perceived as especially restrictive by customers. The many layers of laws and regulations are rarely noticed; most drinkers take them completely for granted.

A third, less surprising characteristic of post-repeal alcohol control is that policy has not been aimed specifically at maximizing what earlier reformers had called "temperance" -- meaning, above all, reducing habitual drunkenness or repeated heavy drinking. In his preface to Toward Liquor Control, Rockefeller maintained that such problems could not be effectively addressed by liquor regulation and that they would have to be taken up by other agencies as part of broader educational and health efforts. Since repeal, these tasks have been adopted by a number of independent and government groups, notably Alcoholics Anonymous and the National Council on Alcoholism, various state and local alcoholism agencies, and, since the early 1970s, the National Institute on Alcohol Abuse and Alcoholism. In recent years, some public health professionals have urged that the control system be used more self-consciously to reduce drinking and some health problems. Such concerns have by and large been imposed on the system, however, and do not flow from its natural workings.

On the other hand, despite all its flaws, post-repeal alcohol control did succeed in turning consumption away from hard liquor (which is much easier to abuse) and back toward beer and wine. Further, alcohol control (coupled with the Depression and World War II) did keep alcohol consumption below pre-prohibition levels. In fact, it was not until 1970 that the total alcohol consumption of the drinking-age population reached the levels of 1915 (Levine and Reinarman, 1993, 1998; Rorabaugh,1979; Miron and Zwiebel, 1991).

In 1936 a second volume of the Rockefeller-sponsored Liquor Study Commission Report was issued. After Repeal: A Study of Liquor Control Administration (Harrison and Lane 1936) analyzed the results of liquor control after "a two-year trial," and described the most important changes and innovations in liquor administration instituted since repeal. The overall thrust of the report was that, with some understandable exceptions, alcohol control worked extremely well. Other observers at the time drew similar conclusions (Sheppard 1938; Shipman 1940).

Legalizing alcohol and then regulating it had accomplished what most temperance and prohibition supporters claimed was impossible: alcohol moved from being a scandal, crisis, and constant front-page news story to something routine and manageable, a little-noticed thread in the fabric of American life. Since 1934, alcohol regulation has quietly and effectively organized and managed the production, distribution and sale of alcohol, as well as public drinking.

Despite frequent claims to the contrary, alcohol control has of course sought to legislate morality. It has not, however, sought to impose the morality of the nineteenth-century Protestant middle class who supported the anti-alcohol crusade. Rather the alcohol control system legislates the more modern morality of the new business and professional middle class, of the corporate elite, and to a large extent of the twentieth-century working class. Accordingly, unlike the use of marijuana, heroin, or cocaine -- drinking has not been criminalized and pushed beyond the pale of normative and regulatory influence. Moreover, once it ceased to be outlawed, the alcohol industry was no longer dominated by unregulated, illicit entrepreneurs who shot at each other, developed crime syndicates, and paid off police and government officials. The leaders of the major alcohol industries, just like other members of the economic establishment, have a strong investment in maintaining order and obedience to law.

Now, many decades after national alcohol prohibition ended, it is easy to forget that all this was the outcome of self-conscious public policy and not the "natural" result of market forces or national zeitgeist. The alcohol control system has worked sufficiently well that it usually goes unnoticed, even by students of prohibition or American history. For purposes of devising new drug policy options, however, it is important to remember that this particular system was the self-conscious creation of a political and economic elite with the power to institute what it regarded as good and necessary. The alcohol control system they devised is not especially democratic; it does not really address public health or social welfare concerns; and it has produced enormous profits for a handful of large corporations. However, it has achieved what its designers sought to do: regulate and administer the orderly and lawful distribution of alcoholic beverages in a way that creates little controversy (Bruun et al. 1975; Beauchamp 1981; Levine 1984).

Lessons from Alcohol Control

There are many different lessons that may be drawn from the story of legalization of alcohol production and sales and the establishment of alcohol control in the United States. Two seem particularly relevant for drug policy.

First, the legalization of drug production and sales and the establishment of drug control along the lines of alcohol control is a reasonable and practical policy option. Supporters of alcohol prohibition always claimed that alcohol was a special substance that could never be regulated and sold like other commodities because it was so addicting and dangerous. However, as the last seventy plus years of alcohol control and the experiences of many other societies have shown, the prohibitionists were wrong. The experiences of drug policy in other nations, and the experiences of U.S. pharmaceutical and drugstore regulation, suggest that most if not all psychoactive substances could be similarly produced, regulated, sold, and used in a generally lawful and orderly fashion. Therefore, it would mark a significant advance if the current U.S. debate on drug policy could be moved beyond the question of whether such a system of legalized drug control is possible. It is. Instead, we think debate should focus on whether a nonmoralistic assessment of the advantages and disadvantages of such a system make it desirable, and what different regulatory options might look like.

Second, a workable system of at least partially legalized drug production and sales -- of drug control -- would have to be a flexible one, geared to local conditions. Edward Brecher recommended in his landmark study Licit and Illicit Drugs (1972), and the importance of local option was also stressed over a century ago by the Committee of Fifty (Levine, 1983). Because towns, cities, counties, states and countries vary enormously, alcohol and drug policies must be shaped according to local environments.

As with alcohol control, drug control could be implemented so as to reduce substantially if not eliminate the illegal drug business and most of the crime, violence, and corruption associated with it. Drug control with a public health orientation would also seek to encourage milder and weaker drugs and to make them available in safer forms accompanied by comprehensive education about risks, proper use, and less dangerous modes of ingestion. In other words, a public-health-oriented drug control regime would seek to reverse the tendencies that appear inherent under criminalization, where production, distribution, and consumption are pushed into deviant subcultures, where purity is uncontrolled and dosage is imprecise.

If a legalized, decentralized drug control system with local option is implemented, then the experience of alcohol regulation suggests that, in the long run, drug problems would probably not rise significantly above the levels now present under drug prohibition, and overall consumption might not rise either (see also Nadelmann, 1989a). Similarly, if such a public health model of drug control were coupled with increased social services and employment for impoverished inner-city populations, then the abuse of drugs like heroin and cocaine might well be expected to decrease (Reinarman and Levine, 1997; Brecher, 1972; Jonas, 1990).

Having said this, it is incumbent upon us to point out that it will be no simple matter to implement such a drug control system in the United States , or in any other place in the world. As the second part of this chapter shows, drug prohibition is a much larger system than national alcohol prohibition in the United States ever was.

Drug prohibition is a world-wide system

Every country in the world now has drug prohibition enforced by its police and military. Every country in the world criminalizes the production and sale of cannabis, cocaine, and opiates (except for limited medical uses). In addition, most countries criminalize the production and sale of other psychoactive substances. Global drug prohibition is a world-wide system structured by a series of international treaties that are supervised by the United Nations. Every nation in the world is either a signatory to one or more of the treaties or has laws in accord with them (Levine, 2002, 2003; Bewley-Taylor, 1999; Nadelmann, 1990; International Narcotics Control Board Web site, http://www.incb.org).

Global drug prohibition is a worldwide system of state power. Drug prohibition is a social fact. For many decades, however, public officials, journalists, and academics rarely identified any form of U.S. drug law as "prohibition." Instead, they referred to a national and international "narcotics control." The international organization that still supervises global drug prohibition is called the International Narcotics Control Board (INCB). Outside of some drug policy, harm reduction, and academic circles, few people have known much about the world-wide drug prohibition system.

In the last decades of the 20th century, some people in many countries became aware of national drug prohibition. They came to understand that the drug policies of the U.S. and some other countries are varieties of drug prohibition. Even as this understanding spread, however, the fact that every country in the world has adopted drug prohibition remained a kind of "hidden in plain view" secret. Until recently, the global drug prohibition system has been taken for granted and nearly invisible. Now that is changing. Global drug prohibition is becoming easier to see and is losing some of its other ideological and political powers.

The rise of global drug prohibition

In the 20th century, the cause of drug prohibition was first taken up by committed alcohol prohibitionists. In the U.S., national drug prohibition developed out of national alcohol prohibition. National drug prohibition is not "similar to" or "like" alcohol prohibition, it is a historical extension and continuation of it.

National drug prohibition began in the 1920s in the U.S. as a subset of constitutional alcohol prohibition. The first generation of U.S. narcotics agents worked for the federal alcohol prohibition agency. In 1930, Congress separated drug prohibition from the increasingly disreputable alcohol prohibition and created a new federal drug prohibition agency, the Federal Bureau of Narcotics, headed by the committed alcohol prohibitionist Harry J. Anslinger (Epstein, 1977; Musto, 1987). In 1933, a combination of majority votes in some state legislatures and unprecedented state-wide public referendums in other states ended national alcohol prohibition. The question of alcohol policy was turned back to state and local governments to do with as they wished. A few states retained alcohol prohibition for years and many rural American counties still have forms of alcohol prohibition ( Kyvig, 1979; Levine, 1984 and Levine, 1985).

Drug prohibition took an entirely different course. Since the early 20th century, U.S. alcohol prohibitionists found European governments far more willing to consider anti-narcotics legislation than anti-alcohol laws. Alcohol prohibitionists urged adoption of drug prohibition and over the years they convinced the U.S. and other counties to establish various forms of drug prohibition. It was often called "narcotics control."

In 1919, the founding Covenant of the League of Nations explicitly mentioned the control of "dangerous drugs" as one of the organization's concerns. In the 1930s, guided by the Federal Bureau of Narcotics and its chief, Harry Anslinger, the U.S. government helped write and gain acceptance for two international anti-drug conventions or treaties aimed at "suppressing" narcotics and "dangerous drugs." In 1948, the new UN made drug prohibition one of its priorities. The UN Single Convention of 1961 (as amended in 1972, and supplemented by UN anti-drug treaties in 1971 and 1988) established the current system of global drug prohibition. In the last 80 years, nearly every political persuasion and type of government has endorsed drug prohibition. (For a discussion of this history see: Bewley-Taylor, 1999 and 2003; Bruun et al., 1972; McAllister, 2000; Walker, 1992; King, 1972; Epstein, 1977; Baum, 1996; Gray, 1998; Duke and Gross, 1993; King, 1972; Musto, 1987, Nadelmann, 1990, McWilliams, 1992; Levine 2002, 2003; Reinarman, 2003; http://www.incb.org for the text of the treaties. For a discussion of why drug prohibition was adopted throughout the world see, Levine 2002 and 2003, and a special issue of the International Journal of Drug Policy, 2003, devoted to a critical analysis of the UN treaties and global drug prohibition).

Drug use and policy in the era of global drug prohibition

The Single Convention of 1961 was put into place just as the world it was designed to govern was being transformed. Over the next two decades the use of prohibited drugs, especially of cannabis (marijuana), moved from the margins to the mainstream and the middle class. Except for cannabis, none of this was very large, and most of it was drug use and not abuse.

By about 1979, most forms of illegal drug use in the U.S. were higher than anytime before or since. By 1993, 22% of Americans aged 18 to 25, and 6% over age 25 had used marijuana once or more in the last year. And by 1993, 5% of American aged 18 to 25 and 2% over age 25 had used cocaine once or more in the last year. With some fluctuations, these rates have remained at roughly the same levels since. Heroin, LSD, psychoactive mushrooms and other illegal drug use is lower than cocaine use, and the levels of MDMA (ecstasy) use is similar to the levels of cocaine use (Reinarman and Levine, 1997:28-33).

The rise of illegal drug use in the 1960s and 1970s, and the persistence of use since 1980, have created enormous pressures on the drug prohibition systems in many Western countries. Different countries have responded to drug use and abuse in a variety of ways. Global drug prohibition is best understood as a long continuum -- with a harsher more punitive and criminalized end (as in the US), and a more tolerant, regulated and public health-oriented end (as in the Netherlands and growing numbers of European counties).

U.S. drug prohibition gives long prison sentences for repeated possession, use, and small-scale distribution of forbidden drugs. Many U.S. drug laws explicitly remove sentencing discretion from judges and do not allow for probation or parole. In the U.S. in the 1980s, the Reagan and Bush administrations substantially increased criminal penalties for drug possession and launched an expensive "War on Drugs." The U.S. now has nearly half a million men and women in prison for violating its drug laws. Most are poor people of color and are imprisoned for possessing an illicit drug or "intending" to sell small amounts of it. The mandatory federal penalty for possessing 5 grams of crack cocaine, for a first offense, is 5 years in prison with no parole (Reinarman and Levine, 1997; Duke and Gross, 1993; Gray, 1998 and McWilliams, 1992).

The cannabis policy of the Netherlands is the best known example of the other end of the drug prohibition continuum––of a decriminalized and regulated form of drug prohibition. Several UN drug treaties require the Netherlands, like other signatories, to have laws criminalizing the production and distribution of cannabis and other drugs. However, since the early 1980s, national policy in the Netherlands allows over 800 cafes and snack bars to sell small quantities of cannabis to adults for personal use, on premises and off. These "coffee shops" are permitted to operate as long as they are orderly and stay within well-defined limits that are monitored and enforced by the police. Unlike legal businesses, cannabis sales are not taxed and coffee shops cannot advertise cannabis.

Even as cannabis sales in the Netherlands are open, routine, and appear to be completely legal, importing and commercially producing this cannabis remain illegal. As a result, the coffee shops have always been supplied, as the Dutch say, through the "back door." This is still formally drug prohibition and the Netherlands prosecutes importers, dealers and commercial growers who handle large quantities of cannabis––as required by the UN anti-drug treaties. In short, for over two decades, the Netherlands has sustained a unique system of regulated, open, quasi-legal cannabis sales supplied by illegal importers and growers. This is as far as any country has been able to go within the current structures of global drug prohibition (Leuw, 1997; Reinarman and Levine, 1997; Englesmann, 1990; Henk, 1989;).

The prohibition policies of all other Western countries fall in between the heavily criminalized policies of the United States and the decriminalized and regulated form of cannabis prohibition of the Netherlands. No Western country and few Third World countries have ever had forms of drug prohibition as criminalized and punitive as the U.S. regime, and since the early 1990s drug policy in Europe, Canada, Australia, and elsewhere clearly has shifted even farther away from the criminalized end of the prohibition continuum. All these countries, however, are required by international treaties to have -- and still do have -- real, formal, legal, national drug prohibition (Levine 2002, 2003; Andreas, 1999; Bewley-Taylor, 1999; Reinarman and Levine, 1997).

Since the early 1980s, global drug prohibition has had to face a series of dilemmas or crises. In the final sections of this chapter, we want to briefly discuss three of these crises: the emergence and development of the harm reduction movement within drug prohibition; the growth of a serious, reputable opposition to criminalized and punitive drug policies; and the inability of drug prohibition to stop the cultivation and use of cannabis throughout the world.

The harm reduction movement within drug prohibition

The harm reduction movement was born in the early 1980s as a pragmatic, remarkably effective response to the spreading hepatitis and AIDS epidemics. Since then, harm-reduction workers and activists in Europe and increasingly throughout the world have sought to provide drug users and addicts with a range of services aimed at reducing the harmful effects of drug use. In the United States, conservative pundits and even liberal journalists have accused harm-reduction advocates of being “drug legalizers” in disguise, but in most other countries many prominent politicians, public-health professionals, and police officials who are strong defenders of drug prohibition also have supported harm-reduction programs as practical public-health policies (Heather et al. 1993). Even the UN agencies that supervise worldwide drug prohibition have come to recognize the public-health benefits of harm-reduction services within current drug prohibition regimes (INCB 2000: 59–60).

It is useful to understand that there are many varieties of drug prohibition, arranged along a continuum from the harsher and more punitive forms to the more tolerant and regulated forms. We want to suggest that harm reduction is a movement that in effect, though not always in intent, pushes drug polices away from the more criminalized and punitive forms of drug prohibition toward the more decriminalized, tolerant, and regulated forms of drug prohibition. Harm reduction encourages policy makers to shift drug policies away from punishment, coercion, and repression, and toward tolerance, regulation and public health. Harm reduction is not inherently an enemy of drug prohibition. However, in the course of pursuing public health goals, harm reduction necessarily seeks policies that also reduce the punitive effects of drug prohibition (Heather, Wodak, Nadelmann & O'Hare, 1993 and Reinarman and Levine, 1997).

Consider some of the significant programs that the harm reduction movement has advocated: syringe distribution and exchange, methadone maintenance, hygienic injection rooms, prescription heroin, medical use of cannabis, drug education for users, and pill testing at raves. These programs have sought to increase public health by helping users reduce the harms of drug use. However, in order to carry out their objectives (like reducing the spread of AIDS), the harm reduction programs have often required changes in laws, policies or funding that quite clearly also reduce the harshness and intolerance of drug prohibition.

We are suggesting that implicitly and sometimes explicitly the harm reductionist stance toward drug prohibition is exactly the same as its stance toward drug use. Harm reduction groups seek to reduce the harmful effects of drug use without requiring users to be drug-free. Harm reduction groups also seek to reduce the harmful effects of drug prohibition without requiring governments to be prohibition-free. Harm reduction's message to drug users is: "we are not asking you to give up drug use; we just ask you to do some things (like use clean syringes) to reduce the harmfulness of drug use (including the spread of AIDS) to you and the people close to you." In precisely the same way, harm reduction's message to governments is: "we are not asking you to give up drug prohibition; we just ask you to do some things (like make clean syringes and methadone available) to reduce the harmfulness of drug prohibition."

Harm reduction offers a radically tolerant and pragmatic approach to both drug use and drug prohibition. It assumes that neither are going away anytime soon and suggests therefore that reasonable and responsible people try to persuade those who use drugs, and those who use drug prohibition, to minimize the harms that their activities produce.

The growing opposition to punitive drug policies

In many countries increasing numbers of people––physicians, lawyers, judges, police, journalists, scientists, public health officials, teachers, religious leaders, social workers, drug users and drug addicts––now openly criticize the more extreme, punitive, and criminalized forms of drug prohibition. These critics, from across the political spectrum, have pointed out that punitive drug policies are expensive, ineffective at reducing drug abuse, take scarce resources away from other public health and policing activities, and are often racially and ethnically discriminatory. Criminalized drug prohibition violates civil liberties, imprisons many nonviolent offenders, and worsens health problems like the AIDS and hepatitis epidemics. Harm reduction is a major part of the critical opposition to punitive drug policies. Indeed, harm reduction is the first popular, international movement to develop within drug prohibition to openly challenge drug demonization and the more criminalized forms of drug prohibition (Reinarman and Levine, 1997, Levine 2002, 2003).

The harm reduction and drug policy reformers have changed the debate. For example, in 2001 the mainstream Toronto newspaper, the Globe and Mail(August 20 and 21), wrote a two part editorial strongly urging Canada to "decriminalize all––yes, all––personal drug use, henceforth to be regarded primarily as a health issue rather than as a crime." At the same time, the conservative British business magazine, The Economist (July 26), devoted an entire issue to drug topics, endorsing decriminalization, harm reduction and consideration of drug legalization. The Economist also reported that U.S. government anti-drug publications "are full of patently false claims" and that U.S. drug policy "has proved a dismal rerun of America's attempt, in 1920–1933, to prohibit the sale of alcohol." Since 2001, UK drug polices have moved to down-classify cannabis, and the Canadian government has been considering decriminalizing it.

As drug policy reform movements have grown, supporters of drug prohibition have been discovering that they cannot make the critics of criminalized prohibition go away. In the reports of the International Narcotics Control Board (the U.N. agency supervising global drug prohibition) and in other publications, the most knowledgeable defenders of drug prohibition warn regularly about the increasing growth of cannabis cultivation and use on every continent, and about the increasing legitimacy given to the critics of drug prohibition. These defenders of global drug prohibition recognize that the advocates of decriminalized drug prohibition––and the political, economic and cultural forces driving that opposition––are gaining strength and legitimacy (see for example, INCB, 2000).

All of this opposition is fairly recent. For much of its history, global drug prohibition has had very few critics. Even today, despite the impressive growth in many countries of the harm reduction movement and of drug policy reform activities, world-wide drug prohibition still has very few explicit, opponents. One reason for the lack of organized opposition to the drug treaties is that until recently the global drug prohibition system has been invisible.

Furthermore, even now few people understand that by ending or even modifying the Single Convention on Narcotic Drugs of 1961, the question of national drug policy could be returned to individual countries and local governments to handle as they wished. Defenders of global drug prohibition like to evoke an international conspiracy of what they call "drug legalizers." But almost nobody thus far has tried to launch even a half-baked international campaign with slogans like "Repeal the Single Convention" or "End Global Drug Prohibition."

Yet it may well be that the Single Convention stands in much the same relationship to world-wide drug prohibition that the 18th Amendment to the Constitution and the Volstead Act stood in relation to U.S. alcohol prohibition. Once the 18th Amendment was gone, state and local governments were free to create alcohol policy at the local level. If the Single Convention was repealed, or even modified, national governments around the world would be freer to create drug laws and policies geared to their own conditions––including prohibition if they should so desire.

At present, many nations, and many more regional and local governments, are reforming their drug policies, expanding harm reduction, and adopting less criminalized forms of drug prohibition. But no national government is even discussing withdrawing from the Single Convention and global drug prohibition. In addition to the domestic political obstacles to such a move, a potential "rogue" nation confronts international barriers in the form of economic and political sanctions from the U.S. and its allies. Therefore, no single country can now formally end its national prohibition regime and completely "defect" from the world-wide prohibitionist system. And it is likely that no single country will be willing or able to defect for a very long time, if ever (Bewley-Taylor, 1999; Bewley-Taylor, 2002; Bewley-Taylor, 2003; Transnational Institute, 2002; Andreas, 1999 and Nadelmann, 1990).

The cannabis crisis

Global drug prohibition's most glaring weakness and greatest vulnerability is cannabis. As UN experts point out, cannabis is by far the most widely used illegal drug in the world. Cannabis grows wild throughout the world, and is commercially cultivated in remote areas, in backyard gardens, and in technologically sophisticated indoor growing operations. Just as it was impossible for prohibitionists to prevent alcohol from being produced and used in the U.S. in the 1920s, so too it is now impossible to prevent cannabis from being produced and widely used, especially in democratic countries. As a result of this enormous and unstoppable production and use, global cannabis prohibition faces a growing crisis of legitimacy (Zimmer, 1997).

Since the 1980s, the Netherlands has successfully administered its system of regulated, decriminalized cannabis sales. A generation of Europeans, Australians, North Americans, and others have learned from the Dutch experience. Politicians, policy makers, police officials, journalists, and ordinary tourists from many countries have seen that decriminalizing cannabis use and regulating cannabis sales have substantial advantages and benefits––especially when compared with the disadvantages and costs of punitive U.S. drug policies. The continued success of the Netherlands's strikingly different and less punitive cannabis policy alternative within drug prohibition has undermined the U.S. anti-drug crusade and contributed to the spread of de facto and formal cannabis decriminalization in Spain, Switzerland, Portugal, Germany, the United Kingdom, Belgium, Italy and other countries (Leuw, 1997; Webster, 1998, Reinarman, Cohen, Kall, 2004).

Further, since the 1960s recreational cannabis use has been steadily normalized in many parts of the world, especially among young adults. Prominent middle-aged politicians––including, for example, the current Republican Mayor of New York City––admit they have used cannabis without deleterious effects. As a result, it has become much harder for drug war advocates to persuasively portray cannabis as one of the dangerous, evil "drugs." Punitive drug prohibition still requires drug demonization. But defenders of cannabis prohibition find it increasingly difficult to offer plausible justifications for harsh anti-cannabis laws, or even for the Single Convention's cannabis policies. Growing numbers of prominent, influential individuals and organizations are concluding that criminalized cannabis prohibition causes more problems than cannabis use.

In recent years, some veteran drug policy reformers have confronted the problem of the currently invincible drug treaties. Like Professor Peter Cohen (2003) of the University of Amsterdam, and Dr Alex Wodak (2003) of St. Vincents Hospital in Sydney, they have suggested that the Single Convention and other narcotics treaties are an unenforceable "paper tiger" or even a "paper corpse." These critics recommend that policy makers disregard the anti-drug treaties when considering drug policy reforms within their own countries. With regard to cannabis, public officials in a number of countries seem increasingly open to such arguments. In Europe, political support for harm reduction approaches and drug policy reform has become so strong that some government officials have discussed systems for licensing cannabis production.

Openly licensing, regulating and taxing cannabis production moves well beyond what the Netherlands has ever done. Licensing production as well as sales creates cannabis legalization within one country. Discussion of such measures appears most developed in Switzerland, but it has been going on as well in the Netherlands and even in Canada. Top U.S. anti-drug officials are openly worried about such possibilities.

Switzerland and other countries could choose to license cannabis farms for domestic consumption. In so doing they would build upon the Dutch experience, but would completely bypass the Netherlands's complicated problems of illegal or "backdoor" cannabis supply. When officials have substantial domestic public support, they will be freer to ignore international pressure and define their own nation's situation as a permissible exception to the anti-drug treaties. And countries that may decide for various reasons to license sales, may also decide to license growers. In short, sooner or later some Western country, perhaps Switzerland, is likely to be the first to create a system of licensed, regulated and taxed cannabis sale and production, despite the narcotics treaties.

In political democracies, when laws and policies are unenforceable and unpopular, over time de facto changes usually become de jure (in law). This is what happened with alcohol prohibition in the U.S., and this process occurs with international laws as well. For opiates, stimulants, and other drugs, the ongoing trend of increasing decriminalization, harm reduction, and medical use could continue for decades within global drug prohibition. But cannabis is a different story. In some countries, cannabis use and cultivation already threatens to burst the bounds of the international drug treaties. Even drug prohibitionists who study global trends openly worry about their capacity to make world-wide cannabis prohibition a workable system.

Recently, some students of global drug policies have outlined strategies for modifying the drug treaties to bring them more in line with current practice. (Bewley-Taylor, 2002 and Transnational Institute, 2002). Calls for modifying the treaties are likely to increase in coming years. And whatever happens with efforts to reform the Single Convention and other drug treaties, some Western democracies are likely to continue moving toward creating their own new national policies for cannabis sales, distribution and production.

One last point: An incisive paper by Martin Jelsma (2002) takes a line from a Monty Python sketch and likens defenders of punitive drug policies and the UN treaties to a pet shop clerk cheerfully trying to sell a dead parrot. "It's not dead," the salesman tells the incredulous customer, "it's just resting." Jelsma suggests rejecting such arguments and points out that policy makers in a number of countries have urged international discussions about modifying the drug treaties. Since 2001, the U.S. government has become increasingly absorbed in its new "War on Terrorism" and is itself withdrawing from or openly breaking with several different international treaties. At the same time, support for cannabis policy reform has been growing in the UK, Canada and other Western countries. In short, in the next five to ten years, modifying the drug treaties, especially for cannabis, may become a more lively political issue.

The end of global drug prohibition?

Global drug prohibition is in crisis. The fact that it is becoming visible is one symptom of that crisis. In the short run, that crisis seems almost certain to deepen, especially for cannabis prohibition and the more punitive and criminalized drug policies. Over the next century, for a variety of practical and ideological reasons––especially the spread of democracy, information and trade––democratic governments in Europe and elsewhere are likely to transform and eventually dismantle world-wide drug prohibition.

If and when this happens, it would not mean the end of all local or national drug prohibition. Rather, ending global drug prohibition, like ending constitutional alcohol prohibition in the US, would clear the path for hundreds of local experiments in drug policy. Many communities and some nations would likely retain forms of drug prohibition and continue to support vigorous anti-drug crusades. But most democratic and open societies probably would not choose to retain full-scale criminalized drug prohibition. Over time democratic societies could gradually develop their own varied local forms of regulated personal cultivation, production, and use of the once prohibited plants and substances. Many places could also allow some forms of commercial growing, production, and sale––first of all of cannabis.

All of this could take a very long time. Drug prohibitionists in every country can be expected to fight tenaciously to maintain their local regimes. And it is likely that enormous power will be employed to prevent the Single Convention of 1961 and its related treaties from being repealed or even modified.

As a result, in coming years there will be even more public discussion and debate about the varieties of drug prohibition and about the alternatives to it. As part of that conversation, many more people will discover that they have lived for decades within a regime of world-wide drug prohibition. That growing understanding will help push global drug prohibition closer to its end.

We are convinced that someday, as Edward Brecher predicted, most Americans will look back on drug prohibition and judge it to have been (like alcohol prohibition) repressive, unjust, expensive and ineffective -- a failure. In the twentieth century, a dozen major scientific commissions in Britain, Canada, and the United States have recommended alternatives to punitive drug policies. The United States is the only nation where these recommendations have been so consistently ignored (Levine, 1994; Trebach and Zeese, 1990). For starters, these recommendations should be more widely discussed and better understood in the United States. The experiences of other nations, regions and cities also provide living examples of decriminalization and harm reduction programs within global drug prohibition. The full range of alternatives to current U.S. drug policy should be studied and debated -- from futuristic visions to pragmatic reforms that could be implemented immediately. For drug policy, as was the case with alcohol policy, discussion of alternatives is an essential part of the transition from prohibition to regulation.


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  1. Earlier versions of portions of this chapter have appeared in several publications. Some of the materials on prohibition and alcohol control are drawn from Levine, 1985; Levine and Reinarman, 1993 and 1998. The materials on drug prohibition are drawn from Reinarman and Levine, 1997; Levine, 2002 and 2003; and Reinarman 2003.