Baltimore Mayor Kurt L. Schmoke sent this letter to National Drug Control Policy Director Bob Martinez on Sept. 11. The mayor's letter and Mr. Martinez's response were published in The Baltimore Sun, which granted permission to reprint. Mayor Schmoke is an advisory board member of the Drug Policy Foundation.
Dear Director Martinez:
I welcome your invitation to offer new ideas about the future direction of our national drug control policy. The need for such ideas is especially apparent to me today with the release of a new report by the National Center on Institutions and Alternatives showing that in Baltimore 56 percent of black males between the ages of 18 and 35 are being pursued by, or under the supervision of, the criminal justice system.
The report lays this tragic finding unambiguously on the doorstep of the war on drugs. It says, and I agree, that we are spending too much time and money incarcerating African-American men and not enough time and money educating them.
The NCIA study confirms my long-held view that having law enforcement rather than public health officials in charge of the fight against drug addiction is a mistake. Not because law enforcement officials lack commitment, but because they lack, and will continue to lack, success.
Keep in mind that the burden of drug-related crime and AIDS falls most heavily on local government and the communities we are charged with protecting. We do not have the luxury of pursuing failed policies in the hope that they might one day work.
In Baltimore and other cities, crime and AIDS are stealing young lives, crippling the criminal justice system and turning our neighborhoods into places of fear, not hope. To put an end to this grim picture, we must have a new public health strategy to fight drug abuse — and we must have the resources to carry it out.
Baltimore offers a typical profile of the growing menace of drug-related crime in cities. In 1991, Baltimore City police made over 17,000 narcotics arrests. In the same year, 46.7 percent of the 304 homicides were drug-related, up from 22.1 percent in 1987. And as with most other communities, the vast majority of drug charges —85 percent in the first half of 1992 — were for heroin and cocaine or their derivatives.
These numbers do not support recent assertions by federal officials that we are winning the war on drugs. In Baltimore there is no shortage of drugs, no shortage of demand and no shortage of drug-related crime victimizing children and families who are otherwise trying to lead stable lives.
Baltimore City does not have the law enforcement resources that are needed to cause a sharp reversal in the level and intensity of drug activity in our neighborhoods — even if law enforcement were the primary solution to this problem. Nevertheless, I want to share with you what we are doing with respect to law enforcement so that you know we take the matter of drug-related crime very seriously.
The Baltimore City Police Department considers stopping major drug trafficking and street level sales to be among its top priorities. To that end, the Department is working closely with federal and state drug enforcement agencies to target violent drug offenders, capture illegal guns, seize assets and slow the flow of drugs into our neighborhoods. We are also moving expeditiously to a community policing structure that will put more police in the neighborhoods. This foot patrol presence will ease fears, discourage "open air" drug sales and give young people positive role models. These changes, along with our request to the Justice Department for weed-and-seed designation, a special grant from the state legislature to fight violent crime, and the hiring of more police officers, demonstrate our determination to put all the resources practicable into combatting drug-related crime.
Unfortunately, drugs do not lend themselves to the same kind of law enforcement model as, for example, bank robberies. Drug addiction in the view of the American Medical Association, and many law enforcement officials dating back to the early part of this century, is a disease to be treated, not a crime to be prosecuted. Baltimore is struggling to provide that treatment. But the number of addicts needing help simply dwarfs our treatment resources. The city has over 34,000 heroin and cocaine addicts but only 5,362 treatment slots, which includes slots for alcohol abuse. This imbalance is an ongoing tragedy for both the addicts and the city. As thousands of addicts go untreated, they seek drugs from the violent criminal underground whose sole concern is the maintenance of their illegal profits.
As for AIDS, it has opened a window on the long-standing connection between drugs and public health. Just last year, the National Commission on AIDS characterized the failure of national policy to take into account the link between AIDS and drug abuse as "bewildering and tragic."
The full extent of that tragedy is being felt in Baltimore. As of July 31, 1992, there were 2,273 people with AIDS in Baltimore City, of whom 1408 (62 percent) have died, including 63 who died while incarcerated within the city. Among adults and adolescents, 38 percent of the AIDS cases are due to intravenous drug use alone. However, among African-Americans, who represent 79 percent of the city's known AIDS cases, IV drug use is now the leading cause of HIV infection. IV drug use is also spreading the HIV infection to the sex partners and unborn children of addicts.
Baltimore is responding to the AIDS crisis by spending up to $7 million a year on AIDS, most of which is federal and state money. The city is also aggressively pursuing Ryan White Act funds. Almost all of this money is directed toward the treatment and prevention of AIDS. The city has a van that goes into all neighborhoods to give free counseling and IIIV testing, and we have organized a Partnership for Drug-Free Neighborhoods. This government/community partnership is developing a long-term strategy for keeping drugs out of our neighborhoods. The city also funds numerous private organizations that provide services related to AIDS. Many of these organizations are represented on our AIDS Coordinating Council, which makes recommendations on funding and policy priorities.
One of these priorities is a needle exchange program that would help slow the spread of HIV among addicts and their sex partners. Needle exchange programs are being tried on an experimental basis in several cities. However, the Office of National Drug Control Policy has repeatedly come out not only against needle exchange, but against even research into the efficacy of needle exchange.
This opposition in the face of the national crisis that AIDS represents is a painful reminder of the national context in which local government is trying to fight drugs and AIDS. In Maryland, one legislative delegate is expected to introduce a bill in the upcoming session that would exempt Baltimore from certain drug paraphernalia laws so that a carefully controlled needle exchange program can be tried. I support this bill. However, its passage is going to be difficult because of the continued opposition of our national leaders — opposition that stems from a flawed anti-drug strategy.
The evidence of that [strategy's flaws] can be seen in [the] worsening state of drug use and drug-related crime nationally over the last four years. What has our country bought for the $45 billion spent on the war on drugs between fiscal years  and 1993? There is some evidence that the use of certain drugs by young people ages 12 to 17 is declining. But that is where the good news ends.
According to a recent National Institute on Drug Abuse survey, cocaine use rose 18 percent between 1990 and 1991. And levels of cocaine use among black men over 35 — most of whom live in cities — rose dramatically. I can only echo your own fears when you said, "As the great middle class cures itself of this epidemic, there is a danger that the media, the Congress and others will walk away from this problem."
Other statistics regarding drug use, drug-related crime and AIDS are equally revealing about the failures of our national drug control policy. It is estimated that at least 10 percent of the U.S. population violate drug laws every year despite the increasingly harsh penalties available to prosecutors. Cocaine production and importation have increased every year since 1988. Interdiction is still only stopping 5 to 15 percent of the drugs sent to the United States, which explains why the price of cocaine has remained pretty much constant.
For people living in cities, violent crime is a constant reminder that national drug policy fosters many things, but peace is not one of them. Nationwide, total homicides have increased every year since 1988. Drive-by shootings, assaults, intimidation and fear are regular occurrences in urban and many smaller communities. In the meantime, the U.S. has the highest per capita incarceration rate in the Western world... .
My purpose in summarizing the failures of the war on drugs both in Baltimore and nationally is not simply to shake up the status quo. Our people are suffering. Our cities are suffering. And our current national policy is making matters worse. It is time for a major change in direction. That change should include the following:
/ 1. The appointment of a national commission of unbiased medical professionals, law enforcement officials, community leaders and policy analysts to make recommendations on how all drugs, legal and illegal, should be regulated.
/ 2. The commission should pay special attention to the approach used in the Netherlands, where most drugs remain illegal except when purchased or sold under government-supervised medical auspices.
/ 3. Government funding priorities should be changed so that at least two-thirds of the federal government's antidrug effort goes toward treatment and prevention. And most of this money should be channeled directly to state and local governments.
/ 4. A national needle exchange program should be started in all major urban communities to slow the transmission of 11IV.
/ 5. The Surgeon General of the United States should be specifically designated as the leading strategist in preventing and treating substance abuse, and a large-scale public information campaign should be started that discourages all drug use and emphasizes the public health nature of addiction.
/ 6. Marijuana should be made immediately available for medical use, as should other drugs that are proven to have medical benefits.
/ 7. Law enforcement efforts in the future should be concentrated on the highest echelons of criminal organizations, preventing the establishment of an underground cocaine and heroin market that competes with drugs provided by public health professionals.
/ 8. Substantial resources now being devoted to the war on drugs should be diverted to education and job training programs that give young people an alternative to selling illegal drugs.
It has been almost four years since President Bush said of drug use: "This scourge will stop." The scourge has not stopped. The scourge has grown worse. Drug abuse and drug-related crime are devastating communities large and small. It is time to admit that doing more of the same is simply an invitation to greater violence, bloodshed and incarceration. It is time for a fresh start.
I urge you and your colleagues at the Office of National Drug Control Policy to call for a major shift in both tactics and strategy — no matter who wins the upcoming election.
The emphasis should be on peace, rational analysis, treatment and prevention of HIV transmission. The American people deserve an anti-drug policy that works. Doing more of the same will not give them that. Treating drug abuse as a health problem will.