rates after they are free from the immediate
threat of jail are much lower than those not
forced to undergo testing.
If prohibition remains the law of the land, is
there much else one could do to make illicit
drugs less problematic for both users and so-
ciety as a whole? The notion of "harm reduc-
tion" acceptance of the practical limits of a
free society to control drug consumption and
to focus on cutting the harmful consequences
of drug use has become the approach of
choice in many Western countries.
depressingly slight. Prevention remains a slo-
gan and aspiration, rather than a set of proven
programs. Treatment, while cost-effective in
the sense that it is cheaper than incarceration,
apparently can make only a modest difference
in recidivism. And, as already noted, draco-
nian enforcement to raise prices and reduce
availability has failed abysmally.
camp and an addiction-treatment center, is
showing signs of a pragmatic move toward
harm reduction. Even Iran, with its huge
opium/heroin market and indifference to in-
dividual rights, has tilted in this direction.
asked access to clean needles, along with col-
lection and destruction of used needles, min-
imizes the risk that addicts will spread AIDS
and hepatitis. A dozen countries, including
the Netherlands, Australia, Norway, Denmark
and Canada, offer these services as do 33
states in this country.
dicts. This service has been available for her-
oin addicts in Switzerland for 15 years and in
the Netherlands for five. Legal access remains
a niche program, however. While it brings
large benefits for those enrolled, only 5 per-
cent of the heroin-dependent population in
Switzerland have chosen to enroll.
MacCoun, a social psychologist at University
of California (Berkeley), and I have argued
that harm reduction is best seen as a bench-
mark for judging policies and programs rather
than a class of interventions. Indeed, harm re-
duction is merely standard cost-benefit analy-
sis applied to a policy area that has so far been
left in the hands of true believers. Cost-benefit
analysis requires that the decision maker list
and value all of the consequences of the deci-
sion, both positive and negative. Harm reduc-
tion can be seen as analysis-lite, since it does
not claim to be able to monetize all the bene-
fits and costs.
the effects of supply-side interventions are
negative. For example, aerial spraying of Co-
lombian coca fields has led to other fields
being planted with coca, which itself causes se-
rious damage to fragile ecosystems. Moreover,
spraying is predictably inaccurate, so legiti-
mate farmers are also hurt by it. And as Vanda
Felbab-Brown, a fellow at the Brookings Insti-
tution, shows in her forthcoming book, Shoot-
ing Up: Counterinsurgency and the War on
increases peasants' willingness to collaborate
with insurgents like the Taliban, FARC and
Shining Path. The benefits from spraying,
however, are elusive, since the most one can