Even though the majority of Americans do not feel the "War on Drugs" has succeeded, they are not willing to give up on drug-fighting efforts, according to an article in a recent issue of The Journal of the American Medical Association (JAMA).

Robert J. Blendon, Sc.D., and John T. Young, M.Phil., of the Harvard School of Public Health, in Boston, reviewed 47 national surveys conducted between 1978 and 1997. They looked at four areas important to health professionals interested in America's drug policy:

• Where do Americans get their information about the extent of the nation's illegal drug problem, and what are their experiences with it?
• What worries Americans most about the country's illicit drug problems?
• Why do Americans think individuals use illegal drugs?
• What are the public's views on various policy proposals to respond to the nation's drug problems, and what are their implications for the future?

On the final question, the researchers found a paradox: "Most Americans (58 percent) do not see the nation's illegal drug problem getting better after years of increases in national spending, and they see the War on Drugs as having failed thus far (78 percent). Yet, despite this assessment, they continue to support greater resources being expended in generally the same policy direction as has been followed in the past."

They go on to write: "Not only do Americans say that more money should be spent dealing with addiction, they report that they are willing to pay more in taxes (66 percent) to support increased antidrug-related spending."

When choosing among 19 options for reducing the use and effects of illegal drugs, the largest share of strong support is found for more severe penalties for drug sale and possession. The second choice is antidrug education in schools. The third choice is increased funding for police.

A majority of Americans believe drugs are one of the most important causes of crime. Only 14 percent of the public supports legalization of illicit drugs. The researchers write:

"The majority of the public (52 percent) believes that drug-related crime would actually increase if drugs were legalized."

But a majority of Americans support legalized use of marijuana for medical purposes: "In early 1997, separate surveys reported that 62 percent and 60 percent of the American public supported a policy where physicians should be able to prescribe marijuana to their seriously and terminally ill patients."

Among other findings of the study: q Most people rely on mass media for information about the scope of drug abuse in America.

• Although 82 percent of the public thinks illegal drug use is a big problem for society, only 27 percent see it as a major problem in their local communities. Eighty-one percent say drug abuse has never caused problems in their own families.
• Seventy-two percent see drug use as changing the national character; 64 percent of adults describe it as morally wrong.
• Seventy-three percent of adults are very concerned about the possibility of themselves or a family member being the victim of a crime committed by a drug user.
• The majority of Americans believe individuals might begin using illegal drugs because of peer pressure, poor parenting, or because drug dealers are trying to expand their markets.

Illicit drugs lead to approximately 11,000 deaths each year, according to information in the article. More than half a million drug-related episodes are reported in hospital emergency departments. Direct government expenditures linked to illicit drugs total $27 billion annually.

Editor's note: This work was supported by the Robert Wood Johnson Foundation.