Drug policy within the United States is rife with instability, injustice, and intolerance. The very definition of an "illicit" drug is an example. From a medical and sociological standpoint the most-abused drugs in the United States are alcohol and tobacco, both of which are regulated only for minors. Mortality studies for the 1980s show that more than 5 million Americans died of tobacco related problems during the decade, 1 million more from alcohol abuse, and just 350,000 from all other addictions combined. Alcohol is, by far, the most serious drug in terms of its link to social problems. Throughout the 1990s, approximately half of all fatal auto accidents and homicides were alcohol related. Alcohol abuse also correlates highly with rape, domestic violence, and a host of illnesses including heart disease and cirrhosis. Alcoholics are seven times more likely to divorce and twice as likely to miss work as non-abusers. One estimate from 1990 claimed that alcohol-related problems cost Americans $86 billion per year, whereas those associated with illegal drugs cost only $58 billion. By 1999 National Institutes of Health statistics pegged alcohol abuse-related problems at $184.6 billion annually, greater than the $151.4 dollar loss associated with drug abuse in a Letwin Group study.
Nonetheless, by the 1990s 36 percent of all federal arrests were for possession, sale, or distribution of illegal drugs, a figure that had doubled since 1980. Those percentages have continued to rise. As the much-ballyhooed "war on drugs" intensifies, class and race inequities have become more obvious. Members of the lower class, African Americans, and Latinos are disproportionately prosecuted for drug offences, even though studies reveal that members of the middle and upper classes use certain types of drugs with greater frequency. This is especially the case for heroin and powder cocaine, an expensive drug whose use is more common among affluent users. In pure form, powder cocaine is more addictive and dangerous than "crack" cocaine, which is smoked. Crack is more common among less-affluent users, and those arrested for crack offences routinely receive much harsher sentences than are meted out for powder cocaine arrestees. Conflict theorists link this disparity to racism and classism.
In fact, contemporary drug abuse is often presented as synonymous with ghettos, poverty, and minority groups, much as drug abuse was associated with hippie subculture in the 1960s. Upper- and middle-class drug use is often ignored altogether, or is considered a medical problem when abuse occurs. In the nineteenth century, for example, many middle-class women used an opium-based substance known as laudanum; likewise, some scholars believe that the largest group of drug abusers in American history was suburban women of the 1950s whose abuse of legally prescribed tranquilizers dwarfed that of ghetto heroin addicts. Conservatives often associate drug use with permissive liberal values, but the link between political ideology and drug use is weak. In fact, cocaine use was highest in the 1980s, when