While writing a book on politics and drug prohibition in 1994, Dan Baum (staff writer for The New Yorker and Wall Street Journal) had the chance to ask John Ehrlichman, a policy advisor for Richard Nixon, a series of questions. In a piece for Harper’s magazine titled, ‘Legalize it all: How to Win the War on Drugs’, Dan revealed the details of their conversation: “You want to know what this was really all about?” Ehrlichman asked with the bluntness of a man who, after public disgrace and a stretch in federal prison, had little left to protect. “The Nixon campaign in 1968 and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana* and blacks with heroin and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did”.
The quote sparked controversy worldwide, shining new light on the reasons behind the United States (US) Government’s ‘War on Drugs’. A Nixon invention, it’s been useful for political figures around the world and its function as a political tool hasn’t changed. Being seen to fight drug crime is a great way for politicians to win votes, regardless of what the evidence tells us. In Australia, the law and order auction that happens during each electoral season has seen ever-increasing penalties for drug offences and more people sent through the criminal justice system. Last year, the Federal Government’s ‘Dob in a Dealer’ anti-ice campaign was widely criticised for being used as a political distraction to take attention off the then Government’s failing legislative agenda.
The definition of insanity, doing the same thing over and over again but expecting different results, would seem to hold true in most places, except drug policy, where the Australian Government is happy to continue burning tens of millions of dollars a year fighting a war on drugs, despite mounting expert opinion telling them to change tack. The $1 million annual cost of the dob-in-a-dealer campaign would almost cover the $1.3 million needed to run a 10-bed rehabilitation unit, so a few more addicts wouldn’t have months longer, often in custody, for the opportunity to beat addiction and get their lives back-on-track.
According to the state of Victoria’s former Chief Commissioner, Ken Lay, this is where the Government should be looking to spend its resources: “For social problems like these, law enforcement isn’t the answer. Unless you get into the primary prevention end, unless you stop the problem occurring you simply won’t arrest your way out of this”, Lay said in 2015. “Ice has been on the scene for over a decade and we’ve had a really strong law enforcement approach and it hasn’t resolved the problem. The time’s right now to look at the other options”. Mountains of research support this view. The Australian Medical Association has pointed out the obvious: “reducing drug addiction reduces demand for drugs, reduces crime, reduces harm to addicts and their families and reduces the burden on our health system, not to mention the courts, prisons and police”. However, in the state of New South Wales (and right across Australia), the police and Government continue to treat drug use just like every other law and order problem, by arresting and sending more people to prison for longer hoping the problem will vanish. Guess what? It hasn’t worked.
Experiments in alternatives to harsh prohibition are underway in many other countries. Twenty-three US states as well as the District of Columbia (D.C.) allow medical Cannabis and four others, Colorado, Washington, Oregon and Alaska, along with D.C. have legalised Cannabis altogether. Several more US states including Arizona, California, Maine, Massachusetts and Nevada will likely vote in November to follow suit. In Vermont, heroin addicts can avoid jail by committing to state-funded treatment. Canada began a pilot program in Vancouver in 2014 to allow doctors to prescribe pharmaceutical-quality heroin to addicts, Switzerland has a similar program and the Home Affairs Committee of Britain’s House of Commons recommended the United Kingdom (UK) do likewise. Last July, Chile began a legislative process to legalise medicinal and recreational Cannabis use and allow households to grow as many as six plants. After telling the BBC in December that “if you fight a war for forty years and don’t win, you have to sit down and think about other things to do that might be more effective”, Colombian President Juan Manuel Santos legalised medical Cannabis by decree. In November, the Mexican Supreme Court elevated the debate to a new plane by ruling that the prohibition of Cannabis consumption violated the Mexican Constitution by interfering with “the personal sphere”, the “right to dignity” and the right to “personal autonomy”. The Supreme Court of Brazil is considering a similar argument.
Across Europe alternatives are also being sought, particularly with regard to the use of Cannabis. In the Czech Republic, the Czech Patient Association for Cannabis Treatment (KOPAC) organised the first-ever educational Cannabis seminars for medical professionals, patients and the general public. In Poland, Cannabis activists managed to attract the attention of the new deputy Minister of Health, meeting with him to discuss the benefits of medical Cannabis for Polish patients. Croatia made world news at the beginning of June with the announcement of the first-ever import from North America to the European Union (EU) of Cannabis extracts containing Delta-9-Tetrahydrocannabinol (THC) and other cannabinoids. Also in June, in Serbia, a number of patient and activist demonstrations were held as more and more people in the Balkans discovered the therapeutic effects, especially of Cannabis oil (Rick Simpson method). In Macedonia the Health Minister announced that pharmacies could sell Cannabis extracts without prescription (THC <0.2%). In Greece, thirty-six members of Parliament from the Syriza government party officially asked the Health Minister to revise current laws in order to allow the legalisation of medical Cannabis products that contain THC. In Hungary, an inaugural medical Cannabis conference took place in the capital, Budapest, demonstrating the growing interest in therapeutic use of the plant among central European countries.
On July 1st, 2001, Portugal decriminalised the possession of small amounts of every ‘drug’ imaginable, from Cannabis, to cocaine, to ice and heroin. Under the new legal framework, all drugs were ‘decriminalised’, not ‘legalised’. Thus, drug possession for personal use and drug usage itself are still legally prohibited, but violations of those prohibitions are deemed to be exclusively administrative violations and are removed completely from the criminal realm. Drug trafficking continues to be prosecuted criminally. Some thought the country would become a drug tourist haven, others predicted that usage among youths would skyrocket. Fifteen years later, neither of those things have happened. Instead, Portugal has seen a drastic reduction in drug addiction. The number of addicts, at 100,000 before the policy was enacted, was halved in the space of 10 years. Portugal’s drug usage rates are now among the lowest of EU member states. This happened because Portugal moved from treating drug use as a criminal law problem, to what it actually is, a health issue. Possession and use was moved out of criminal courts and into special tribunals where each user’s unique situation is judged by legal experts, psychologists and social workers. This is an important step to make as no-one chooses for drugs to overwhelm their lives. Providing users with pathways outside the traditional justice system is a win-win for all involved.
This idea isn’t as far fetched as it sounds and is beginning to affect drug laws around the world. An international commission of medical experts, set up by the Lancet medical journal and Johns Hopkins University in the US, called on the United Nations (UN) to back global drug decriminalisation, arguing that current policies lead to violence, death and disease, and harm health and human rights. In a report published on the eve of a special session of the UN’s General Assembly devoted to illegal narcotics, the group urged Governments around the world to begin decriminalising minor, non-violent drug offences involving the use, possession and sale of small quantities.
“The goal of prohibiting all use, possession, production and trafficking of illicit drugs is the basis of many of our national drug laws, but these policies are based on ideas about drug use and drug dependence that are not scientifically grounded”, says Dr Chris Beyrer of the Johns Hopkins Bloomberg School of Public Health. “The global ‘War on Drugs’ has harmed public health, human rights and development. It’s time for us to rethink our approach to global drug policies and put scientific evidence and public health at the heart of drug policy discussions”. While politicians win votes and private prison companies and criminal lawyers get rich, the hard working taxpayer will continue to foot the bill for the failed ‘War on Drugs’ and users who want to reach out will not only fail to get the support and assistance they need, but will be labelled as criminals in the process and more than likely be persecuted and prosecuted for their trouble.
“Drugs have destroyed many people, but wrong policies have destroyed many more”, said Kofi Annan, former UN Secretary-General. Indeed, international drug policy has been fraught with inconsistency and controversy. Global drug control started when the first international drug treaty, The International Opium Convention, was signed at The Hague in 1912. However, a global system against narcotic drugs was not fully fledged until 1961, when the Single Convention on Narcotic Drugs was adopted. The Convention is an international treaty that seeks to prohibit production and allow supply of narcotic drugs exclusively for medical and scientific purposes and combats drug trafficking through international cooperation. Although considered as a landmark convention in the history of the campaign against narcotic drugs and the bedrock of the current UN-based global drug control regime, the Single Convention on Narcotic Drugs was also criticised as neither reflecting the huge negative impact of pursuing drug prohibition on public health and human rights nor being scientifically grounded.
In 2010 the International Centre for Science in Drug Policy (ICSDP) was created as a response to scientific misinformation in the public discourse around drug policy. Today, the need for scientists to actively engage in the drug policy dialogue is greater than ever before. As an increasing number of jurisdictions experiment with approaches other than conventional, enforcement-based drug policies, members of the public, policy-makers and the media are asking a lot of questions about how the shift in policies impacts drug-related harms. In a perfect world, the answers to these questions would be evidence-based. Yet, in the absence of engagement from the scientific community, it is all too common for evidence to be misinterpreted, overstated, or simply ignored when discussing matters of drug policy. Given that policy decisions are influenced by public opinion and media reports, there is a very real risk that mischaracterisation of scientific evidence can lead to misinformed and potentially harmful, drug policies.
Research into the effectiveness of drug policies is crucial, but equally important is working to incorporate research findings into policy-making. This perspective has significant implications for the role of scientists. Traditionally, scientists are expected to identify the truth, but to leave the implementation of their findings to others. We must ask whether confining the work of scientists to the laboratory makes any sense whatsoever. Those that discover the facts are certainly well suited to be a part of the subsequent policy-making dialogue. Scientists are not only well positioned to inform the design of drug policies, but according to Molecular Biologist, Buddhini Samarasinghe, “have a moral obligation to engage with the public about their findings; to advise and speak out on policy, and to critique its consequent implementation”. We know that without a sustained commitment to implementing their research findings, the impact of a scientist’s research may very well be squandered. Scientists have a responsibility to take their research out of their laboratories and employ their findings in a push for evidence-based drug policies. It is only then that the advances made in research can become advances in society.
It is a statistical fact that you are more likely to die while horseback riding (1 serious adverse event every ~350 exposures) than from taking Ecstasy (1 serious adverse event every ~10,000 exposures). Yet, in 2009, the scientist who said this was fired from his position as the chairman of the UK’s Advisory Council on the Misuse of Drugs. Professor David Nutt’s remit was to make scientific recommendations to government ministers on the classification of illegal drugs based on the harm they can cause. He was dismissed because his statement highlighted how the UK Government’s policies on narcotics are at odds with scientific evidence.
Such incidents of silencing are sadly commonplace when it comes to politically controversial scientific topics. The US Government muzzled climate scientists in a similar manner in 2007 when it was reported that 46% of 1,600 surveyed scientists were warned against using terms like ‘global warming’ and 43% said their published work had been revised in ways that altered their conclusions. US preparations for oncoming climate change were checked as a result, a failing that persists today. The scientific method is defined by the Oxford English Dictionary as “a method or procedure … consisting in systematic observation, measurement and experiment, and the formulation, testing and modification of hypotheses”. It is our finest instrument for unearthing the truth. Applied correctly it is blind to and corrects for our inherent biases. Scientists are trained to wield this formidable tool in their quest to understand the universe around us. The truths they uncover can be at odds with our current beliefs; but when the facts (based on evidence and arrived at through rigorous testing) change, minds also need to change.
Science impacts on the life of every single species on our planet. It is ludicrous that the very people who discover the facts are not part of any subsequent policy-making dialogue. Science needs to be an essential component of the public discourse; currently it is not. Governments and other institutional actors have prioritised a small set of indicators to evaluate drug policy success as a result of a narrow focus on reducing the demand and supply of illegal drugs. These include the price, purity, perceived availability, number and volume of illicit drug seizures, number of drug-related arrests and incarceration, and the level of drug use in the general population (with no discrimination between problematic and non-problematic forms of drug use). Unfortunately, based on these indicators, drug policies combining street-level drug law enforcement with drug supply interdiction (i.e., seizures, the dismantling of clandestine drug laboratories, border security measures, etc.) have not, by and large, demonstrated effectiveness.
While experts have identified many factors that increase an individual’s risk of problematic drug use (mental health issues and trauma, among others), there is a comprehensive scientific literature delineating how many drug-related harms, including HIV and hepatitis C transmission, fatal overdose and substance use disorder, are exacerbated by current drug policy responses. Indeed, a scientific consensus has emerged that policies of drug prohibition and criminalisation substantially heighten the risk that people who use drugs will encounter negative health and social outcomes. Nevertheless, governments have prioritised law enforcement and interdiction over public health and development interventions, with few tangible results in reducing the supply or use of illegal drugs. Law enforcement-based approaches have in turn led to increases in high-risk behaviours among drug-using populations (e.g., use of unsterile needles as a result of enforcement-based barriers to clean injecting equipment). Drug law enforcement has also resulted in the spatial displacement of vulnerable drug-using populations and illicit drug production in a number of settings.
Importantly, drug policies that employ criminal justice interventions to disrupt illicit drug markets are known to paradoxically contribute to drug market violence and have not been associated with changes in illicit drug availability, purity or price. Enforcement-based drug policies have also been associated with widespread human rights violations in a range of settings including South-east Asia, Latin and North America, Eastern Europe and Russia. Finally, the coverage of evidence-based treatment and harm reduction services for drug-dependent individuals has not been brought to scale in most settings, which critically undermines the effectiveness of efforts to reduce the harms of drugs and reduce the expansion of epidemics of HIV and hepatitis C. The narrow set of evaluative drug policy indicators currently in use provides little insight into how drug policies affect peace and security, human development, human rights and the health issues that intersect all three of these pillars. For example, the presence of cheap and available illicit drugs in a community does not in and of itself provide policy-makers insight into the drug-related harms experienced by that community, or what policy approach may be most effective. To meaningfully evaluate illicit drug policies, then, indicators that measure ‘real-world’ outcomes of relevance to communities need to be prioritised.
Given that robust indicators have been developed by experts to assess a range of impacts of drug policies on community health, safety, development and human rights, UN Member States and other international stakeholders should commit to the creation of an expert advisory group to conduct a formal revision of drug policy metrics. Without such action, the unacceptably high levels of drug-related harms experienced in many settings, including epidemics of HIV and hepatitis C, widespread and increasing levels of fatal overdoses, epidemics of drug-related violence, social and human rights violations and major economic consequences (e.g., tax burden) related to the incarceration of drug users, will continue, with grave implications for communities affected by illicit drugs across the globe.
Adapted from Legalise it All: How to Win the ‘War on Drugs’, with Europe Update: The Latest Cannabis News from the Continent, Reforming International Drug Policy, The Role & Responsibility of Scientists in Drug Policy Reform, Scientists Should Stick to Science, A Call For A Reprioritisation Of Metrics to Evaluate Illicit Drug Policy
*Cannabis sativa L., is the correct botanical term, marijuana is a North American colloquialism