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Free Drugs or Drug Free?

The Indipendent/The Guardian on 2 September 2010

The sterile debate between those who dream 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 vs. legalization would be more fruitful if focussed on the appropriate degree of regulation for addictive substances (drugs, but also alcohol and tobacco), and how to attain it.

Current international agreements are hard to change.  All nations, with no exception, agree that illicit drugs are a threat to health and their production, trade and use should be regulated.  In fact adherence to the United Nations 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 are needed and achievable, especially in areas where current controls have produced serious collateral damage. 

Why such a resistance to abolish the controls?  In part, because the conventions’ success is undeniable, in restraining both supply and demand of drugs.

Look first at production.  Drug controls slashed global opium supply dramatically:  in 2007 it was 1/3 the level of 1907 (most other drugs did not exist then, so it’s impossible to compare). What about recent trends? Over the last 10 years, world output of cocaine, amphetamines and ecstasy has stabilized, 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 then is 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) 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 compares well with those of tobacco, a legal drug used by 30% of the world’s population.  Even more people consume alcohol.  The deadly statistics are even more convincing.  Tobacco causes 5 million deaths per year and alcohol 2 million, against the 200 thousand killed by illicit drugs.  My second point is therefore 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 policy that would increase the public health damage caused by drugs by making them more freely available.


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Yet, 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.


Healthmust 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. Yet, ideology has displaced health from the mainstream of the drug debate, and this has happened on both sides of the prohibition vs. legalization dispute.


In the past half century, governments’ drug control rhetoric has been right, but in reality, prevention and treatment programs have lagged>  Priority was wrongly given to repression and criminalization.  Similarly, those in favour of legalization have lost sight of health as the priority.  They prioritize 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 about drug addiction?  People to the left or right of the political spectrum are not divided on the need for preventing tuberculosis, so why with drugs?  


We must not only stop the harm caused to health by drugs:  they can do good, as recognized by the UN Convention which states: … the medical use of narcotic drugs is indispensible for the relief of pain.  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, this 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 cross-fire of drug trafficking.  In Mexico a bloody drug war has erupted among crime groups fighting for the control of the US drug market – itself shrinking because of lower addiction, dollar depreciation and law enforcement.  Equally tragic is the situation in West Africa, where traffickers have corrupted leaders, gained power and established new routes -- to bring cocaine to Europe and also tap the local market.


The legalizers’ argument on security is striking, though brought to the wrong conclusion.  Prohibition causes violence and crime by creating a lucrative black market for drugs, the argument goes: so, legalize drugs to defeat organized crime. As an economist, I agree. But this is not only an economic argument.  Legalization would reduce crime profits, but it will also increase the damage to the 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 liberalizing drugs. Society can and must protect both health and safety.


A bigoted logic is alsoat play here on the side of legalizers: 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 onto a global scale and imagine the impact of unregulated drug use in developing countries, with no prevention or treatment available. This would unleash an epidemic of drug addiction.


Last but not least, the question of human rights.  Around the world, millions of people caught taking drugs are sent to jail, not to treatment.  In some countries, drug treatment amounts to cruel punishment -- the equivalent of torture.  People are sentenced to death for drug-related offences, or gunned down by extra-judicial squads.  Although drugs kill, governments should not kill because of them.


The prohibition vs. legalization debate must stop being ideological and look for the appropriate degree of controls.  This is not the task of governments alone:  it is a society-wide responsibility.  Are we ready to engage?


Antonio Maria Costa

UNODC Executive Director

May 2002-August 2010

Last Updated on Tuesday, 25 January 2011 08:46