Pubdate: Wed, 30 Sep 2015
Source: Victoria Times-Colonist (CN BC)
Copyright: 2015 Times Colonist
Author: Trevor Hancock
Note: Dr. Trevor Hancock is a professor and senior scholar at the 
University of Victoria's school of public health and social policy.
Page: A10


In this centenary of the Great War, it is worth considering the 
lessons to be learned as we contemplate the current war on drugs.

One of the distinctive features of the First World War was that the 
military leaders constantly reinforced failure, simplistically 
believing that a larger and harder push would succeed where others 
had failed. Many lives were pointlessly lost in the process.

Fast-forward to our present war on drugs. Clearly, it has not been 
working, yet the federal government insists on reinforcing failure, 
rather than pausing to re-think its options. One would think that we 
might have learned the lesson of prohibition in the 1920s; it doesn't 
work. But as in the Great War, the rigid adherence to a failed 
strategy simply causes more harm and more deaths, to little purpose.

A current election briefing from the Canadian Public Health 
Association begins with the recognition that "the prohibition and 
criminalization of psychoactive substances are not achieving their 
intended objectives of reducing drug use and associated harms." It 
then lists the many ways in which the war on drugs, and in particular 
prohibition, has failed.

These include the institutionalization of organized crime as a 
powerful force; the spread of HIV, hepatitis and other infectious 
diseases; more deaths because people are driven away from prevention 
and care services by enforcement, and because the unregulated illegal 
drugs can be much stronger or contaminated; increased property damage 
and criminal activity by addicts who need to support their habit; and 
other harms too numerous to list here.

In the face of all these harms, and little evidence that the war on 
drugs is being won, we need a more rational, humane and 
evidence-based approach that would reduce the harms resulting from 
our current failed policies. The common thread is to recognize that 
drug use is best dealt with as a public health issue, not a criminal issue.

Fortunately, the public-health association has done a good job of 
bringing together the evidence and putting forward sensible policy 
options. These are available in its 2014 report, available on the 
association's website. The report describes a vision:

Criminal prohibition of illegal psychoactive substances has been 
replaced by a public-health-oriented regulatory program to manage the 
production, sale and distribution of substances. Product promotion is 
restricted, and exposure of youth to product promotion is prohibited. 
Retail models that allow access while protecting public health are in place.

If this sounds an impossible and undesirable state, think again. The 
report notes that countries such as Switzerland, Norway, Portugal, 
Australia and New Zealand have implemented at least some of these 
steps. In particular, it notes: "In 2001, Portugal decriminalized 
possession of all drugs and shifted their emphasis to addressing 
health issues. This change led to reductions in problematic substance 
use, drug-related harms and criminal justice overcrowding."

For a "soft" drug such as marijuana (which I do not use), it is hard 
to see a reason to treat it differently from alcohol. I have never 
seen the difference between people smoking a joint after work and 
people having a beer or glass of wine. In fact, alcohol causes far 
more health problems than does marijuana. The legalization of 
marijuana in Washington, Colorado and Uruguay shows it is possible.

As to heroin, as a medical student in London in the early 1970s, I 
saw that legally prescribing and providing heroin through a clinic 
could enable at least some people who have this terrible addiction - 
a disease, not a crime, just like alcoholism - to lead a fairly 
normal and productive life.

The stubborn adherence to a failed strategy, the demonization and 
vilification of those who advance an evidence-based, humane and 
rational alternative, and ongoing efforts to shut down and prevent 
the replication of the successful Insite model for safe injection - 
all do more harm than good.

It is time for a re-think.
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MAP posted-by: Jay Bergstrom