Arguments for and against drug prohibition

For broader coverage of this topic, see

Prohibition of drugs and Drug liberalization

.

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Commonly-cited arguments for and against the prohibition of drugs include the following:

Efficiency

Drug laws are effective

Supporters of prohibition claim that drug laws have a successful track record suppressing illicit drug use since they were introduced in the 1910s.[1]^[2] The licit drug alcohol has current (last 12 months) user rates as high as 80–90% in populations over 14 years of age,^[3] and tobacco has historically had current use rates up to 60% of adult populations,^[4] yet the percentages currently using illicit drugs in OECD countries are generally below 1% of the population excepting cannabis where most are between 3% and 10%, with six countries between 11% and 17%.^[5]

In the 50-year period following the first 1912 international convention restricting use of opium, heroin and cocaine, the United States' use of illicit drugs other than cannabis was consistently below 0.5% of the population, with cannabis rising to 1–2% of the population between 1955 and 1965.^[6] With the advent of the counter-culture movement from the late 1950s, where illicit drug use was promoted as mind-expanding and relatively harmless,^[7] illicit drug use rose sharply. With illicit drug use peaking in the 1970s in the United States, the "Just Say No" campaign, initiated under the patronage of Nancy Reagan, coincided with recent (past month) illicit drug use decreases from 14.1% in 1979 to 5.8% in 1992, a drop of 60%.^[8]

In March, 2007, Antonio Maria Costa, former executive director of the

United Nations Office on Drugs and Crime, drew attention to the drug policy of Sweden,^[9][10]

arguing:

Sweden is an excellent example. Drug use is just a third of the European average while spending on drug control is three times the EU average. For three decades,

UNODC (March 2007). "Cannabis... call it anything but 'soft'", The Independent (UK).^[11]

One of the prominent early critics of prohibition in the United States was August Vollmer, founder of the School of Criminology at University of California, Irvine and former president of the International Association of Chiefs of Police. In his 1936 book The Police and Modern Society, he stated his opinion that:

Stringent laws, spectacular police drives, vigorous prosecution, and imprisonment of addicts and peddlers have proved not only useless and enormously expensive as means of correcting this evil, but they are also unjustifiably and unbelievably cruel in their application to the unfortunate drug victims. Repression has driven this vice underground and produced the narcotic smugglers and supply agents, who have grown wealthy out of this evil practice and who, by devious methods, have stimulated traffic in drugs. Finally, and not the least of the evils associated with repression, the helpless addict has been forced to resort to crime in order to get money for the drug which is absolutely indispensable for his comfortable existence.

The first step in any plan to alleviate this dreadful affliction should be the establishment of Federal control and dispensation – at cost – of habit-forming drugs. With the profit motive gone, no effort would be made to encourage its use by private dispensers of narcotics, and the drug peddler would disappear. New addicts would be speedily discovered and through early treatment, some of these unfortunate victims might be saved from becoming hopelessly incurable.

Drug addiction, like prostitution, and like liquor, is not a police problem; it never has been, and never can be solved by policemen. It is first and last a medical problem, and if there is a solution it will be discovered not by policemen, but by scientific and competently trained medical experts whose sole objective will be the reduction and possible eradication of this devastating appetite. There should be intelligent treatment of the incurables in outpatient clinics, hospitalization of those not too far gone to respond to therapeutic measures, and application of the prophylactic principles which medicine applies to all scourges of mankind.^[15]

Stephen Rolles, writing in the

Consensus is growing within the drugs field and beyond that the prohibition on production, supply, and use of certain drugs has not only failed to deliver its intended goals but has been counterproductive. Evidence is mounting that this policy has not only exacerbated many public health problems, such as adulterated drugs and the spread of HIV and hepatitis B and C infection among injecting drug users, but has created a much larger set of secondary harms associated with the criminal market. These now include vast networks of organised crime, endemic violence related to the drug market, corruption of law enforcement and governments.

These conclusions have been reached by a succession of committees and reports including, in the United Kingdom alone, the

The editor of the British Medical Journal, Dr. Fiona Godlee, gave her personal support to Rolles' call for decriminalisation, and the arguments drew particular support from Sir Ian Gilmore, former president of the Royal College of Physicians, who said we should be treating drugs "as a health issue rather than criminalising people" and "this could drastically reduce crime and improve health".

Danny Kushlik, head of external affairs at Transform, said the intervention of senior medical professionals was significant. He said: "Sir Ian's statement is yet another nail in prohibition's coffin. The Hippocratic oath says: 'First, do no harm'. Physicians are duty bound to speak out if the outcomes show that prohibition causes more harm than it reduces."

Nicholas Green, chairman of the Bar Council, made comments in a report in the profession's magazine, in which he said that drug-related crime costs the UK economy about £13bn a year and that there was growing evidence that decriminalisation could free up police resources, reduce crime and recidivism and improve public health.^[17]

A 2006 report sponsored by the New York County Lawyers' Association, one of the largest local bar associations in the United States, argues on the subject of US drug policy:

Notwithstanding the vast public resources expended on the enforcement of penal statutes against users and distributors of controlled substances, contemporary drug policy appears to have failed, even on its own terms, in a number of notable respects. These include: minimal reduction in the consumption of controlled substances; failure to reduce violent crime; failure to markedly reduce drug importation, distribution and street-level drug sales; failure to reduce the widespread availability of drugs to potential users; failure to deter individuals from becoming involved in the drug trade; failure to impact upon the huge profits and financial opportunity available to individual "entrepreneurs" and organized underworld organizations through engaging in the illicit drug trade; the expenditure of great amounts of increasingly limited public resources in pursuit of a cost-intensive "penal" or "law-enforcement" based policy; failure to provide meaningful treatment and other assistance to people who use substances and their families; and failure to provide meaningful alternative economic opportunities to those attracted to the drug trade for lack of other available avenues for financial advancement.^[18]

Moreover, a growing body of evidence and opinion suggests that contemporary drug policy, as pursued in recent decades, may be counterproductive and even harmful to the society whose public safety it seeks to protect. This conclusion becomes more readily apparent when one distinguishes the harms suffered by society and its members directly attributable to the pharmacological effects of drug use upon human behavior, from those harms resulting from policies attempting to eradicate drug use.^[19]

With aid of these distinctions, we see that present drug policy appears to contribute to the increase of violence in our communities. It does so by permitting and indeed, causing the drug trade to remain a lucrative source of economic opportunity for street dealers, drug kingpins and all those willing to engage in the often violent, illicit, black market trade.

Meanwhile, the effect of present policy serves to stigmatize and marginalize drug users, thereby inhibiting and undermining the efforts of many such individuals to remain or become productive, gainfully employed members of society. Furthermore, current policy has not only failed to provide adequate access to treatment for substance use, it has, in many ways, rendered the obtaining of such treatment, and of other medical services, more difficult and even dangerous to pursue.^[20]

In response to claims that prohibition can work, as argued by

The professor emeritus in criminology at the University of Oslo, Nils Christie, pointed out Sweden as the hawk of international drug policy in a 2004 book. He said that Sweden is serving the role of being welfare alibi for, and lending legitimacy to, the US drug war. Adding that USA and Sweden have had an extraordinary influence on UNODC as the biggest donor countries.^[25] Sweden was the second biggest donor financing 8% of the UNODC budget behind the European Commission in 2006, followed by the US. In 2007 and 2008 Sweden was the fourth biggest donor, behind the European Commission, USA and Canada. In 2009 it was the third, as USA withdrew some of its funding.^[26]

A 2009 editorial in The Economist argued:

fear [of legalisation] is based in large part on the presumption that more people would take drugs under a legal regime. That presumption may be wrong. There is no correlation between the harshness of drug laws and the incidence of drug-taking: citizens living under tough regimes (notably America but also Britain) take more drugs, not fewer. Embarrassed drug warriors blame this on alleged cultural differences, but even in fairly similar countries tough rules make little difference to the number of addicts: harsh Sweden and more liberal Norway have precisely the same addiction rates.^[27]

Antonio Maria Costa's conviction that "countries have the drug problem they deserve" if they fail to follow the "Swedish Model" in drug control has also been criticised in Peter Cohen's work – Looking at the UN, smelling a rat.^[28]

In its 2011 report, the Global Commission on Drug Policy stated that "The global war on drugs has failed, with devastating consequences for individuals and societies around the world".^[29]

Deterrence

Arguments that prohibition discourages drug use

A 2001 Australian study, of 18- to 29-year-olds by the NSW Bureau of Crime Statistics and Research suggests that prohibition deters illicit drug use.^[30] 29% of those who had never used cannabis cited the illegality of the substance as their reason for never using the drug, while 19% of those who had ceased use of cannabis cited its illegality as their reason.

Gil Kerlikowske, director of the US

Controls and prohibitions help to keep prices higher, and higher prices help keep use rates relatively low, since drug use, especially among young people, is known to be sensitive to price. The relationship between pricing and rates of youth substance use is well-established with respect to alcohol and cigarette taxes. There is literature showing that increases in the price of cigarettes triggers declines in use."^[31]

The DEA argues "Legalization has been tried before—and failed miserably. Alaska's experiment with legalization in the 1970s led to the state's teens using marijuana at more than twice the rate of other youths nationally. This led Alaska's residents to vote to re-criminalize marijuana in 1990."^[32]

Drug Free Australia has cited the Netherlands as an example of drug policy failure because it is soft in approach. They argue that the Dutch idea of going soft on cannabis dealers, thereby creating a "separation of markets" from hard drug dealers has failed to stem the initiation to drugs such as heroin, cocaine, and amphetamines, saying that, in 1998, the Netherlands had the third highest cannabis and cocaine use in Europe.^[1] According to Barry McCaffrey of the US Office of National Drug Control Policy, Dutch tolerance has allowed the Netherlands to become a criminal epicentre for illicit synthetic drug manufacture, particularly ecstasy, as well as the home for production and worldwide export of strains of cannabis with THC reportedly 10 times higher than normal.^[33] Gil Kerlikowske has attested that, where there were once thousands of cannabis cafés there are now only several hundred.^[34] Levels of cannabis use, in 2005 only marginally higher than in 1998, while other European countries have accelerated past them, are more likely, Drug Free Australia argues, the result of a growing intolerance of cannabis in the Netherlands rather than a growing tolerance.^[1] Drug Free Australia has also argued that British reductions in cannabis use after softer legislation may be more so the result of heavy UK media exposure of the stronger evidence of links between cannabis and psychosis.^{[35][36][37][38]}

Arguments that prohibition does not discourage drug use

It has been suggested that drug law reform could reduce the use of hard drugs as it has in countries such as the Netherlands.

American teenagers are drinking and smoking less and doing fewer drugs than their predecessors in more than 40 years of tracking. Use of marijuana is down among 8th- and 10th-graders, though it is flat among high school seniors, according to the annual Monitoring the Future survey of American teens.[42]

A 2008 scholarly study found that intensified enforcement of marijuana laws does not achieve the stated goals of marijuana prohibition and that "decriminalizing marijuana possession or deprioritizing marijuana law enforcement does not appear to increase marijuana use".^[43][44]

Gateway drug theory

Arguments that cannabis is a gateway drug

The US Drug Enforcement Agency's "2008 Marijuana Sourcebook" argues that recent research supports the gateway hypothesis that certain drugs (such as cannabis) act as gateways to use of 'harder' drugs such as heroin, either because of social contact or because of an increasing search for a better high.^[45] Proponents cite studies such as that of 311 same sex twins, where only one twin smoked cannabis before age 17, and where such early cannabis smokers were five times more likely than their twin to move on to harder drugs.^[46]

Arguments that cannabis is not a gateway drug

In the American Journal of Public Health, Andrew Golub and Bruce Johnson of the

A twin study (of 510 same sex twin pairs) which adjusted for additional confounders such as peer drug use, found that cannabis use and associations with later hard drug use existed only for non-identical twins. The study suggested that a causal role of cannabis use in later hard drug usage is minimal, if it exists at all, and that cannabis use and hard drug use share the same influencing factors such as genetics and environment.[49]^[50]

Health

Health arguments for drug laws

Advocates of prohibition argue that particular drugs should be illegal because they are harmful. Drug Free Australia for example argues "That illicit drugs are inherently harmful substances is attested by the very nomenclature of the 'harm reduction' movement."^[1] The U.S. government has argued that illegal drugs are "far more deadly than alcohol" saying "although alcohol is used by seven times as many people as drugs, the number of deaths induced by those substances is not far apart. According to the Centers for Disease Control and Prevention (CDC), during 2000, there were 15,852 drug-induced deaths; only slightly less than the 18,539 alcohol-induced deaths."^[51] Ratios of the harms of illicit opiates to licit alcohol and tobacco in Australia are similar, with 2 deaths per hundred opiate users per annum versus 0.22 deaths per hundred for alcohol (9 times less) per year and 0.3 for tobacco (7 times less).^[1]

The DEA has said:

Marijuana is far more powerful than it used to be. In 2000, there were six times as many emergency room mentions of marijuana use as there were in 1990, despite the fact that the number of people using marijuana is roughly the same. In 1999, a record 225,000 Americans entered substance abuse treatment primarily for marijuana dependence, second only to heroin—and not by much. ... According to the National Institute on Drug Abuse, "Studies show that someone who smokes five joints per week may be taking in as many cancer-causing chemicals as someone who smokes a full pack of cigarettes every day." Marijuana contains more than 400 chemicals, including the most harmful substances found in tobacco smoke. For example, smoking one marijuana cigarette deposits about four times more tar into the lungs than a filtered tobacco cigarette. ... The short-term effects are also harmful. They include: memory loss, distorted perception, trouble with thinking and problem solving, loss of motor skills, decrease in muscle strength, increased heart rate, and anxiety. Marijuana impacts young people's mental development, their ability to concentrate in school, and their motivation and initiative to reach goals. And marijuana affects people of all ages: Harvard University researchers report that the risk of a heart attack is five times higher than usual in the hour after smoking marijuana.

— US Drug Enforcement Administration (2003). "Speaking Out Against Drug Legalization"^[32]

Many of the deaths from using cannabis, other than from car accidents while intoxicated or violence and aggression,^[52][53] are more likely to figure in the longer term, just as with tobacco, where both nicotine overdose and cannabis overdose are extremely rare or nonexistent. While ecstasy may have lower rates of immediate mortality than some other illicits, there is a growing science on the already recognized considerable health harms of ecstasy.^[54] Drug Free Australia argues that distinctions between "soft" and "hard" drugs are entirely artificial, and titling cannabis "soft" or ecstasy "recreational" does not lessen the extensive harms of these substances.^[1]

Gil Kerlikowske, former director of the US Office of National Drug Control Policy (ONDCP) argues that in the United States, illegal drugs already cost $180 billion a year in health care, lost productivity, crime, and other expenditures, and that number would only increase under legalization because of increased use.^[55]

Drug Free Australia claims arguments that increased health harms of illicit drugs are the result of lack of government regulation of their purity and strength are not well supported by evidence. In Australia, which has had the highest opioid mortality per capita in the OECD,^[1] studies found that "overdose fatality is not a simple function of heroin dose or purity. There is no evidence of toxicity from contaminants of street heroin in Australia."^[56] Drug Free Australia claims that other causes of death such as suicide, murder and accidents are an effect of the drug themselves, not of their purity or otherwise.^[1]

Addiction

Drug Free Australia argues "Regarding the freedom of choice of those addicted to a drug, it is important to recognize that addiction is defined as compulsive by its very nature and that addictions curb individual freedom." ... "As is the case with alcohol addiction, illicit drug addictions likewise serve to keep many such users functionally in poverty and often as a continued burden on friends, family and society. Where it is argued that all disabilities are a burden on society it must be recognized that most disabilities are not the result of a choice, whereas the decision to recreationally use illicit drugs is most commonly free, and with the knowledge that they may lead to an abundance of addictions."^[1]

Health arguments for drug law reform

There is evidence that many illicit drugs pose comparatively fewer health dangers than certain legal drugs.^[57] The health risks of MDMA (Ecstasy) have been exaggerated for instance,^[58] the risks from cannabis use also overstated,^[59] and health problems from the use of legal substances, particularly alcohol and tobacco, are greater, even than from cocaine use for example (occasional cocaine use does not typically lead to severe or even minor physical or social problems).^[60][61]

Health benefits

Many trials have shown beneficial effects associated with psychoactive drug use:

• There is evidence that MDMA (ecstasy) can treat or cure post-traumatic stress disorder and anxiety in cases of terminal illness.
• LSD has been widely researched as a therapeutic agent, and has shown effectiveness against alcoholism, frigidity and various other disorders. See Psychedelic therapy.
• Researchers at Harvard-affiliated McLean Hospital found members of a religious group regularly using peyote scored significantly better on several measures of overall mental health than did subjects who did not use the hallucinogen.^[62][63]
• A 2007 study, by Santos et al. found that users of ayahuasca scored better on tests measuring anxiety and hopelessness than people who did not use the drug.^[64]

Quality control

According to a World Health Organisation report: "As cannabis is an illegal drug its cultivation, harvesting and distribution are not subject to quality control mechanisms to ensure the reliability and safety of the product used by consumers. It is well recognised in developing countries, such as Kenya, that illicit alcohol production can result in the contamination with toxic by-products or adulterants that can kill or seriously affect the health of users. The same may be true of illicit drugs such as opiates, cocaine and amphetamine in developed societies."^[65]

The government cannot enforce quality control on products sold and manufactured illegally. Examples include: the easier to make derivative MDA being sold as MDMA,^[66] heroin users unintentionally injecting brick dust, quinine, or fentanyl with which their heroin had been cut;^[67][68] and heroin/cocaine overdoses occurring as a result of users not knowing exactly how much they are taking. If the supply of drugs such as ecstasy came from legitimate pharmaceutical companies, their product would be far less likely to contain toxic additives or varying dosages. This is a view supported by a number of parents whose children have died of overdoses.^[69]

The illegality of injectable drugs leads to a scarcity of needles which causes an increase in HIV infections.^[70] An easy cure to this problem, while upholding the illegality of drugs, is the Dutch policy of distributing free needles. The money spent on both increased health costs due to HIV infections and drug prohibition itself causes a drain upon society.^[71][72]

Studies on the effects of

In particular, research suggests that recreational drugs may have psychiatric applications, which many demonstrating potential for treatment-resistant mental health conditions, such as depression and anxiety.[76] Those who support the legalisation of recreational drugs for research purposes highlight that it is unethical not to conduct research into therapeutic interventions that may have the potential to treat these conditions.^[77]

Misleading health statistics

The United States Drug Enforcement Administration (DEA) has suggested that illegal drugs are "far more deadly than alcohol", arguing that "although alcohol is used by seven times as many people as drugs, the number of deaths induced by those substances is not far apart", quoting figures from the Centers for Disease Control and Prevention (CDC), claiming "during 2000, there were 15,852 drug-induced deaths; only slightly less than the 18,539 alcohol-induced deaths."^[51]

The DEA's use of such figures is questionable however. An article in the Journal of the American Medical Association gave the number deaths caused by alcohol in year 2000 as 85,000 – over four and a half times greater than the DEA's preferred figure.^{[78][nb 2]} The DEA's argument also overlooks tobacco, causing 435,000 US deaths in year 2000.^[78] And, the CDC definition of "drug-induced death" includes suicides using drugs, accidental overdose,^{[nb 3]} and deaths from medically prescribed (not illegal) drugs. An analysis of drug-induced deaths for the 20-year period 1979–1998 found the vast majority attributable to accidental overdose, and suicide by drug taking, which together account for about 76 percent of all such deaths.^[80] Taking into account deaths from non-illegal drugs leaves only 21 percent of CDC "drug-induced death" figures actually due to the use of "illegal" drugs.^[81]

Claims that cannabis is far more powerful than it used to be are also dubious, with "scare figures" skewed by comparing the weakest cannabis from the past with the strongest of today.^[82] Figures regarding emergency room mentions of marijuana use can be misleading too, as "mention" of a drug in an emergency department visit does not mean that the drug was the cause of the visit.^[83][84]

Medical uses

A document published for the non-profit advocacy organization Europe Against Drugs (EURAD) argues that "one cannot vote for a medicine" and that a scientific approval basis is essential. It says that EU rules set out strict criteria for the acceptance of a drug for medical use:

All active ingredients have to be identified and their chemistry determined. They have to be tested for purity with limits set for all impurities including pesticides, microbe & fungi and their products. These tests have to be validated and reproduced if necessary in an official laboratory. Animal testing will include information on fertility, embryo toxicity, immuno-toxicity, mutagenic and carcinogenic potential. Risks to humans, especially pregnant women and lactating mothers, will be evaluated. Adequate safety and efficacy trials must be carried out. They must state the method of administration and report on the results from different groups, i.e. healthy volunteers, patients, special groups of the elderly, people with liver and kidney problems and pregnant women. Adverse drug reactions (ADR) have to be stated and include any effects on driving or operating machinery.

— EURAD^[85]

Arguments against medical uses of prohibited drugs

According to Janet D. Lapey, M.D., of Concerned Citizens For Drug Prevention, " Due to a placebo effect, a patient may erroneously believe a drug is helpful when it is not. This is especially true of addictive, mind-altering drugs like marijuana. A marijuana withdrawal syndrome occurs, consisting of anxiety, depression, sleep and appetite disturbances, irritability, tremors, diaphoresis, nausea, muscle convulsions, and restlessness. Often, persons using marijuana erroneously believe that the drug is helping them combat these symptoms without realizing that actually marijuana is the cause of these effects. Therefore, when a patient anecdotally reports a drug to have medicinal value, this must be followed by objective scientific studies."^[86]

The US Drug Enforcement Administration also says:

There is a growing misconception that some illegal drugs can be taken safely. For example, savvy drug dealers have learned how to market drugs like Ecstasy to youth. Some in the Legalization Lobby even claim such drugs have medical value, despite the lack of conclusive scientific evidence.

— US Drug Enforcement Administration (2003). "Speaking Out Against Drug Legalization"^[32]

Arguments for medical uses of prohibited drugs

Most of the psychoactive drugs now prohibited in modern societies have had medical uses in history. In natural plant drugs like opium, coca, cannabis, mescaline, and psilocybin, the medical history usually dates back thousands of years and through a variety of cultures.^[87]

Under prohibition, millions of people find it very difficult to obtain controlled medications, particularly opiate pain-relievers. The United Nations 1961 Single Convention on Narcotic Drugs requires that opiates be distributed only by medical prescription, but this is impractical in many areas.

According to the Transnational Institute, June 2008:^[98]

According to the International Narcotics Control Board (INCB) and the World Health Organisation (WHO) there is now an unmet demand in opiates. Ironically, the current drug control regulations hamper access to controlled opiate medications for therapeutic use. Many patients are unable to access morphine, methadone or an equivalent opioid. Global medical morphine consumption would rise five times if countries would make morphine available at the level of the calculated need, according to a recent WHO estimate.

According to the New York Times, September 2007:^[99]

Under Sierra Leone law, morphine may be handled only by a pharmacist or doctor, explained Gabriel Madiye, the hospice's founder. But in all Sierra Leone there are only about 100 doctors — one for every 54,000 people, compared with one for every 350 in the United States.... "How can they say there is no demand when they don't allow it?" he [Madiye] asked. "How can they be so sure that it will get out of control when they haven't even tried it?"

Economic

Economic arguments for prohibitive drug laws

The DEA argues that "compared to the social costs of drug abuse and addiction—whether in taxpayer dollars or in pain and suffering—government spending on drug control is minimal."^[32]

Antonio Maria Costa, executive director of the