Mark Kleiman

Transcription

[ Silence ] >> Ron Shaiko: Good afternoon, and welcome to the Rockefeller Center. My name is Ron Shaiko. I'm the Associate Director for Curricular and Research Programs, here at the center. It is my pleasure today to introduce our featured speaker, Prof. Mark Kleiman. Professor Kleiman is one of our nation's leading authorities on drug policy. He has reached this level of notoriety through his academic work, as well as, through his real-world engagement in the public policy making process at the federal, state, local and international levels. A true pracademic -- that is, a practitioner and an academic, Professor Kleiman is not one of those ivory tower pontificators. He has wrestled with the real-world ramifications of drugs and their usage in American society and around the world, and is well aware of the complexities of our -- of the interaction between -- the intersection between policy and politics. This year, while much attention is given to the contest for president of the United States, voters in Colorado, Oregon, Washington, Massachusetts, Arkansas and Montana will make choices in the voting booth in November that will have a direct impact on the role of drugs in their states. Professor Kleiman's academic work on drugs and drug policy in the United States continues to be influential in these real-world debates that often lead to electoral initiatives. He's written numerous books and countless articles on the topic. His path breaking books include "Marijuana -- Costs of Abuse, Costs of Control," "Against Excess -- Drug Policy for Results," "When Brute Force Fails -- How Do I Have Less Crime and Less Punishment," and his best-selling, "Drugs and Drug Policy -- What Everyone Needs to Know." "Drugs and Drugs Policy," 2005 Nobel Laureate in Economics, Thomas Schelling said the following, it is "A product of genius, informing content more than 200 questions all relevant and urgent with succinct and lucid answers. When I started the book, I had strong opinions on many of the topics it covered. Again and again, every time the book came in conflict with my own beliefs, the authors changed my mind. If you care about drugs, you need to read this book; if you don't, read it anyway, just to see how it is done." Professor Kleiman's most recent book like "Drugs and Drugs Policy," is published by Oxford University Press. It is entitled, "Marijuana Legalization -- What Everyone Needs to Know." Already, this book is garnering wide praise. Professor Kleiman's academic home is at the UCLA Luskin School of Public Policy where he's a professor of public policy. Today, however, Professor Kleiman comes to us from the Batten School of Leadership and Public Policy at the University of Virginia where he is currently a visiting professor of public policy. Also this year, Professor Kleiman is a visiting fellow at the National Institute of Justice. A magna cum laude graduate of Haverford College, Professor Kleiman holds a master's degree in public policy, and a Ph.D. from the Kennedy School at Harvard. We at the Rockefeller Center are thrilled to have Professor Kleiman here on campus. He has already met with students and Professor Whalen's Policy 20 class earlier today, and has interacted with a number of faculty members here, as well. We now welcome Professor Kleiman to speak to us on which drugs should be legal, how legal should they be. Ladies and gentlemen, please, [applause] help me welcome Professor Kleiman. [ Applause ] >> Professor Kleiman: Thank you for that very kind introduction, but it contains one small piece of false advertising. >> Ron Shaiko: Okay. >> Professor Kleiman: It's not my intention to speak to you in the sense that I have a prepared text; I'd like to make this interactive from the beginning. So what drugs should be legalized and how legal should they be? I mean, I should say this much. The second part of the title refers to the fact that deciding to legalize a drug is actually a kind of non-decision until you decided what's going to replace prohibition as the new set of rules that apply. So think about all the questions we'd have to answer about a drug we had decided to legalize. Who can buy it? Anybody? Any age? Any restrictions on prior behavior? At what price? Do we want to tax it heavily? Who can sell it? In what quantity? What times and places? With how much marketing? What are the rules on what the behavior of people is under the influence? Are they allowed to drive? Are they allowed to operate heavy equipment? Are they allowed to be on duty, as say police officers? Now, those may seem like silly questions but until you consider that caffeine is a drug and a rather potent one. Right? So caffeine is currently legal. There are essentially no restrictions on buying it, selling it or using it, except in some places labeling restrictions. All right. So some places you actually have to put caffeine on the label. I was very surprised to discover that orange soda has lots of caffeine in it, or at least many orange sodas do, until a friend of mine said, "Oh yes, that's programmer food." [Laughter] And during a period when I was trying to do without stimulants, that was actually a rather unpleasant surprise. All right, so caffeine is legal. Should we leave it legal? Should caffeine be a legal drug? And if we leave it legal, do we want to put any restrictions on it at all, or are we happy with what we have? [ Pause ] Does the word "Four Loko" ring a bell? I see some knowing looks. [Laughter] So what's Four Loko? Some energy drink and they say it's virtually pure caffeine. And there's a question about whether that's a really a good idea to have very highly caffeinated beverages available. Actually, there's one restriction now on caffeine. You can't put caffeine in beer. [Laughter] [Inaudible] my good friend, David Kennedy, who's invented lots of important ideas in criminal justice, passed up an opportunity to get rich when he invented the idea of caffeinated beer about 15 years ago. He was going to call it "Whipsaw" -- "Friends don't let friends go to sleep drunk." [Audience laughter] And then of course, once we had Whipsaw, we could extend the line to decaffeinated Whipsaw. And of course, if you added Valium instead of caffeine to the beer, then you'd have [inaudible], but anyway [audience laughter]. But in fact, the Food and Drug Administration decided that you weren't allowed to add caffeine to beer. Possibly a prudent decision, though of course there's nothing that keeps you from buying a bottle of caffeine tablets to take with your beer, or dissolving a caffeine tablet in your beer, or having a cup of coffee with your beer. So even with caffeine, it's not fully legal. There's some things you're not allowed to do with it. All right, but that's probably no place we're actually going to go. How about tobacco? Should we legalize tobacco? No, I see a clear no here. Somebody have the mic? [ Pause ] >> Professor Kleiman: So... >> [Inaudible]. >> Professor Kleiman: It already is, but -- I'm going to say, "Wait for the mic to show up." This room has such good acoustics that you can actually do without but... >> [Inaudible]. >> Professor Kleiman: No, these are cordless. So, you say "No. We shouldn't keep tobacco legal." Why not? >> I just think it causes too many side effects injurious to the body. >> Professor Kleiman: Mm-hmm. >> And even though I am not a smoker but I'm subject to tobacco -- second-hand tobacco and so forth, and it could cause me -- especially cancerous things and that it should be regulated in some way. And I know that they do at least supposedly under 18 I think are not supposed to be able to purchase it, but that will be the day. >> Professor Kleiman: Right. All right, so several ideas in that comment. Right? First thing is; we might want to regulate a drug or even prohibit it, because it damages the people who use it. Or, we might want to regulate or prohibit it because it damages other people -- pardon, damages other people. Second-hand smoke is an example. We're thinking about alcohol, we wouldn't think about second-hand alcohol fumes much. What do we think about if we're talking about alcohol? >> Crime. >> Professor Kleiman: Crime. >> Drunk driving. >> Professor Kleiman: All right, so then -- so with alcohol it's the act of consumption that might damage somebody else. With alcohol, it's what people do when they're under the influence. So either of those might be a good reason to put legal limits -- folks, there are lots of seats down front. I know there's a taboo on sitting down front, but you're certainly welcome to join the [inaudible] and I promise I won't ask you any questions. [ Pause ] The third idea that was in the answer was, well, even if it were okay for adults, in fact, if we make something legally available to adults, children could get it and most people, right? So what's the argument against regulating a behavior that simply damages the people who engage in it? Right? Does everybody -- or does everybody here agree, that if we discover that tobacco is bad for your health, we should make it illegal? Who would disagree with that? Okay? So somebody want to give a reason why? [Laughter] No? >> You told me you weren't asking questions. [Laughter] >> Professor Kleiman: Okay. So pass to his back. Good. >> Basically in enforcement, being a historian I've studied the prohibition experiment of the 1920s and that didn't do too well and you can grow tobacco as -- on the -- out in the backyard, or as well as you can pot. >> Professor Kleiman: Mm-hmm. >> I'm sure you'd be getting the pot but... [Laughter] >> Professor Kleiman: So, yes, we could ban tobacco and then we have to worry about enforcing the law, right? So this is the problem of who belled the cat? Right? It'd be a nice idea to have the cat wear a bell but who's going to make it happen? >> I'm also arguing against [inaudible] that we shouldn't interfere with people's private health decisions if they don't affect others. >> Professor Kleiman: Right. So that's -- right, is there a name associated with that? >> [Inaudible]. >> Professor Kleiman: Hmm? Right, but the name of the person. Right? That's the argument of John Stuart Mill's "On Liberty," which was in fact written to oppose alcohol prohibition which Maine had just passed. That was the origin of that book; it was a protest against the Maine temperance law. Right, so the argument is, "Look, if somebody's damaging himself, right, he should be allowed to. Why? Why not?" All right. That's what it means to have a free society, that wouldn't be [inaudible] have a liberal society. Yes, I'd be better off 40 pounds later, but that probably is not something we need to legislate. All right, so a couple of different reasons, now you've noticed these are different reasons to look twice before illegalizing a drug. One is that it may not being justified or beneficial. Do you interfere with private choice even those choices look unwise to you? And the other is that if you try somebody can break the law, and when they break the law all sorts of bad things happen as happened during alcohol prohibition in the 20s. All right. How about a case -- is that conclusive? Does that mean we shouldn't think about doing something about tobacco? Pass this down if you would. >> There are some evidence to suggest that prohibition doesn't actually reduce use or at least reduce the concentration of use, as opposed to education, specifically talking about smoking when it was widely -- became widely known that smoking was as harmful as it is, just the educational aspects of that encouraged a great deal of people. I think the number was as high as 50% to quit, and which is certainly a statistic that prohibition can't claim in any regard. >> Professor Kleiman: All right. So the claim here is that prohibition is going to be less successful than education. And the evidence is that without prohibition, we reduce prevalence of smoking among adults from something like 50% to something like 23% the last time I checked. >> Yeah, and along with that there's also the argument that when a substance becomes prohibited, it becomes harder for people to get help, that the taboo encourages use in that way. >> Professor Kleiman: Mm-hmm. But notice something curious. If it's true that prohibition is less effective in reducing consumption than education, then you'd expect that some of the currently prohibited drugs would be more widely used than tobacco. Right? But in fact the prevalence of cocaine abuse -- cocaine use -- is down around 1.5% of the population. Right? So tobacco is used by 15 times as many people, as use cocaine. >> That started off with a social acceptability with tobacco that didn't exist with cocaine, and also there's the argument that's been displaced. >> Professor Kleiman: That it's been... >> That use has been displaced by other drugs that are also illegal. So we're not -- we're sharing the field [inaudible] >> Professor Kleiman: Right. They're sharing the field more, but in fact, prevalence of use of all the illicit drugs combined can't get us anywhere near tobacco. If we legalize any of the current illicit drugs and the consumption level rose to the tobacco level, that would be a huge increase in the number of users. In fact, the history of prohibition is not as quite as it's often made out. The best measure of heavy drinking by long-term heavy drinkers is death from cirrhosis because that usually results only from one thing. Cirrhosis death numbers fell by two-thirds in the early years of prohibition. So the claim that prohibition is not effective even for a drug as widely used as alcohol or tobacco, seems to me hard to sustain. But there's still this different claim that if we made tobacco illegal, we'd have a huge illicit market and we'd be improperly interfering with people's private choices. Let me take a look at the private choices argument for a moment, because I don't think it's quite as transparent as John Stuart Mill thought it was. So typical person who starts smoking in the United States is 18 years old, right? And Mill by the way did not extend his principle to minors, so obviously to him the children ought to be ordered [phonetic] around by adults. Now, maybe he wasn't right about that. But it'd be hard to make the strong claim that adolescents have full foresight about the consequences of their actions on the rest of their lives. But in addition, when a 50-year-old man drops dead of a heart attack due to smoking -- by the way, heart attacks are more frequent cause of death for smokers than lung cancer. Is that person the only person affected? Right? Was he doing something that was self-regarding in Mill's sense? Right? He might have a wife, might have children. Right? I mean, I don't know what the willingness to pay is not to be widowed or not to be orphaned, but it's probably not small. And the notion that the 18 year old who decides to take up smoking and become addicted to it has full foresight about the damage that that decisions could do to the wife he hasn't met yet and the children who haven't been conceived yet strikes me as far-fetched. So particularly with behaviors, they tend to somewhat escape self-control, right? I mean, we all know about bad habits. You know, our mothers all told us not to develop bad habits because they're hard to break. That seems to be was good advice. And the drugs we're going to be talking about are drugs that frequently form bad habits. Now, by frequently I don't mean more often than not. The only drug I know of that's abused by most of the people who use it is nicotine in the form of tobacco cigarettes. About 90% of American smokers, people who use cigarettes at all smoke between half a pack and a pack and a half a day. They are habituated. Most pipe smokers, by the way, are not. Right? So it even matters what form you're using. For most of the other drugs, for alcohol, cocaine, cannabis, the rate of developing a bad habit is between 10% and 25% over a lifetime. [Inaudible] not a huge risk but not a negligible risk either. Right? That's a risk of getting into a situation where you're saying to yourself or other people, "Gee, I really need to do less of X. I really need to cut down on my drinking, but I'm having a hard time doing so." Now, that's a hard sentence for an economist to parse, but it seems to me it's not hard sentence for any ordinary human being to parse. We all have bad habits, and if there are things that are bad -- sorry, bad habit traps, we might even want to think about not making them ordinary articles of commerce the way we have with caffeine. How many people here would get a headache if they didn't have their cup of coffee in the morning? Okay. That's a withdrawal syndrome. I thought I'd mentioned that. Yes, sir? Mic, please. [ Footsteps ] >> I just wondered if there's a factor here, the economic factor. As members of a society, we are going to bear as we go through life, millions of dollars curing that is or shepherding toward death people with lung cancer, people with heart conditions, et cetera, et cetera. Is there an argument made perhaps not of banning but somehow making -- shifting the responsibility to the people who have decided, "Oh, I'm going to smoke and enjoy it."? Let them pay it. Okay. Very, very strong point. So both insurance policies and progressive taxation make health-damaging behavior not entirely self-regarding in those sense. Right? I have an interest in the smoking behavior, but everybody who has the same insurance plan I do because I'm going to pay a premium that's based on how sick they get. Now, it's fair to point out that everybody is going to die of something and it's not clear that smokers die more expensively than the rest of us, but they die a lot earlier. Basic fact about cigarette smoking is that if you're a pack-a-day smoker, your mortality at every rate is [phonetic] -- ages twice what it would otherwise be. Right? So people are getting sick sooner which means, you know, discounting means their disease are more expensive. And of course they're missing more time from work, probably consuming more healthcare, before they die. So, yeah, there's some losses to others from smoking and there's second-hand smoke damage. I think when you do the arithmetic, the 400,000 deaths a year which almost entirely the death of smokers, deaths from second-hand smoke are pretty rare. Right? If you're a bartender or a cabin attendant or the infant child of a pair of smokers, you're being exposed to enough second-hand smoke to do some damage. The rest of us, it's an annoyance; it's not really a health damage for those without allergies, but 400,000 deaths a year? If you think about what those people would pay not to die -- and lung cancer is not a good way to go. That it seems to me is where the losses are concentrated, so we get back to the question whether it's legitimate or when it's legitimate to interfere with people's personal choices in their own interests. Again, the John Stuart Mill answer is "Never," might want to modify that a little bit. Say, when I do a survey of smokers in the U.S. and ask them, 90% will say that they wish they'd never started. Now, okay, that's the socially desired response so I got to mark it down a little bit for that. But, you know, if 8 out of 10 people who do something report that they wish they hadn't, then I'm at least somewhat prepared to think about whether new people should be prevented from taking what seems very likely to be a bad step. Right? So there's an example in "On Liberty" where Mill asked the question, "Imagine that you know that a particular bridge has been blown down by some recent storms, and you see somebody walking toward that bridge. And because of the current windstorm, he can't hear you when you shout at him. Are you interfering with his liberty when you physically restrain him from walking across the bridge which will not support him?" And Mill's answer is "No. Liberty is being able to do what you want to do and he doesn't want to fall into the river." Now, I would argue that that 18 year old does not want to become a nicotine addict. Now, again, that's supported by survey data to suggest that most young smokers expect not to be smoking a year from now, that expectation is just wrong. So, my bottom line doesn't have to be your bottom line. There are forms of tobacco that are not carcinogenic. You can grow and cure tobacco in a way that does not produce what are called "tobacco-specific nitrosamines." The Food and Drug Administration under pressure from the anti-smoking groups has forbidden tobacco companies from advertising if they have a non-carcinogenic tobacco product. That seems to me like a very weird policy. But even if you're not getting any carcinogen, you're still getting lots of heart gases and particulates and ammonia and God knows what else. On the other hand, nicotine is really not very bad for you -- nicotine itself, the active agent in cigarettes. Some maybe cardiovascular issue because it's a vasoconstrictor but there's not much. So the people who chew tobacco -- very little health impact unless they get a mouth cancer. And, again, there's a version of chewing tobacco that doesn't have any carcinogen. So Sweden has a product called Snus, which is, you know, an oral tobacco product, and it seems to have cut the rate of smoking among Swedish men by half, compared to anybody else in Northern Europe, even those Swedish women who do not use Snus smoke at the same rate anybody else in Europe. So that looks like to be a pretty straight substitute for smoking that's non-carcinogenic and doesn't have any other health damage. There's also the e-cigarette. It's basically a crack pipe [Laughter] that vaporizes nicotine and so you're breathing in pure nicotine fumes, not as far as I can tell, bad for your health. And though it doesn't have the flavor of the cigarette, it has all the psychoactive properties of the cigarette other than the flavor. So I'm prepared to go as far as to say, and since we've got lots of forms of tobacco that people use instead, other tobacco cigarette or lots of forms of nicotine, if people can use these instead of tobacco cigarette, I will be prepared to ban sales of tobacco cigarettes, make them illegal; and maybe provide maintenance supplies for existing smokers who can't be persuaded to switch to the e-cigarette or the nicotine patch or a pipe or a chewing tobacco or whatever it is because I think 400,000 deaths a year is just too many to take. And I suspect if you did it that way, you could minimize the illicit market. I could be wrong. We've already got a fairly large illicit market in tobacco just because we tax it a lot. Right? In New York City, pack of cigarettes is 12 bucks. Two-thirds of the cigarettes sold in the South Bronx are illegal cigarettes, mostly smuggled in from North Carolina. So the big point here, deciding not to prohibit cigarettes in New York doesn't mean you don't have an illicit market in cigarettes. But there's a fantasy that we could legalize things and put very tight taxes -- high taxes and tight regulations on them. If all the benefits of prohibition and none of the cost, but that's an obvious fallacy. The taxes and the regulations need to be enforced the same way the prohibitions do. All right. Alcohol. Can alcohol be legal? Yes? >> Yeah. >> Professor Kleiman: A 100,000 deaths a year, a lot of those non-drinkers. Right? Half to homicides, half to auto accidents, almost all the boating deaths. Very large fraction to suicides -- those are drinkers of course. Almost all house fires turn out to be people who both smoke and drink and fall asleep with a lit cigarette. And so all the cost we take, you know, in flame-resistant fabrics and stuff is all the cause of somebody else's drinking; and an extraordinary amount of crime and incarceration due to crime. Not well known, alcohol is legal; arrests for breaking the alcohol laws, not for alcohol-induced bad behavior, which is a very large category. We just look at reaches of the alcohol laws. Not what would those be? How do you break the alcohol laws given that alcohol is a legal drug? >> Underage drinking. >> Professor Kleiman: Underage drinking. >> Driving while intoxicated. >> Professor Kleiman: Driving while intoxicated, drunk in public, sales to minor which goes with the underage drinking. >> Buying on Sunday. [Audience laughter] >> Professor Kleiman: I think people don't get arrested for that. Yeah, so but if you add up -- oh, and drunk and disorderly, right? You add those categories of arrest up; you get to 2.5 million arrests per year in the U.S. It's about 20% of all arrests in the United States are for breaking the alcohol laws even though alcohol is no longer prohibited. If I did that same calculations for all the illicit drugs combined, all the sales offenses and all the possession offenses comes to about 1.4 million. Jon Caulkins, my coauthor on the two books that were mentioned last, did the following calculation. Look at people who are clinically dependent who have habits for marijuana and for alcohol; and look at arrests as a ratio to dependent users. It comes out to the same number. So legalizing alcohol did not reduce the number of alcohol arrests, though it greatly reduced the violence in the alcohol market, greatly reduced the number of people going to prison. Though even then, North Dakota, one-third of all state prisoners are in for DUI. DUI is a very, very hard crime to deter people from committing for one simple reason -- most people know that they should not drink and drive when they're sober, it's only when they're drunk that they forget that they shouldn't drink and drive. [Audience laughter] And they're being -- well, the one thing we know about alcohol intoxication is it greatly reduces the salience of the future in people's decision making; that's the reason it's used for seduction. So you give somebody a drug, that reduces his concern for the future, you just -- it reduces his deterrability; and that's the reason that despite ferocious penalties, drunk driving continues to be a very frequent activity. So, but, we tried prohibiting alcohol and didn't really have very good time at that; though as I said earlier, it's been 80 years since we de-prohibited alcohol and I want to ask "Zippy the Conehead" a question. Are we having fun yet? Right? Alcohol generates more arrests, more death, more dependency, more disease, more injury, more crime than all of the illicit drugs combined. So if alcohol prohibition was nobody's idea of a success, not very easy to argue that alcohol legalization has been such a sterling winner either, and the competition between two not very attractive policies. You have at least two policies with not very attractive results. So, let's assume for the moment that we're not going to prohibit alcohol which of course we're not, and think about what else could we do. So let's look at the "How legal should it be" question with respect to a drug that's currently legal. How could we make alcohol less of a problem without going as far as prohibition? Yes, sir. >> Increase the price. >> Professor Kleiman: Could increase the price. Right? Price less is either going to end [phonetic], and it turns out the sensitivity of alcohol consumption to price is very high for two groups of people -- poor people, which includes most teenagers; they have a lot of disposable income compared to adults, and heavy drinkers who are using a large fraction of their income on alcohol. Right? So if you have a drink a day and we tripled the federal alcohol tax from basically a dime on a beer to 30 cents on a beer, well, if you have a beer a day that's 20 cents a day is 70 bucks a year. Ah! Round the year. [Laughter] If you're a six-beer-a-day drinker, it's a bigger hit. 50% of all the alcohol consumer in the U.S. is consumed by the 10% of the drinkers who consume four or more drinks a day on average year round. Another 30% is the next decile that do two to four drinks a day. So 80% of the booze goes to -- well, only 20% of the alcohol goes to people I would consider social drinkers, who average two or fewer drinks a day. So when the alcohol companies tell you they're in favor of responsible drinking, they mean that they intend to go out of business [Audience laughter] because it's not responsible drinkers that built all those breweries. So, we could raise the price. If we triple the federal alcohol tax, you'd bring it about $17 billion a year to the federal government, even adjusting for the fact that there'd be less consumption. And according to Phil Cook at Duke who's done these numbers, we would reduce auto accidents by about -- fatal auto accidents by about 2000 a year and homicides by about 1000 a year. 3000 lives a year we just saved without putting anybody in jail because there's no way that extra 20-cent alcohol tax is going to generate an illicit market in alcohol. So that is the closest thing I know in public policy to a free lunch. It's a policy that puts minimal burdens on responsible drinkers, puts heavier burdens on people who are drinking too much and saves a lot of injury both to heavy drinkers and to third parties without generating any need for enforcement. Right? I can literally do that with a stroke of a pen because the taxes are pretty straightforward to collect, because people drink branded alcohol. If people are drinking a lot of hard cider, it'd be harder to collect the tax. But if they want something that says "Coors" on the label, then they're going to have to pay the tax to get it. So if I left you with one thing this afternoon, that would be it, that at a moment where the federal government and the state governments are in fiscal crisis, it is a crime that nobody's looking at booze. Most of the ways we could raise taxes, particularly at the state level, are destructive. Here's a way to raise taxes that actually improves other things, as well. So that seems to me obvious. It's of course, a political non-starter given the power of the beer distribution lobby. What else? Other than raising prices is there anything else we could do about the drinking problem? Yes -- mic please. >> Limit the content of alcohol... Limit the content of alcohol percentage. >> Professor Kleiman: Okay, and with what benefits? >> If the price stays the same, it's kind of analogous I think to increasing the price. >> Professor Kleiman: Oh, sure but that's just a different way of saying a tax increase. Remember, two-thirds of the alcohol consumer in the U.S. is consumed as beer, the lowest potency form. And there's no evidence that people are less likely to get drunk on beer than or anything else. So I'm not sure other than is a hidden tax increase potency rules would have much effect. Yes, sir? >> States have different ways of regulating the sale of alcohol, so I know in Arizona we have drive-thru liquor stores where you can get alcohol until 1:00 in the morning, so I would say probably it's not the best idea if you want to cut down on drunk driving. >> Professor Kleiman: Now [Audience laughter], New Orleans beats that. They actually have drive-thru bars [Audience laughter]. I'm serious, you can actually, you know, stop at the window and get a drink in your -- yes, there's evidence that regulation on time and places of sale matters because a lot of drinking is impulsive. Right? If people really were, you know, foresightfully planning ahead, of course they could stock up on booze first, but it turns out time and place regulations matter -- not a ton, but some. What else? >> More stringent protections on bars selling to intoxicated people. >> Professor Kleiman: Okay. So the current rule is that bars can't sell to people who are currently intoxicated, but not clear how well that's enforced. >> What about alcohol rations? >> Professor Kleiman: Alcohol rations. Okay? Now, it's actually a serious idea. Sweden had it for a long time and actually the politics of that was interesting. Sweden had it, it was a state monopoly system and everybody had a card and you could buy against your ration and that was much as you can get that month. And that was ended in the 50s when the Swedish Prohibition Party got some votes and the socialists who were in charge didn't do so well in that election. I mean, they used the Prohibition Party to form their coalition. And the Prohibition Party thought it was immoral for the Swedish state to be selling alcohol, so they insisted on going to private distribution. Anyway, it seemed to have worked recently well. A creative version of that would be to say, "Yeah, you've got to -- and remember, technically those things are much easier now, right? Visa has no problem regulating my use of credit and, I don't know, 200 million merchants around the world. So it shouldn't be hard to regulate my use of alcohol, most of those bars are computerized anyway. A creative version of that would be to say there's a quota and you set your own, which would allow people who have a problem controlling their drinking to make one decision a month. And, you know, a way to allow their long-term planning self to have a little bit of control over their impulsive self. So, yes, we could limit how many people drink too much by limiting how much people drink. Now, you have to worry about somebody providing some of his quota for a friend who wants to drink more heavily. That might be a big enough problem to destroy the idea, or it might not. Notice, everything we talked about so far treats all of the drinkers alike. But in fact, it's only a small minority of drinkers who are repeatedly drunk and disorderly, who commit drunk and assault or drunk and sexual violence, or drive drunk. Now, what do we do when we convict a drunk driver? What's the sentence, first-time DUI? >> Off the road for 30 days? >> Professor Kleiman: Yeah, you lose your driving license. We don't actually know that he guy is a bad driver. Right. Well, what we know is that he's a bad drinker. When he's drunk he forgets his civic duty not to drive drunk. So I would propose instead of taking away his driving license, which doesn't work very well, it turns out, because they just drive suspended -- take away his drinking license. So I'm a resident of California. [Papers shuffling] Here's my California driver's license. If I were younger, then unfortunately I am [Audience laughter], the picture would be on the other side of the license and it would be in three-quarters rather than full face. So if a bartender or a package clerk asked somebody to see his driver's license, he doesn't have to do the arithmetic by looking at the date of birth. If the person is too young to drink, he has the driver's license that shows it on his face. So my proposal is you catch a DUI, maybe he would take away your driving license for a while, as well, but when you get it back it has the "non-drinker" marking on it, which means that everybody has to be carded. Right? If you want to buy a drink, you're going to have to show some ID. It seems to me not, again, a horrible imposition given what fraction of drinks are paid for with credit cards. You'd have to worry about an illicit market developing to supply the banned drinkers, but notice that compared to the age restriction, a ban on drinking by problem drinkers; they have a lot more moral legitimacy. I think people would be much more reluctant to provide a drink for somebody who is a convicted drunk driver than to provide a drink for somebody who is 20 instead of 21. Nobody really think it' morally wrong for a 20 year old to drink. I don't know that you can make that work. I know that it's something well assured of prohibition that's much tighter than our current system. We could take the 5% most problematic drinkers and de-license them. We could probably cut the alcohol problem in half. Now, I can think of a thousand administrative problems to go with that. None of them is bad as the administrative problems with prohibiting cannabis. Right? So the case for leaving cannabis is fully legal -- I mean, fully illegal -- and allowing problem drinkers to go right on drinking. It seems to me hard to make out. All right, enough on alcohol. I just want to suggest that short of prohibition there's a lot we could do. We are most problematic currently illicit drug. [Background Sound] All right, marijuana, right, sort of the obvious candidate for legalization. Pieces of it are happening. There are three states this fall that will vote not on medical marijuana but on full legalization of production and sale for nonmedical use -- Oregon, which has the most bizarre proposition I've ever seen [Audience laughter]. Honestly, the proposition is just a long set of "whereas" clauses, and one of the "whereas" clauses is that "whereas the prohibition of marijuana forbids the use of "herb-bearing seed" as given to mankind by God in Genesis 1:27 [Audience laughter]." Marijuana prohibition is a violation of religious liberty as protected by Oregon Constitution Section Number 135 [phonetic] [Audience laughter]. So my summary of the proposition is what is -- it's what you get if you've got some tea party guy really, really, really stoned. [Audience laughter] That was going nowhere but Washington State and Colorado have much more reasonable piece of legislation that might actually pass. I think Washington State probably will pass, which will set up a very interesting conflict between federal law and state law. Well, why not nationally? What's the case against making marijuana legal nationally? Just the way alcohol is. It's by many accounts a less dangerous drug. Less toxic physically, somewhat less likely to form a bad habit, somewhat -- it forms a bad habit that's somewhat easier to get out of. I mean, there are some very, very long-term chronic dependent marijuana users, but that's much more rarer, much more uncommon than being a chronic long-term drunk. And of course, there's less violence. Marijuana intoxication has lots of bad characteristics but it very rarely unleashes aggression. So, why not? Sir? >> There's no good test for whether you're intoxicated or not? >> Professor Kleiman: There's no good test for whether you're intoxicated or not, and therefore... >> It's hard to prove if someone's driving... >> Professor Kleiman: Right. So it'd be hard to enforce the laws against driving under the influence. If the prevalence of cannabis use went up, there'd be a lot of people at least potentially driving under the influence, and the law couldn't do much about it. And the issue here is that with alcohol, if it's in the blood, it's in the breath, and so the breathalyzer test is a pretty cheap way of figuring out whether somebody's impaired or not. In the case of cannabis, you actually have to take a blood sample which cops are not going to do at the roadside. So that's a serious argument. Then you have to ask, "Well, how bad is stoned driving?" Yes? [ Noises ] >> In my experience, it's the argument against legalizing marijuana, simply goes to public perception that, I don't know if it's a generational thing but marijuana is sort of "reefer madness" [Laughter] and the alcohol is winked at. We use alcohol at celebrations, at weddings, in movies, and television if someone is having a bad day they have a drink so that they feel better. But marijuana is for -- even for -- I run into -- even for medical use, it's still considered taboo. >> Professor Kleiman: Right. Right. So if you think about the politics of this, there's a large chunk of the population that just regards cannabis use as evil and weird, and wants to suppress it. There's generational change there, right? That opinion is concentrated in at increasingly high ages, so -- but here's a harder question. Every culture is defined in part by the drugs it uses. Right? And very few cultures have ever had multiple drugs that people use whenever they wanted to use them. Right? If you look anthropologically, drug use is always very tightly custom-bound. And just think about even, you know, American society, there are customs around alcohol use that are not fully observed, but people sort of know they're not supposed to drink when they get up in the morning. [Audience laughter] Right? But they're not supposed to drink and drive. Right? So we don't have -- oh, and there's a set of rituals around alcohol use that somewhat limit the damage and again, that varies enormously within subcultures. So if you look at Europe, you get two very clear patterns about drinking. You get the Mediterranean pattern which is mostly wine, mostly with meals, mostly with family and rarely get drunk. Now, it's hard to say the Italians don't put away an awful lot of alcohol and their livers notice, but Italy does not have a drunk and violence problem. The Northern pattern, where the north starts about at Paris, is beer and distilled spirits in all male groups to drunkenness. And it's hard to tell whether it's the form of alcohol used, or the ethnicity, or the religion because it turns out to be largely the same line as Catholic Protestant, or just the long winter nights up north, right, every high-latitude country has a bad drinking problem because that's the way you get through a 16-hour night. But Northern Europe drinks badly and Southern Europe drinks well. I'm told by people who spend time among upper middle class people in Australia where cannabis use is relatively widespread, that the norm of use is passing a joint around before dinner and everybody has a puff. And when an American shows up and goes, [Background Sound] he's just regarded as unbelievably rude and vulgar. [Audience laughter] "What, are you trying to get stoned?" So one argument is that we do not have in fact norms of responsible cannabis use and therefore we should expect a bumpy ride. And a different argument is, well, we're never going to get unless we normalize the behavior. Yeah? >> Back to the earlier question, my concern would be -- my concern would be, Philip -- I don't want to legalize marijuana only because I don't want Philip Morris selling it, and I don't want the government selling it either. And my concern back to where you were is that any profit maximizing firm is going to try and set those norms, and I'm not really excited about that. >> Professor Kleiman: Right. So if -- I mean, I actually don't believe the tobacco companies would have any role in the marijuana market for the following reason. I think a lot of their tobacco customers would be horrified to have their normal, say, an American behavior, identified with a hippie crap [Laughter], so I think going into the marijuana business would wreck Philip Morris' tobacco business. And I also think that the curse on tobacco would mean that if Philip Morris marijuana product would have to go absolutely nowhere in the market. But, there'd be a marijuana company and just like a beer company, it would be completely dependent on chronic [inaudible] wake-and-bake stoners, because the Saturday night marijuana smoker just isn't using enough to matter. So, yeah, I'd be worried about marketing. It's interesting the state monopoly, right? So New Hampshire is, you know, the home of the state lottery, absolutely irresponsible heavy marketing of addictive gambling. And yet we know of things that are state monopolies that are handled in a health and safety way and not in a profit-maximizing way; it's really hard to tell. A different version of it will be that people grow their own or form coops, so there are no businesses. You could also do a quota, but the fact that you can actually grow your own probably matters a lot for cannabis. A big question here is if we legalize cannabis, what happens to heavy drinking? The advocates of marijuana legalization will tell you, "Well, much better to have people get stoned than get drunk." And that's a reasonable thing to say, but how do we know that people are going to get stoned instead of getting drunk rather than doing both? And the evidence is completely indecisive as to whether the two products are complements or substitutes. And if legalizing pot led to more heavy drinking, it'd be very hard to see any advantage to legalization that would outweigh the damage from additional heavy drinking. Big advantage from legalization is more than 10 million people allowed to do something they like to do and do with no harm to anybody else, without breaking the law. That's a big gain; they're suddenly on the right side of the law, possibly better citizens. In other ways; getting higher quality, more reliable pot, saving a lot of money, not putting $15 to $30 billion a year into the hands of criminals, not having 800,000 arrests a year, not having 30,000 people behind bars at any one time. I know those are all pretty big gains. My view is, if we legalize cannabis and we only got a doubling in heavy marijuana use. I mean, there are about 3 million people in the U.S. today, or if you do a survey, will report themselves as having a marijuana habit that's interfering with their lives -- 3 million people. If that went to six that would not be a small social loss. I think that's about the best outcome you could expect from legalization. On the other hand, given all of the cause of the legality, I would say that's probably a good deal unless it increases heavy drinking. But if instead of six it went to nine, 12, 15, that's about how many heavy drinkers we have? If we had as many heavy smoker -- pot smokers as heavy drinkers, and it was "instead of," "instead of." So in addition to "instead of," "instead of," would losing the cause of prohibition be a good enough reason to incur that additional damage? Harder to tell, and I want to claim we have no idea until we specify a legal regime and a price and a set of marketing rules where they are more likely to get the doubling or the quadrupling. Yes, sir -- or sorry... >> I was going to mention [Inaudible] for concern about increasing the rate of cigarette smoking with legalizing pot smoking. >> Professor Kleiman: Why do you think that? I hadn't thought about that. >> You hadn't thought about that? Well, right now they go together; 50% of the marijuana users smoke cigarettes. Depending on which studies you look at, sometimes cigarettes come first, sometimes marijuana is coming first nowadays, since the ban on cigarettes has gone... >> Professor Kleiman: Very interesting. >> ...they've cracked down. So, you know, once you break the smoking -- into the smoking the types of cigarettes, all of a sudden it becomes more palatable for... >> Professor Kleiman: Now, there's a question about whether if cannabis were legal, people would smoke it in the sense of burning the leaves and breathing the smoke rather than just getting a vaporizer, which again is much less damaging to health. But you're right, it's certainly a risk. All right. So I'm going to leave -- yes, sir? >> Isn't it possible to... Do you think it'd be possible to lessen the manner fashionability [sic] in smoking marijuana similar to what's happened in cigarettes? >> Professor Kleiman: Hard to imagine that that could go along with legalizing it. Right? So illegality... >> I mean, if you didn't legalize it, instead try to just market it like [inaudible] cigarettes, I don't know... >> Professor Kleiman: All right, so you could try to de-market it? >> Yeah. >> Professor Kleiman: Right. Well, that's what their programs do, right? And we get some effect -- I don't think we have them. The thing about smoking is, when the anti-smoking campaign started, people didn't know how about bad smoking was for you. Right? There's just not a lot of bad news about marijuana that still remains to [inaudible] out there. All right. So I want to leave cannabis as I don't know. I don't know, just -- I mean, if you asked me what I would do, I think I would say, "Let people grow their own" or have small not-for-profit coops producing for them without avoiding the marketing problem -- maybe. Would that really eliminate the illicit market? Would people just want to, you know, get from the -- who knows? It's hard to tell. All right. How about cocaine? Right? I mean, so far we're two-thirds of the way to this discussion and we haven't mentioned at all any of the drugs that lead there to be half a million people behind bars in the U.S. Right? We have a shocking incarceration problem in the U.S. -- 1% of all American adults are behind bars right now. We have more prisoners in the United States than any other country in the world, not more prisoners per capita. We have more prisoners than China. We have five times as many prisoners as we've ever had in the history of this country, and about 20% of that is drug law violation. So we have as many drug law violators behind bars as anyone in Wales has a total people behind bars per capita, and about twice as many as the Netherlands, right? Netherlands runs about 70 prisoners per 100,000 population, we run about 750; so colossal incarceration problem. Again, only a piece of that has to do with the drug war. Those people are in prison as dealers, not users, despite the legalizer propaganda, and they're in prison for overwhelmingly heroin, cocaine, methamphetamine, not for cannabis. So, if we want to end the drug war, playing around with marijuana is not going to get us any place. We're really concerned about the illicit drug business, about the violence and [phonetic] the illicit drug business, about the incarceration, that's all on the, if you will, hard drugs. So, should we legalize cocaine? [ Noises ] Reason to, reason not to. Why should we legalize cocaine? Take away $30 billion a year from criminals. What's the downside of legalizing cocaine? >> It's very addictive. >> Professor Kleiman: Very addictive and therefore if we legalized it? >> [Inaudible]. >> Professor Kleiman: They have more use and more problems, and more people ruining their lives. And in the case of cocaine we absolutely know that it's complementary with alcohol. So cocaine legalization would definitely mean more heavy drinking, more combination use of alcohol and cocaine. Now, just as a pharmacological matter, if you're drinking and use cocaine together, a molecule forms in your blood stream called "cocaethylene"; and unlike either alcohol or cocaine alone, you can show in the laboratory with rats that cocaethylene directly generates aggression. So the alcohol cocaine combination -- very, very, very, very bad combination; and we know that it would be used. Right? The limiting factor on getting drunk is passing out; cocaine will take care of that problem for you. The big disadvantage of a long cocaine binge is you can't get to sleep; alcohol will take care of that problem for you. So these are naturally complementary drugs. >> Caffeine works that way with alcohol... >> Professor Kleiman: Yes, not as effectively -- not as effectively. Yeah? But yes, that's the reason there's rum and coke. >> Okay. There would also be more users probably because it would be a lot cheaper, and that's why people use other stimulants like meth is because it's so expensive from the risk of, you know, criminality. >> Professor Kleiman: Right. So cocaine if it were legal. Right. If you go back to marijuana, marijuana if it were legal would trade at something at 1% of its current illicit price plus whatever the tax we put on it. Cocaine, it'd be more like 10% of the current illicit price. But there'd be a big drop in price in addition to a big increase in availability and therefore you'd have to expect a huge increase in consumption and problem use. Yeah? >> Who would supply it? >> Professor Kleiman: Okay. Well, would supply it? That's an option, right? So Parke-Davis could supply it, right? I mean, it used to be a pharmaceutical drug, right? And, you know, it could be next to the pseudoephed in your pharmacy. I think it's going to be thought through carefully what illegal cocaine dealership would look like. But I do want to claim that all the people who say the drug war is terrible and therefore we have to legalize marijuana are just missing the point. Right? The big stake here is cocaine and cocaine seems to be, along with meth, about the least legalizable drug there is. Now, if I were speaking entirely from the perspective of Mexico, or the South Bronx, places that are being devastated by cocaine prohibition, I might say, you know, people have to learn to deal with it. The distributional consequences of prohibition or the benefit mostly white -- mostly middle-class neighborhoods, most of the country, and to harm a relatively few poor urban minority neighborhoods that are being devastated both by the abuse that these drugs which are available there and by the dealing. Right? So they're not getting any benefit from prohibition and they're going to shift from prohibition. While, you know, I don't know what the level of cocaine use is in Hanover but it's probably not very high. All right. And it would be a lot higher if cocaine were legal. So Hanover would lose from legalization and Harlem would gain. Suggest to me that this is not going to be a politically viable idea anytime soon. All right, but are we stuck with our current cocaine policies? What can we do about cocaine other than making it legal that would reduce the devastation of the drug control effort? Right. About 300,000 of the 500,000 drug prisoners are in there for cocaine dealing. Proposal? >> Focus the efforts on preventing it coming in to the country? >> Professor Kleiman: Which would mean a different kind of enforcement? >> Yeah, more international enforcement rather than domestic. >> Professor Kleiman: Okay. But let me just say as somebody who's been working at this -- hopeless. [Audience laughter] Hopeless. The stuff comes into the country at about 10% to 15% of its retail price. There's very little we could do at the supply and it would matter. Somebody in the world is going to supply us with whatever drugs once that Americans are willing to sell them or not to sell to Americans. But one direct way we could reduce the number of people behind bars for cocaine dealing is to arrest fewer of them and hand out fewer long sentences. Right. Think about this law enforcement problem for a second. If the police arrest a burglar and put him in prison and the guy next door who is thinking about going into burglary for a trade or has been doing a little bit of burglary says, "Ooh, I guess that's really too dangerous," and quits. Right. So that's the incapacitation effect, locking somebody away and the deterrence effect of keeping people out of that activity. We've reduced the number of burglaries because neither the guy in prison nor the guy who's been scared away is doing burglaries and nobody is doing their burglaries for them. There wasn't a queue of people waiting for an apartment to break into. The apartments aren't scarce. The limiting factor in burglaries is burglars, and if I can deter or incapacitate burglars, I can reduce the amount of burglary. Now, let's imagine instead I have an open crack market in a big city, and I arrest one of the 20 crack dealers and put them away and discourage his younger brother from going into crack dealing. What effect have I had on the amount of cocaine sold in that market? None. There were lots of people waiting for those dealer jobs, many of them people who already have a cocaine dealing eviction, therefore can't get any legitimate job. The volume of cocaine sold is determined by the buyers, not by the sellers. Now, if you had a place that didn't have a cocaine dealer and a cocaine dealer showed up, there'd be value in getting that guy off the street so there's no supply there. But once you have an established mass market, the benefits of more enforcement rather than less enforcement -- negligible. So I believe if we had 100,000 drug law violators in prison instead of 500,000, drugs would be no cheaper and no more available than they are today. That's a very straightforward proposition, reduce -- police force across the country are shrinking. Let's shrink the drug part of that activity, rather than, they penetrate crime part of that activity. And let's change the current system where this ends is with drug dealing are frequently longer than the sentences for violent crime. [ Papers shuffling ] DA caught a large-scale LSD manufacturer and a federal judge gave him two life sentences without parole to be served consecutively, which if you think about it is really a good trick. I think it means it has to do his next incarnation in the federal prison. Now, if he just killed somebody, he wouldn't spend that long behind bars. That seems to me both morally and operationally insane. So massively cut back on the drug enforcement machinery and focus it not on the quantities of drugs moving, but on the side effects of dealing. Violence, corruption and disorder opens street markets that wreck neighborhoods so we could refocus our drug enforcement. Right? Now, so this is a long way from legalizing cocaine. I didn't make anything legal that wasn't legal to start with. You just change the enforcement system and you could enormously reduce the damage that's done by a prohibition without much losing the benefit of prohibition in the form of reduced consumption. I saw two hands. >> What's your opinion on legalizing various psychedelics that might not be as addictive as cocaine? >> Professor Kleiman: Okay. Long story -- short answer -- - yes, under some version of legalization. Do I think you should be able to go to the 7-Eleven and buy LSD? No. [background laughter] The -- if I can use the technical term, the hallucinogens -- LSD, mescaline, DMT, psilocybin -- have very different risks than alcohol, tobacco, cocaine. It's an accident but because they are chemicals people put into their body to influence their mind, they get treated legally as if they were sort of the same thing - well, actually radically different. The risk of the hallucinogens -- very small addictive risk, almost none with the single exception of ketamine -- which is actually a slightly different category; but LSD, almost no addictive risk partly because if you take a dose of LSD today, and then do it again tomorrow, nothing will happen. It takes to your brain a couple of days to be ready to have that experience again, so it's hard to be a daily user of any of these things. That doesn't mean they're safe. The risks of the hallucinogens are people doing stupid things under the influence, yet that urban myth about people thinking they can fly -- that's real; that happens. People do jump out of windows thinking they can fly, or more commonly just one in front of cars because they're not seeing the car. And so people again get killed or badly hurt, as a result of the dumb stuff they do while they're tripping. The other big class of risk is that they can have a very scary experience while they're tripping, and the fact that the experience is imaginary doesn't make it any less scary. And so people can wind up with what is in effect post-traumatic stress from a trauma they experienced in a bad trip. That's the famous flashback story. And again, that's not -- most people have a bad experience can be talked down from it. Most people even have to be admitted to the hospital, get released in 24 hours, nothing particularly horrible has happened, but a small number of people really wind up with some serious problems. And there are some people who do manage to develop a bad habit. I hold Timothy Leary at minimum high esteem [Audience laughter], but he said something very sensible about LSD. He said, "You know, nobody thinks that hitting a golf ball is immoral, or even inherently dangerous. But you're not allowed to do it in the middle of the green." Right? So when you [phonetic] hit a golf ball, you go to a golf club which is set up for that activity and the golf pro will show you how to do it safely. And that's what he proposed for the hallucinogens and I think that was substantially correct. There are already licensed establishments with lots of liability insurance, [Audience laughter] whose job it is to take care of people who want to have these experiences and get them out safely to themselves and others. This is especially important in my view in light of the research that just come out of Hopkins over the last three or four years about people who are interested in having a spiritual experience and are given psilocybin as an aid to that. About two-thirds of them have a major mystical experience which they will report two years later as having permanently improved their lives and rank it as among the five most important things that ever happened to them. Right. That's eight hours of preparation and one afternoon in a room with a couple of guides. And it's a pretty big payoff for a pretty small investment. And I think that's actually a religious liberty question about whether people who, you know, want to drop acid and see God shouldn't be allowed to do that given that their chances of seeing God are pretty high. [Audience laughter] So that's my view about -- I mean, they're valuable and dangerous and ought to be given to people who are well selected and well prepared by people who know what the hell they're doing. And at least for your first few experiences, and I'm sure -- I'm sure that in this wonderful law-abiding place, nobody would think about using an illegal hallucinogenic drug. But if you happen to do that, do it with a babysitter. Find somebody who's been through the experience who knows what it's like, who's prepared to spend some time with you beforehand and be locked to you during the experience; and just agree in advance whatever he says I'm going to do. Right? That's the way to come out of that thing on the other end, you know, in decent shape. So I think that ought to be permitted. I don't think it'll ever be a mass-market activity. I think that's the case where you definitely want the government fighting the drugs or some regulated entity providing the drugs. They're very expensive because, again, it's occasional activity. MDMA; ecstasy is the hard case. The hallucinogens are never going to be a mass market thing. Most people do not want that experience, though -- so I should take that back. It's quite possible that much lower doses would have a much larger potential market. Adults it's considerably less risk. MDMA, a lot of people would want the full experience and we now know that despite the early reports, some people do manage to form a pretty bad habit around MDMA, especially in the context of the rave scene. All of those things are probably useful therapeutically, I'm sure MDMA is and if we can get the prejudices out of the way. There's some recent work on PTSD suggesting that MDMA might be a very important -- not a drug you take because the drug cures the disease, but an adjunct to therapy. [Background Sound] That's all unimportant in terms of the drug war; almost none of the drug war is about the hallucinogens. That's about the personal liberty issue and about the foregone benefit. I mean, I don't think there's any reason to doubt people's reports have benefited from these things if they could made available in a safe and responsible way. So -- and if we could break this out of the whole drug war question, I think we'd have a much better chance of getting some sort of a reasonable answer. [ Noises ] All right. Most of what we said about cocaine have placed methamphetamine only in spades; that's got to be the least legalizable drug ever. The illicit methamphetamine market does a limited amount of damage. Methamphetamine itself has an enormous amount of damage; there's no safe way to use it. So that seems to be like the last thing you'd want to legalize. The opiates are a more complicated question. Unlike the stimulants and unlike alcohol, an opiate abuser is engaging in mostly self-regarding damage. There is nothing more peaceful in the world than a heroin addict who's had his fix. And on the other hand when you make heroin illegal, heroin addicts or users of other potent opioids, I mean, oxycodone and heroin are essentially pharmacologically equivalent. Those people get to be more dangerous because they need to steal to support their habit. And the problem with the opiates is that the desire is a bottomless pit, right, like it's a story about Thor's contest with the giantess where he's supposed to fill a bag and no matter how much puts in it, it will hold more. Five milligrams of heroin will get any naïve user floating pretty thoroughly on the ceiling for a couple of hours. 100 milligrams of heroin would kill anybody in this room. One of the problems with the opiates, very narrow therapeutic index, very narrow range between the effective dose and a lethal dose; and it's unpredictable. In Switzerland where long-term incorrigible heroin addicts are admitted to a program where they can come to a state-run institution and get as much heroin as they want as long as they stay there. Now, they've got -- they have to walk out under their own powers. They leave sober. Some of the people in that trial got up to two grams a day -- 2000 milligrams of heroin -- and they were just being normal, right? That's what they needed to be normal. So very hard to make the stuff available and not have the habits run out of control, given that we have substitution drugs which we don't have for any other class of drugs. Right? We've got buprenorphine and methadone and LAAM, all of which are ways of giving people relief from their opiate craving. That's I think the closest we're likely to get to legalizing those things. What we're going to do about the prescription drug abuse problem, I don't have a clue. I mean, this is really a ticking time bomb under our current drug laws, but the volume of opioids used illicitly that originated in the pharmaceutical market is now larger than the volume of strictly illicit opioids. Right? So the kid with his mother's Percodan prescription has now replaced the heroin dealer and -- so that's the case where you made the drug legal for medical purposes, and then that turned out to spin out of control. All right. Let me turn it over to you. What haven't we talked about we ought to talk about. We've got 10 minutes. Question down here? Question over there? >> Is just targeting crimes surrounding like the cocaine underworld politically feasible, or is that under the umbrella of harm reduction that you can't really do? >> Professor Kleiman: If you don't call it harm reduction, maybe nobody will notice. So I know at least one major DA's Office on the East Coast that asked the police department to make a list of the most violent drug dealers in town, and that's going to be the focus of their prosecution efforts. So, yeah, I mean law enforcement has enormous discretion, but the problem is the whole notion of the drug war, right? So the story was told, we've got this drug problem; it's a single problem; its society threatening; there's three things we do about it -- prevention, treatment, enforcement. So prevention is trying to keep new people from starting, treatments trying to help people who currently have a problem to get out of that problem. And enforcement is basically trying to hold the line while prevention and treatment get a chance to work, right? That's the story that was told going back to at least the Nixon days. In that story, enforcement is the supply control effort and prevention and treatment are the demand control effort. But that assumes that drug law enforcement can actually reduce drug supply. I want to distinguish between two claims that sound like they're the same but I want to argue or not. One is that prohibition reduces drug consumption; I absolutely believe that. If heroin were legal, there'd be an awful lot of heroin users and a lot of them would be heroin abusers, the same thing with cocaine as we've discovered with alcohol. If you're going to prohibit a drug you need to do some enforcement or the law is a dead letter. You know, it's -- Massachusetts I think it's illegal to bowl on a Sunday, but like, who cares? [Audience laughter] So, you need to enforce the law some or it's a joke. But beyond the minimum threshold that forces people not to be flagrant about breaking the law, I suspect that increased drug law enforcement does not reduce drug supply very much. So we're asking enforcement to do a job that it can't do and here's the arithmetic. In 1980, we had 15,000 drug dealers behind bars. Now, we have 30 times that many. The price of heroin is down more than 90% over that 30-year period. The price of cocaine is down about 75% over that 30-year period. So if drug -- we've done the experiment about whether regressed drug enforcement can raise prices -- it looks like it can't, which means we're asking law enforcement to do a job it can't do. And a job that's outside its core mission, right? Law enforcement is supposed to protect safety and order, not to protect public health; but the supply side of the drug war is a public health mission. So I think we ought to redirect our law enforcement forces and say to them, "Look, your job is what it always was, protecting public safety and order. The drug market gets violent, put a stop to it. If it gets flagrant, put a stop to it. Make it clear that there in fact is a law and that people can be arrested for violating it. But it's not your job to shut down the supply and that's the way it seems to me we can maintain drug prohibition and not have half a million people behind bars." And focus the enforcement activity on the minority of drug dealers because there's always a minority that are, in fact, violent and dangerous people -- put them away; in which effort you'd have the support of all the other drug dealers. Sir? >> You answered my question. >> Professor Kleiman: All right. One more -- or two more. Yep? >> Do you think that sentencing could be reformed so that there's more judicial discretion instead of a strict, [inaudible] three years and stuff? >> Professor Kleiman: It would be a good idea. At the moment, the politics of it don't allow it. But it's a strange fact that if you look at this year's two national party platforms, drug policy enters almost not at all and the biggest current movement on the Republican side around the whole crime and drug issue is a group called Right On Crime which is calling for an end to mass incarceration. And the head of that effort was Newt Gingrich. [Laughter] When Gingrich became the frontrunner against Romney -- she was for about three weeks -- Romney absolutely destroyed him, hit him with everything; hit with multiple wives; hit him with government-sponsored enterprises; hit him with health ethics violation; hit him with colonies on the moon. The one thing Romney's people never mentioned was that Gingrich was online, on a public website calling for a substantial reduction in the number of Americans behind bars, specifically on the drug side. So the Romney campaign did not think that that position was a vulnerability for Gingrich in a Republican primary. So all of the answers I would've given a year ago about what's not feasible, I'm suddenly raising questions about. I think the collapse in crime rates has transformed the politics to drugs and crime in a way that may make certain kinds of progress possible that weren't possible before. >> You mentioned MDMA as a hard case because of its clear potential for a therapeutic benefit, but given the, like, potential for abuse if it's fully legalized, how do you feel and to specifically address the legalization of MDMA. >> Professor Kleiman: Well in the case of MDMA, it could be made available for therapeutic use by making it an FDA-approved medicine without changing its availability for nonmedical use, particularly because unlike [snap] Prozac [snap] where you get a prescription and take it home and, you know, take one a day, the therapeutic use of MDMA would be a very small number of sessions with a physician present. So you could legalize MDMA for medical use without ever having a patient have the stuff. So there's a case where we can break out the medical from the recreation entirely. I hope we will see it approved for PTSD -- not soon but, you know, with reasonable speed. There's a different question that an awful lot of people took MDMA and thought it transformed their life; and relatively few of them developed any problem with it, right? So many who takes MDMA once has almost no risk of having any bad habit; it's really an astoundingly safe drug and it has, unlike the hallucinogens, no bad trip risk. There's just no such thing your first time. Right? The weird thing about MDMA is if your risk of having a bad experience goes up with your experience level, so your 20th MDMA experience is much more likely to be unpleasant than your first. So I think it probably is legalizable for nonmedical use, you just have to try to figure out the control system. But that's the case where if you said, "Everybody can have one dose a year," that would cover all of the beneficial uses and none of the problem uses. The real issue with the illegal MDMA today is it's not MDMA. Right? The stuff you buy is ecstasy, I mean, I don't know what the market is around here, but I assume if you bought an ecstasy tab on this campus, your chances of having any MDMA in it at all would be no better than 75% and your probability of getting pure MDMA would be essentially zero. There'd be other crap in there you wouldn't know what it was. You wouldn't know how much MDMA you were getting. It's a drug that's extremely sensitive in terms of the volume. So illicit MDMA is a very, very dangerous thing to use, and, you know, again, that's one I think it's clearly legalizable but not soon. All right. We have run out of time. I'm happy to linger if there are other people who want to ask questions. Thanks for your attention. [ Applause ]