MEXICO CITY — America’s drug problem is shifting from illicit substances like cocaine to abuse of prescription painkillers, a change that is forcing policymakers to re-examine the long and expensive strategy of trying to stop illegal drugs from entering the United States.
This rethinking extends beyond the United States, where policymakers are debating how to better reduce demand for painkillers. The effects would also be felt here and in Central America: With the drug wars in Mexico flaming violence, some argue that the money now used for interdiction could be better spent building up the institutions — especially courts and prosecutors’ offices — that would lead to long-term stability in Mexico and elsewhere.
“The policies the United States has had for the last 41 years have become irrelevant,” said Morris Panner, a former counternarcotics prosecutor in New York and at the U.S. Embassy in Colombia, who is now an adviser at Harvard’s Kennedy School of Government. “The United States was worried about shipments of cocaine and heroin for years, but whether those policies worked or not doesn’t matter because they are now worried about Americans using prescription drugs.”
While a major change in policy is not imminent — “It’s all aircraft carriers, none of it moves on a dime,” as one senior Obama administration official put it — the election of a new president in Mexico, Enrique Pena Nieto, is very likely to have an immediate impact on the debate. Pena Nieto has promised to focus not on drugs but rather on reducing the violent crimes that most affect Mexicans.
Mexico and its neighbors, especially Honduras, El Salvador and Guatemala, are withering under a metastasizing threat: violence caused by drug traffickers battling for power, to move drugs, extort businesses and kidnap and kill for ransom. The U.S. response so far has mostly involved a familiar escalation of force, characterized by the addition of law enforcement and military equipment and personnel to help governments too weak to combat trafficking on their own.
Other experts are more critical of the Obama administration, pointing to the continued focus on cocaine interdiction, especially in Honduras, where commando-style DEA teams have been involved in a series of recent raids, including one that left four people dead, including two pregnant women, and another one, last week, in which two people who were said to be smugglers were killed.
“It just hasn’t worked,” said Mark Schneider, a special adviser on Latin America at the International Crisis Group. “All interdiction and law enforcement did was shift cultivation from Colombia to Peru, and the increase in interdiction in the Caribbean drove trafficking to Mexico, and now with the increase in violence there it has driven trafficking to Central America as the first stop. So it is all virtually unchanged.”
What has changed is Americans’ use of cocaine.
The most recent National Survey on Drug Use and Health found 1.5 million people who had used cocaine in the past month, down from 2 million in 2002 and, according to an earlier government survey, 5.8 million in the mid-1980s. (Methamphetamine use has also fallen in recent years, while heroin use is up somewhat.)
Studies show that prescription painkillers, and stimulants, to a lesser extent, are the nation’s biggest drug problem. The same survey that identified 1.5 million cocaine users in 2010 found 7 million users of “psychotherapeutics.” Of the 36,450 overdose deaths in the United States in 2008, 20,044 were from prescription painkillers, more than all illicit drugs combined.
And whereas cocaine and heroin have been concentrated in big cities, prescription drug abuse has spread nearly everywhere. “Today there is drug use in every county in Ohio, and the problem is worse in rural areas,” said Mike DeWine, attorney general of Ohio.
“This is an urgent, urgent issue that needs to be addressed promptly,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse.
Momentum for a broader change in domestic drug policy — as in foreign policy — appears to be building. DEA officials say they have recently created 37 “tactical diversion squads” focusing on prescription drug investigations.