INTER-AMERICAN DRUG ABUSE CONTROL COMMISSION C I C A D

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INTER-AMERICAN DRUG ABUSE CONTROL COMMISSION C I C A D Secretariat for Multidimensional Security FIFTY-FIFTH REGULAR SESSION April 29 - May 1, 2014 Washington, D.C. OEA/Ser.L/XIV.2.55 CICAD/doc.2097/14 29 April 2014 Original: English DRUG TRAFFICKING IN SMALL QUANTITIES: DIAGNOSIS AND CURRENT CHALLENGES HAROLD POLLACK, UNIVERSITY OF CHICAGO

Drug trafficking in small quantities: diagnosis and current challenges Harold Pollack, PhD Helen Ross Professor of Social Service Administration Co-director, University of Chicago Crime Lab

Seven promising violence reduction strategies in drug policy More effective policies towards illegal gun acquisition, possession, and use. Violence-oriented supply-side drug policies. Maintaining illegality of dangerous illicit substances, but appreciating low value, at the margin, of punitive enforcement efforts. Dealing more effectively with alcohol, which is Chicago s most criminogenic substance. Addressing access to mental health/substance abuse services among potential offenders. Better supervision of dependent users who actually commit crimes. Helping young people deal more effectively and safely with each other and with adults.

Chicago at forefront of problem and solutions Chicago had 433 homicides in 2013, roughly 15 per 100,000. We re not the most dangerous American city, but we are the one with the most homicides. Drug trade a part of that problem, though in a complicated way not perfectly understood.

Unknown #1: How do we break the link between drug activity and gun violence? Chicago homicides. Male: 90% of all homicide victims & offenders (2011 CPD) Young: 53% homicide victims & 57% offenders < age 25 Guns: 83% of homicide victims shot, almost all with off the shelf handguns. Relatively impulsive and apparently non-strategic: 73% of homicides attributed to altercation. The drug economy is important to the violence, but in a more complicated way than it was twenty years ago. Rates of cocaine-positive and heroin-positive urine tests among criminal offenders way down, as well. Cocaine roughly half the prevalence of a decade ago. Only ~10% to strategic gang disputes over narcotics. One-third of victims high blood alcohol at time of death.

Fundamental equation of many homicides Young men + disagreement + impulsivity + gun = dead body

That +gun part is where Chicago really falls behind CPD recovers more guns than NYPD and LAPD combined. Very hard to break this cycle, when young men arm up because they are scared of each other. Self-protection most common and most powerful motive for gun-carrying. In jail interviews, we find large percentages of young offenders who have actually been shot. Drug trade may be more lethal in its impact on gun access/possession/use than in its internal operation. Fragmentation/decapitation of criminal organizations into smaller cliques and crews creates new dilemmas, as well. Some of these cliques and crews sell drugs, some not. Some are rather tiny groups. It s a major law enforcement challenge. Unclear whether gang leaders can influence peer violence.

Unknown #2: What is the impact of supply-side enforcement on market prices? Mere illegality of heroin, cocaine, and other substances dramatically increases production and distribution costs, and thus market prices by more than we often realize. The need to pay risk-premiums to employees. Lack of access to contracting and efficient production methods. The variety of costs that accompany covert conspiracies. Inefficient boundaries of illicit firms. Barriers to marketing of the sort we see for legal intoxicants. Full marijuana legalization very likely to reduce (pre-tax) prices by half, maybe 80%.

Illegality and basic enforcement dramatically increase illicit drug production & distribution

Much less evidence that marginal increases in enforcement raise street drug prices Pollack and Reuter Addiction (2014) survey evidence. Little evidence that more stringent supply-side enforcement is helpful at the margin in raising street prices. Little accountability & research on supply-side enforcement efforts, compared for example with the standard of evidence expected for demand-side interventions. Community backlash on over-incarceration complicates efforts to find/incapacitate most violent offenders and to address gun violence.

The famous (and embarrassing) RAND graph

Much less evidence that marginal increases in enforcement raise street drug prices There is much less evidence that marginal increases in law enforcement really increase street drug prices. And this brings out the tensions among the different goals in drug enforcement. Reducing gram-consumption and the size of the drug market. Reducing the power and reach of drug-selling organizations, including the national security dimension. Reducing public health harms associated with drug use. Violence reduction on the supply-side.

Unknown #3: How can we induce drug-selling organizations to see violence as bad business model? Marginal law enforcement resources better-deployed to make violence a bad business model for drug-selling organizations. David Kennedy, Mark Kleiman, Andrew Papachristos and others offer helpful approaches to doing that. Social network models also appear useful in identifying high-risk offenders and victims and for targeted deterrence. Focus on violence reduction rather than market-share or certainly selling weight in targeting offenders and organizations. Community disruption, weapons violations, hiring juveniles, corruption/interference with law enforcement, and other socially harmful activities.

Unknown #3: How can we induce drug-selling organizations to see violence as bad business model? High Point, North Carolina model associated with useful violence reductions. Best available research suggests 14% reduction in violence by suppression of open-air drug market and targeted deterrence. But.. Highpoint is roughly 4% size of Chicago. Scaleability a real question mark. If we could turn drug-selling organizations into the American mafia, this wouldn t be ideal, but it would represent substantial progress.

Unknown #4: How can we better-supervise druginvolved offenders? Interventions such as drug court useful for individuals, but seem unlikely to alter the prison population (Pollack, Reuter, and Sevigny 2011). Scale of drug court effort is too small. Most drug-involved incarcerated offenders would be ineligible for most drug courts. Prior felonies. Violent or gun-involved offense.

Unknown #4: How can we better-supervise druginvolved offenders? Reentry may be more promising venue Hawaii HOPE and its variants. Improved health insurance coverage for substance abuse treatment and mental health services Affordable Care Act Medicaid expansion.

Unknown #5: Addressing alcohol Most criminogenic substance. Real value of beer taxes has declined in US over time. Alcohol disorders common comorbidity with other substance use disorders. Many individuals with alcohol disorders lack access to proper treatment.

Who are the 4.8 million Americans who are both uninsured and experiencing substance use disorders? (Data from 2011 National Survey on Drug Use & Health)

Why does it matter? Welcome to Cook County Jail

On any given night at 26 th and California 2,000 inmates with significant psychiatric disorders. With proper insurance, many can be moved to better care settings. Option is rarely feasible for uninsured w/same disorders. Change in inmate Medicaid eligibility due to health reform legislation. 2012 90% of inmates ineligible, virtually all uninsured. 2014 90% of inmates will be Medicaid-eligible. Cook County Sheriff Tom Dart Medicaid waiver+ ACA have the potential to be game changers--ending the [federal, state, and city budget] cuts that have made the Cook County Jail the provider of first resort in the city of Chicago and Cook County.