zondag 28 oktober 2012

Drugs - without the hot air: Minimising the harms of legal and illegal drugs (David Nutt) [8]


Our politicians have backed themselves into a corner. In making the “tough on drugs” stance the only electorally-viable policy, and attacking anyone who proposes an alternative, they are forced to ignore the evidence all around them and the solutions that follow from seeing the world as it is, not as we pretend it is to fit in with a given political view point.

This may be an easy vote winner at election time, but in the longer term it’s bad for democracy, bad for science, and bad for the millions of casualties around the world affected directly and indirectly by this unwinnable War.

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What are the alternatives? If you criticise the War on Drugs, the stock media response is to accuse you of wanting to see heroin “on the supermarket shelves”. This is a ridiculously-reductive response to the wide range of options available for dealing with drugs once prohibition stops being the only policy that can be considered. 

For a start, there is a big difference between legalisation and decriminalising possession. In Portugal, heroin, cocaine and cannabis remain illegal, but possession of small amounts doesn’t carry any criminal sanctions, like minor traffic offences in the UK. Decriminalisation allows countries to focus on harm-reduction strategies while staying within the terms of the UN Single Conventions, but leaves all the supply-side problems intact. 

If we wanted to go further and make certain drugs legally available, there are lots of alternatives to unregulated sales: Making drugs available on prescription, so your doctor can monitor your use and help you through withdrawal if you wish to stop. Selling them from pharmacies, so the pharmacist can give advice on dose and possible side-effects. This idea could be developed to create a new profession specialising in recreational drugs, who are able to give counselling and intervene if they think someone is in danger of addiction. 

Licensed sales, so that only certain shops can sell them, under certain conditions and at certain times. Licensed premises for consumption on site, like pubs or the Dutch cannabis cafes. These licences could be exclusive, so that a place which is allowed to sell ecstasy can’t sell alcohol, for example, and licensees could be partially responsible for the behaviour of their customers. 

The Dutch coffee shops that sell cannabis are not only banned from selling alcohol, but also don’t allow tobacco smoking on the premises. Membership-based licensed premises, where users have to be registered, and consumption can be monitored and controlled. Although we don’t currently use this for drugs, it’s similar to the model we’ve adopted for casinos, and in Spain a similar scheme for cannabis use seems to be working well. The point is, there are a lot of alternatives. 

We don’t have to choose a single option and apply it to every drug which is currently prohibited. We can decriminalise possession of small amounts for personal use without making all – or even any – drugs legal. We can treat addicts with dignity and respect and help them reduce the chaos of their lives without allowing dangerous substances to be aggressively advertised as alcohol is today. We can support poor coca and opium farmers while still trying to break the power of the criminal gangs that exploit them. 

We could do all sorts of things, weighing up the harms and benefits of different policies, learning from the experiences of other countries, and having reasoned debates about what the evidence shows and what we think that means we should do. But none of this is possible while the War on Drugs continues.

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