Legalise drugs and a worldwide epidemic of addiction will follow
Those who argue we should decriminalise the trade in narcotics are blind to the catastrophic consequenses
Antonio Maria Costa
The Observer, Sunday 5 September 2010
The debate between those who dream of a world free of drugs and those who hope for a world of free drugs has been raging for years. I believe the dispute between prohibition and legalisation would be more fruitful if it focused on the appropriate degree of regulation for addictive substances (drugs, but also alcohol and tobacco) and how to attain such regulation.
Current international agreements are hard to change. All nations, with no exception, agree that illicit drugs are a threat to health and that their production, trade and use should be regulated. In fact, adherence to the UN's drug conventions is virtually universal and no statutory changes are possible unless the majority of states agree quite unlikely, in the foreseeable future. Yet important improvements to today's system are needed and achievable, especially in areas where current controls have produced serious collateral damage.
Why such resistance to abolishing the controls? In part, because the conventions' success in restraining both supply and demand of drugs is undeniable.
Look first at production. Drug controls slashed global opium supply dramatically: in 2007, it was one-third the level of 1907. What about recent trends? Over the last 10 years, world output of cocaine, amphetamines and ecstasy has stabilised, and in many instances dropped. Cannabis output has declined since 2004. Since the mid-90s, opium production moved from the Golden Triangle to Afghanistan where it grew exponentially at first, but started to decline (since 2008).
My first point is factual: in the distant past as well as recently, production controls have had measurable results. What about drug-use levels? There are 25 million addicts (daily use) in the world, 0.6% of the population. Ten times as many people (5% of the world's population) take drugs at least once a year. As these amounts are relatively small, statements such as "there are drugs everywhere" or "everybody takes drugs" are nonsense. The drug numbers compare well with those of tobacco, a legal drug used by 30% of the world's population. Even more people consume alcohol. Tobacco causes 5 million deaths per year and alcohol 2 million, against the 200,000 killed by illicit drugs.
My second point is logical: in the absence of controls, it is not fanciful to imagine drug addiction, and related deaths, as high as those of tobacco and alcohol. What are recent drug-use trends? In rich countries, addiction is high but declining. In North America and Australia, it has declined in the past 10 years, especially among the young. In Europe, opiates use has declined, offset by greater cocaine sales; cannabis and amphetamines are stable or lower. In developing countries, drug use is low, but growing. In South America and west Africa, this applies to cannabis and cocaine; in Asia and southern Africa to heroin.
My third point is intuitive: rich countries are addressing the drug problem, while poor countries lack resources to do so. With the building blocks of my reasoning in place (stability of the world drug supply; alcohol and tobacco hurt more than drugs; the divergent drug trends in poor and rich nations), I find it irrational to propose policies that would increase the public health damage caused by drugs by making them more freely available.
At the same time, drug controls are not working as they should. The resulting collateral damage is the platform upon which critics build the abolitionist argument.
Let's look at health, security and human rights. Health must be at the centre of drug control, because drug addiction is a mix of genetic, personal and social factors: gene variants (predisposition), childhood (neglect), social conditions (poverty). The pharmacological effects of drugs on health are independent of their legal status. Drugs are not dangerous because they are illegal: they are illegal because they are dangerous to health. Unfortunately, ideology has displaced health from the mainstream of the drug debate and this has happened on both sides of the prohibition versus legalisation dispute.
In the past half-century, drug control rhetoric by governments has been right, but prevention and treatment programmes have lagged. Priority was wrongly given to repression and criminalisation. Similarly, those in favour of legalisation have lost sight of health as the priority. They prioritise handing out condoms and clean needles, while addicts need prevention, treatment and reintegration, not only harm reduction gadgets. In short, the debate on drug policy has turned into a political battle. But why? There are no ideological debates about curing cancer, so why so much politics in dealing with drug addiction?
But there is more. Drugs do harm to health, but they can also do good. Greater use of opiates for palliative care would overcome the socio-economic factors that deny a Nigerian suffering from Aids or a Mexican cancer patient the morphine offered to Italian or American counterparts. Yet such relief is not happening.
Next is the security question. Drugs pose a threat not only to individuals. Entire regions think of Central America, the Caribbean and Africa are caught in the crossfire of drug trafficking. In Mexico, a bloody drug war has erupted among crime groups fighting for the control of the US drug market. The legalisers' argument on security is striking, though it leads to the wrong conclusion. Prohibition causes crime by creating a black market for drugs, the argument goes, so, legalise drugs to defeat organised crime. As an economist, I agree. But this is not only an economic argument. Legalisation would reduce crime profits, but it would also increase the damage to health, as drug availability leads to drug abuse.
Drug policy does not have to choose between either protecting health, through drug control, or ensuring law and order, by liberalising drugs. Society must protect both health and safety.
In a world of free drugs, the privileged rich can afford expensive treatment while poor people are condemned to a life of dependence. Now extrapolate the problem on to a global scale and imagine the impact of unregulated drug use in developing countries, with no prevention or treatment available. Legalised drugs would unleash an epidemic of addiction in the developing world.
Last but not least, there's the question of human rights. Around the world, millions of people caught taking drugs are sent to jail. In some countries, drug treatment amounts to the equivalent of torture. People are sentenced to death for drug-related offences. Although drugs kill, governments should not kill because of them. The prohibition versus legalisation debate must stop being ideological and look for the appropriate degree of controls. Drug control is not the task of governments alone: it is a society-wide responsibility. Are we ready to engage?
