Abstract
Since Nixon's 1971 declaration of a “war on drugs,” federal drug policy has been built around a patchwork of institutions that have remained relatively stable despite massive changes in the drug market and drug-related harms, changing cultural norms, and structural changes in social and economic policies. Paradoxically, we argue that this apparent stability arises from a lack of consensus about the nature of drug use and addiction in both elite and public opinion (ideological fragmentation), leaving a modest consensus around law enforcement and, to a lesser extent, public health programs. Drug-related issues have spread into other domains of policy such as child welfare, immigration, food assistance, and general health care, where there is often vigorous contestation around the diverging goals of programs and services (policy sprawl). Support for programs and policies have also devolved to state and local governments. An unraveling of the Nixonian consensus may be underway, however, accelerated by diminished confidence in public health programs and looming cuts to federal funding for drug treatment and prevention programs. Future directions remain uncertain, but the immediate outlook suggests a retreat toward more individualistic and market-driven approaches.
