Losing The War On Drugs: Weighing The Costs Of The Drug War, Part 13

THE PROS AND CONS OF PROHIBITION

Legalization isn't perfect, but it's better than a drug ban.

Humans have used psychoactive drugs in just about every society in every
time in history. There has never been, and can never be, a "drug-free world."

If drug use will always be with us, it follows that the harms drugs can
cause will also remain. There is no "solution" to the drug problem.

That might sound resigned, but it's not. We still can, and must, make
important choices: Which drug-related harms will society cope with? Some
are worse than others. Given the range of possible drug policies we could
adopt, which policies will produce the fewest and least destructive harms?
We can't choose solutions, but we can, and do, choose our problems.

Beginning in the early 20th century, most countries chose the most extreme
policy available: Some drugs were banned and their production, sale, or
possession made a crime. The people who originally made this choice
believed prohibition would create a drug-free Utopia. By that standard,
drug prohibition has been a spectacular failure.

But the justification for prohibition has evolved. Officials who seriously
talk of "drug-free societies" are now rare. Instead, government leaders
claim prohibition at least keeps down the rate of drug use and thus limits
the damage of drugs. To withdraw the criminal prohibition of drugs, they
say, would send the number of drug users and addicts soaring. Society would
suffer horribly.

As I argued yesterday, I don't believe that's true. There is no substantial
evidence that prohibition keeps down drug use. But what if it were
true? Wouldn't criminal prohibition then be the best drug policy? The
answer is still no.

In the broadest terms, there are two basic drug policies: The first is
prohibition, in which the production, sale and possession of drugs are
crimes. The second is legalization. Although many levels of legalization
are possible, most supporters of legalization want a policy that regulates
drugs at least to the degree that we regulate (but don't ban) other
products that can be dangerous to health. Alcohol regulation is often cited
as a model.

What are the problems caused by these policies? Which is the least harmful?

As my series Losing the War on Drugs has tried to show, the harms caused by
prohibition are many and terrible. Third World countries, where illegal
drugs are produced, have to struggle with drug lords and traffickers whose
staggering wealth is used to corrupt institutions and pay for private
armies to murder opponents. Central governments are weakened, fostering
unrest. Billions of dollars that could go to development are wasted on
futile fights with traffickers and producers. Eco-systems are ravaged by
futile efforts to stamp out drug crops. Many people, often desperately
poor, are lured by black-market wealth into a business where they risk
prison or death. In this way, Colombia stands at the brink of civil
collapse. Mexico and other countries on the traffickers' routes have also
suffered economic distortions, violence and corruption.

In drug-consuming countries such as Canada, police are frustrated by the
impossible task of stopping the flow of drugs, so they ask for and get more
powers, eroding everybody's civil liberties in the process. Some succumb to
the unique opportunities for corruption presented by black-market
drugs. Others turn, in frustration, to vigilante justice -- lying under
oath, planting evidence and committing other heinous acts to win an
unwinnable war.

Prohibition leaves users buying untested, unlabelled drugs that are often
tainted, fraudulent or even poisonous. It causes the purity of drugs to
rise. It encourages users to favour the fastest-acting, most potent
varieties of drugs and use them in the most cost-efficient way: injection.
It stigmatizes addicts as criminals, pushing them to the margins of society
where they can't get the help they need. All of this multiplies fatal
overdoses and drug-related deaths, and spreads infections among users. Drug
prohibition is a major contributor to the AIDS epidemic.

Prohibition fuels petty property crime by forcing addicts to pay
black-market prices for drugs. It turns what would otherwise be an ordinary
business like the alcohol industry into one run by criminals who settle
business disputes with bullets and bombs, turning streets into
battlefields. Prohibition gives organized crime its largest source of
revenue and power.

Prohibition has cost governments worldwide hundreds of billions of
dollars. The U.S. government's anti-drug budget is now more than $20
billion U.S. a year. Of that, almost $13 billion is devoted to fighting the
production, distribution, sale and possession of drugs. That doesn't
include drug-related state and municipal spending on police, prisons and
courts that, by one estimate, has topped $16 billion.

Canadian governments don't itemize drug-enforcement costs, but there are
indications taxpayers are footing an enormous bill. The RCMP alone has
1,000 officers devoted full-time to prohibition. There are drug specialists
in all police forces across the country. Add the time spent by regular
officers, in the RCMP and all other police forces, dealing with illegal
drugs in the course of their duties. And the specialists who fight
organized crime, including the many officers who have spent years trying to
cope with Quebec's biker war. The customs officers searching for drugs at
borders -- and putting a drag on the economy as they slow cross-border
traffic -- are also part of the bill. And the forensic accountants
tracking money laundering. And the judges and court officials processing
almost 70,000 drug charges each year. And the guards needed to watch over
the nine per cent of Canadian prisoners behind bars for drug crimes.

The loss of fundamental liberty is surely prohibition's greatest harm.

These direct monetary costs are only half of what we pay. There is also all
the good that could have been done if these vast resources had been
available for other priorities.

And lastly, there is the fundamental injustice of imprisoning people simply
for choosing to take a substance not approved by the state, or for selling
that substance to those who choose to buy it. If the right to control one's
own life means anything, it must include the right to choose what to
ingest. The loss of fundamental liberty is surely prohibition's greatest harm.

This is a short summary of a much longer list. But it's enough to weigh
against the harms of legalization. If legalization did not cause an
increase in drug use -- and I do not think it would cause one -- the
argument is over. But what if it did cause a significant increase in drug
use? Would legalization inflict equal or worse harms and costs than
prohibition?

To answer, we must distinguish between use and abuse. Drug-law enforcers
refer to all illegal drug use as "abuse," but this is inaccurate. Drug use
that does not harm or impair one's health, work or relationships is
generally considered mere "use." Consumption that hurts the user or others
is "abuse."

Most of us recognize the line between "use" and "abuse" of alcohol.
Dr. Harold Kalant, professor emeritus in the faculty of medicine at the
University of Toronto and researcher emeritus with the Centre for Addiction
and Mental Health, says that alcohol abusers make up between 10 to 15 per
cent of the total number of drinkers. Between five and eight per cent of
problem drinkers are addicted, he says, while the other alcohol abusers
drink in ways that are harmful to themselves or others -- drinking and
driving, for example, or binge drinking that interferes with work or family
life. That means 85 or 90 per cent of alcohol users generally consume
without significant harm.

The same line between use and abuse exists with illegal drugs. Dr. Kalant
estimates that the ratio of use to abuse of marijuana is roughly the same
as for alcohol. But drugs like cocaine and heroin are more addictive than
alcohol and so, Dr. Kalant says, instead of a 10 or 15 per cent abuse rate,
"you're more likely talking of 30 per cent or more." (Only one drug causes
addiction among a majority of its users: nicotine.)

That's a rough estimate. Unlike alcohol, we don't have detailed pictures of
illegal drug users and the effects of their use, for the obvious reason
that users tend to avoid attention. But it appears the majority of users of
illegal drugs do not abuse them, and their consumption of drugs, like
consumption of alcohol, generally has no serious ramifications. "If you're
a light, casual user," notes Dr. Kalant, "you probably don't have any
significant health effects."

There may be more involved in these numbers, cautions Dr. Kalant, than just
the effects of illegal drugs. He says the very fact that some drugs have
been made illegal gives them an anti-social image which may attract people
inclined to seek novelty and danger. And "people like that," he says, "may
be more at risk (of problem use) than others." Thus, the abuse rates we see
with illegal drugs may be higher than they would be if the drugs were legal.

None of this detracts from the real dangers of drug use. It's difficult for
a drug user to know in advance, for example, if he is one of the minority
of users who is susceptible to addiction. And some methods of drug-taking
are dangerous in themselves; injection, for example, risks infection. And
even casual, light use of some drugs may pose small risks of serious
harms. Synthetic drugs like ecstacy, for example, haven't been
well-studied, but there is evidence that even one dose has, on rare
occasions, done grave harm. These risks alone are reason enough to avoid
drug use.

But the distinction between use and abuse puts things in perspective. In
the unlikely event that legalization led to an increase in drug use, the
majority of that increase would be casual use; health and social
consequences would not be daunting.

Those who see drugs as a moral issue may still consider an increase in
casual use unacceptable. But for people concerned only with limiting the
individual and social damage of drug use, such an increase should not cause
great alarm. How many people are having a Saturday night toot of cocaine
doesn't matter nearly so much as how many people are ending up in the
morgue. Current drug policy cares far too much about the former, and not
nearly enough about the latter. The American government, for one,
celebrates the fact that casual cocaine use is down from its peak -- while
staying remarkably silent about the fact that drug-related deaths are at a
record high.

Of course, a rise in casual drug use might also be accompanied by a smaller
rise in addiction. That would obviously be a major concern, but that, too,
must be put in context. As I tried to show in this series, most of the
horrific harms that we now associate with addiction -- overdose deaths,
crime, homelessness, infections, marginalization -- stem for the most part
from the criminal prohibition of the drugs that the addict depends on, not
from the drugs themselves. Eliminate prohibition and these harms will go as
well.

This is not to treat addiction lightly. Even with legal access to clean
drugs and good health care, addiction is a serious burden on health and
relationships. But addiction would not mean, as it so often does now,
squalour, fear and early death. With the proper health care and social
programs, individuals and society could cope. It would not be an
overwhelming crisis.

So let's compare the harms of two drug policies, prohibition and
legalization. Prohibition inflicts a horrendous cost, in lives and
suffering and wasted effort, all over the world. And legalization? Even
under the false assumption that it would cause an increase in drug use,
legalization would lead to an increase in casual use, perhaps accompanied
by a rise in addiction; the former would inflict modest personal and social
harms, while the harms of the latter would be more painful but still
manageable.

Which policy causes the least harm? For anyone who looks at the question
intently and honestly, the answer is clear.

A 1998 letter sent to the United Nations by hundreds of statesmen, Nobel
laureates, and drug experts put the answer bluntly: "We believe that the
global war on drugs is now causing more harm than drug abuse itself."
That's a conclusion that more and more public health experts, researchers,
and even politicians are coming to as well. "The criminalization of drug
use does not achieve the goals it aims for," said Dr. David Roy of the
University of Montreal when he and others released a major report in 1999
looking at drug use and AIDS. "It causes harms equal to or worse than those
it is supposed to prevent."

In 1933, Americans came to exactly that conclusion about the attempt to ban
alcohol. They remembered the real harms done by alcohol before it was
banned in 1920. But they also saw that those harms weren't nearly as
terrible as the damage done by Prohibition itself. Being able to contrast
the two situations, Americans decided to legalize alcohol.

We can't draw on personal memory as Americans did in 1933, but we can look
carefully at the evidence. It's a difficult task. It may mean uprooting
comfortable assumptions and old ways of thinking. But so many have
needlessly suffered and died. More will follow. Surely we owe them at least
the willingness to try.