The War on Drugs is Harmful

It is almost 50 years since President Robert Nixon declared the War on Drugs – against ‘public enemy number one’. Since then, the costs have soared to about $50 billion dollars a year for the USA alone and no good has come of it. About 500,000 US citizens are incarcerated each year for drug offenses – one in five black men during their lives.[1] Mexican drug cartels appear to hold their country to ransom.[2] Tracts of Peru and Columbia are laid waste by intensive chemical methods used by producers who move on to poison another area of jungle to avoid law enforcers armed with US guns.[1] Indeed, it is difficult to see who benefits from the War on Drugs other than the military-industrial complex and organised criminals.

In the UK, the 1971 Misuse of Drugs Act brought to an end decades of controlled medical prescribing. About 2% of our population are ‘drug addicts’ at a cost of something like £15 Billion to the national economy a year, mainly from crime and lost productivity. One in seven people on benefits in the UK are signed off work with drug dependency. Less than 0.5 billion is spent on treatment and prevention in total, whilst drug use is reckoned to account for 40% of acquisitive crime and 40% of prisoners have tried heroin.[3] Many prisoners, perhaps one in five or more, are first introduced to opiates while they are there.

Under current laws, people can be jailed for up to 7 years for possessing a Class A drug (most opiates, including heroin, but also most hallucinogens) and can be jailed for life for producing or supplying. Obviously, opiates are very dangerous drugs – possibly the most dangerous – but hallucinogens are very safe drugs. Class B drugs include the relatively dangerous amphetamines and ketamine, but also cannabis – possession of which has effectively been decriminalised. The only drug which may be more dangerous than heroin is alcohol,[4] which is of course legal despite costing the UK economy something like £21 Billion a year.[5]

In short, our drug laws are irrational and inconsistent, as well as draconian and ineffective. They may even exacerbate drug problems.

Certainly, being hard on drugs does not reduce use. Last year, a Home Office report concluded that tough laws for drug possession do not help and if anything worsen the prevalence as well as the health and crime problems associated with illicit drug use.[6] We know alcohol prohibition did not work and had adverse effects in the ‘roaring’ 1920s America. Evidence from the Czech republic, one of very few countries that has recently toughened drug laws, suggests that criminalising drug possession (in 1997) was disadvantageous.[6]   To quote the Czech government report: ‘The implementation of a penalty for possession of illicit drugs for personal use did not meet any of the tested objectives and it is loss-making from an economic point of view’.[7]

In contrast, decriminalisation and treatment seem to work well. Cannabis cafes in Netherlands have not led to an increase in use there,[6] nor has more recent legalisation in several US states.[8] Drug consumption rooms for heroin and cocaine users are associated with less social disturbance and better retention in treatment.[6] Prescribing heroin for treatment resistant patients has reduced crime and improved health measures in many countries.[9] And treating addicts in prisons reduces reoffending and may actually save lives.[10] Treating drug possession more widely as a health issue shows promise in promoting treatment and employment in the USA and reducing drug use and improving health in Portugal.[6]

There is no hiding from the fact that drug misuse is a serious problem for sufferers and society alike. But current drug laws don’t help and probably make things worse. Punishment doesn’t reduce consumption and can ruin young people’s lives. Prohibition just drives drug production and use underground and can actually worsen harms (e.g. ‘meths’ in the past and ‘superman’ pills recently).[11] It is clear that we would do better to treat drug misuse as a health rather than a criminal problem. Clearly, the law needs to change. The key question is: should drugs be decriminalised or legalised?

REFERENCES

[1] Wikipedia. https://en.wikipedia.org/wiki/War_on_Drugs

[2] A Ahmedaug. Young Hands in Mexico Feed Growing U.S. Demand for Heroin. New York Times, Aug 29, 2015 [http://nyti.ms/1UcBEBB]

[3] Public Health England. Drug Statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2012 to 31 March 2013. Published 6 November 2013. http://www.nta.nhs.uk/uploads/annualdrugstatistics2012-13-statisticalreport.pdf

[4] Nutt DJ, King LA, Phillips LD; Independent Scientific Committee on Drugs. Drug harms in the UK: a multicriteria decision analysis. Lancet. 2010 Nov 6;376(9752):1558-65. http://www.ncbi.nlm.nih.gov/pubmed/21036393

[5] Health and Social Care Information Centre. Statistics on Alcohol, England 2015. First published:25 June 2015 http://www.hscic.gov.uk/catalogue/PUB17712

[6] Home Office. Drugs: international comparators. 2014. [https://www.gov.uk/government/publications/drugs-international-comparators]

[7] Zábranský, T et al. (2001) PAD: Impact analysis project of new drugs legislation. Prague: Office of the Czech Government, Secretariat of the National Drug Commission. http://www.drogy-info.cz/data/download/813/4150/file/PAD%20english.pdf

[8] Hasin DS, et al. Medical marijuana laws and adolescent marijuana use in the USA from 1991 to 2014: results from annual, repeated cross-sectional surveys. Lancet Psychiatry. 2015 Jul;2(7):601-8. http://www.ncbi.nlm.nih.gov/pubmed/26303557

[9] Strang J, et al. Heroin on trial: systematic review and meta-analysis of randomised trials of diamorphine-prescribing as treatment for refractory heroin addiction. Br J Psychiatry. 2015 Jul;207(1):5-14. http://www.ncbi.nlm.nih.gov/pubmed/26135571

[10] Rich JD, et al. Methadone continuation versus forced withdrawal on incarceration in a combined US prison and jail: a randomised, open-label trial. Lancet. 2015 Jul 25;386(9991):350-9. http://www.ncbi.nlm.nih.gov/pubmed/26028120

[11] Nutt, D. The Superman pill deaths are the result of our illogical drugs policy. The Guardian, 5th January 2015. http://www.theguardian.com/commentisfree/2015/jan/05/superman-pill-ecstasy-pma-deaths-drugs-policy

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