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Although much of the public debate surrounding drug policy occurs at the federal level, many important decisions are made at the state and local levels. Local and state narcotics control within the United States emerged in the latter part of the 1800s, originating in those communities directly threatened by drugs such as morphine, opium, and cocaine. A current trend in drug policy involves a growing shift of responsibility from the federal level to the state and local levels. This is plainly seen in the area of enforcement where local police make the preponderance of arrests. Increasingly, states and localities are also assuming larger roles in the funding and implementation of social programs used to combat drug abuse. Both federal and state drug laws typically involve the use of mandatory sentencing. On the state level, laws can vary in severity and change from time to time.

The earliest semblance of local and state narcotics control began during the mid-to late 1800s in those communities directly affected by such substances. In 1860, Pennsylvania, home to leading morphine manufacturers, passed an antimorphine law. Despite early laws prohibiting certain substances, widespread illegalization of drugs did not emerge until the early 1900s. Early antidrug legislation developed to protect the citizenry from “quack” medicines. Although not necessarily hazardous to citizens' health, many of these alleged medications contained high levels of narcotics and alcohol while not possessing the healing properties purported.

In the beginning of the 20th century, physicians developed a clearer understanding of the long-term effects of substances formerly recommended to the general public for common consumption. Although the medical community began to advise against the use of substances such as cocaine, morphine, and heroin, these drugs continued to be peddled by an unregulated patent medicine industry. Between 1901 and 1903, the efforts of the American Pharmaceutical Association prompted states to increase their control of opiates and cocaine.

Local laws met with criticism for disparity regarding their severity. Whereas the complexity and all-inclusiveness of some laws rendered the enforcement of their stipulations nearly futile, others contained loopholes permitting the continued sale of patent medications containing narcotics. By 1905, the Proprietary Association of America, composed of leading manufacturers, condoned strict limitations regarding the amount of narcotics contained in over-the-counter medications. Initially, manufacturers did not divulge the narcotic and alcohol contents contained in their products. In fact, many manufacturers denied the obvious presence of such substances. The 1906 Federal Pure Food and Drug Act mandated that all manufacturers must specify the proportions of alcohol, narcotics, and numerous other substances used in the preparation of the medication. This legislation precipitated the decline of the patent medicine industry.

Today, drug policy encompasses an array of issues more commonly addressed at the state and local levels. States and localities are assuming increasing levels of responsibility in terms of drug policy. Many of the critical decisions concerning drug policy, including enforcement and budgetary decisions, are made beneath the federal level. Increasingly, states and localities are accountable for funding and implementing social programs to combat drug abuse. Funding allocations for law enforcement, drug prevention, drug treatment, job training, health care, mental health programs, and community-based programs are largely determined at the state and local level. One source of funding for drug enforcement and prevention is from asset forfeiture, whereby criminal assets are seized and used by law enforcement and other governmental agencies, such as education, to bolster their efforts in combating drug use.

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