We found alcohol intoxication to be a differential predictor of violence. The data on illicit drug use provide evidence that drug use, as a general category, has a differential association with violence. There is an enormous amount of literature on drug treatment, drug crime prevention, and drug policy. Here, we focus on the matter of using alcohol and drug policy to prevent violence.

First, authors generally agree that enforcement of drug laws has been the “centerpiece” of US drug policy, “far outstripping other approaches to the problem” (Drucker, 1999, p. 17). Those who advocate a harm-reduction-oriented public health approach to drug policy are particularly bothered by this, howling that drug use can cause harm, but “our selective application of punitive drug prohibition laws are at least as dangerous” (p. 28). The harms include spawning criminal drug markets and infectious diseases. Today many authors blame the drug war for the escalation in violent crime in the 1970s, 1980s, and early 1990s (e.g., Ostrowski, 1998).

Drug policy as it has been practiced in the last four decades has resulted in the incarceration of many low-level drug offenders. This is not an efficient way to reduce violent crime. Most “drug violence” is due to actors in the illicit marketplace fighting each other, killing over turf or stolen merchandise, or attacking law enforcement due to fear of substantial punishments. Seminal articles by Brownstein and colleagues have been cited as evidence of the dominant role of “systemic violence” in homicide (Brownstein, Baxi, Goldstein, & Ryan, 1992) and others have replicated their finding (e.g., Marvell & Moody, 2001; Miron, 1999). Therefore, most authors emphasize changing drug policy to reduce drug-related crime. Vaillant (2001) advocates the integration of care and coercion applied to reduce drug use. Kleiman, Caulkins, and Hawken (2011) advocate catching more offenders and using graduated sanctions rather than instant harsh penalties.

Very heavy drug users are part of this violent system, to be sure. Some addicts become desperate and commit assaults due to psychopharmacological effects, but their number is small. The addict’s role in the violence problem is probably mostly due to economic-compulsive crime (due to the high cost of drugs) and the energizing role that addicts play in creating demand in the drug market. So reducing addiction has many benefits, most prominently shrinking the illegal market for drugs, improved health, improved social functioning, and, one hopes, reduced violent crime. Effective treatment of addicts has many positive benefits; particularly noted are cost-benefits related to their crimes, their criminal justice costs, and their medical problems. Drug treatment works, and the benefits of popular drug treatment courts are probably due to the provision of treatment for addicts. Treating addicts is seen as one of the best investments the system can make.

Another area we might emphasize in this section is the role of alcohol use in domestic violence incidents, which comprise an enormous percentage of violent events in many places. Reducing alcohol abuse in violent couples could go a long way to reduce this enormous problem, with residual effects in other arenas such as employment and parenting. There are many effective treatments for alcohol abuse, and this is already part of most intervention strategies for domestic violence perpetrators.

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