Time to decriminalise drugs?
The drug trade has increased globally in intensity and reach, and substance abuse in South Africa has escalated rapidly. Drug misuse is a major social, legal and public health challenge despite the war on drugs, in which the USA has a disproportionate influence. Why this lack of progress and what can be done about it?
The case for decriminalisation
The war on drugs has failed! Humans have always taken psychoactive substances and prohibition has never kept them from doing so. The international evidence suggests that drug policy has very limited impact on the overall level of drug use. Making people criminals for taking psychoactive substances is in itself criminal, for one is dealing with, at worst, a vice but not a crime.
The two most widely used legal drugs, alcohol and tobacco, lie in the upper half of the harms ranking. 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 our responses 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 to 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.
People with a history of drug problems are seen as blameworthy and to be feared. Stigma is a major barrier to their successful recovery and prevents them from playing a more positive role in communities and re-integrating into society. People recovering from drug dependence should be part of the normal community.
Such actions have been successfully implemented in some European countries. In the USA there is increasing support for initiatives such as the California Proposition 19, also known as the Regulate, Control and Tax Cannabis Act of 2010, that would have legalised various marijuana-related activities, allowed local governments to regulate and collect marijuana-related fees and taxes, and authorised various criminal and civil penalties.
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).
• Using psychoactive substances may be a vice but should not be considered to be a crime, thus criminalising a large proportion 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.
• Improved state control of substances, as with alcohol and cigarettes, could provide taxes and significantly reduce the roles of drug dealers.
A recent MRC Research Brief outlines strategies to effectively address substance abuse problems among young people, but decriminalisation is not mentioned. It is time to face realities squarely and rationally debate the question of decriminalisation. Vested interests 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!
South African Medical Journal (SAMJ) Vol. 101, No. 2