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February 12, 1997

Crack vs Inhaled Cocaine and Sentencing-Reply

Author Affiliations

University of Minnesota Minneapolis
Columbia University New York, NY

JAMA. 1997;277(6):458. doi:10.1001/jama.1997.03540300026020

In Reply.  —Dr Hamilton suggests that cocaine users may better be treated in prison where they are removed from the conditions in which they sell drugs. Imprisonment may be the answer for those nonusers who are selling drugs for profit. However, for the drug abusers who are selling drugs primarily to support their drug use, mandated treatment without imprisonment may be a better solution. Random urine samples can be obtained, and the contingencies (ie, drugpositive urine test results can lead to prison) made clear. Such a policy would be cost-effective,1 as we argue in our article, and the expected outcome would be at least as good as voluntary treatment.2Dr Byck suggests that the statement that cocaine is ultimately the same substance whether smoked or snorted is irrelevant and that the intent of the user is of greater importance. However, our job as scientists is to educate the public, and