LEGALISING DRUGS WILL NOT CURB VIOLENCE TO THE PSYCHE

The Real Horror of Drugs Stems Not From Gangs Selling Them, but From
Their Effects on Users, Writes Chris Luke

THE WONDERFULLY mischievous Mae West memorably skewered the perennial
dilemma surrounding illicit intoxication when she quipped, "To err is
human, but it feels divine!" And of course, it is a truth - almost
universally acknowledged - that humans love to self-medicate, to seek
oblivion and respite from the "grim predicament of existence", with
whatever mind-altering substance they can get hold of, be it 21st
century psychotropic or ancient herbal concoction.

It seems equally likely that a debate has raged for ever between those
who fret about the effects of such intoxicants on humanity, and those
who see them as divine anaesthetics, soporifics and tonics.

The problem with contemporary substance misuse is mainly to do with
its sheer scale and unnatural geography. These can be attributed to
the global trading which took off in the 17th century, and to modern
chemistry which led in the mid-19th century to the refining of organic
produce into powders and liquids. These could be conveniently consumed
by wealthy Europeans and Americans in a variety of oral, smokeable and
injectable formulations.

The acceleration, since Victorian times, of mechanised global trading
and the dissemination of simplified chemistry kits now means that all
sorts of chemical contraband are routinely transported thousands of
miles from their source, and are easily and universally available for
a small sum.

The illicit drug trade is arguably the most successfully globalised of
all. Unfortunately, this enormous commercial success for "drug barons"
(and sometimes the difference between life and death for dirt-poor
drug-cultivators) has created a global pandemic of substance misuse
with immensely problematic consequences.

For the most part, these tend to be viewed through the prisms of crime
control and drug addiction treatment, and a remarkable number of
commentators are now arguing - as did Dr Paul O'Mahony recently in
these pages - for "decriminalisation" as the solution. Their central
thesis is that it is the violent drug gangs which cause the main
problems associated with substance misuse, and that legalisation would
squeeze these menacing middlemen out of the equation.

Sadly, I think that this is extraordinarily naive and completely
misses the point.

As a doctor who has been on the "receiving end" of industrial levels
of substance misuse for many years (in inner-city hospital emergency
departments in Dublin, Edinburgh, Liverpool, and now Cork), I am
convinced that the question of "legality" of drugs is largely
irrelevant in terms of the hazards of drugs to society in general and
people's health in particular.

Putting it very simply, the criminality of users is almost never an
issue. It is the deaths, destruction of health and communities and the
distraction from the primary function of the emergency department, due
to substance misuse, that are of interest to me.

And as for Fintan O'Toole's recent assertion, in The Irish Times, that
"there is no great evidence that the demand is actually higher now . .
. than it was a century ago", I would point out that there is no
funding for research into the healthcare frontline workload. So he
will have to take my word that, while the appetite for them may not
vary much over time, the intoxicants du jour in Ireland are much more
worrisome than they were, say, in the post-war period, adding
incalculably as they do, in terms of complexity and labour-intensity,
to the existing tobacco and alcohol burdens.

The notions of "legalising", "purifying" and "controlling"
once-illegal drugs are frankly laughable in today's risk-averse
society. But drug users (including those who consume alcohol and
tobacco) are prone to utter hypocrisy and self-delusion when it comes
to their own prescriptions.

The fact is that people are no longer prepared to accept even minimal
levels of risk when it comes to existing, legal and fastidiously
purified pharmaceuticals (thalidomide is notorious but all medicines
carry a risk of occasionally tragic adverse effects) and patients
eagerly litigate, even after rare and unpredictable complications from
the medications they have been prescribed.

The same would immediately apply to consumers of (hypothetically)
legalised "hard drugs" like cocaine and heroin - and even cannabis -
whose natural (ie "pure") effects will always be unpredictably
catastrophic for some individuals and inevitably disastrous for
society, as dysphoric or delirious people interact with their
hazard-ridden environment, as well as with other individuals who may
often be less than sympathetic to their drug-addled fellow citizens.

In addition, just because a commodity is legal doesn't mean that it
won't be of interest to criminal gangs: think petrol, tobacco and
alcohol and simply look North, after all.

Setting aside such specious reasons for "decriminalising" drugs, it is
vital that people grasp the pivotal reality about drug misuse: the
hideous and worsening global epidemic of violence - be it in British
and Irish cities or Caribbean hotel rooms - is primarily fuelled by
the effects of alcohol, cannabis and cocaine on the human psyche, and
not by the illegality of the drugs.

Drugs (including drink) derange. That is the whole point of taking
them, and those who are easily or already deranged will do terrible
things to the people around them as a direct result.

Sadly, "anti-prohibitionists" continue wilfully to forget that before
drugs (like cocaine, cannabis or opium) were illegal, they were legal
- - with violent, woeful consequences. My greatest fear is that the
ignorance of this seems invincible.