Governments acting on behalf of society have deemed the production, distribution and consumption of (some!) drugs to be unacceptable and the subject of criminal law. Add to this strong policing and public campaigns to discourage use and we have the "War on Drugs".
Although it is clear that this war has not abolished the drug industry, the drug warriors say it is a justifiable use of public authority and resources because it sends a clear message about the dangers of drug use and acts as a disincentive for involvement in the different parts of the industry. In other words it constrains what might otherwise be an epidemic of drug use and abuse.
At one level it is an argument based on values ("just say no to drugs") and at another level an argument based on empirical claims ("criminalisation reduces use").
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On the other side are the drug law reformers who are mostly libertarians or realists.
Libertarians argue that individuals have the right to choose. Criminalising (or even regulating) the human desire of some to use drugs to achieve altered states of mind is an invasion of our rights. They say the market in drugs should be free, that is to say, drugs should be legalised. They are usually also supportive of the harm reduction approach, which pragmatically seeks to reduce harms associated with drug use.
The realists, who are also harm reductionists, argue that such a desire has always – and in all likelihood – will always be part of the human condition. However, they note the potential risks to the individual and the community from the use of some if not all drugs. They want to see new forms of regulation for production and distribution based on the degree of potential harms, the decriminalisation of use and the wider implementation of harm reduction strategies. They certainly don't argue for a laissez-faire approach.
This is where the "evidence" is so important. What are the consequences of decriminalisation of drug use? Does the tough approach work to constrain the industry as its supporters claim? If it does, are the results achieved in a manner acceptable to a civilised society and at a cost less than the alternatives?
The realists have a battery of evidence on their side.
Firstly, they point to the success of initiatives such as needle syringe programs, methadone treatment programs, and supervised injecting facilities. They show how they help drug users to stay alive, ensure better public amenity and reduce the transmission of blood borne infections such as HIV.
Secondly, they point to the cost effectiveness of these interventions compared to law and order enforcement. Returns on investment in needle syringe programs are particularly high.
Thirdly, they can point to jurisdictions that have taken up decriminalisation without any concomitant expansion in drug use as was predicted by the opponents.
Fourthly they point to the real life consequences of the war on drugs as it affects drug users, their families and the wider community. Whether you look at it from a social welfare, human rights or public amenity point of view it's not a pretty picture.
If this is the evidence, one is led to ask – why have politicians not responded?
Well to some extent in our own country they have, and that is why we now have evidence as to the effectiveness of localised harm reduction strategies (for example the Medically Supervised Injecting Centre in King's Cross) and generalised programs (for example the needle and syringe program).
However, it is true to say that most are still reluctant to take a comprehensive approach to drug law reform. People worry that easier access to drugs – even if regulated – would add to rather than subtract from today's major issue that is alcohol abuse. In respect of alcohol it is true that prohibition didn't work, but enlightened regulation doesn't seem to be all that effective either. This wall of worry makes it difficult for the evidence on the effectiveness of a comprehensive alternative to break through.
Although not present in thinking about economics or international relations there remains a strong utopian and fundamentalist streak in our thinking – if not always in our practice – when it comes to drug policy. It is a search for simplicity in a world of complexity with the issue being viewed through the prism of individual cases (usually of tragedy) rather than population-wide statistics and cost-effectiveness studies.
Note also the powerful and important belief in personal responsibility that underpins the judgements we make about human behaviour. Never far from the surface in arguments about drugs is the view that drug users only have themselves to blame if things go wrong. This lack of sympathy leads to prejudice and stigmatisation and makes campaigning all that much harder for public health professionals seeking support and resources for harm reduction initiatives.
However, the fact that the path of reform has many obstacles - continuing problems with alcohol and its regulation, the search for simplicity in a complex world of imperfection and the belief in personal responsibility often above all else and certainly before community obligation – this should not blind us to the case for continuing reform. The evidence is overwhelming so there must be a reform narrative that has the potential to survive the test of public opinion.
June 7, 2011
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