Crises and radical thinking on drug policy

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

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

A drug user injects heroin. Photograph: Getty Images

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

Photo: Getty
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The Tories play Game of Thrones while the White Walkers from Brussels advance

The whole premise of the show is a pretty good metaphor for the current state of British politics.

If you’re a fan of asking “who’s that, then?” and “is that the one who killed the other one’s brother?”, I bring great news. Game of Thrones is back for a seventh series. Its vast assortment of characters was hard enough to keep track of before half of them got makeovers. But now the new Queen Cersei has reacted to the arrival of the long winter by investing heavily in the kind of leather ball gowns sold by goth shops in Camden, and Euron Greyjoy, once a fairly bland sailor, has come back as a Halloween costume version of Pacey from Dawson’s Creek, all eyeliner and epaulettes.

The show’s reliance on British character actors is the only thing keeping me vaguely on top of the cast list: what’s Diana Rigg up to these days in Highgarden? And what about that guy who was in Downton Abbey that time, who now has the scaly arms? (Luckily, the next thing I watched after the Game of Thrones series premiere was the first two episodes of the revived Twin Peaks, which put my confusion into perspective. There, Agent Cooper spent most of his time talking to a pulsating bladder attached to one of those fake trees you get from Ikea when your landlord won’t let you have real plants.)

The day-to-day business of Game of Thrones has always been power – answering the question of who will sit on the Iron Throne, forged by Aegon the Conqueror from the swords of his defeated enemies. But its backdrop is a far bigger threat: the arrival of a winter that will last many years, and the invasion of an army of the undead.

That might seem like an unkind way to think about Michel Barnier and his fellow Brexit negotiators – inexorably marching towards us, briefing papers in hand, while Liam Fox frantically rings a bell at the entrance to the Channel Tunnel – but nonetheless, the whole premise of Game of Thrones is a pretty good metaphor for the current state of British politics.

The current internal Conservative struggle for power might be vicious but it is at least familiar to its contestants; they know which weapons to deploy, which alliances are vital, who owes them a favour. Meanwhile, the true challenge facing every one of them is too frightening to contemplate.

In 2013, this magazine celebrated the early success of the show with a cover depicting one of our terrifying painted mash-ups: “The Tory Game of Thrones.” Our casting has been strangely vindicated. George Osborne was our Jaime Lannister – once the kind of uncomplicated bastard who would push a child out of a window but now largely the purveyor of waspish remarks about other, worse characters. Our Cersei was Theresa May, who spent the early seasons of The Cameron Era in a highly visible but underwritten role. Now, she has just seized power, only to discover herself beset by enemies on all sides. (Plus, Jeremy Corbyn as the High Sparrow would quite like her to walk penitently through the streets while onlookers cry “shame!”)

Michael Gove was our Tyrion Lannister, the kind of man who would shoot his own father while the guy was on the loo (or run a rival’s leadership campaign only to detonate it at the last minute). Jeremy Hunt was Jon Snow, slain by the brotherhood of the Night Shift at A&E, only in this case still waiting for resurrection.

The comparison falls down a bit at Boris Johnson as Daenerys Targaryen, as the former London mayor has not, to my knowledge, ever married a horse lord or hired an army of eunuchs, but it feels like the kind of thing he might do.

We didn’t have David Davis on there – hated by the old king, David Camareon, he was at the time banished to the back benches. Let’s retrospectively appoint him Euron Greyjoy, making a suspiciously seductive offer to Queen Cersei. (Philip Hammond is Gendry, in that most of the country can’t remember who he is but feel he might turn out to be important later.)

That lengthy list shows how Conservative infighting suffers from the same problem that the Game of Thrones screenwriters wrestle with: there are so many characters, and moving the pieces round the board takes up so much time and energy, that we’re in danger of forgetting why it matters who wins. In the books, there is more space to expound on the politics. George R R Martin once said that he came away from The Lord of The Rings asking: “What was Aragorn’s tax policy?” (The author added: “And what about all these orcs? By the end of the war, Sauron is gone but all of the orcs aren’t gone – they’re in the mountains. Did Aragorn pursue a policy of systematic genocide and kill them? Even the little baby orcs, in their little orc cradles?”)

Martin’s fantasy vision also feels relevant to the Tories because its power struggles aren’t about an “endless series of dark lords and their evil minions who are all very ugly and wear black clothes”. Instead, everyone is flawed. In Westeros, as in the Conservative Party, it can be difficult to decide who you want to triumph. Sure, Daenerys might seem enlightened, but she watched her brother have molten gold poured down his throat; plucky Arya Stark might tip over from adorable assassin into full-blown psychopath. Similarly, it’s hard to get worked up about the accusation that Philip Hammond said that driving a train was so easy “even a woman” could do it, when David Davis marked his last leadership campaign by posing alongside women in tight T-shirts reading “It’s DD for me”.

The only big difference from the show is that in real life I have sympathy for Barnier and the White Walkers of Brussels. Still, maybe it will turn out that the undead of Game of Thrones are tired of the Seven Kingdoms throwing their weight around and are only marching south to demand money before negotiating a trade deal? That’s the kind of plot twist we’re all waiting for.

Helen Lewis is deputy editor of the New Statesman. She has presented BBC Radio 4’s Week in Westminster and is a regular panellist on BBC1’s Sunday Politics.

This article first appeared in the 20 July 2017 issue of the New Statesman, The new world disorder