"We can't arrest and incarcerate addiction out of people," said Botticelli, head of the White House Office of National Drug Control Policy's (ONDCP), referring to "this old war on drugs." "Not only do I think it's really inhumane, but it's ineffective and it cost us billions upon billions of dollars to keep doing this."
This isn't the first time Botticelli has made the claim, previously saying something similar to Vox and the Washington Post when he was first named to the position. "We can't arrest our way out of the problem, and we really need to focus our attention on proven public health strategies to make a significant difference as it relates to drug use and consequences to that in the United States," he told me in 2014.
But is it true? Has America really moved on from its old war on drugs, and begun treating drugs as a public health issue?
It's complicated. No, America has not ended its war on drugs. But over the past several years, the Obama administration has shifted federal anti-drug efforts to focus more on treatment and prevention — the public health, or "demand," side of the war on drugs — over law enforcement and interdiction, the traditional "supply" side of the war on drugs, which treats drugs as a law enforcement and national security issue.
There's still a lot of war in the war on drugs
Here are ONDCP's budget numbers over the past few years, which represent the federal government's anti-drug spending:
The figures show a mixed story. A greater proportion of anti-drug spending is going to treatment and prevention — about 44.8 percent in fiscal year 2016, up from 36.9 percent in 2009. But a majority — 55.2 percent — is still going to the side of the drug war associated with incarceration and fighting drug cartels and gangs. ONDCP even requested an increase to law enforcement and interdiction efforts in 2016 (even to controversial programs like civil asset forfeiture), although the increase is smaller than the increase to prevention and treatment efforts, particularly over the past few years.
The numbers don't tell the entire story. As Botticelli pointed out, recent changes to federal law — the Mental Health Parity and Addiction Equity Act, the 2008 Medicare Improvement for Patient and Providers Act, and Obamacare — imposed new rules on health insurers, requiring them to cover drug and alcohol treatment as an essential health benefit. That means public and private plans, like Medicaid or employer-provided insurance, must insure a higher standard of addiction services, just like they fully include heart disease or diabetes treatments in their coverage. These measures improve access to drug abuse treatment by letting people pay for it.
But there's still a lot of work to do on the treatment end. According to 2014 federal data, at least 89 percent of people who meet the definition for a drug abuse disorder don't get treatment. And that's likely an underestimate: Federal household surveys leave out incarcerated and homeless individuals, who are more likely to have serious, untreated drug problems. So the increased spending for treatment and prevention is going to a seriously underfunded issue.
Still, ONDCP's figures show that a majority of anti-drug spending keeps going to the traditional parts of the war on drugs. At the current pace, it will take a few years for treatment and prevention to overtake the law enforcement and interdiction side — and there's no sign that law enforcement and interdiction efforts are going away anytime soon. The war on drugs is changing, but it's still very much with us.
Watch: How the DEA invented "narco-terrorism"