DRUG POLICY - THE CASE FOR REALISM

Governments acting on behalf of society have deemed the production,
distribution and consumption of (some!) drugs to be unacceptable and
the subject of criminal law. Add to this strong policing and public
campaigns to discourage use and we have the "War on Drugs".

Although it is clear that this war has not abolished the drug
industry, the drug warriors say it is a justifiable use of public
authority and resources because it sends a clear message about the
dangers of drug use and acts as a disincentive for involvement in the
different parts of the industry. In other words it constrains what
might otherwise be an epidemic of drug use and abuse.

At one level it is an argument based on values ("just say no to
drugs") and at another level an argument based on empirical claims
("criminalisation reduces use"). Advertisement: Story continues below

On the other side are the drug law reformers who are mostly
libertarians or realists.

Libertarians argue that individuals have the right to choose.
Criminalising (or even regulating) the human desire of some to use
drugs to achieve altered states of mind is an invasion of our rights.
They say the market in drugs should be free, that is to say, drugs
should be legalised. They are usually also supportive of the harm
reduction approach, which pragmatically seeks to reduce harms
associated with drug use.

The realists, who are also harm reductionists, argue that such a
desire has always - and in all likelihood - will always be part of the
human condition. However, they note the potential risks to the
individual and the community from the use of some if not all drugs.
They want to see new forms of regulation for production and
distribution based on the degree of potential harms, the
decriminalisation of use and the wider implementation of harm
reduction strategies. They certainly don't argue for a laissez-faire
approach.

This is where the "evidence" is so important. What are the
consequences of decriminalisation of drug use? Does the tough
approach work to constrain the industry as its supporters claim? If
it does, are the results achieved in a manner acceptable to a
civilised society and at a cost less than the alternatives?

The realists have a battery of evidence on their side.

Firstly, they point to the success of initiatives such as needle
syringe programs, methadone treatment programs, and supervised
injecting facilities. They show how they help drug users to stay
alive, ensure better public amenity and reduce the transmission of
blood borne infections such as HIV.

Secondly, they point to the cost effectiveness of these interventions
compared to law and order enforcement. Returns on investment in needle
syringe programs are particularly high.

Thirdly, they can point to jurisdictions that have taken up
decriminalisation without any concomitant expansion in drug use as was
predicted by the opponents.

Fourthly they point to the real life consequences of the war on drugs
as it affects drug users, their families and the wider community.
Whether you look at it from a social welfare, human rights or public
amenity point of view it's not a pretty picture.

If this is the evidence, one is led to ask - why have politicians not
responded?

Well to some extent in our own country they have, and that is why we
now have evidence as to the effectiveness of localised harm reduction
strategies (for example the Medically Supervised Injecting Centre in
King's Cross) and generalised programs (for example the needle and
syringe program).

However, it is true to say that most are still reluctant to take a
comprehensive approach to drug law reform. People worry that easier
access to drugs - even if regulated - would add to rather than
subtract from today's major issue that is alcohol abuse. In respect
of alcohol it is true that prohibition didn't work, but enlightened
regulation doesn't seem to be all that effective either. This wall of
worry makes it difficult for the evidence on the effectiveness of a
comprehensive alternative to break through.

Although not present in thinking about economics or international
relations there remains a strong utopian and fundamentalist streak in
our thinking - if not always in our practice - when it comes to drug
policy. It is a search for simplicity in a world of complexity with
the issue being viewed through the prism of individual cases (usually
of tragedy) rather than population-wide statistics and cost-
effectiveness studies.

Note also the powerful and important belief in personal responsibility
that underpins the judgements we make about human behaviour. Never
far from the surface in arguments about drugs is the view that drug
users only have themselves to blame if things go wrong. This lack of
sympathy leads to prejudice and stigmatisation and makes campaigning
all that much harder for public health professionals seeking support
and resources for harm reduction initiatives.

However, the fact that the path of reform has many obstacles -
continuing problems with alcohol and its regulation, the search for
simplicity in a complex world of imperfection and the belief in
personal responsibility often above all else and certainly before
community obligation - this should not blind us to the case for
continuing reform. The evidence is overwhelming so there must be a
reform narrative that has the potential to survive the test of public
opinion.