ARTICLE DRIFTED INTO COUNTERPROPAGANDA

Editor:

Drummond is quite right to criticise a "documentary" that attributes the
damage done by injecting to adulteration by unscrupulous dealers.1 Why
would dealers damage their client base? Injecting itself carries a risk of
damage, and the legal benzodiazepines, especially temazepam in gel form,
seem to cause the most damage.

He also is quite right to point out that tobacco and alcohol kill more
people than illicit drugs. We should not let governments gloss over this
inconvenient fact, nor their dependence on the income derived from sale of
these dangerous drugs. But I fear Drummond drifts into counterpropaganda
when he claims that legalisation would actually lead to an increase of
addiction, when no one has that crystal ball. The Netherlands, with a more
open and logical approach to cannabis, has the lowest rate of use in the
Organisation for Economic Cooperation and Development, for example.2 The
assertion that the governments of the Netherlands and Switzerland are
considering a reversal of policy is just untrue. On the contrary, many
European countries have already followed suit, or are preparing to do so.

"Legalisation" is also an emotive but unhelpful term here. It is not legal
to use cannabis in the Netherlands, but the police overlook minor use, for
example. There are many steps between rigid prohibition and open slather,
and only those afraid of change seek to terrify others by using the term
legalisation. Why not different strategies for different drugs, just like
we have today for tobacco, coffee, paracetamol, insulin, and morphine?

There are other misleading statements. Britain is, in most people's terms,
engaged in a war on drugs, no less so than the United States or Australia.
Although some may agree that even poor treatment is to be preferred over
good incarceration, others may ask why we need to treat a problem created,
in the main, by our own laws. And heroin prescribing is vastly more
effective at recruiting and retaining people who have failed repeated
attempts at methadone, and at improving their health and social
functioning.3 We surely do not wish to promote the "one size fits all"
approach of the past?

As for any changes flooding our streets with yet more drugs, most clinical
workers think that the place is going under already. More availability,
lower prices, and higher purity of illicit drugs throughout the world
suggest that a plentiful supply exists. When current strategies do not
work, should we redouble our efforts, like the United States, or consider
the possibility that the whole strategy is flawed?

A R MacQueen, clinical director Mid West Area Health Service, Alcohol and
Other Drug Services, Bloomfield Hospital, Orange, New South Wales 2800

1. Drummond C. Drug laws don't work: the phoney war. BMJ 2001; 322:
1551[Full Text]. (23 June.) 2.
www.emcdda.org/infopoint/publications/annrep_00.shtml (accessed 8 Oct
2001). 3. McClusker C, Davies M. Prescribing drug of choice to illicit
heroin users: the experience of a UK community drug team. J Sub Sbuse Treat
1996; 13: 521-531[Medline].