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Crises and radical thinking on drug policy

Reform has always been a “two-steps forward, one-step back” undertaking.

By Kasia Malinowska-Sempruch Published 16 August 2012 9:29

A drug user injects heroin. Photograph: Getty Images

It’s sad that drug policy reform must always be wrapped tragedy but alas – in the context of drugs – crisis has historically been the mother of invention.

It was in the face of thousands of overdoses and the highest HIV prevalence in Western Europe that Switzerland introduced effective heroin-prescription programmes, safe injection facilities, needle and syringe-exchange programmes and low-threshold methadone services.

Helped along by lawmakers who were not afraid to lead from the front, these policies resulted in making Switzerland’s HIV prevalence among people who use drugs one the lowest in Western Europe, at about 1.4 per cent.

In Portugal, the year the country witnessed 1,430 new HIV infections among people who use drugs (accounting 52 per cent of all new infections), the government introduced dramatic reforms, decriminalising all drugs and establishing model services for drug users.

Almost 10 years later, new HIV infections among people who use drugs dropped to 164 (15% of all new infections).

It was a similar HIV crisis in the UK in the mid-1980s that spurred the then-Conservative government to launch a number of harm reduction interventions that greatly reduced HIV among people who inject drugs.

Now, as Latin America faces its own supply-side crises with tens of thousands of drug-related killings, gross human rights abuses and overflowing prisons, governments are increasingly vocalising a desire to take bold action toward reform of failed prohibitionist policies.

In 2009, the Latin American Commission on Drugs and Democracy – including the former presidents of Mexico, Colombia and Brazil, as well as leaders in journalism, politics, academia and literature – called for a paradigm shift in the approach to drugs. This was followed by a report by the Global Commission on Drug Policy that encouraged “experimentation by governments with models of legal regulation of drugs to undermine the power of organized crime and safeguard the health and security of their citizens.”

Subsequently, numerous Latin American governments have openly discussed forms of regulation, including government sale of marijuana or licencing private facilities.

However, drug policy reform has always been a “two-steps forward, one-step back” undertaking and while creativity is being sought in the Americas, Europe is losing some of its pioneering spirit.

Austerity, in some contexts, is a danger to gains made in HIV prevention, among people who use drugs. In Greece, the European Monitoring Centre on Drugs and Drug Addiction (EMCDDA) warned of an increase in the number of newly identified HIV cases among people who use drugs, from between 3 and 19 a year from 2001 to 2010, to 113 new HIV cases as of July 2011.

The Greek government has increased services for drug users to address the situation but the EMCDDA cautions, that “the level of activity is still insufficient to meet the demand within the injecting drug using population.”

In other cases, a nascent abstinence-agenda is trying to manufacture a bogus tension between treatment models – suggesting that providing life-saving services to drug users, like needle-and-syringe exchange programmes, is at odds with ensuring availability of abstinence-based treatment for those who want it.

Some other lawmakers may argue that services to drug users are poor investments in lean times, ignoring the fact that it is immensely cheaper to prevent blood-borne viruses and bacterial infections like HIV, than treat them.

This is the current global paradox in drug policy.

While a new approach may indeed be rolled out to reduce black market violence in Latin America and other parts of the world, a regression to old, expensive and failed ideas in Europe may revise costly and avoidable crises from the past.

And, perhaps, inspire some fresh thinking once again.

Kasia Malinowska-Sempruch is the director of Open Society Foundations Global Drug Policy Program

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Tags: Drugs

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11 comments

Fri, 2012-08-17 16:35 — E. Kenneth Eckersley (not verified)

FRESH THINKING ON ADDICTION POLICIES:

Instead of "fighting a war on illegal drug suppliers" lets start REDUCING DEMAND by training existing addicts to bring themselves to relaxed lasting abstinence.

This is already being done at 169 residential addiction recovery training centres (including prison units) in 49 countries and has been succeeding in bringing 55% and more of its enrollees to relaxed lasting abstinence since 1966 in America and since 1974 in the UK.

For a free copy of the 120 page book: "THE ADDICTION TRAP: How We Get Into Drugs and How To Escape - A practical guide to achieving relaxed lasting abstinence."
Ring 01342 810151.

Kenneth Eckersley,
CEO Addiction Recovery Training Services (ARTS)
a not-for-profit community support operation established in 1975.

Fri, 2012-08-17 11:37 — Gart Valenc (not verified)

As a European citizen who looks in horror at the heinous consequences Prohibition and the so-called War on Drugs policies have had on drug producing and transit countries, in particular Latin American ones, I cannot help but feel ashamed by the total lack of support shown so far by European countries for the call made by sitting Latin American presidents to engage in an open debate to find alternatives to current drugs policies.

Why have we not heard a single word of encouragement, let alone support, from European countries that have "quasi legalised" their demand for, as well as their domestic supply of, drugs?

How can we explain the silence of countries such as the Czech Republic, Denmark, Germany, Holland, Italy, Portugal, Spain, Switzerland, among many others, which have de jure or de facto depenalised or decriminalised the personal consumption of some drugs?

Or the silence of countries that allow users to grow a number of marijuana plants in their homes and for their own consumption, or tolerate the operation of so called “cannabis social clubs”, or authorise the cultivation of marijuana to supply dispensaries where consumption on medical grounds is allowed?

I do not have any doubts that harm reduction programmes, decriminalisation or depenalisation of the demand for drugs are sensible and necessary policies. But if we were serious about tackling the so-called drug problem, we should be accompanying those policies regarding the demand with equally sensible policies towards the supply of drugs coming from Latin America—or from any other part of the world for that matter.

It is disgraceful, almost criminal, to see that while Latin America is trying to promote the discussion of current and alternative drug policies, we behave in the most cowardly fashion: we remain in silence.

Our mutism is totally inexcusable, for in the final analysis the onus is on us, drug consuming countries in the developed world. We should be the ones promoting the Legalisation & Regulation of the supply. We should be the ones making all the noises calling for a change in the national and international legislation on drugs. We should be spearheading the movement seeking the end of Prohibition and the War on Drugs, and the regulation of the production and distribution of all drugs.

Gart Valenc
Twitter: @gartvalenc

Fri, 2012-08-17 13:06 — Bklyn Exile (not verified)

You make some good points. I still the US market is the biggest driver of violence in the Latin American black market. But you're right? Regulation of production would probably best function with the resgulated consumer market. But US prohibition of alcohol is kind of interesting in this regard. Most other countries carried on usual. Canada and UK continued to produce and tax alcohol that would be exported to the US's black market. They just didn't get too caught up in the transit (a bit but not too serious). In fact the Bahamas made a fortune by taxing booze that passed through its ports.

Fri, 2012-08-17 13:10 — Bklyn Exile (not verified)

Sorry, I think a question mark or two slipped in there unnecessarily. Pls ignore

Fri, 2012-08-17 08:18 — Darryl Bickler (not verified)

Lets be clear there is no war on drugs, no illicit drugs and no illegal drugs either! We should desist from using these terms because they are fictions created by the prohibitionist paradigm as forms of deception about the true nature of control.

Even talk of decriminalising or legalising drugs as mooted by Transform and Release is rooted in a fictitious construct about how the law operates. They are seeing the whole thing in reverse, ascribing legal status to objects; this is impossible. One result is that the entire system of addressing negative outcomes connected with human actions associated with drug misuse is lost. The envisaged regulatory system of controlling human actions has been replaced with an indivisible illegality imposed on some persons concerned with some drugs, this via the misnomer that (some) potentially harmful drugs are illegal and some are legal. Tom Lloyd was right in his oral evidence to point out that this is nonsense, but he did not touch upon the profound significance of the replacement of the legal subject (person) with an object (drug). Simply put, we are avoiding the elephant in the room, we completely misconstrue the Misuse of Drugs Act with catastrophic consequences for all.

The expression ‘war on drugs' masks the true focus of attack, which is people who use some drugs (and indeed the possibility that any one of us might one day wish to), it is people who endure a perpetual climate of suspicion and stigmatisation irrespective of the need for the administrators to demonstrate any of the anti-social mischief. Concurrent over and under regulation of different classes of drug user thwarts the proper application of the law and progress in this arena. When we think of a war on people, it seems unconscionable to talk about winning it, its unjust and unconscionable; the various punitive policies are arbitrary.

Via objectification, the whole human rights discourse and libertarian considerations are obscured. Many consider that this is a war upon our possibilities to benefit from open objective research into remarkable molecules. Civilisation mandates that we have inalienable rights as human beings, rights to know what is. We think, we are conscious, we are chemical - controlling body chemistry is something that should be done with anxious concern for the limitations we impose on the experience of being. Why is personal chemistry any business of the state whilst persons experiment peacefully and do not endanger others? My message is that by misconstruing the problem we lost ourselves to pernicious censorship of the self. The state refuse to recognise legitimate uses for thousands of molecules both naturally occurring and synthetic; all proportionality of interference has been lost to a double-speak concerning a supposed war on illegal objects. There is no threshold for interference into some people’s lives, they are deemed fair game before a significant anti-social outcome can even be foreseen.

We might contemplate a ‘war’ targeting the worst outcomes of drug misuse, and develop best policies concerning harm reduction and prevention. Yet we ended up in this mess by failing to differentiate between good, acceptable and bad outcomes for some drug users, after all, ‘it‘ is supposedly illegal. Yet there is no law against using any drug except opium. The law is supposed to regulate property to curb misuse, not to deny all use in almost all circumstances for controlled drugs. Information is deemed to be lacking in credibility because it is so lacking. Most people misusing drugs are completely ignored by the administrators of the law, a policy borne of “cultural and historic preferences“# that declares them lawful within the purview of the very law supposed to address such misuse, this by merit of them being associated with supposedly ‘legal drugs’ - the law is drafted to be neutral, people are not supposed to be exempt!

In the resultant artificial divide between different classes of persons using different drugs, some people are awarded privileged property rights, and others are denied their rights absolutely. This is maintained via the abuse of power inherent within the misadministration of outcome-based neutral primary law. Using a ‘smoke and mirrors’ deception, that the law controls drugs not persons, the government cannot recognise the Misuse of Drug’s Act’s true form to address antisocial outcomes via the flexible regulation of different persons with respect to different drugs#. Rather their policy protects vested interests in drugs, this by according sacrosanct status to some persons, resulting in the irrational policy that presumes that some drug taking is presumed more worthy, even holier than other possibly potentially less harmful consciousness modifying practices.

The flip side of the ’illegal drugs’ myth is the myth of ‘legal drugs’ - the lie that some people are exempted from the law. The majority would not tolerate sufferance of imprisonment for having a peaceful home brewing interest - yet a cultivator of cannabis loses their liberty. This is perverse social engineering towards poor drug choices.

www.drugequality.org

Fri, 2012-08-17 02:03 — Iliana (not verified)

Open Society funded the Global Commission. I'd post a link, but that seems to trigger the profanity filter, but it's easily Googled. Nothing against the piece, but that should have been made clear.

Fri, 2012-08-17 11:32 — Gart Valenc (not verified)

Even though I wholeheartedly welcome both reports (Latin American Commission and Global Commission), I do believe they downplay the need for regulated legalisation of drugs supply See my post: Wilful Ignorance: The New Reality? (as you said, no links allowed, I'm afraid. Just click on my Twitter account, which shows my website address).

Gart Valenc
Twitter: @gartvalenc

Wed, 2012-09-05 12:12 — Gart Valenc

Alternatively, follow this link: bit.ly/NjF961

Gart Valenc
Twitter: @gartvalenc

Thu, 2012-08-16 22:38 — Lupe (not verified)

Latin America is really aching for some inspired leaders to turn things around. What is it that they say about doing the same thing over and over again and expecting different results?...

Thu, 2012-08-16 17:49 — Kato (not verified)

Very well articulated thought without a doubt indeed.
Human cost of the war on drugs has been rather dramatic and it is now apparent that glorious debates on the topics are not beneficial for people on the ground. Some pragmatic approaches are rather urgently needed to help the locals to survive in their every day lives - too many people lose their children, wives, sisters, brothers, mothers and fathers in this what I call cold bloodshed drug control that has nothing to do with the common good pr protection of common values...
When power and money becomes so easily accessible - human values and concept of freedom and rights as well as democracy becomes a vanity.

Thu, 2012-08-16 14:57 — Bklyn Exile (not verified)

See the Alternative World Drug Report. It shows pretty much the entire world is in crisis thanks to these policies.

Can someone explain once again why everyone is screaming for reform?