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Confronting drug policy: Illicit drugs in a free society
Book Reviews
Confronting Drug Policy: Illicit Drugs in a Free Society, by Ronald Bayer and Gerald M. Oppenheimer. The Cambridge University Press, Cambridge, 1993. 369pp., $59.95 (Cloth), $19.95 (Paper). Illicit drug use is a worldwide problem, but its control is not easy, even in the United States, a country with an effective administration, a good judicial system, and high values for human rights. This volume includes discussions of the problem of substance use in detail, highlighting the dilemma of failure of administrative measures, an individual's social and human rights, and medical aspects of illicit drug use. The book is not entirely original because most of the articles have been published earlier in the Milbank Quarterly. The combining of related articles in a book form, highlighting the real problem of control of illicit drugs in a Western society for policy makers is a good effort. This book may not be relevant for readers and policy makers in developing countries where illicit drugs use is much higher and machinery and will on the part of the governments to control the problem is lacking. The objectives of printing various articles in book form are summarized in the Introduction by Ronald Bayer. He has also discussed decriminalization and medicalisation of drugs, the impact these actions might have on the judicial system. The contribution on social demography deals with the prevalence of different drug and substance abuses in United Stated by age cohorts, gender, and ethnicity. An examination of temporal trends shows changes over the years. It is heartening to see that illicit drug use is decreasing in United States whereas it is increasing in developing countries. It is also surprising to note that cocaine is the commonest illicit drug, with disastrous effects on the individual and society in United States as compared to heroin which is a major problem in developing countries. The various sources of data for this article have also been discussed regarding their validity and comprehensiveness. In the second article in this book, drug policy is analysed. A discussion of psychoactive drugs is included. Also, emphasis is placed on the need for reduction both in the supply of and demand for illicit drugs, not only by regulation but also by changing attitudes towards substance abuse and treatment. The effects of a legalised drug market on prevention of such diseases as AIDS and other STDs and the reduction of drug trafficking is discussed well in three articles on legalisation of drugs. For example, Charles Winick examines the effects of drugs on human productivity. With some reservation, he has shown that drug users may be as active and productive as any other individual of the society. The higher rate of crimes among drug users is a part
Environmental Hazards: Second Edition, by Keith Smith. Routledge, New York, 1996. 400pp., $84.98 (Cloth), $27.95 (Paper). Environmental hazards, both natural and technological, are of particular recent interest to Smith. With advances in technology and available data, the possibility of predicting, controlling and reducing impacts of environmental hazards is much more feasible than in the past. This circumstance has sparked more research geared towards understanding the causes and effects of these hazards. Smith does a very comprehensive job in integrating what is currently known about a wide variety of environmental hazards, including the risks and impacts associated with them in all parts of the world.
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of their psychological behavior rather than an effect of drug use. In the next article, Levine and Reinarman attempt to draw a parallel between the alcohol prohibition in the 8th amendment of the U.S. Constitution and its repeal through the 21st amendment, linking illicit behaviours from the earlier period to present-day drug use. Though they believe that the situation is not identical, they still recommend that policies should be aimed at reducing the demand for drugs rather than reducing the supply. According to the authors, the current situation leads to black marketing and increased cost of drugs rather than reduced consumption. To tackle the problem of illicit drug use, Oppenheimer suggests the British model in which the supply of drugs is restricted but is freely available to physicians for treatment of their patients. He has also discussed the effectiveness of the Dutch "needle and syringe exchange program" in reducing AIDS prevalence among the drug users. In the seventh article, M.H. Moore discusses and questions the effectiveness of the American criminal justice system with a high operational cost that may promote corruption and its inability to control the problem. He also draw some reference from the alcohol prohibition experience. L.O. Gostin then discusses the effectiveness of compulsory treatment for the drug addicts and its beneficial role to society in reducing pressure on the judicial system, reduced operational cost and rehabilitation of drug addicts. Women and children are often neglected in findings about the drug problem. Being a pediatrician, 1 was delighted to see that the contribution by P.A. King on the effects of drugs on women and children was included in the book. In her contribution, she stresses the need for a special policy for mothers and the children. The last two chapters, by Levine and Warner, deal with the benefits of medicalisation of drugs and its economic effects. Levine makes a case for medicalisation of drugs with some reservations, whereas Warner has touched upon various economic aspects. Overall, this book is interesting and comprehensive, dealing with various dilemmas encountered by policy makers for solving the problem of illicit drug use in the United States. However, it is surprising to note that smoking and alcohol use, norms in most societies, have also been included in the checklists of illicit drugs in many chapters of the book.
The Department of Pediatrics The Aga Khan University and Hospital Stadium Road P.O. Box No. 3500 Karachi Pakistan
S.Q. Nizami
The book is divided into two parts. The first deals with environmental hazards in general and includes discussions of such issues such as risk management and perceptions of recovery after disasters. Chapter one is particularly useful because it defines many of the terms and concepts referred to throughout the book. The second part of the book is much more specific, and each chapter is devoted to a specific hazard. Included are such diverse topics such as tectonic and technological hazards. Each chapter contains discussions about such issues as vulnerability and loss-sharing adjustments specific to each hazard. A most valuble aspect of this book is the large volume of statistical and graphic material presented. This book would be suitable as a supplementary text in a more general environmental dilemma course or alone in
Confronting Drug Policy: Illicit Drugs in a Free Society, by Ronald Bayer and Gerald M. Oppenheimer. The Cambridge University Press, Cambridge, 1993. 369pp., $59.95 (Cloth), $19.95 (Paper). Illicit drug use is a worldwide problem, but its control is not easy, even in the United States, a country with an effective administration, a good judicial system, and high values for human rights. This volume includes discussions of the problem of substance use in detail, highlighting the dilemma of failure of administrative measures, an individual's social and human rights, and medical aspects of illicit drug use. The book is not entirely original because most of the articles have been published earlier in the Milbank Quarterly. The combining of related articles in a book form, highlighting the real problem of control of illicit drugs in a Western society for policy makers is a good effort. This book may not be relevant for readers and policy makers in developing countries where illicit drugs use is much higher and machinery and will on the part of the governments to control the problem is lacking. The objectives of printing various articles in book form are summarized in the Introduction by Ronald Bayer. He has also discussed decriminalization and medicalisation of drugs, the impact these actions might have on the judicial system. The contribution on social demography deals with the prevalence of different drug and substance abuses in United Stated by age cohorts, gender, and ethnicity. An examination of temporal trends shows changes over the years. It is heartening to see that illicit drug use is decreasing in United States whereas it is increasing in developing countries. It is also surprising to note that cocaine is the commonest illicit drug, with disastrous effects on the individual and society in United States as compared to heroin which is a major problem in developing countries. The various sources of data for this article have also been discussed regarding their validity and comprehensiveness. In the second article in this book, drug policy is analysed. A discussion of psychoactive drugs is included. Also, emphasis is placed on the need for reduction both in the supply of and demand for illicit drugs, not only by regulation but also by changing attitudes towards substance abuse and treatment. The effects of a legalised drug market on prevention of such diseases as AIDS and other STDs and the reduction of drug trafficking is discussed well in three articles on legalisation of drugs. For example, Charles Winick examines the effects of drugs on human productivity. With some reservation, he has shown that drug users may be as active and productive as any other individual of the society. The higher rate of crimes among drug users is a part
Environmental Hazards: Second Edition, by Keith Smith. Routledge, New York, 1996. 400pp., $84.98 (Cloth), $27.95 (Paper). Environmental hazards, both natural and technological, are of particular recent interest to Smith. With advances in technology and available data, the possibility of predicting, controlling and reducing impacts of environmental hazards is much more feasible than in the past. This circumstance has sparked more research geared towards understanding the causes and effects of these hazards. Smith does a very comprehensive job in integrating what is currently known about a wide variety of environmental hazards, including the risks and impacts associated with them in all parts of the world.
1461
of their psychological behavior rather than an effect of drug use. In the next article, Levine and Reinarman attempt to draw a parallel between the alcohol prohibition in the 8th amendment of the U.S. Constitution and its repeal through the 21st amendment, linking illicit behaviours from the earlier period to present-day drug use. Though they believe that the situation is not identical, they still recommend that policies should be aimed at reducing the demand for drugs rather than reducing the supply. According to the authors, the current situation leads to black marketing and increased cost of drugs rather than reduced consumption. To tackle the problem of illicit drug use, Oppenheimer suggests the British model in which the supply of drugs is restricted but is freely available to physicians for treatment of their patients. He has also discussed the effectiveness of the Dutch "needle and syringe exchange program" in reducing AIDS prevalence among the drug users. In the seventh article, M.H. Moore discusses and questions the effectiveness of the American criminal justice system with a high operational cost that may promote corruption and its inability to control the problem. He also draw some reference from the alcohol prohibition experience. L.O. Gostin then discusses the effectiveness of compulsory treatment for the drug addicts and its beneficial role to society in reducing pressure on the judicial system, reduced operational cost and rehabilitation of drug addicts. Women and children are often neglected in findings about the drug problem. Being a pediatrician, 1 was delighted to see that the contribution by P.A. King on the effects of drugs on women and children was included in the book. In her contribution, she stresses the need for a special policy for mothers and the children. The last two chapters, by Levine and Warner, deal with the benefits of medicalisation of drugs and its economic effects. Levine makes a case for medicalisation of drugs with some reservations, whereas Warner has touched upon various economic aspects. Overall, this book is interesting and comprehensive, dealing with various dilemmas encountered by policy makers for solving the problem of illicit drug use in the United States. However, it is surprising to note that smoking and alcohol use, norms in most societies, have also been included in the checklists of illicit drugs in many chapters of the book.
The Department of Pediatrics The Aga Khan University and Hospital Stadium Road P.O. Box No. 3500 Karachi Pakistan
S.Q. Nizami
The book is divided into two parts. The first deals with environmental hazards in general and includes discussions of such issues such as risk management and perceptions of recovery after disasters. Chapter one is particularly useful because it defines many of the terms and concepts referred to throughout the book. The second part of the book is much more specific, and each chapter is devoted to a specific hazard. Included are such diverse topics such as tectonic and technological hazards. Each chapter contains discussions about such issues as vulnerability and loss-sharing adjustments specific to each hazard. A most valuble aspect of this book is the large volume of statistical and graphic material presented. This book would be suitable as a supplementary text in a more general environmental dilemma course or alone in