How the First Black Surgeon General Was Silenced for Considering Drug Legalization

December 8, 2020

The movement to decriminalize all drug users has enjoyed historic wins in 2020, surely in part due to activists’ successful efforts to push authorities to accept it as a public health measure.

But exactly 27 years ago—decades before the United Nations and the World Health Organization endorsed decriminalization—United States Surgeon General Joycelyn Elders, a former director of the Arkansas Department of Health, called for the consideration of full drug legalization.

Immediately, President Bill Clinton—a staunch prohibitionist who had appointed Elders as Surgeon General earlier in 1993, as well as to the Arkansas Health Department directorship in 1987 when he was governor—silenced her. A year later, he forced her to resign.

“I do feel that we would markedly reduce our crime rate if drugs were legalized.”

Elders believes she, the first Black person to hold the position, was not the only political casualty of Clinton’s anti-drug rebuke; her son, a person with a substance use disorder, was next.


Speaking Out and Shutting Down

“That really is a very tough question,” chuckled Dr. Joycelyn Elders, as an hour-long press conference on violent crime and public health neared its end on December 7, 1993. “You must have arranged them in order of hard.”

The National Press Club journalists laughed. She had just been asked by Clayton Boyce, the organization’s president, about a touchy subject on which she had progressive, albeit controversial, opinions. Dubbed the “condom queen,” she was already known for her positions on ensuring sex workers’ access to reproductive health care and condoms’ availability to all public high schoolers.

“Is the legalization of drugs one of the difficult choices we must face to fight violence?”

Staying on the press conference’s theme, she pointed to an association between drug use and crime associated with poverty. “[M]any times they’re robbing, stealing and all of these things to get money to buy drugs,” she said. “And I do feel that we would markedly reduce our crime rate if drugs were legalized.”

Importantly, she added: “But I don’t know all of the ramifications of this. I do feel that we need to do some studies.” Her comments were met with scattered applause by audience members.

“The president is against legalizing drugs, and he’s not interested in studying the issue,”

Responding to a different question, Elders voiced a similar interest in medicinal uses of cannabis. “[T]he medicinal properties of marijuana should be evaluated,” she said. “It should be passed or approved by the FDA like any other drug, and that it should be available for order by their physicians, just like any other drug. So I feel if we’re going to talk about the medicinal uses of marijuana [then] we should really follow the same standard of practice that we would for any other drug that we use in this country.”

A Clinton spokesperson swiftly denounced his appointee’s comments. “The president is against legalizing drugs, and he’s not interested in studying the issue,” said Dee Dee Myers, the White House press secretary. “She expressed a personal opinion […] It’s been made clear to her that the president doesn’t share that view.”

Despite the blowback, Elders stood her ground. “There are a lot of things that are sensitive subjects, and just because they’re sensitive subjects does not mean that we should ignore them when they are destroying the very fabric of our country,” she told reporters, according to the New York Times

Her comments attracted criticism from law enforcement leaders, and even leading medical experts.

“It would take me about 30 seconds to study it. I think all of the information and experience I have has shown that it is a completely unacceptable option,” said FBI director Louis Freeh before the National Press Club just a day later.

“You can ask the people of Zurich and the people of London what has happened with the legitimization and sale of narcotics.”

In that press conference, Freeh denounced jurisdictions known for their harm reduction programs, suggesting they exemplified the perils of legalization. “You can ask the people of Zurich and the people of London what has happened with the legitimization and sale of narcotics. I don’t think it’s worthy of a long discussion.”

The American Medical Association even scolded Elders for her stance in a letter, noting that the professional organization had in the past called for a “national drug control policy” that preemptively “prohibits drug legalization.”

To the contrary Arnold Trebach, president of the Drug Policy Foundation (one of the predecessors of the Drug Policy Alliance), supplemented his expression of support for Elders’ comments by identifying  public-health-oriented programs, like those in the European cities, as a way forward. Although Trebach voiced his personal support of full drug legalization—“selling of the drugs like alcohol, under regulations for adults”—in a December 9 C-SPAN interview, he said that the Drug Policy Foundation had “been working on some middle ground approaches which are called medicalization, or harm reduction.”

Overall: “I think it’s time to consider new approaches,” he said.


The Criminalization of Kevin Elders

The controversy did not end with the widespread media coverage in the days following Joycelyn Elders’ National Press Club appearance.

On December 15, 1993, almost exactly a week after her comments, the Little Rock Police Department in Arkansas issued an arrest warrant for her son—charging him with the sale of an eight-ball (one-eighth of an ounce) of cocaine to friend-turned-informant Calvin Walraven on July 29 of that year. When submitted as evidence, the quantity of drugs measured only as 1.85 grams, not an eight-ball’s 3.5 grams, according to the journalist Cynthia Cotts.

Similar to the timing of his arrest months later, the deal—which Kevin Elders believed to be a set-up—took place just six days after his mother appeared before the US Senate for her first confirmation hearing,

“Calvin had called me several, several times [about buying cocaine] and I kept telling him, no,” Kevin Elders testified in July 1994, according to Cotts. “[T]hen he called and said, ‘Kevin, if you don’t do this [he threatened] to go to the press about my personal life.’”

His mother remained suspicious of “how Kevin became a target and whether the police entrapped him.”

Kevin Elders believed the encounter to be a politically motivated entrapment—so much so that he took a 10-year sentence over a plea deal that would have required his admission of guilt. His mother remained suspicious of “how Kevin became a target and whether the police entrapped him,” she wrote in her 1997 autobiography.

“Through this whole thing I have tried to resist the idea that Kevin may have been a victim of my association with the President. But given the rage and pure vindictiveness of some Arkansas Republicans feel toward Bill Clinton, it’s hard to keep from making connections.”

There’s no hard evidence that a higher-up politician green-lit the remarkably timed arrest. The prosecutor behind the charges denied any vengeful intent on his part, and a police department spokesperson said the detective paying Walraven to set up the buy didn’t know Kevin Elders was the son of the much-publicized soon-to-be Surgeon General, according to Cotts.

Elders maintained that her comments on drug legalization were not influenced by her son’s substance use disorder. “I have to base what I say on the best scientific knowledge I have available,” she said. “I can’t let my emotions or personal opinions get in the way. If I were to do that, I should not be Surgeon General.”


Just Fifteen Months in Office

One year after her comments on studying drug legalization, Joycelyn Elders was forced to resign from her Surgeon General post by the Clinton administration.

The final straw was another one of Elders’ progressive public health opinions. At a United Nations conference on HIV and AIDS, she had suggested that masturbation ought to be included in youth sex education, in part to potentially reduce the risks of HIV transmission.

Just like her infamous comments on drug legalization, her view on masturbation as an HIV prevention tool was an affirmation to a question suggesting it. Later, she clarified to the Associated Press that she “intended to relate that masturbation is a natural part of human sexuality—not that schoolchildren should be taught how to masturbate.”

Since her rocky time as Surgeon General, Elders has stood steadfast by her perspectives on youth sexual autonomy and the possibility of drug legalization. In 2010, she came out in support of cannabis legalization, and then seven years late penned an argument in its support

“I reviewed the literature years ago,” she said in a 2010 interview, “and for at least 15 or 20 years I have been at this opinion and I feel that it should be legalized.”

If President Clinton hadn’t swiftly shut her down, she may have been able to say the same thing about all drugs.


Photograph of President Bill Clinton (second to left) and Surgeon General Joycelyn Elders (far right) at the Congressional Black Caucus Dinner in September 1993, by Ralph Alswang/Public Domain

Sessi Kuwabara Blanchard

Sessi is an independent drug journalist and drug-user activist. She lives in New York City.

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