In 1920 the Volsted Act went into effect. This act enabled the legislation for the amendment that prohibited manufacturing, sale and transport of alcoholic beverages; this policy is collectively termed “Prohibition”.  Those who were in support of the Prohibition were motivated by the desire to reduce the detrimental effect of alcohol abuse on individuals and families (Marlatt & Witkiewitz, 2002). These effects included poverty, domestic violence and overall neglect. People who were addicted to alcohol would spend all of their earnings on alcohol and would neglect their responsibilities as parents, spouses and members of the community.
Prohibition was significantly effective in lowering overall consumption of alcohol and the social problems associated with it. After Prohibition went into effect alcohol related death rates, hospital admissions and arrests decreased to an incredible extent (Tammi & Hurme, 2007). However, the benefits gained from prohibition brought about dire consequences that were comparable in severity to the problems that Prohibition was designed to remedy.

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The outlawing of liquor created an underground market for production, transport and sales of alcohol. People who were otherwise upstanding citizens turned to crime because the underground alcohol market was a readily available and lucrative industry. It was difficult to make a living at the time because the nation was faced with the Great Depression. In addition, the prohibition resulted in corruption of the police and politicians, which in-turn nurtured the massive growth of organized crime (Tammi & Hurme, 2007). Also, people who were caught attending an establishment that served alcohol or were somehow recognized to have consumed alcohol, were immediately arrested and prosecuted. The prohibition was a “abstinence only” policy for alcohol consumption, sale or transport. There was no minimum allowed consumption and no exceptions were made; except for those that pertained to corruption. Any amount consumed lead to arrest for a regular person.

With the passage of the 21st amendment in 1933, the prohibition finally ended; primarily due to loss of tax revenue. The nation was already struggling financially because of the Great Depression. It turned out that the loss of revenue from taxing alcohol sales was too great of a loss for the nation’s economy at the time. Americans resumed drinking, but exercised moderation more so than before the prohibition. This suggests that the Prohibition brought about lingering effects on alcohol consumption habits of an average American.

After the Prohibition ended, harm reduction policies took the place of the “abstinence only” policy enacted during the prohibition. Harm reduction policy is one that does not outlaw the use of a substance, but creates efforts to minimize the detrimental individual, social and economic effects associated with the abuse of a given substance. Harm reduction is any measure which decreases the negative consequences of drug use (Kleinig, 2008). These efforts include forbidding sales to minors, educating the public about the adverse effects of alcohol abuse (especially driving under the influence of alcohol), increasing taxes on alcohol and regulating hours of operation and closing times for establishments that serve alcohol.

Currently (depending on the state) a person who is 21 or older may be allowed to have a blood alcohol level that is at or below the legal limit. As long as they pass the field sobriety test and do not surpass the legal limit, the individual is let off any legal consequences associated with driving under the influence. Individuals who are presently struggling with substance abuse issues are treated as victims of a disease. The guidelines for treatment of alcoholism and substance abuse are outlined by the “disease model”. In other words, abuse and dependence of alcohol is now viewed as a disease and not a personal shortcoming; in accordance with “harm reduction” approach. During the prohibition, on the other hand, people who used alcohol were arrested and prosecuted for drinking with no regard for the fact that they are physically dependent on alcohol. This illustrates the difference in approaching alcohol abuse with a “harm reduction” policy versus an “abstinence only” policy.

Both, zero tolerance and harm reduction policies have their strengths and downfalls.  For example, the zero tolerance approach focuses mainly on the immorality of the act of consuming, manufacturing or selling the substance in question, rather than the outcomes of arresting and incarcerating millions of people who could otherwise be productive members of society if they got help for their substance abuse problem (Wodak, 2007). When zero tolerance policy is applied to drug abuse, consumption of a substance in any amount is viewed as categorically wrong, regardless of the social impact of enacting this policy e.g. millions of people serving jail time while they could be contributing to society. The zero tolerance policy focuses primarily on the social responsibility of following rules and ignores the consequence of enacting this policy. The founding principle of zero-tolerance policy is that it is morally just to permit harm if doing so will result in the prevention of more harm from occurring (Wodak, 2007). That would make sense if the techniques used to enact the policy indisputably lead to the greater good. The impact that today’s drug policy has on society is far from a direct path to the greater good. The criminal records, jail time and inability to gain employment after release for drug offenders, are all factors that point to the need to rethink today’s drug policy in the united states. Zero tolerance policy does decrease the negative effects of substance abuse, but this effect is surrounded by a plethora of other social issues that point to this type of policy being “not worth it”. Zero tolerance policy would only work the way it is intended to work in a perfect world. Otherwise, abstinence only policy will continue to nurture the growth of organized crime, decrease contribution to society and make the black market a profitable industry.

Harm reduction, may not reduce the number of addicts, but places priority on public health, instead of focusing on the morality of substance use. In general, a judgement-free stance is upheld by the harm-reduction policy, by focusing on the problems that cause drug use and problems that result from it; instead of labeling individuals as morally corrupt. The individual is viewed as playing an active role in the problem as well as its solution (Cheung, 2000). A notable difference between harm reduction and zero tolerance policies is that harm reduction emphasizes the importance of outcomes, rather than demonizing the intent to use a substance. HIV/AIDs prevention efforts are a major reason for why harm reduction is gaining acceptance by politicians. Reduction of health, social and economic effects associated with substance abuse is now starting to be considered of greater importance than the overall reduction in substance abuse (Wodak, 2007). Harm reduction strategies aim at solving more immediate and dangerous consequences of substance abuse through enacting community-based programs; such as needle exchange, methadone, education for high-risk populations and safety zones such as injecting rooms, where addicts can use drugs in a physically safe environment (Cheung, 2000).

  • Cheung, Y. (2000). Substance Abuse and Developments in Harm Reduction. Canadian Medical Association Journal, 162 (12), p.1697-1700.
  • Marlatt, G. A., & Witkiewitz, K. (2002). Harm reduction approaches to alcohol use:
    Health promotion, prevention, and treatment. Addictive behaviors, 27(6), 867-886.
  • Kleinig, J (2008). The Ethics of Harm Reduction, Pragmatic Strategies for Managing High-risk Behaviours. Substance Use & Misuse, 43 (1), p.16.
  • Tammi, T., & Hurme, T. (2007). How the harm reduction movement contrasts itself against
    punitive prohibition. International Journal of Drug Policy, 18(2), 84-87.
  • Wodak, A (2007). Ethics and Drug Policy. Psychiatry, 6 (2), p.59–60.