BMJ gets a dog biscuit

for making analysis and commentary on drug prohibition open access. (Scroll about halfway down the page to the box headed "tackling injection drug use," where you'll see links to several articles and multimedia. You have to click through a couple of links to get to the articles, but they're available. This link will only be good for a week or so since it's the front page of their web site. I'm not sure where the material will go after that.)

I particularly want to commend this piece by Stephen Rolles of the Transform Drug Policy Foundation. His first paragraph just about says it all:

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, militarised crop eradication programmes (environmental damage, food insecurity, and human displacement), and funding for terrorism and insurgency.

Much of the world has figured this out. I'll bet you didn't know that drug possession has been decriminalized in much of Latin America, and there is considerable movement in that direction in Europe. And did you know that the Mexican government wants the U.S. to decriminalize? It's obvious that the most serious social, and for that matter individual harms associated with drug abuse stem directly from prohibition, not the drugs themselves. No prohibition, no violent criminal drug cartels destroying Mexican society. Oh yeah -- how do you think the people the U.S. is fighting in Afghanistan get their financing?

Two of the countries where entrenched political ideology is preventing a common sense approach to drug abuse are Russia, and the United States. And whaddya know, those happen to be two of the countries with the biggest problems associated with illicit drug use. In Russia, drug injecting is the basis of its HIV epidemic. That's a significant problem here in the U.S. as well, and we also have the highest percentage of our population incarcerated in the world, with the exception of a couple of totalitarian competitors we probably don't want to emulate. And our prison-industrial complex is fueled by one thing only, drug prohibition, as implemented in a blatantly racist manner.

In a kind of Mobius strip logic, the harms caused by prohibition get assigned to the drugs themselves, and become a justification for continuing, and reinforcing, prohibition. We can either have drugs with prohibition and its attendant harms; or drugs without prohibition and instead rational, evidence based harm reduction policies. Countries that decriminalize do not experience an increase in abuse or addiction. Decriminalization makes possible regulation, containment, taxation, easier access to treatment, and it instantly eliminates a whole lot of crime. Of course it puts prison guards out of work, which is one reason why it doesn't happen -- they have powerful unions that fight against liberalization of drug laws.

There are major, legitimate debates to be had about exactly what would be the right policies concerning specific substances, age groups, and drug using behaviors. Alcohol policy presents an obvious template for some substances, but others no doubt need to be approached somewhat differently. I'm not going to lay out any detailed prescriptions here, but let's at least have the discussion.