U. S. Drug Sentencing Policy: A Health Disparity Barrier to Effective Drug Treatment

Drug abuse is a leading public health disorder in the United States. Drug abuse results from a complex interplay between the individual and the drug. From 1980 to 1986, cocaine use increased from 1.2 to 1.3 million cocaine initiates per year (1) and became a major concern of politicians and law enforcement. In an effort to combat the problem, the 1986 Anti Drug Abuse Act was legislated. This law, with a 100- to-1 crack cocaine to powdered cocaine sentencing provision, resulted in the United States having the highest percentage of incarcerated citizens of any country in the world. While the chemical structure, biological metabolites, and effects of the two forms of cocaine are similar, the legal outcomes vary greatly and disproportionately affect African American and Hispanics. African Americans, who constitute 12% of the total population and 13% of drug users, are 35% of those arrested for drug possession, 55% of those convicted of possession and 74% of those sentenced to prison for drug possession (2). From 1986 to 1991, the number of African American drug offenders in prison increased twice as fast as rates for any other racial/ethnic group, increasing the number imprisoned by 429% (3). This incarceration rate results in poorer health care, disrupted households, loss of income, and separation from parents for children of the incarcerated individuals. Increased understanding of the how cocaine sentencing policy and racial disparities in incarcerating people of color impacts health care is of paramount public health importance. Incarceration is an inadequate treatment for drug abuse. References: 1)U. S. Department of Health and Human Services, Office of Applied Statistics, 1997 National Household Survey on Drug Abuse: Preliminary Results www.oas.samhsa.gov/nhsda/nhsda97/nhsda984.htm 2)Human Rights Watch Report: Punishment and Prejudice: Racial Disparities in the Criminal Justice System, May 2000, Vol. 12, No. 2 (G). 3)How Criminal System Racial Disparities May Translate into Health Disparities Iguchi MY, Bell J, Rajeef R, Terry F. Journal of Healthcare for the Poor and Underserved, Vol. 16, No. 4, Sup B, Nov 2005.