With a new presidential administration, there is some indication that drug policy reform may be a national issue as part of the federal health reform agenda. In addition, there has been considerable state-level policy focus on substance abuse treatment quality. The resulting state-level drug policy landscape includes continued prohibition as well as harm reduction, medicalization, and decriminalization. During this period, state initiatives have been in the forefront of drug policy experimentation via ballot initiatives, legislative actions, or judicial and administrative policy decisions. In recent years, there has been little federal interest in drug policy reform and a continuing focus on a prohibitionist deterrence approach. The history of United States drug policy is complex, ranging from laissez-faire to strict prohibition.
