Time to decriminalise drugs?

The war on drugs has failed. It is time to face realities squarely and rationally debate the question of decriminalisation. Pragmatism is urgently needed in debates about the issues involved and in the responses to them.

This is the crux of an article in the just published February edition of the South African Medical Journal (SAMJ). The article by Prof. J P de V van Niekerk, managing editor of the SAMJ and former dean of medicine at the University of Cape Town, traces the history of society and government responses to psychotropic substances through the ages and comes to the conclusion that international evidence suggests that drug policy has very limited impact on the overall level of drug use.

The irony that “the two most widely used legal drugs, alcohol and tobacco, lie in the upper half of the harms (to the individual and society) rankings,” also does not escape him.

“This important information should surely be taken into account in public debate on illegal drug use. Discussions based on formal assessment of harm rather than on prejudice and assumptions would enable a more rational debate about the relative risks and harms of drugs.

“Pragmatism is urgently needed in debates about these issues and for our response to them. The tone of our debate about responses to the treatment and supervision of drug-dependent offenders should change.

“Focusing on enforcement and compliance further erodes discretion for those responsible for treating and supervising such offenders, Policy should aim to reduce the harm that drugs cause, and not embroil more people in the criminal justice system.

“Society should have some faith in the capacity of drug-using offenders to change, and actively assist and enable them to achieve this goal,” Van Niekerk argues.

Referring to a 2007-study in the United Kingdom he points out that with regard to classification systems that purport to relate to the harms and risks of each drug, it was found that tobacco and alcohol together account for about 90% of all drug-related deaths in the UK, “They are the most widely used unclassified substances, but were both ranked in the top 10 higher-harm group and cannabis (marijuana) in the lower 10 (out of 20).

“Drugs that can be taken intravenously, such as heroin, carry a high risk of death and score highly. Their results also emphasise  that excluding alcohol and tobacco from the Misuse of Drugs Act is, from a scientific perspective, arbitrary and that there is no clear distinction between socially acceptable and illicit substances.”

He points out that resulting from its declaring war on drugs, the US has the world’s largest per capita prison population: 738 per 100 000 people compared to South Africa’s 335 and the UK’s 124. The war on drugs has criminalised a large sector of the population.

He also points out the war on drugs also plays havoc with the political and economic stability of producer countries, attracts organised crime and leads to political and police corruption.

Writing that while much of South Africa’s approach to drug abuse is progressive and enlightened, “evidence-based facts and sober reflection suggest that our strategies require re-thinking

• The vision of the National Drug Master Plan is a drug-free society. Human history and international experience clearly demonstrate that this does not reflect reality. We should acknowledge this and develop better ways of dealing with human frailty;
• A more evidence-based, nuanced approach to the harms of drugs is required. For example, it makes no sense to legalise the use of alcohol and tobacco but not the less dangerous cannabis (which also has beneficial effects – Ware MA,Wang T, Shapiro S, et al. Smoke cannabis for chronic neuropathic pain; a randomizes controlled trail. CMAJ 2010;182:1515-1521);
• Using psychoactive substances may be a vice but should not be considered to be a crime, thus criminalising a large portion of our citizens;
• Making drugs illicit cedes their control to the drug dealers;
• Escalating the drug war makes drugs more valuable and attracts more participants into the illicit drug economy; and
• Improved state control of substances, as with alcohol and cigarettes, could provide taxes and significantly reduce the role of drug dealers.”

About a debate on the issue of decriminalisation Van Niekerk predicts that “vested interest in maintaining the status quo will have unexpected support from those who stand to lose the most, namely the drug dealers and those in their pay (including the law and politics) All the more reason to proceed!”

(For a PDF of the full article, click here