Obama wants to fundamentally change how we fight the war on drugs

The Obama administration has given a lot of lip service to the idea of treating drugs as a public health problem, not a criminal justice issue. Most recently, White House drug czar Michael Botticelli said, “We can’t arrest and incarcerate addiction out of people.”

Finally, the Obama administration appears to be — and I’m sorry for the cliché here — putting its money where its mouth is.

As Chris Ingraham pointed out at Wonkblog, for the first time since the beginning of the escalation of the war on drugs in 1980s, the White House is asking to spend more money on the public health side of the drug war (“demand reduction”) than law enforcement and interdiction (“supply reduction”).

Here are the proposed budget numbers for the Office of National Drug Control Policy:

Congress will ultimately need to approve this budget, which certainly casts a lot of uncertainty about its chances of happening. But one reason for optimism is that much of this spending would go to Obama’s plan to combat the opioid epidemic — an issue that both parties seem to agree needs serious attention.

The “supply reduction” side is what the drug war is traditionally about — going after drug cartels, drug users, and drug dealers. The idea behind these policies is that by limiting the supply of drugs, prices will go up and a drug habit will be much costlier.

But while this approach has very likely pushed the prices of drugs higher than they would be otherwise, illicit drug prices have still plummeted over the past few decades as drug use has remained roughly the same.

The “demand reduction” spending goes to all sorts of programs, mostly focused on preventing and treating drug abuse as a health care issue. The goal is to eliminate demand for drugs by either treating addiction or preventing it — and if there’s no demand, there’s going to be no market for illicit drugs.

The budget numbers don’t tell the whole story. Recent changes to federal law — the Mental Health Parity and Addiction Equity Act, the 2008 Medicare Improvement for Patient and Providers Act, and Obamacare — imposed new rules on health insurers, requiring them to cover drug and alcohol treatment as an essential health benefit. So people with health insurance are more likely to have addiction treatment covered in their plans.

The shift to a public health approach is in line with public and expert opinion. Polls show that most Americans prefer treating drugs as a public health issue, not a criminal one. And many experts, including the International Narcotics Control Board, have asked for a greater focus on public health policies to curtail demand for drugs.

Still, there’s been a massive gap in access to drug treatment for years. According to 2014 federal data, at least 89 percent of people who meet the definition for a drug abuse disorder don’t get treatment. And that’s likely an underestimate: Federal household surveys leave out incarcerated and homeless individuals, who are more likely to have serious, untreated drug problems. So the White House’s new spending could address a big gap in the health care system.

But the Obama administration’s proposal is also a big symbol of how much times have changed. A couple decades ago, both parties heralded tough-on-crime policies in the war on drugs. Today, there’s a good chance the federal government will soon spend more on public health policies in the drug war than tough-on-crime measures.