There has been some interesting discussion recently about the death penalty, and its popularity with our near Northern neighbours as a punishment for drug crimes. There is a lot of international pressure, from the US, as well as from our neighbours to the north, to wage a fierce war on drugs. They see drug running as a terrible crime, worthy of the ultimate punishment. There are many facets to the issue, but one that has been prowling around my own head with increasing agitation is the very idea of a war on drugs.

Our attitude to drugs is very strange, and it’s not often that we are able to step back and examine where it came from. First of all the very definition of drugs seldom includes alcohol and tobacco – which is a strange omission. They are no less addictive, no less dangerous, no less destructive than many of the illegal drugs that we blithely declare war on, but they are socially acceptable by historical accident.

In fact, someone snorting cocaine in my vicinity is unlikely to cause me direct harm, even if they do it regularly, unlike the very clear and definite dangers of second hand smoke. I would much rather be around someone shooting up with heroin or munching on a hash cookie than have someone lighting a cigarette beside me.  Alcohol, too, seems to lead to vastly more antisocial behaviour than, for example, marijuana.

Then there are the personal downsides. Consider this list of short term effects of a well known drug: Speech slurred; Balance and coordination impaired; Reflexes slowed; Visual attention impaired; Unstable emotions; Aggressive behaviour; Nausea, vomiting; Unable to walk without help; Apathetic, sleepy; Laboured breathing; Unable to remember events; Loss of bladder control; Possible loss of consciousness.

Or this one, for a different drug: Confusion; Pain relief; Slowed breathing; Decreased blood pressure and heart rate; Constricted pupils; Dry mouth; Suppressed cough reflex; Reduced sexual urges; Drowsiness; Slurred and slow speech; Reduced co-ordination; Nausea and vomiting.

Both drugs pose the risk of death in case of overdose. Both are addictive, and withdrawal from either drug, once addicted, is physically and emotionally traumatic. If you look purely at short term effects, though, those of the first seem rather more alarming than those of the second. The first is, of course, alcohol. The second? Heroin.

Most of the serious downsides that we see as a result of illegal drugs seem to be a result of prohibition rather than the drugs themselves. Overdoses result from not knowing for sure the content or purity of the drug, which could be avoided if drugs were regulated, over-the counter purchases. Regulation would also deal with a lot of the peripheral crime (burglaries etc to finance drug habits), as drugs would presumably be cheaper and easier to obtain.

I have to admit that I am no expert – my personal experience of potentially addictive drugs is limited to alcohol (and limited even there) and caffeine. There is no doubt that drugs are bad for the body, and addiction to almost anything can kill you. I’m not suggesting that we all rush out and look for the nearest source of illicit drugs and get stoned. But I think it is high time (sorry) that we questioned the paranoid, hysterical rhetoric that gets trotted out any time anyone suggests something like decriminalising marijuana.

Prohibition doesn’t work. It doesn’t make sense. The winners in any prohibition scenario are the criminals who take over the supply. Even worse, prohibition of some drugs but not others seems to be randomly political rather than based in science. Truly the world needs more scientists and engineers in charge.

Wars are never won. They are inevitably lost by all sides – it’s just that some lose more than others. It’s time we took a more rational, evidence based approach to solving our problems. I can’t help but wonder what the world would be like if human beings were better at objectivity. If we were able to take the evidence, weigh up the research, and take the most effective, evidence-based approach to our legislation. Instead we seem to take the approach of soothing the loudest pressure group – regardless of their size, rationality, or relationship to the truth.

So next time someone rants about the need for a war on drugs, ask yourself – who is winning this war? And why are we waging it?


6 thoughts on “Warmongering

  1. Joe

    We *are* waging a war on tobacco. It’s much slower because usage rates are much higher and legalised interests are already in place.

    For alcohol, the recreation -> addiction -> fatal thresholds are very wide compared to, say, heroin.

    If alcohol were a “new” drug then, yes, we would be “waging war ” on it. And, yes, we *are* waging war against alcohol abuse, with legal penalties for exceeding “safe” limits which have been tightening over time.

    The drug-induced-social-trauma scene is bad enough with tobacco and alcohol without adding more trauma options into the mix. It’s not necessarily that any particular new drug is “worse” than a currently socially entrenched one, just that merely having a “worse” drug socially entrenched is not an excuse for adding another one as well.

    1. lindamciver

      Hi Joe, and welcome to my blog. I quite agree, we don’t want to add more drug options. But heroin is already an option, and we can’t take it away, because prohibition simply doesn’t work. Of course, socially acceptable and legal are not the same thing. It’s quite possible for it to be legal and still socially unacceptable (witness how unacceptable smoking has become).
      It’s clear we need to try something new.

  2. Joe

    Heh. I think after this lengthy ramble I have not much else to add to the discussion, but for what it’s worth…

    In advance let me clarify my framework:

    I am not opposed to considering different approaches to controls over harmful drugs.

    I’m undecided on the issue of limiting the harm people choose to do to themselves, acknowledging harm “to yourself” still harms others. I’m firm on limiting the direct harm people do to others, including encouraging others to do something materially risky / harmful to themselves. I’m also firm that 18 is too young to choose whether to take up a habit that is more likely to kill you than the net of all other factors in your life, or at least is highly likely (>5% chance?) to negatively dominate your life. And I’m firm that accessibility to addictive drugs as teenagers is THE primary reason to control availability of such drugs.

    As far as I’m concerned anyone who takes up heroin at 30 is Not My Problem. I’m not sure where I feel the cutoff age would be, but it should be noticeably *after* wherever we think people “come of age” into self responsibility. Only a small minority of our 18 year olds (or 21 year olds these days) are full caretakers of their own lives. I don’t know about anyone else but at 21 I was still not capable of fully appreciating potential impacts to my life as a whole. (And I think I was more boring / sensible than most people.)

    So, on to some responding…

    “Prohibition simply doesn’t work”? I suppose that depends on what you think prohibition is trying to achieve and whether a different strategy would achieve less net harm. It “doesn’t work” to the extent that it doesn’t eliminate use of the drug. But on that point I doubt anybody actually expects that you can eliminate the use of drugs. Prohibition is one possible framework to lower use, just as we have traffic controls to lower road incidents without anyone rational expecting everyone obeys every control every time.

    I believe having no control at all over highly addictive drugs (which I know is not what you are suggesting), especially drugs where one person’s recreational dose is another person’s on-the-spot-lethal dose, would be far worse than the current situation. Some kind of control is needed.

    I do agree it is likely there are various ways to reduce the total social harm vs having “no controls”, with different approaches potentially needed for different drugs. But between prohibition / stern enforcement and a legalisation-with-controls approach my own instinct is the “net effect question” is a bit of a coin toss. Sure, making the drug illegal increases the price, addiction may of itself lead to loss of incomes and in any event addiction + poverty drives *some* users to secondary criminal acts. However legalised regulation of any drug and hence reduction in street price would clearly lead to wider uptake, even if uptake was supposed to be restricted. And at almost whatever price there will be a threshold for those who cannot afford their net habit (especially where addiction leads to loss of incomes) and hence resort to doing not-nice things to fund it. (Heck one of my siblings in his youth resorted to crime to fund cigarettes. He went on to bigger and worse things for a while but eventually quit most of it.)

    Another tobacco example… the recent hike in Australian tobacco taxes directly led to a significant reduction in the amount being consumed and a spike in people quitting.

    People are price sensitive even for highly addictive drugs. Lower price = more usage.

    Also, if people feel there are safety nets (eg medical supervision, controlled reliable doses, airbags and antilock brakes) then they are more inclined to take “risks” in that arena … sample the drugs, or drive more carelessly. (I understand lower speed limits and alcohol limits have saved lives on the roads … airbags and ABS have done little because their marginal benefit is offset by riskier behaviour. The exception here is seatbelts, which have such a huge benefit in so many circumstances they massively outweigh the behaviour factor.)

    I’d love to see us, as a whole society, quit smoking and most drugs and consume alcohol at its optimal level. (Alcohol abstinence is less healthy than having a little.) But it’s not gonna happen. Our biology is inherently susceptible to manipulation-for-pleasure and comes with built in circuits to entrench habit, especially pleasurable ones.

    Heroin, specifically, is scary with the small margin for error (one person’s minor recreational level is another person’s death) coupled with very high addictiveness and very rapid withdrawal kick-in even from “recreational” levels, plus (unlike alcohol) adverse health effects even at the most basic recreational use.

    Prompted by this discussion I just hunted out arbitrary studies on heroin use and was reading one specifically targeting long term stable users with the aim to research / highlight the “hidden” population of users who are maintaining long term habits without obvious adverse effect… somewhat akin to specifically studying people who have an occasional drink with dinner.
    These users were fairly representative of occupational status in their society, were mostly aged in their late 20s or 30s, and were not generally suffering psychological circumstances warranting investigation / treatment. They had a pretty hefty overconsumption of *alcohol* between them (17% to 50% reporting various types of significant alcohol incidents such is drinking to unconsciousness).
    – Heroin health effects was the direct cause of visits to hospitals or doctors for about 6% of the users in the year of study
    – 12% said they had problems (that year) with heroin affecting their employment
    – 2% reported ever losing their jobs over heroin
    – 59% said heroin had ever affected their employment.

    Remembering the above statistics are only for heroin users who have settled into a long term stable recreational habit who had never required “treatment”, averaging (with variation obviously) a dose every few days. The vast majority of alcohol users having a basic recreational drink every few days are not so social-functionally impaired, nor health affected.

    Tobacco, of course, has so few immediately obvious adverse effects it’s been a long hard case to make to move it to being seen as a Bad Thing by most people. It’s easy to see why social tobacco is such a tough nut to crack. You say “see how unacceptable smoking has become”… yet with well over 20% of adults still regularly smoking, “socially unacceptable” has a lonnnng way to go if it’s going to be a satisfactory control on its own. And that’s even though someone smoking does *direct* harm to people around them, with *immediate* unpleasant impact.

    Drug use, including illegal drugs and seeking getting outright drunk, is already way too “acceptable” to young people I know, on a “not for me but shrug up to them though” kind of basis. Legalising further softens the message on acceptability. And I’d hate to think how we’d be going as a society if 20% of adults were smokers plus 20% of adults were using heroin plus 20% of adults were using cocaine plus … …

    As something of an aside… personally I think it’s an evil born of having a comfortable and safe society with few “frontiers” to inspire the next generation and few survival challenges to create a genuine sense of achievement. Climb the financial ladders, acquire the latest pointless toys, achieve arbitrary “high marks” in academia… pah. Our instincts are wired for more real world and tangible challenges… defeat the elements, find food and shelter for your family, slay the wolf, stay alive against adversity. The only core goal / challenge we have left to us in modern society is social climbing. Food shelter and health are “solved”, for any sensible interpretation for the majority. (There is fringe work available in *medicine*… I’m talking social hygiene.) No wonder so many people are directionless.

    1. lindamciver

      Actually regulation does not necessarily have to lead to lower prices – and I don’t think it’s the price alone that leads to illegal behaviour in support of drug habits. You can still use price as a regulator of behaviour (as with your tobacco tax example), and yet have a legally regulated supply of known quality and strength (I think this is key).
      And perhaps legalising and regulating heroin is not the answer, my husband recently suggested a radical approach – why not research into psychoactive drugs and come up with something less dangerous but still fun? I think there is a problem in our attitude to drugs (first that we don’t characterise alcohol & tobacco as drugs – did you see the recent british study on social harm from alcohol?) – the prohibition mentality restricts this kind of approach. People are always going to want something to take away the pain, make life more interesting, give them a buzz. Our pleasure centres are strong drivers of our behaviour. Maybe the answer is to provide something (find something?) that provides the buzz with less risk. An alternative approach to harm minimisation.
      Ahem. I digress. My point wrt illegal behaviour is that making access to drugs massively illegal and risky means that users have already crossed a psychogical line and put themselves beyond the legal & societal pale. A step further into robbing/harming others to support the habit is a smaller step now.

      You make an interesting point about the base level of risk, but I’m not sure how much the lure of risky behaviour drives drug taking, and how much is the physical buzz. I know there have been times where I have really wanted a stiff drink to help me cope with some kind of emotional trauma, and I am very wary of using alcohol that way. But I am well friended and supported, with a very good and satisfying life. I have other avenues for relief. If I didn’t, I suspect I could very easily become an addict.

      In the study you report, how many of those figures are due to heroin being obtained from dubious sources and of dubious strength? Some of those issues might go away with a regulated supply (or at least diminish). I confess I haven’t had time to go and read the report due to the exigencies of a new job, so I could be way off base.

      I shall stop rattling on now as I desperately need coffee. Ah. drugs. This is an interesting and eye opening discussion. Thanks!

      1. Joe

        An *excellent* point about being able to legalise while still controlling price. It’s an obvious and persuasive point that I apologise for overlooking. This would have to be a headline in the approach… control without increased accessibility.

        The harm-to-society conclusions about alcohol were because of the overall prevalence of alcohol being used, rather than per user. While it’s an appropriate indicator of where to spend public resources reducing harm in society, it’s a bit of misdirection to use it in comparing the relative harm of allowing various drug use, which needs to be done on a per-user basis.

        Personally I object to drugs-for-outright-escape. I try to only consume alcohol when I’m already in a good mood, never as an “escape” from a problem or situation. I’ve been tipsy, I’ve been outright drunk, but rarely or never as an escape from my woes. A session of moderate exercise is a far better physiological pick-me-up than any drug anyway. (Exercise is by far the best antidepressant there is.)

        Mostly, I think it’s especially harmful to our emerging young adults to accept the very idea of drugs as escape. I’d prefer learning / practicing other coping techniques, leading to actual resolutions. A large part of the hidden harm of drugs (any drugs) is people tying their use into avoiding issues in their lives and letting those issues fester and multiply.

        btw I don’t think drug taking is (usually) driven by an appetite risk. Having a “safe high” in drug form would, for my mind, be even worse for society than having hazardous ones. The rational understanding of lifetime risks is the core restraint for many of us. (A skill that’s provably not well developed in even the most well adjusted 18yo.)

  3. Joe

    “(There is fringe work available in *medicine*… I’m talking social hygiene.)” … sorry, what I really mean is “(Clean water, sewerage, vaccination, and antibiotics have massively reduced exogenous health risks.)”

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