Friday, December 21, 2007

Legal drugs?

"The Global War on Drugs can Be Won"
No, it can't. A "drug-free world," which the United Nations describes as a realistic goal, is no more attainable than an "alcohol-free world" -- and no one has talked about that with a straight face since the repeal of Prohibition in the United States in 1933. Yet futile rhetoric about winning a "war on drugs" persists, despite mountains of evidence documenting its moral and ideological bankruptcy. When the U.N. General Assembly Special Session on drugs convened in 1998, it committed to "eliminating or significantly reducing the illicit cultivation of the coca bush, the cannabis plant and the opium poppy by the year 2008" and to "achieving significant and measurable results in the field of demand reduction." But today, global production and consumption of those drugs are roughly the same as they were a decade ago; meanwhile, many producers have become more efficient, and cocaine and heroin have become purer and cheaper.

It's always dangerous when rhetoric drives policy -- and especially so when "war on drugs" rhetoric leads the public to accept collateral casualties that would never be permissible in civilian law enforcement, much less public health. Politicians still talk of eliminating drugs from the Earth as though their use is a plague on humanity. But drug control is not like disease control, for the simple reason that there's no popular demand for smallpox or polio. Cannabis and opium have been grown throughout much of the world for millennia. The same is true for coca in Latin America. Methamphetamine and other synthetic drugs can be produced anywhere. Demand for particular illicit drugs waxes and wanes, depending not just on availability but also fads, fashion, culture, and competition from alternative means of stimulation and distraction. The relative harshness of drug laws and the intensity of enforcement matter surprisingly little, except in totalitarian states. After all, rates of illegal drug use in the United States are the same as, or higher than, Europe, despite America's much more punitive policies.

"We Can Reduce the Demand for Drugs"
Good luck. Reducing the demand for illegal drugs seems to make sense. But the desire to alter one's state of consciousness, and to use psychoactive drugs to do so, is nearly universal -- and mostly not a problem. There's virtually never been a drug-free society, and more drugs are discovered and devised every year. Demand-reduction efforts that rely on honest education and positive alternatives to drug use are helpful, but not when they devolve into unrealistic, "zero tolerance" policies.

As with sex, abstinence from drugs is the best way to avoid trouble, but one always needs a fallback strategy for those who can't or won't refrain. "Zero tolerance" policies deter some people, but they also dramatically increase the harms and costs for those who don't resist. Drugs become more potent, drug use becomes more hazardous, and people who use drugs are marginalized in ways that serve no one.

The better approach is not demand reduction but "harm reduction." Reducing drug use is fine, but it's not nearly as important as reducing the death, disease, crime, and suffering associated with both drug misuse and failed prohibitionist policies. With respect to legal drugs, such as alcohol and cigarettes, harm reduction means promoting responsible drinking and designated drivers, or persuading people to switch to nicotine patches, chewing gums, and smokeless tobacco. With respect to illegal drugs, it means reducing the transmission of infectious disease through syringe-exchange programs, reducing overdose fatalities by making antidotes readily available, and allowing people addicted to heroin and other illegal opiates to obtain methadone from doctors and even pharmaceutical heroin from clinics.

Britain, Canada, Germany, the Netherlands, and Switzerland have already embraced this last option. There's no longer any question that these strategies decrease drug-related harms without increasing drug use. What blocks expansion of such programs is not cost; they typically save taxpayers' money that would otherwise go to criminal justice and healthcare. No, the roadblocks are abstinence-only ideologues and a cruel indifference to the lives and well-being of people who use drugs.

"Reducing the Supply of Drugs Is the Answer"
Not if history is any guide. Reducing supply makes as much sense as reducing demand; after all, if no one were planting cannabis, coca, and opium, there wouldn't be any heroin, cocaine, or marijuana to sell or consume. But the carrot and stick of crop eradication and substitution have been tried and failed, with rare exceptions, for half a century. These methods may succeed in targeted locales, but they usually simply shift production from one region to another: Opium production moves from Pakistan to Afghanistan; coca from Peru to Colombia; and cannabis from Mexico to the United States, while overall global production remains relatively constant or even increases.

The carrot, in the form of economic development and assistance in switching to legal crops, is typically both late and inadequate. The stick, often in the form of forced eradication, including aerial spraying, wipes out illegal and legal crops alike and can be hazardous to both people and local environments. The best thing to be said for emphasizing supply reduction is that it provides a rationale for wealthier nations to spend a little money on economic development in poorer countries. But, for the most part, crop eradication and substitution wreak havoc among impoverished farmers without diminishing overall global supply.

The global markets in cannabis, coca, and opium products operate essentially the same way that other global commodity markets do: If one source is compromised due to bad weather, rising production costs, or political difficulties, another emerges. If international drug control circles wanted to think strategically, the key question would no longer be how to reduce global supply, but rather: Where does illicit production cause the fewest problems (and the greatest benefits)? Think of it as a global vice control challenge. No one expects to eradicate vice, but it must be effectively zoned and regulated -- even if it's illegal.

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