How Would the Candidates Debate Drugs?

By Walter Armstrong 10/15/12

Predictably, in round 2 in the Obama vs. Romney debates there were no questions about drugs. If they had been asked, here's how the candidates would have responded.

Obama and Romney posters photo via

The second presidential debate of the 2012 campaign will dominate the prime-time airwaves tonight at 9 pm as President Barak Obama and his Republican challenger, Mitt Romney, go tongue to tongue in a town hall–style meeting. What will the two candidates have to say about drugs and addiction? If most commentators are to be believed, nada.

You should tune in anyway. Presidential debates rarely decide elections, but this year’s race looks like an exception. After their first debate two weeks ago, where the former Massachusetts governor was widely viewed as trouncing a listless Obama, the horse race has tightened going into the home stretch. The President still leads in most polls—only by a nose.

Questions for the second debate have been selected by moderator CNN's Candy Crowley from submissions from a hundred "undecided" voters who will make up the audience. (They all come from Nassau County, Long Island, with local Hofstra University hosting the debate.)

Although this format may allow for a smidgen of unpredictability in the questions, most pundits expect the “domestic” issues to be about the economy—job growth, the national debt, entitlements, etc.—while “foreign” queries will be limited to Middle East conflicts, the size of the military and trade with China. If there is a “surprise” question, reproductive rights, same-sex marriage, even funding for public broadcasting rate higher than drug issues. Not even the War on Drugs—one of the few issues that is a major policy matter with both domestic and foreign reach—makes most lists.

The political class does not prioritize drug issues, and many Americans do not, either. In a recent Gallup poll, while only 31% said they thought the government was making progress dealing with illegal drugs, only 29% think it is a very serious problem. But, dammit, we at The Fix do! So we surveyed our columnists and contributing writers for the top five drug questions they would ask Obama and Romney.

What follows is what they told us, along with an at-a-glance comparison of the two candidates' positions, based on what they have said or done.

1. The official position of every government health agency is that addiction is a medical disease. Every national association of physicians and addiction specialists agrees. yet the overwhelming majority of government spending on addiction and its consequences goes to the criminal justice system. A much smaller piece of the pie—well under $1 billion nationally—goes to prevention and treatment. Many studies have shown, however, that increased investment in prevention and treatment would lead to improved outcomes—less drug use and more savings.

As president, would you support the disease model of addiction and, if so, would you reallocate funding so that these medical matters have a bigger share of the pie?

Obama: The president's National Drug Czar, Gil Kerlikowske, has led the administration's effort to promote drug addiction as a treatable disease rather than a moral crime. Obama has increased federal funds for improving and expanding treatment centers and prevention programs—but not at the expense of the War on Drugs. His healthcare reform legislation, which he's happy to call Obamacare, requires private insurance companies as well as Medicaid and Medicare to increase coverage for many kinds of prevention and care.

Romney: While he has not commented directly about the moral vs. medical status of addiction, he has promised to "repeal" Obamacare—while offering few specifics about what would replace it. His pledge to cut discretionary spending could result in less access to healthcare coverage. Romney has emphasized drug education as prevention.

2. Since 2001, more than 2 million members of the US military have deployed to serve our country. Of these, an unprecedented number—estimated in the hundreds of thousands—now suffer from addiction or from other health problems like PTSD, brain injury, or depression with a high risk for addiction. Yet a lack of resources has long caused gaps in prevention, diagnosis, treatment and access that continue to thwart their care.

As president, how would you address this growing epidemic among our soldiers and veterans?

Obama: After being criticized for not making strides to improve the VA's healthcare for vets, Obama has won plaudits for tackling mental health–related needs of veterans. For example, he has upped the number of mental health clinicians by 1,600 while adding 800 suicide prevention counselors. He also launched a public/private initiative that would incentivize 135 medical schools and 500 nursing schools to ramp up research and training.

Romney: The former governor has promised to make sure that vets get high quality care, while offering few specifics about how he would do so. He has suggested that privatizing certain VA services, and even the VA itself, would cut costs and raise quality. Similarly he has suggested that cutting regulations would result in cutting vets' very long wait times to access benefits. Critics point out that his top advisor on VA affairs is the Bush-appointed agency chief who was forced to resign after several scandals, including a policy of denying care to veterans in order to keep costs down.

3. The US, with 5% of the world's population, contains 25% of the world's prisoners—even though crime has fallen by 40% in the last 20 years. Some 760 per 100,000 Americans are incarcerated—seven to 10 times the rate of most other developed countries. Over a quarter of those behind bars, or 1.7 million in 2009, have a drug offense as their "most serious" conviction. The vast majority are nonviolent offenders. The average cost of incarcerating one prisoner for a year is estimated at over $31,000. These statistics have many policy experts of every political stripe calling for reform.

As president, what policies would you support to insure that the benefits of our current drug laws outweigh the costs?

Obama: The president has fulfilled some (but not all) of the promises he made during his 2008 campaign regarding reform. He has increased drug courts as well as the sentencing of offenders to drug treatment programs rather than prisons. He signed the Fair Sentencing Act, which not only reduces the disparity in the sentencing of crack vs. cocaine users but eliminates mandatory minimums for possession. In 2009, he rescinded the ban on federal funding of needle exchanges, only to reinstate it this year rather than veto a piece of important legislation. 

Romney: As governor of Massachusetts, he pushed for stricter laws for drunk driving, and he has promised as president to do the same for drug laws in general. For example, he backs sentencing under the three-strikes law. He opposes clean syringe swaps.

4. The Global Commission on Drug Policy famously declared last year that the War on Drugs was a “total failure” and “cannot be won.” The group stated that despite the US's spending $20 to $25 billion a year on counternarcotics efforts over the last decade, the global use of illegal drugs has increased—by as much as 35%. At the same time, price has fallen—by as much as 75%. Drug violence has intensified, especially in Mexico and Central America. Drug cartels are now bigger, militarized, global operations—and harder to combat. The group called for drug possession (and low-level sales) to be "depenalized." Similarly, last summer, leaders of nine Latin American countries called for a debate about legalization.

As president, how would you prosecute a more effective effort to reduce drug trafficking and drug use?

Obama: Drug Czar Kerlikowske made a point of publicly rejecting the term "War on Drugs" in favor of what he called the administration's "third way" approach. Yet few actions have followed up the rhetoric. In his budget proposal for 2013, Obama requested $25.6 billion for drug enforcement—the highest annual total yet.

Romney: He has pledged to increase funding for counternarcotics efforts using military tactics like those employed in combating cartels and narco-terrorists in Colombia. He has also vowed to complete the border fence between the US and Mexico.

5. In next month's election, two states will vote on the legalization of marijuana, and a third on medical marijuana. Many of the arguments against decriminalizing pot have been disproved. For example, marijuana is the least harmful illegal drug and has a better safety profile than alcohol or cigarettes. Countries that have decriminalized pot don't show higher use rates than the US does. The “gateway” theory is not supported by statistics. At the same time, enforcement appears to be discriminatory: African Americans are arrested for marijuana crimes at a rate 10 times higher than that for whites, although they use the drug less.

As president, what would your policy be regarding the legalization or decriminalization of marijuana?

Obama: The president opposes any loosening of the interdictions against pot. As for medical marijuana, upon entering office, he pledged to stay out of state laws legalizing it, but his DEA and Justice Department have conducted more raids on, and prosecutions of, dispensaries in four years than in the Bush administration’s eight-year term.

Romney: He opposes the legalization of both marijuana and medical marijuana, and he would continue federal raids on medical marijuana patients and caregivers.

Will Godfrey, Maia Szalavitz, Katie Drummond, Dr. Richard Juman and George Carter contributed their expertise on these issues.

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Walter Armstrong is the Medical Editor at  Saatchi & Saatchi Wellness and the former deputy editor of The Fix. You can find him on Linkedin.