Alternative strategies.

Drug treatment alternatives in the United States are constrained by what is politically correct and expedient and by a federal policy of 'zero tolerance' for any illicit psychoactive drug use. A war on drugs will not solve all the problems posed by cocaine. Alternative strategies must address fundamental problems in ghetto life: violence, poverty, poor health, no education, no jobs, and few reasons for not taking drugs. Despite warnings of pharmacological determinism, cocaine is like other psychoactive drugs. Even with cocaine, when alternative behaviours are possible most people avoid out-of-control use. Public health strategies promoting a harm-reduction policy offer advantages. Recent reductions in cocaine use are a consequence of education, awareness of good health practices, and interest in other activities. Alternatives could include cocaine in a safer, non-lethal and controllable form but are unlikely in a political climate where politics and law prevail rather than medicine and humanity.