Drug Policy reform refuseniks, and the discrepancy between the arguments for prohibition, the evidence base and the changing need for service provision

Citation

Klein, A. (2012), "Drug Policy reform refuseniks, and the discrepancy between the arguments for prohibition, the evidence base and the changing need for service provision", Drugs and Alcohol Today, Vol. 12 No. 4. https://doi.org/10.1108/dat.2012.54412daa.001

Drug Policy reform refuseniks, and the discrepancy between the arguments for prohibition, the evidence base and the changing need for service provision

Article Type: Editorial From: Drugs and Alcohol Today, Volume 12, Issue 4

It is one of the declared objectives of this journal to give voice to the arguments for and against drug policy reform, as it is universally acknowledged that the current state of affairs leaves much to be desired. Technical experts and policy makers agree that contemporary society has a complex and unresolved relationship with mind altering substances. But there is disagreement over how to move forward. It is the editorial position that there is a fundamental problem with a prohibitionist approach and that we need to move towards regulated markets for certain substances. Others disagree – for reasons that are hard to summarise. Tracking a number of public debates that have been held over the course of last year, I argue that this is basically a refusal of the evidence. There are multiple risks in not acknowledging failure and the need to regroup. The continuing rise in crime is too well established to labour here. But we also note that prohibition caused shifts in drug consumption will result in new problems for a generation initiated into new synthetic drugs, with unknown effects and symptoms. It is important to note that neither process – the fall in heroin and the rise in NSDs – has been triggered or prevented by enforcement, which in terms of trend progression remains irrelevant.

At a time when changes to the public health dimension of the national drug policy are being reconfigured, it pays to learn from past successes. There is a risk that policy objectives are now being shaped by the need to measure outcomes. One of the dilemmas of the NTA noted in previous editions of this journal, has been the compulsive need to evidence the efficacy of interventions against ever more complex criteria. Clients contacting treatment services were subjected to an ever more detailed “assessment” process, in which the clinical needs of the individual were secondary to the aggregate demands of a public service. Perhaps there was an understandable need for a branch of medical practice that had long been obscured by lack of information and moral stigma to continue establishing the credentials for practice. But there was a cost in terms of treatment efficacy, and client confidence, as many people looking for help – or simply a place where they could talk – found that their counselling session consisted of filling in extensive questionnaires and reading a leaflet.

The treatment field, by not addressing this underlying question opened a space for a stinging, if unsubstantiated, critique spearheaded by an assault on methadone maintenance. The current government then, in the guise of the tendentious “abstinence agenda” (abstinence meaning abstinence from a list of substances – not from harmful or compulsive behaviour) is using the impasse to enact a reform in funding allocation. Informed debate has been replaced by the prohibitionist prayer wheel, “drugs do harm to communities … ”, leaving unaddressed all the questions raised by drug policy reformers around perverse consequences, the rise of criminal organisation, the damaging effect of criminal records on young people, the rising THC content and so on.

Rational explanations for government policy are usually provided by supporting constituencies of technical experts and voiced in open fora where objections can be raised and positions defended. We have argued in previous issues that these are strangely missing in the drugs field, where the prohibitionist movement consists often of people salaried to enforce that prohibition. There are considerable differences between countries and cultures. The US and Scandinavian taxpayers, for instance, dedicate significant resources to fund people to generate information and prepare justifications for government policies. Insights into this closed circuit of system supporting evidence gathering can be gained from the work of Esa Österberg (2011). An alcohol researcher at the Finnish National Institute for Health and Welfare in Helsinki, who argues forcefully in favour of raising alcohol taxes as opposed to minimum pricing. With the latter the profit accrues to private sector corporations; with the former the government collects more tax. Drinking is reduced and the tax take increases – “a win-win situation”. So the government funds institutions to devise policies that justify the expansion of government. Whatever the potential benefits for public health, this is not an uncontested position. Many may object to increasing the role of the state or believe that money should be the consumer’s to spend at her free will, not be taken by a state that knows better.

In this country a more restrained approach was chosen, and even the repressive turn taken with the 1971 Misuse of Drugs Act was tempered by the creation of an independent advisory body to guide government, the Advisory Council on the Misuse of Drugs. Finding vocal champions for a criminal justice approach to public health, as drug prohibition may well be characterised, has become difficult. Instead, there have been recommendations to downgrade substances like MDMA or cannabis, warnings about the relative harm of licit and illicit drugs (and activities) and a caution against the unintended consequences of clumsy restrictive measures.

Without a salaried cohort of prohibition experts at home, organisers of the largest drug policy discussions ever held, the Google launch webinar staged in London in May 2012, could only muster a handful of British experts to make the case. Most of them were from the USA, including the leader of the prosecution, the former New York State Governor Eliot Spitzer. What were the organisers thinking when recruiting a politician forced to resign for consorting with call girls in a state where prostitution is illegal? Was there a point about hypocrisy in unleashing a war on some drugs while celebrating others.

No such subtleties were noted by star witness Barry Richard McCaffrey, the head of the Office of National Drug Control Policy 1996-2001. The appointment of a military man who had distinguished himself in Vietnam and then in the first Gulf war[1] to lead a drug control agency offers some explanations for mindset, policy orientation and overall failure. First of all, it suggests that the war on drugs provides huge organisations like the US military with demobilization strategy for retired personnel. But the consequences for the domestic terrain are considerable, as their approach comes from Carl von Clausewitz’s classic strategy: the enemy must be pursued to destruction. The scale is one of absolutes: drugs – or as we do not fight them, but drug users – have to be destroyed, and any questioning of methods or doctrine is treachery. Hence also the dehumanization of the drug user articulated in previous talks – “go knock yourself out”, and the disregard of facts, for example the claim that homicide rates in The Netherlands are far higher than in the USA because of the cannabis drug policy “The murder rate in Holland is double that in the United States… That’s drugs” (Reinarman, 2011). All things are fair in love and war, and truth is famously the first casualty. Moreover, once declared, war in the hands of the military shifts from a means (political goals achieved by force) to an end, the expansion of the war machine, regardless of outcome. That two of the most colossal martial failures in US history, the wars in Vietnam and against drugs, converge in terms of personnel may not be coincidental. We should beware, however, when generals seek to justify their costly errors and deny the human cost of the collateral damage. Because like all the witnesses called, the questions of lives ruined by criminal records, or destroyed by police or military actions, MacGaffrey avoided explaining how the benefits of prohibition outweighed the costs.

The handful of British experts did little to further the debate. The leading (only?) prohibitionist academic, Neil McKeganey, was on record with safe platitudes about the need for a balanced approach. The former Met Commissioner Ian Blair sought to establish credibility with a claim of having been in “more crack dens (lunches with journalists surely) than I care to remember” (Blair, 2012), leaving it to Peter Hitchens to inject some form of intelligent argument about responsibility and the autonomy of the individual. The Daily Mail journalist has emerged as a regular campaigner for a tough approach on drugs in several public debates, a forthcoming book and a lively and readable blog. His take on it is that the war on drugs has not been lost because it has never been fought. Nobody gets arrested for drug use because the police simply refuse to enforce the law. At the Lewes Speaker festival (15 July), a member of the audience countered that he had made a career as a solicitor out of representing defendants on drug charges. “And when was the last time that anybody was ever convicted for cannabis possession?”, asked PH. “Last week” came the answer (Hitchens, 2012b). It is unlikely that this will sway this most thoughtful of prohibition advocates from his basic contention, because like most people in the fray it is not rational analysis or cost benefit appraisals that motivate him, but emotion. Sad memories of youthful promise undone by untimely and immoderate cannabis habits, a story that only too many readers can relate to, prompted him to write the book. Yet it is not closer regulation and the provision of decriminalised access that will protect the young and the vulnerable, but harsher laws and bigger, bleaker prisons.

There are innumerable inconsistencies in this position, but none so jarring as the assertion that an action is criminal because it is in breach of the law. “All crime is caused by law, and that to say ‘enforcing this law causes problems’ is to dodge the question of why we have laws against certain things in the first place” (Hitchens, 2012a). Beyond the stupefying reassurance of any truism there is little to recommend this observation. First, how would we account for changes in law? And further, laws are social constructs designed to meet the needs of communities to protect their members, appease morality and allow for congenial social intercourse. They run on a continuum with custom, etiquette and social rules, but are qualitatively different by involving the authority of the state. Most importantly, laws protect the public interest by maintaining order, but not at the expense of individual rights. There are always conflicts as more powerful groups give legal expression to their material interests. In the US slave states of the nineteenth century it was illegal, for instance, to aid and abet a fleeing state, hence the need for an “underground railroad”, and the restless nights spent by Huckleberry Finn (Twain, 1884) wrestling with the moral question whether helping Jim escape is stealing Miss Watson’s property[2]. As Emile Durkheim reminded us, it is not the breach of the law that shocks us into recognizing a crime. It is because we are shocked that we know it is a crime, whether so defined by law or not. Law has to be aligned to social mores, customs and values, and in a complex, diverse society take care of minorities.

Hence the argument for legal access to drugs for millions of adults who so choose to spend their free time for reasons beyond anyone’s purview or business. How to regulate such access is of course the hottest topic of debate. One interesting argument for drug control has been put forward by the former secretary of the United Nations Office on Drugs and Crime. Antonio Costa also appeared at the Google webinar but developed the point further at a public debate with this author in the Italian town of Otranto[3] (Figure 1). There is a danger, he warned, of large companies in the pharmaceutical and alcohol and tobacco industries appropriating drugs that are currently illicit and marketing them for profit. He even accused “his friend” Richard Branson, an outspoken campaigner for drug policy reform, of only wanting to make money out of drugs and in response to the suggestion of the DAAT editor that opium could perhaps be prescribed to the elderly for pain management he warned the audience to be careful when listening to an Englishman talking about the opium trade – a reference, confused perhaps, to the nineteenth century opium wars between Britain and China. Without wishing to dwell neither on inaccuracies nor bizarre theories of entitlement to comment (is Antonio Costa himself precluded from talking on organized crime because of his Italianness?) we pick up the positive points in the statement. If big business and capital are a problem with the potential opening of markets for currently controlled drugs, then we could win the former UN head over to champion the cause of homegrowing. It has long been recognized that in countries that have gone a long way to decriminalize consumption, particularly Denmark, The Netherlands and Portugal, problems persist with the supply side. Criminal groups dominate the trade and create a problem over time as they accumulate capital that can be used for diversification into other criminal businesses. As Mr Costa is worried about all these issues, he should really be introduced to viable alternatives. Spanish cannabis cooperatives provide one fascinating model where drugs are produced and consumed outside of organized crime networks, while the current proposal in Uruguay seems designed to encourage cultivation (either registered with the state as a drug user or grow your own).

Figure 1 Drugs and Alcohol Today Editor, Axel Klein, explaining the danger of Coca Cola as a gateway drug to Antonio Costa, ex-Secretary of United Nations Office on Drugs and Crime), Roberto Calzadilla (Bolivia’s ambassador to The Netherlands) and Franco Corleone (former secretary of state for Justice) in Otranto, Italy, 26 July 2012

All over the world a rising number of people are growing their own weed precisely in order to guarantee quality, reduce costs and stay clear of the law and the lawless. We therefore suggest to appoint Mr Costa, now that he has the time, as patron for the non-commercial cannabis cultivators. He may set an example for a new role for the UNODC itself as it moves from its obsession with fighting drugs to one of regulating the market. He can take much comfort from studies in the link suggest that groups with the lowest intelligence quotient (IQ) scores seek comfort in high rates of between IQ scores and cannabis consumption among adolescents. While successive studies cannabis consumption, the highest achievers in IQ gains are young people who are moderate current users (Fried et al., 2002). A future slogan of the venerable institution, then may be, “grow your own and smoke sensibly”.

Notes

1. 1.

   Where he allegedly ordered his troops to destroy Iraqi units after a ceasefire had been declared.

2. 2.

   Note that psychology flew to the assistance of justice by providing the diagnosis of drapetomania. A mental illness prompting slaves to flee.

3. 3.

   Presentation at the Otranto Legality Experience, 29 June 2012 Otranto, Italy. Drugs and power. Producing countries, drug trafficking and international strategies for the fight against drugs in a geopolitical perspective. Axel Klein, Antonio Costa, Roberto Calzadilla, Franco Corleone.

Axel Klein