Class A drugs the most harmful? Think again, Mrs. May.
The report ‘Drugs: Breaking the Cycle‘ by the special Home Affairs Committee is the result of a deep revision of the UK’s drug policy. It is a wonderful piece of research not only because of the rarity of a non-partisan mea culpa but also because it openly calls for a policy overhaul aiming to place the drug debate in a harm-reduction, health-oriented and evidence-based framework.
However, any reader would be shocked by the stark contrast between the report and the response to it published by the Home Office. One by one, the recommendations are politely dismissed by the Government either as unnecessary or as already taken care of. Regardless of the fact that the Home Office later partially tempered its “if it ain’t broke, don’t fix it” stance, this aversion to a much needed mature debate on the issue of drugs is regrettable. The same biased affirmations are repeated without hesitation regardless of the piling evidence of a faulty approach.
One example concerns the classification of drugs, a scheme with blatant incoherences that I aimed to portray in the graphic above. How is it that Mrs May can keep affirming that ‘Class A drugs’ are the most harmful when coca, an innocuous vegetable, is still listed as being one of those powerfully harmful drugs? Could we agree that there is no need to ‘fundamentally’ rethink drug policy in the UK when we check the mortality associated to the consumption of a legal drug such as alcohol?
Most Brits do not agree with current regulation on cannabis.
The Transform Drug Policy Foundation released yesterday a poll by Ipsos MORI on attitudes in the UK vis-à-vis drug policy.
The graph shown here plots the results for a question that asked respondents which form of regulation was more appropriate for cannabis. A considerable majority (53%) does not support the current legislation, preferring some form of legal control or decriminalisation.
Curiously enough, support/opposition for alternatives to prohibition do not align in a left-right divide. In fact, both Conservative and Labour party partisans show similar positions with regards to this topic.
More information on the poll and the data can be found at Transform’s website.
Is the UK’s drug policy working? Statistics do not suggest so.
In December of 2012, when a [cross-party] Commons Home Affairs select committee urged the Government to undertake a necessary overhaul on drug policy, PM David Cameron brushed off the call by affirming that: “We have a policy which actually is working in Britain. Drugs use is coming down…”
He wasn’t wrong suggesting that less youngsters tried drugs nowadays; but, is this the essential objective of drug policy? Bringing numbers down? The UK Drugs Strategy 2010 makes ‘Reducing Demand’ a fundamental objective of the Government’s drug policy. But why? Though the Strategy fails to say it clearly, the rationale behind it should be reducing harm. It shouldn’t be about changing numbers, but about improving human lives.
The story that this graph tells us is different. Regardless of the official boasting, the prevalence of the most potentially harmful drugs (Class A drugs) has either remained stable or increased in the last 15 years or so. In fact, most of the fall that we observe on the overall numbers concerning prevalence is due to a decrease in cannabis consumption (the trend-lines are pretty much parallel…).
Of course, the fact that less youngsters are starting to use cannabis is positive; but it is terribly irresponsible to avoid mentioning that only 0.26% of the deaths related to illicit drug poisoning in England and Wales are reported as being caused by cannabis. Most of these deaths, over 25% of them, are caused by heroin, morphine and cocaine; and, contrary to the case of cannabis, these numbers are not going down.
So, is the current policy really ‘working’ in Britain? I think the graph made with data from the ONS is pretty evident…
Banning as reflex – The campaign of Baroness Warsi against khat.
There is an ongoing debate in the UK on the use of khat, a stimulant leaf chewed mostly by immigrants from the Horn of Africa. By chewing the leaves, the users release naturally-existing psychotropic substances that produce a mild ‘kick’ characterised by ‘a feeling of wellbeing and alertness’. But the excessive use of khat has been associated with liver damage, mood swings, dependency and deteriorating mental health. Also, organised members of the Somali diaspora argue that, beyond the most tangible effects, khat is capable to convert otherwise productive young men into hopeless inactive addicts.
Now, I do not contend that the substance can be harmful. The evidence and their experiences suggest so. Actually, the fact that such a significant amount of voices are raised against the practice is revealing of an issue worth investigating. What is the Government to do, then? A rational course of action would require to compile a robust amount of information to take a sensible decision of what seems to be a legitimate grievance.
And this was what started to be done in 2005. The [by then] Minister of State for Public Health, Caroline Flint, asked the Advisory Council on Misuse of Drugs to issue a report on the harms of khat. The report came out showing that, whilst there were ‘detrimental’ effects linked to the use of khat, the incidence of the problem was very limited and did not require a ban. Instead, education and efficient advice were encouraged. The Home Office respected the decision, after due consideration.
But, in 2008, as elections approached, the [then] Shadow Minister of State for Community Cohesion and Social Action, Sayeeda Warsi, made an odd promise. Regardless of the scientific advice of the ACMD and its confirmation by the Home Office, Conservatives would ban khat once in power. Why? Because families were suffering. The decision of the Conservatives was not based on evidence or rationality, it was based on values and subjectivity. And when the latter ignore the former, the result is policy, and politics, which are all kinds of suboptimal.
First, it creates a rift between the Government and the ACMD. The latter recently published another report on khat, even more substantial than the previous in demonstrating how banning khat is not the right course of action. So the decision has now been reduced to a tug-of-war between the advisory council and the Home Office, which has allegiances with the vociferous Baroness Warsi. Either way, the result will damage the credibility of elements of the Government and send the wrong message to the population that drug policy is the result of games of power and influence, not evidence or science.
Second, using khat as a scapegoat for unemployment and lack of social cohesion in the Somali community in the UK is shortsighted and misleading. Experiences of violence, asylum-seeking, discrimination and alienation should be explored as potential rationales for regrettable social indicators (i.e. Somalis, as an ethnic group, has the lowest employment rate in the UK), especially as khat prevalence is declining.
Third, banning these substances would not only have very little effect on consumption but also generate collateral damage that would further ostracise these communities. The evolution of patterns of drug consumption tends to have very little to do with the legal framework and the criminalisation of use can only act as a catalyst for marginalisation.
Most likely, in the following weeks, Home Secretary Theresa May will have to decide on this subject matter. While it might not be as spectacular as Colorado’s recent legislation, the outcome of this debate has the potential to have an impact on the architecture of drug policy in the UK.
In recent history, the Netherlands has been considered an avatar of pragmatism and forward thinking in the domain of drug policy. Already in 1976, an amendment to its Narcotics Act inaugurated an era of non-enforcement of the illegality of certain drugs. While ‘hard drugs’ (Schedule I) such as heroin and cocaine were deemed to present an imminent societal threat, some ‘hemp products’ (Schedule II) became the object of a formal non-enforced illegality. This system allowed for the limited consumption and commercialisation of the latter to be ‘tolerated’ by public authorities. By adopting a harm-reduction strategy and limiting the repressive aspect of their drug policy while not suffering surges in drug consumption, the Dutch became a poster-child for defenders of alternatives to prohibition. Nevertheless, in the last few years, ideologically-based legislation has been proposed in ways that could potentially thwart advances on the issue.
One of these measures was the idea of creating a ‘wietpas’ or ‘cannabis card’. Under the proposed nationwide scheme, coffeeshop entrance would have been limited to Dutch residents who would have been required to register in a State-administered database. The measure, which started to be implemented locally in cities such as Maastricht, both diverted consumption to nearby cities and increased crimes related to unregulated street drug-peddling in the implementing cities. This led the government to drop the project and transfer the competence of adoption and implementation to local authorities.
Yet, in a move that seems to cater to the conservative centre-right more than the public interest of Dutch citizens, the Minister of Justice, Ivo Opstelten, has vowed to ban ‘skunk’ from coffeeshops. According to Opstelten, cannabis exceeding a 15% content of THC must be considered as a ‘hard drug’, thus akin to heroin or cocaine. The move has been based on the alleged link between psychological disorders and cannabis consumption but has no scientific or even economic rationale: 1) it fails to explain how the causal link between psychosis and cannabis consumption might be lessened by decreasing the availability of high-THC-concentration cannabis (already at an average of 15-18% for Dutch varieties), 2) it might drive prices up and stimulate the black market by forcing business-owners to carry out constant THC-concentration tests and, 3) it disregards research pointing at the inexistence of a link between prevalence of cannabis use and national legislation.
The measure announced by the government distances itself from the harm-reduction paradigm that the Netherlands pioneered in the 70s, bypassing the Government’s responsibility to dwell upon the effects of cannabinoids and turning to sub-optimal policies that will inevitably lead to further flip-flops.
In 2010, a proposition by then French Minister for Health and Sports, Roselyne Bachelot, aiming at launching a debate on the creation of ‘drug consumption rooms’ (locally known as ‘salles de shoot’) was quickly and openly rejected by the Government of the time. According to the former Prime Minister, François Fillon, it wasn’t the role of the State to ‘accompany’ or ‘organise’ drug consumption. While this stance is representative of the century-old prohibitionist paradigm crystallised definitely in the Single Convention of 1961, it opposes a powerful emerging trend that, since the 1980s, has sought to find alternatives to the now evidently sterile repressive strategies to curtail drug abuse.
Europe occupies a prominent place in terms of contesting the existing model to the extent a set of pioneering countries within the continent have adopted ‘harm-reduction’ as a governing principle of their policy on drugs. The Netherlands has been the emblematic champion, but Germany, Luxembourg, Norway, Portugal, Spain and Switzerland have also shown that a sensible shift is possible. In these countries, drug consumption rooms, substance testing, decriminalisation and heroine prescription have had measurable impact on decreasing ‘hard drug’ consumption and avoiding fatalities. An appreciation that has been confirmed by the EU agency in charge of monitoring the issue (the EMCDDA), which is now preaching the benefits of DCRs.
With authoritative reports being published denouncing the inefficacy of the ‘War on Drugs’ and even the US showing signs that point towards concessions, the questions multiply: why are there still so many laggers at the heart of the EU? Why is information still patchy and scarce on topics of paramount importance such as thresholds for overdose? Why is drug classification still a political decision and researchers are silenced/sacked when they present solid scientific proof on the ineptitude of current legal frameworks?
In this ‘International Overdose Awareness Day’ we must take time to mourn the persistence of shattering human loss, but also reflect on the need to take action and demand from authorities to fulfil their role as guarantors of public welfare. It is in our hands to take these views to the polls and demand for better and life-saving strategies to deal with this issue.
Joe Biden, Central America and Drugs: the irrational propaganda of a persisting hegemon.
The Vice-President of the United States, Joe Biden, will be in the Central American countries of Honduras, El Salvador, Panama, Costa Rica and Guatemala today and tomorrow. His visit comes in a time where the region has been stirred by recent declarations of Guatemalan President, Otto Pérez Molina, on the possibility of modifying the regional security strategy towards the decriminalisation of drugs. Thus, it is expected that alternative strategies against drug-trafficking will be discussed by the Heads of State and the American VP. Nevertheless, the White House has already expressed, through Latin American Advisor, Dan Restrepo, its “clear” opposition to such ideas.
This rejection echoes a certain consensus amongst an important sector of high-level officials and politicians in the region, who believe decriminalising would have “a negative impact”, making their countries “a legal paradise for drugs or a free-zone for the use of drugs” and increasing “traffic accidents by people driving under the influence of marihuana” (!). These reactions are not only based on old-fashioned clichés about triggering indiscriminate consumption, which have been partially debunked by legally innovative solutions such as the Portuguese experience; but on the persistence of a hegemonic influence of the United States and its bellicose understanding of a solution to the issue of drugs in Latin America.
This suboptimal vision perpetuates an alarming statu quo of murderous violence, increasing drug consumption and rampant corruption. According to the most recent report of the INCB, about “900 local gangs (maras)” operate in the “Northern Triangle” (El Salvador, Guatemala and Honduras) driving homicide rates up to reach the world’s highest. In parallel, drug consumption of youngsters in Honduras have increased 30% last year. Why? One of the reasons could be the progressively aggressive missions of the US Administration on drug-trafficking operations in the Caribbean, which have made the Central American corridor a preferential transit route towards the world’s biggest cocaine market: the United States.
To reduce this plague, the political caste is demanding more implication of the US in the region. For example, the President of the Honduran National Council for the Fight against Drug-Trafficking, Víctor Hugo Barnica, considers his country to be in need of more surface-to-air capabilities to gun down unidentified aircrafts potentially participating of illegal trafficking. This war-like approach does not only open the possibility of furthering the arms race between drug-traffickers and a weak State; but it will also increase the rarity and hence the price of drugs, making them even more attractive in countries with very low purchasing power. Moreover, these are resources that are not going to be invested in alternative development or decriminalisation, public policies which could be complementary but on the which tradition and a lack of international agreement impose an irrational veto.
Mexico: third opium poppy producer and first to patent a vaccine against heroin addiction?
One of the reasons why it is so difficult to succeed in applying supply-side measures to drive drug trafficking organizations out of the market is that it is based on a labor-intensive economy. Drug trafficking organizations offer high wages, which makes them particularly attractive to young people and, on top of that, policemen in charge of intervention, whose salary is very low compared to the risks they incur, have great incentives to cooperate. By creating these jobs, traffickers gain legitimacy and popular support.
In that sense, the perverse effect of a country’s policy against drugs that is based on the suppression of the illicit economy involved (an economy that employs sometimes hundreds of thousands of people) is to increase the political capital of the groups that support it. Indeed, those who find themselves unemployed after this suppression tend to blame the government and often remain faithful to their former employers. One of the adverse consequences of that is that the concerned population will not provide information on the traffickers to the government.
Also, the drug business generates very high profit margins and the ability for drug trafficking organizations to absorb increased costs is extraordinary. In addition to that, this industry has proved its capacity to survive by staying one leap ahead of changes in the economy or in the political context, quickly adapting to new schemes. One example of this is the “balloon effect”: the success of eradication in one area reduces the supply, translating into a price rise, which only stimulates producers to plant crops elsewhere.
In the 1990s, coca production shifted from Peru and Bolivia to Colombia after successful eradication projects. Today, after antinarcotics forces recently succeeded in Colombia, cultivation is switching again: Peru’s coca production is increasing and Mexico’s poppy growers have taken a step ahead from Colombia’s producers. In Colombia, opium poppy cultivation went from about 7,000 hectares in 2002 to 267 in 2010, whereas in Mexico poppy fields have increased, amounting to 19,500 hectares in 2009, thus becoming the third largest area in the world after Afghanistan and Myanmar.
Mexican poppy crops, mostly grown in the Sierra Madre mountains are converted into “Black Tar” and “Mexican Mud” heroin, providing billions of dollars to the cartels. If this powerful business has been attacked principally with military operations, often seen as inefficient and counterproductive (last month, Mexican authorities said 47,515 people had been killed in drug-related crimes since the beginning of Calderón’s war on drugs), another type of weapon against the drug business is being developed in the laboratories: last week, a group of Mexican researchers announced they were working on a vaccine to combat heroine addiction.
These scientists, who work for the National Institute of Psychiatry and have received funds from the US National Institute on Drug Abuse as well as the Mexican government, have already tested the vaccine on mice with successful results and will soon test it on humans. Their hope is to induce in humans the results they could observe on mice: a drop in heroin consumption due to a resistance to its effects. Indeed, if the vaccine appears to be successful, users will no longer get a rush of pleasure after a heroin injection.
If the effectiveness of the vaccine is yet to be proved, the efforts done to produce it are an example of the type of actions states can encourage to curtail the drug trade, other than fighting the drug trafficking organizations. Working in the reduction of the demand is increasingly important in Mexico, that has about 450,000 hard drug addicts, but it should be crucial in its neighbor country, still the world’s largest consumer of cocaine and heroin.
Photo 1: Creative Commons by Papaver
Photo 2: Creative Commons by Odedr
In times of crisis, drug policy regression in Greece.
Tomorrow, the International Narcotics Control Board (INCB) will release its 2011 Annual Report. If we are to follow the hints from both last year’s report (discussed by us then) and a myriad of alarming articles from all over Europe, the issue of designer drugs as well as the control of their chemical precursors will be, once more, a top priority. But there appears to be another [linked] trend that might be reflected by the report: the irruption of highly lethal ersatz drugs and their generalised used amongst an already marginalised population at risk. Two cases are particularly salient: that of “krokodil” (a form of desomorphine) in Russia and “sisa” (for which the chemical nature remains obscure) in Greece. Both drugs seem to have surfaced as a result of soaring heroin prices, hard to obtain substitutes (such as methadone) and plunging purchasing power amongst these countries’ poorest.
While less publicised than the Russian, the Greek case is also a recipe for disaster. On the one hand, the austerity mandate negotiated by Greece and its European partners to palliate the economic crisis keeps deteriorating both health and social policy public expenditure and general purchasing power, reducing the availability of treatment while driving its costs up. On the other hand, the increasing performance of specialised police corps in heroin seizures (which have witnessed the sharpest increase since 1985 during the last three years) makes high-purity heroin rarer and more harmful alternatives progressively attractive/demanded. In parallel, disturbing consequences are starting to reach alarming levels; HIV infections as a result of drug use have risen dramatically, especially in the fringes of society (illegal immigrants, prostitutes, homeless persons).
With the recent approval by the Greek Parliament of a new austerity plan amongst violent protests, the subsistence of treatment programmes led by the responsible national entity (OKANA) seems doomed; a situation that presages further intensification of what has become a sanitary emergency.
Photo by: greekadman
In times when politics has been characterised as being under the influence of pernicious phenomena such as the cartelisation of political parties (and the consubstantial wane of the weight of ideas) and its “denaturalisation” by populist debates, it is remarkable that so many former/current political leaders have taken a clear stance on the need to rethink drug policy. In a witty manner, they have decided to “come out” loud and in bulk to denounce a [holy] “War on drugs” that has caused massive human and material losses.
The “Global Commission on Drug Policy”, for example, has recently issued a report that condenses the perspectives of an initiative that counts amongst its higher.ranking members the former Secretary General of the United Nations (Kofi Annan), former Mr. PESC (Javier Solana), former/current chiefs of Government and of State Zedillo (Mexico), Cardoso (Brasil), Gaviria (Colombia), Dreifuss (Switzerland) and Papandreu (Greece); as well as renowned names from international organisations, the private sector, the arts. In it, a clear exhortation to “end the criminalization”, “encourage experimentation by governments with models of legal regulation of drugs”, “offer health and treatment services to those in need” and “the reduction of violence” is explicit from the very first pages. The content is highly illustrative, showing negative correlations between current repressive politics and the levels of consumption, proposing pragmatic solutions to begin the transition to a new legal framework and even presenting independent research on the actual and potential harms of drugs that shows LSD, cannabis and amphetamines to be less risky than alcohol use.
The move against moralist points of view and for the rational understanding of this matter has shaken all latitudes. Similar groups have spawned earlier across the world and with particular emphasis in Latin America, where the cocaine business ravages the lives of thousands. An example of this emerging consensus is the “Latin American Initiative on Drugs and Democracy“, again with the participation of prominent public figures (some of them already in the Global Commission on Drug Policy) that serve to legitimise a necessary cause.
Regardless of the evidence, some members of the current elites remain adamantly opposed to changes of heart in matters of legislation. In France, a country where 12.5 million persons declare to have at least experimented with cannabis, the law and its application remain particularly repressive compared to its European neighbours. Smoking a joint could represent a year of prison and a fine of up to 3750 €. While a certain level of de facto tolerance has become the rule, this incongruous situation creates a judicial insecurity that cannot be disregarded. Nevertheless, for some reason, the current Minister of Interior, Claude Guéant, flaunts a suspicious simplicity of thought when he declares himself to be “completely opposed” because de-penalising would increase the “health risks”, because drugs are “something dangerous” and because the experience has not worked in countries like Spain “according to this colleagues” there. Is he convinced or is he just trying to appeal to an electorate that does not really know why drugs such as cannabis are bad (because the State has never conducted consistent research) but is convinced they just are?
Former Minister of Interior, Daniel Vaillant, is not convinced, and has recently issued with other few members of the Socialist Party a report that proposes a controlled legalisation. His position proposes a proactive action by the State to inform the population and inspect all the production/commercialisation process, thus diminishing potential dangers. In view of the most recent polls on vote intentions for the 2012 French elections, this expositions becomes all the more appealing…
Photo by Laurent Gauthier
[Re]Thinking Drug Policy 