Drug Laws

WAR ON DRUGS DOES MORE HARM THAN GOOD

Editor:

It is 30 years since the then president of the United States, Richard
Nixon, declared a war against drugs. But global drug prohibition had its
beginnings as far back as 1909. In 1988 the United States Congress passed
legislation requiring that country to become drug free by 1995. This denial
of reality is global. In 1998 the international community committed itself
at the United Nations to eradicate illicit cultivation of coca plants and
opium poppies by 2008. By any measure, this is an international crusade and
one that has been expensive, ineffective, and often counterproductive. The
dictum "first, do no harm" has not applied to drug policy for the last century.

It is disappointing that Drummond's comments repeat so many old myths.1
Assumptions are presented as unarguable fact. The claim that heroin is
inherently dangerous is false. Heroin is rapidly metabolised to morphine,
which is used safely by the healthcare system in large quantities
throughout the world. In the Swiss heroin prescription trial (1994-7),
there were no deaths from overdose in almost 1500 patients followed up for
18 months.2

Drummond may believe that legalisation will increase addiction, but this
should not be presented as an established fact. What does he mean by
legalisation? There is no evidence that heroin prescription to about 1000
patients in Switzerland who were refractory to treatment has increased
addiction, but there was enough evidence of benefit to convince 71% of
voters to support continuation of this option in a 1997 national referendum.

Calls for more research are simply not enough. The rapid increase in deaths
from drug overdose in many countries (including the United Kingdom and
Australia) is a scandal. The experiment of treating drug use as a law
enforcement issue has shown this to be a resounding failure. Drug use
should be regarded as primarily a health and social issue, with funding
raised for these measures to the level of drug law enforcement. Research
will improve outcomes only if carried out without blinkers. The time has
come to think outside the box, even though many, like Drummond, beckon us
to stay inside.

Alex Wodak, director, alcohol and drug service
St Vincent's Hospital, Darlinghurst, New South Wales 2010, Australia

1. Drummond C. Drug laws don't work: the phoney war. BMJ 2001; 322:
1551[Full Text]. (23 June.)
2. Uchtenhagen A, Dobler-Mikola A, Steffen T, Gutzwiller F, Blaettler R,
Pfeiffer S, eds. Prescription of narcotics for heroin addicts: main results
of the Swiss national cohort study. Basle: Karger, 1999.