This is my column. This is my column on drugs. Any questions?

June 12th, 2009 by Ben Goldacre Tags:
in bad science, drurrrgs, evidence based policy, politics | 66 Comments »

Ben Goldacre
Saturday 13 June 2009
The Guardian

In areas of moral and political conflict people will always behave badly with evidence, so the war on drugs is a consistent source of entertainment. We have already seen how cannabis being “25 times stronger” was a fantasy, how drugs-related deaths were quietly dropped from the outcome measures for drugs policy, and how a trivial pile of poppies was presented by the government as a serious dent in the Taleban’s heroin revenue

The Home Affairs Select Committee is now looking at the best way way to deal with cocaine. You may wonder why they’re bothering. When the Advisory Council for the Misuse of Drugs Act looked at the evidence on the reclassification of cannabis, they were simply ignored. When Professor David Nutt, the new head of the advisory council, wrote a scientific paper on the relatively modest risks of MDMA, he was personally attacked by the Home Secretary.

In the case of cocaine, there is an even more striking precedent for evidence being ignored: during the early 1990s the World Health Organisation conducted what is probably the largest ever study of global cocaine use. In March 1995 they released a briefing kit which summarised their conclusions, with some tantalising bullet points.

“Health problems from the use of legal substances, particularly alcohol and tobacco, are greater than health problems from cocaine use,” they said. “Few experts describe cocaine as invariably harmful to health. Cocaine-related problems are widely perceived to be more common and more severe for intensive, high-dosage users and very rare and much less severe for occasional, low-dosage users.”

The full report – which has never been published – went on to challenge several of the key principles driving prohibition, and was extremely critical of most US policies. It suggested that supply reduction and law enforcement strategies have failed, and that alternative strategies such as decriminalisation might be explored, flagging up such programmes in Australia, Bolivia, Canada and Colombia.

“Current national and local approaches which over-emphasize punitive drug control measures may actually contribute to the development of heath-related problems,” it said, before committing heresy by recommending research into the unintended adverse consequences of prohibition, and discussing “harm reduction” strategies. “An increase in the adoption of more humane, compassionate responses such as education, treatment and rehabilitation programmes,” it said, “is seen as a desirable counterbalance to the overreliance on law enforcement measures.”

It specifically singled out anti-drug adverts which sought to modify behaviour through fear. “Despite a broad range of educational and prevention approaches, most programmes do not prevent myths, but perpetuate stereotypes and misinform the general public. Such programmes rely on sensationalized, exaggerated statements about cocaine which misinform about patterns of use, stigmatize users, and destroy the educator’s credibility. This has given most education campaigns a naïve image and has reduced confidence in the quality and accuracy of these campaigns.”

It also dared to challenge the prevailing policy view – still enduring – that all drug use is harmful misuse. “An enormous variety was found in the types of people who use cocaine, the amount of drug used, the frequency of use, the duration and intensity of use, the reasons for using and any associated problems they experience.” Experimental and occasional use are by far the most common types of use, it said, and compulsive or dysfunctional use, though clearly worthy of close attention, are much less common.

It then descended into outright heresy. “Occasional cocaine use does not typically lead to severe or even minor physical or social problems … a minority of people start using cocaine or related products, use casually for a short or long period, and suffer little or no negative consequences, even after years of use.” And finally: “use of coca leaves appears to have no negative health effects and has positive, therapeutic, sacred and social functions for indigenous Andean populations.”

At the point where mild cocaine use was described in positive tones, the Americans presumably blew some kind of outrage fuse. This report was never published, because just two months after the press briefing was released, at the 48th World Health Assembly, the US representative to WHO threatened to withdraw US funding for all their research projects and interventions unless the organisation “dissociated itself from the conclusions of the study” and cancelled the publication. According to WHO, even today, this document does not exist, (although you can read a leaked copy in full on the website of the drugs policy think tank Transform at www.tdpf.org.uk/WHOleaked.pdf ).

Drugs instantiate the classic problem for evidence based social policy. It may well be that prohibition, and the inevitable distribution of drugs by criminals, gives worse results for all the outcomes we think are important, like harm to the user, harm to our communities through crime, and so on. But equally, it may well be that we will tolerate these worse outcomes, because we decide it is somehow more important that we publicly declare ourselves, as a culture, to be disapproving of drug use, and enshrine that principle in law. It’s okay to do that. You can have policies that go against your stated outcomes, for moral or political reasons: but that doesn’t mean you can hide the evidence, it simply means you must be clear that you don’t care about it.


++++++++++++++++++++++++++++++++++++++++++
If you like what I do, and you want me to do more, you can: buy my books Bad Science and Bad Pharma, give them to your friends, put them on your reading list, employ me to do a talk, or tweet this article to your friends. Thanks! ++++++++++++++++++++++++++++++++++++++++++

66 Responses



  1. MrNick said,

    June 13, 2009 at 12:21 am

    I have thought for ages that most of the problems associated with drug use are directly due to the criminality of the supply chain. The drug lords, who are not nice people, make tons of money. The users are supplied with often contaminated end product which can have profound health consequences.

    Prohibition made organised crime in the USA strong and wealthy and the world is still living with the fallout from that.

    I know that it is a highly contentious view but I honestly believe that the world would very likely be a better place if drugs were decriminalised.

    Nick

  2. The Biologista said,

    June 13, 2009 at 1:40 am

    “But equally, it may well be that we will tolerate these worse outcomes, because we decide it is somehow more important that we publicly declare ourselves, as a culture, to be disapproving of drug use, and enshrine that principle in law.”

    Which would be fine, if there were any hint at all that holding that principle has any benefit or indeed means anything at all. It does rather seem like it does not. I also think that figuring out the whole mess is being hampered by some rather colossal prejudices. Where did it all come from? Same place as the push to prohibit booze? Was this all born in the minds of faithful types?

  3. xtaldave said,

    June 13, 2009 at 7:27 am

    But… “Drugs are baaad, Mmmkay?”

  4. thepoisongarden said,

    June 13, 2009 at 8:58 am

    I think it’s important to concentrate on the central issue; the suppression of information because you disagree with it.

    Collecting information on illegal substance use is bound to be problematic and whilst the report can rightly claim ‘The WHO/UNICRI Cocaine Project is the largest study on cocaine ever undertaken’ that does not make it a very large study. The results are based on information from 22 sites in 19 countries. On top of survey data from people who can be expected to know what they are talking about the researchers interviewed 311 users of various types.

    311 is a pretty small sample and, even with the best methods, must be prone to distorting effects.

    The tradegy is that the USA’s action has, so far, meant that there has been no larger study to see if these results are robust.

    The laughable, and chilling, thing is the comment, minuted to a Mr Boyer, from the USA, that ‘its (WHO’s) programme on substance abuse was heading in the wrong direction’. ‘Don’t tell us what is; tell us that what we tell you is, is.’

  5. Michael Gray said,

    June 13, 2009 at 9:25 am

    I think that Noam Chomsky has this otherwise bizarre situation explained more than adequately, vis:
    that U.S. so-called illegal drug policy has nothing whatsoever to with health outcomes, nor harm reduction.
    (In fact it quite consciously serves to exacerbate same.)

    Its main purpose can be explained effortlessly if one assumes that it is a calculated policy by the elite minority to control an otherwise ‘useless’*1 or ‘unprofitable’ sector of the population.

    Of course, that it my distillation of several hefty tomes on the subject, and is necessarily slightly flawed*2, but gives one a broad target of conundrum resolution.*3

    ______
    *1 A human who does not act as a trouble-free slave for their personal profit and power.
    *2 NOT Bogus, mind you!
    *3 Not forgetting that prisoners gaoled for gardening ‘crimes’ are forced to work for sundry corporations in the US, at a discount rate.

  6. Synchronium said,

    June 13, 2009 at 9:31 am

    Cool post. I’m surprised no one at the ACMD has resigned yet.

    Neuroscientist & atheist Sam Harris reckons the war on drugs is all about religion. Sorry for the links, but at the end of this post is an episode of Horizon which goes through a lot of common drugs rating them according to the harm they do. Some very surprising results!

  7. JonathanD said,

    June 13, 2009 at 9:52 am

    Excellent article Ben, I’ll certainly be having a read of the leaked doc. For anyone who hasn’t already seen it, Nick Davies wrote an excellent article back in 2001 on Heroin which is a must-read: tinyurl.com/cpnvhj

  8. anotherfakeid said,

    June 13, 2009 at 10:37 am

    Agree with MrNick. No illegal drugs, no drug pushers, poor people in Afghanistan can grow them and sell them legitimately so no fear of taliban, drug users get cheaper drugs and so no need to rob people, silly drug users get dead so no long term health care provision needed for them (good for tax payers). Not sure MrNick meant all this but it would be one logical follow through.

  9. Synchronium said,

    June 13, 2009 at 10:55 am

    anotherfakeid: Then all the money tied up in keeping drug users locked up could be reallocated to the NHS, doing everyone a favour.

  10. stephend said,

    June 13, 2009 at 11:45 am

    Interesting stuff. As others have noted, it’s a difficult area to study given the legal situation which make a study of a population of 10mm all the more interesting…

    “The results by 2007 were an increase in cannabis use but drop in use of other drugs. Deaths from drugs dropped dramatically.”

    This is in Portugal.

  11. Minsx said,

    June 13, 2009 at 12:57 pm

    I’m a little bit confused by this bit:

    “Occasional cocaine use does not typically lead to severe or even minor physical or social problems … a minority of people start using cocaine or related products, use casually for a short or long period and suffer little or no negative consequences, even after years of use.”

    If only a minority of people suffer little or no negative consequences, then doesn’t that mean a majority of people do suffer negative consequences?

  12. tommmy said,

    June 13, 2009 at 1:10 pm

    Synchronium that’s kind of what they are doing in Portugal; www.time.com/time/health/article/0,8599,1893946,00.html?xid=newsletter-europe-weekly

  13. bald_rob said,

    June 13, 2009 at 1:17 pm

    No, no, no, anotherfakeid, you haven’t thought this through. If the west legalises heroin and cocaine the price will drop dramatically. Then the poor producers in Afghanistan and South America will be ruined. Yet another example of a misguided liberal wishy-washy policy idea which will benefit the rich west, but will result in the poor of the developing world missing out on an opportunity to make themselves a better life. For the benefit of these poor people, we must keep the prohibition. [/sarcasm]

    OK, I know the producers sadly don’t make the real money. If we can’t end prohibition then maybe it’s time for fair-trade heroin?

  14. thepoisongarden said,

    June 13, 2009 at 1:29 pm

    9.Minsx

    That is a slightly convoluted sentence.

    It’s saying a minority of ALL people start to use cocaine. Of that minority some use cocaine for a short time, some for years. And that minority suffers little or no negative consequences.

    In other words, cocaine use is finite and the harm it causes is finite.

    Finite problems can be solved.

  15. GavinH said,

    June 13, 2009 at 4:14 pm

    An interesting point, and good article Ben. The general public need to be sure of what the policy makers are really hoping to achieve.

    If the underlining tenant of your drugs policies is really that “drug use damages people physically, mentally, socially and/or financially, both users and those in their social and family circles, and this damage should be stopped”, what you’re really trying to achieve is an improved quality of life for these people who are being harmed, directly or indirectly.

    So, morally (in my opinion), you’d better be damn sure they are being harmed, and that what you are doing isn’t, in fact, making people worse off. If you’re going to ignore the evidence, be prepared to be as bad a problem, or make a whole new problem, for people, as the one you’re trying to resolve.

    If the evidence goes against your policies, and you really do want to improve the quality of life of people, man the f@#k up, say it was wrong, listen, think and change your policies based on the best currently available information.

    Though, whilst such an approach is lauded in science, in politics this is apparently perceived as being the act of a weak willed and poor leader.

    Oh for a rational based approach to government policy…

  16. BKrapcha said,

    June 13, 2009 at 4:31 pm

    I’ve always thought this quote from our (America’s) best ex-president sums things up quite nicely:

    “Penalties against drug use should not be more damaging to an individual than the use of the drug itself.”
    – U.S. President Jimmy Carter – Message to Congress, August 2, 1977

  17. samarkeolog said,

    June 13, 2009 at 5:52 pm

    Cheers, JonathanD, nice link.

  18. Drug Equality said,

    June 14, 2009 at 3:05 am

    Drug equality said that this sites duplicate detector fired off at the first shot and then logged it anyway! bad program … bad operator? sorry about the duplicates! ben, thanks for being!

  19. killary45 said,

    June 14, 2009 at 11:01 am

    OK so we legalise cocaine, then what? What about crack? Crystal meth?

    Legalising cocaine or marijuana would not mean that the illegal drugs trade would disappear – merely move on to the promotion of more harmful drugs.

    So there would be no benefit in crime reduction unless all drugs were legalised. Is that what you want?

  20. thepoisongarden said,

    June 14, 2009 at 12:24 pm

    19.killary45

    Yes, obviously.

    Legalisation doesn’t mean promotion.

    It means introducing sensible controls which have a fair chance of protecting the young from exposure to substances which might be harmful during development.

    It means quality controls on strength and contents.

    There are only two possible situations. Either these substances are not harmful, in which case there is no justification for them to be illegal. Or they are harmful, in which case it is immoral for governments to leave their manufacture and distribution in the hands of criminals whose only interest is profit.

  21. killary45 said,

    June 14, 2009 at 1:11 pm

    #20 tpg

    Do I understand correctly that you would make all drugs, including crack and crystal meth legally available? What effect do you think that would have on society?

    Am I right in assuming that when you use the word “harmful” in your argument you mean “harmful to the user”? Ben’s post, and the research it is based on, only look at the impact on the active participant.

    Whether or not an activity is harmful to the user is neither a necessary nor a sufficient reason for it to be banned. Governments ban lots of activities which do no harm at all the active participant (downloading “pirate” music, stabbing other people, burgling houses), and allow lots of activities that are certainly harmful to the participant (smoking, eating at McDonalds, watching reality TV).

    The answer to the question about whether or not an activity should be banned is esentially determined by the impact of the activity on our own society. Britain used to promote the opium trade to China because it was very beneficial to our economy – the effect on the user was irrelevant. China fought and lost two wars to ban the trade because the widespread use of opium was very harmful to their society, for example by reducing the amount of cheap labour available.

    When discussing the question of the legalisation of drugs the amount of harm to the user is at most a secondary issue. The question is whether or not society as a whole is better or worse because of the ban.

  22. brian faux said,

    June 14, 2009 at 3:11 pm

    #13 bald rob
    how about fairtrade dope?

  23. mrmuz said,

    June 14, 2009 at 5:35 pm

    Wasn’t I reading something the other day that likened crack to moonshine or bathtub gin; dangerous, sure, but just a cheap version of the good stuff and hardly worth the hysteria. The fact that that people blame crack for decimating America’s ghettos in the eighties rather than poverty or a slew of other issues serves the point quite nicely: it makes a simple symbol that’s easy to rail against out of a complex set of problems.
    (I can’t link to this story though, as I don’t recall where I saw it).
    It’s very likely that there will be considerable regulation of recreational drugs should they be legalised. But where these debates get caught up is in the idea that we need to know the shape of this regulation and all its attendant possibilities and consequences or we can’t even try this. I think that’s silly. Surely we know change this large is going to be a little bumpy and require some adjustment (like everything!). The issue is why continue to prohibit these things in particular when it doesn’t work and largely makes things worse for all concerned (except crooks). As Ben points out, the case there is absent or intent to rely on force instead of argument.

  24. mjr said,

    June 14, 2009 at 11:21 pm

    Whenever I think of the “war on drugs” I am reminded of the explanation of witch hunts in “cows pigs wars, and witches” (Marvin Harris) Harris’ view is that witch hunts have great value for the state because they justify the presence and maintenance of a police state/force to control the populace, as well as a useful distractor. Rather than people asking “why is the lord of the manor living so well, while I am so poor?” they are told that the state exists for the important purpose of protecting them … …against imaginary problems.

    As someone else mentioned, the “crack epidemic” did a lot to demonize inner city poor into dirty, filthy, disreputable trash who brought their problems on themselves – rather than economically disenfranchised victims of a poor educational system, racism, and social injustice. Doesn’t it strike people as interesting that rich and famous people’s addictions are treated as foibles (“Oh, look, so-and-so is in rehab again!”) which are ultimately curable, whereas the poor are treated as permanently damaged goods?

    In the US, the war on drugs has become a cash cow for law enforcement. In recent years, with their ability to confiscate property of “drug dealers” there have been abuses, such as conspicuously targeted suppression against high net worth citizens. Creating a self-perpetuating police state doesn’t help in the slightest bit if your premise is that you’re concerned about making people’s lives better. But, we all know that is not what it’s all about.

    Ultimately, Sam Harris is right that the intellectual basis for anti- self-abuse is rooted in christian “thinking” – but its purpose is much more sinister: it’s just a lever in the great control game.

  25. Filias Cupio said,

    June 15, 2009 at 2:59 am

    19.killary45

    “Legalising cocaine or marijuana would not mean that the illegal drugs trade would disappear – merely move on to the promotion of more harmful drugs.

    You have an unstated assumption here that the size of the illegal drug market will stay the same when softer drugs are legalized. This is a possible outcome, but not I think the most likely.

    A rational decision on whether a drug should be illegal or not balances the bad effects of the drug, against the good effects of the drug* and the bad effects of criminalization. If we decide that this balance favours legalization of marijuana, it does not follow that we will decide the balance also favours legalization of heroin.

    Indeed, we already have made such judgements – alcohol and nicotine are on the legal side of the line, despite the known harm they cause. I could claim your position logically implies you must be in favour of (or will inevitably lead to) making these illegal to. This would be as much a straw man as your argument is.

    *All these drugs have good effects, at least in the short term from the point of view of the user, else there wouldn’t be a demand. There’s no underground market for recreational use of chemotherapy drugs.

  26. Jono said,

    June 15, 2009 at 3:04 am

    MrMuz beat me to it – but yeh, the only reason meth or crack are popular drugs is their relative availability and price.

    Much as I hate to say it, it’s an economic problem – alcohol has terrible effects on society, but we regulate it heavily and allow its sale.

    As a result, only “clean”, relatively high quality products are available, there’s competition and they’re reasonably priced, even with high taxation.

    There’s nothing to suggest that legalisation of all drugs won’t be the same – for example, the only reason heroin (diamorphine) is popular is because it is the highest concentration and the easiest to transport. If transportation weren’t the greatest cost involved, there wouldn’t be a need to create morphine that strong.

    Tax the snot out of drugs, and suddenly your society is making money instead of spending it on a losing battle. Take the money you make and spend it on the people who are worst effected by the new policy (addicts, their families), spend it on education, enforcing regulation, rehabilitation.

    The net result is far, far better for society [i]and[/i] the individuals.

  27. killary45 said,

    June 15, 2009 at 7:35 am

    #25 Jono are you saying that crack and crysal meth should be legal for anyone who can afford to pay the taxes? Could there really be a legal trade in something that is so harmful to the user?

    If the taxes and prices are low would that really be a good thing for society? If the taxes were high how are the poor and the unemployed going to be able to afford it? How are pregnant women and the under 18s going to be able to get their supplies? By stealing? Or by buying from illegal sources?

  28. wilsontown said,

    June 15, 2009 at 7:52 am

    I think the point is that any decision on whether to legalise or prohibit use of a particular drug should be based on evidence. So, perhaps it is sensible to legalise cocaine based on the evidence that Ben wrote about above. That doesn’t mean you have to legalise crack or crystal meth: you would make a judgment based on the evidence.

  29. Skimmer said,

    June 15, 2009 at 8:45 am

    This video is simply delicious. Long serving cops, judges, DA’s DEA guys etc advocating dropping the drug war. Having walked the walk for 30+ years they know what they’re talking about, and not as easy to dismiss as some long haired pot heads, or pointed headed researchers :)

    www.youtube.com/watch?v=LayaGk0TMDc

  30. Skimmer said,

    June 15, 2009 at 8:58 am

    And to respond to killary45 they make a very good point about the legalization of the nastiest drugs – go into any school and try to buy a Carlsberg. Now go into the same school and try to buy some heroin. Your odds have massively improved on the second mission. Why? Is heroin more popular than Carlsberg? Of course not, it’s because Carlsberg is legal, and subject to the strictures of its licenses, whereas the heroin trade is in the hands of the worst scum in the land.

    We’ve cut nicotine use in half in the last couple of decades, and we couldn’t have done that through force. Better to treat it as a health problem than a criminal justice problem.

  31. Jono said,

    June 15, 2009 at 9:03 am

    Killary, the question of whether or not to legalise crack or meth wouldn’t even be relevant if there were cheaper alternatives.

    It’s like the bathtub gin thing – people only use crack because:

    1) It’s cheap.
    2) It’s available.

    The same can’t be said for “preferred drugs”.

    Legalise and regulate the right drugs, and there’s no demand for the really damaging stuff (just as nobody sells – or is allowed to sell – terrible quality distilled liquor).

  32. hatter said,

    June 15, 2009 at 10:36 am

    killary45, yes those drugs should be legal. It’s questionable whether freebased cocaine, aka crack, would even have come onto the market as a separate product if not for drug prohibition. Yes some people went in for freebasing before that, but it was hardly a common method of use. In addition there is no evidence that crack is even a serious problem, i.e. that those who go for that form represent a significant portion of drug users. And clearly prohibition is not doing anything to keep crack out of consumers’ hands. Methamphetamine is another example of a drug that has very likely been made more dangerous through prohibition. The most potent form has now become the standard. Also prohibition does absolutely nothing to stem supply – the drug is easy to make and current measures to restrict access to the necessary chemicals only serve to inconvenience ordinary people. The fact is that crack was a bugbear of the 80s, a terror built mostly on lies. Methamphetamine is, like cocaine, a drug that can be used responsibly and when used in moderation is not going to cause its users serious harm. And everyone can drop the crystal part, it’s really silly.

    There are of course a number of groups that have a vested interest in maintaining the current legal situation. Drug barons that produce nicotine and alcohol products obviously don’t want competition. Drug barons that make their fortunes from the likes of cocaine really would not want it legalised either (note that while the farmers make more than they can from say coffee, they still get very little for their crops). Drug squads don’t want these things legalised, nor do they want to win (what are all those DEA agents going to do if the drug trade disappears?) Politicians are only interested in what they think will get them votes, and at the same time there is an automatic mechanism built in to suppress users of politically incorrect drugs and maintain discrimination against them (and it is nothing more than persecution); how can a cocaine user speak up and demand their rights, hold rallies and so on?

  33. Bogusman said,

    June 15, 2009 at 12:16 pm

    It seems to me that we have reached a point similar to where the anti-smoking “movement’ was in the 1970s. Everyone with a functioning brain has come to the conclusion that the “war on drugs” is not winnable and that a new approach is necessary. Subject to further proper research, the approach of legalise, regulate and tax applied to all currently illegal drugs must be the desired outcome. But the body politic is not yet ready for this move just as it wasn’t ready for smoking bans and accelerating taxation of tobacco products back in the 70s. Maybe by 2040 or so we will have rational drugs policies.

  34. petrossa said,

    June 15, 2009 at 5:31 pm

    And if one sees it like this:
    There you are sitting on tens of billions of dollars of drugs profits. Which congressmen are you going to support? Worldwide?

    Age old wisdom: always look for who gains the most from a given situation to find the cause.

  35. ChickPea said,

    June 15, 2009 at 6:35 pm

    You need to realise who you’re up against:
    1) The booze and tobacco industries;
    2) The “no-one deserves fun” tendency.

    It’s not going to be easy.

    When marijuana was first banned, a lot of the impetus came from the press, particularly Hearst.

    Guess why? A by-product from hemp cultivation (cheap cloth) was a competitor with Hearst Paper Products.

    There will be all sorts of vested interests to dig out, not least the law enforcement agencies- they’re not doing that well against drugs, but the fight does get them a metric shitload of funding.

  36. killary45 said,

    June 15, 2009 at 7:44 pm

    #28 The legal drugs alcohol and nicotine are much more widely used than illegal drugs. If cocaine and marijuana are legalised it seems very likely that their use will also increase, after all they can be more enjoyable than alcohol and nicotine. Whether they should be legalised depends on a calculation about the effect on society if the majority of people used them. However those who prefer heroin, crack and crystal meth are unlikely to revert to cocaine and marijuana, so unless they are legalised it will not end the illegal trade in drugs.

    #30 I don’t know what schools Skimmer goes to, but it is not difficult for anyone over the age of 12 at any school to get Carlsberg.

    #32 Hatter tells us that methamphetamine can be used responsibly and that it has been made dangerous through prohibition. Perhaps he could give us his estimate of the percentage of users who become dependent upon it, and are likely to seek out the most potent form they can buy. Does he suggest that only the less potent forms should be legally available? If so would that not create a market for those who want to sell

    #35 – The Hearst campaign against hemp took place after Marijuana was first banned in the UK in 1928.

  37. omnis said,

    June 15, 2009 at 10:13 pm

    The main anti drugs arguments I’ve heard tend to go like this:

    Soft drugs lead to hard drugs. But, thanks to Ben we know there are no real good studies into these things. I suspect what they mean is all hard drug users use soft drugs first. But all soft drug users almost certainly experiment with alcohol first, but no-one ever cites marijuana as a reason for alcohol prohibition. What they might mean is that interacting with illegal soft drug dealers brings you the opportunity to sample hard drugs. But if the soft drugs were legal, you wouldn’t meet the illegal dealers and so the connection is broken.
    They could mean that having a taste for soft recreational drugs will tempt you to want to get bigger kicks, but again without evidence to back it up you might as well say anyone who likes a glass of wine is going to end up downing a bottle of gin every night.

    Cocaine destroys the economy of Columbia and promotes murder, torture, poverty, etc. So if it was legalised and production done by fairtrade farms this wouldn’t happen. I’m not a chemist, but is it impossible to synthesise from other ingredients? Surely the pharmaceutical industry could have a good crack at it, if they were allowed to.

    Drugs cost society billions (of whatever currency) because of the associated crime. This is the most fallacious statement. Here we’re definitely only talking about the real addicts, on crack and heroin. If it was legal, the price would be so much lower, they could afford to buy enough to stay high all day and stave off the withdrawl, and wouldn’t need to put a brick through my car window in the hope of getting a £50 bag in exchange for the stereo.

  38. omnis said,

    June 15, 2009 at 10:25 pm

    Oh, and one more point (sorry, this one is slightly anecdotal). The argument that legalisation (lets say marijuana) will lead to more people taking it. Sorry, but I’ve discussed this with an awful lot of people over the years and I think the majority of the population have had the opportunity at some point in their lives. A huge proportion of those refused it. Of those that have tried it, the vast majority said they didn’t like it and never bothered again. A fair chunk will continue to try it occasionally if offered, but aren’t really bothered, and a tiny proportion like it a lot.
    Of those, most have no obviously associated negative health problems, and perform perfectly well as good productive members of society. Just keep it away from the kids.

  39. killary45 said,

    June 15, 2009 at 11:32 pm

    #38 Omnis, you could well be right. However you could also be wrong. Few people really enjoy their first cigarettes. I would guess that if it were illegal to smoke cigarettes the vast majority would either refuse the chance of a cigarette when offered one, or after trying one or two say they didn’t like it and never bother again. Similarly it seems pretty likely that if marijuana were legal many of the huge proportion who refuse the offer would accept it, and those who did not like it at first would be much more likely to perservere until they had acquired a taste for it.

  40. thepoisongarden said,

    June 16, 2009 at 7:12 am

    38.omnis

    You are quite right to say that just because heroin users once used cannabis that doesn’t mean the cannabis is the reason for them becoming heroin users.

    I assume there is another factor which makes cannabis a ‘gateway’ drug.

    We lie about it.

    Tell people that using cannabis will make their hair turn blue and their ears fall off and their own experience and that of their peers will be vastly difference.

    Now tell them that heroin is an addictive drug which, in overdose, can kill and they’ll say, ‘Well you lied to me about cannabis, why should I believe you now?’.

    Suppressing factual information about drugs, which Ben’s piece was about, MAY (studies needed, etc) increase the use of these substances.

  41. speedkermit said,

    June 16, 2009 at 8:27 am

    I notice the WHO Report – or at least the way it represented in this article – didn’t really draw a distinction between the basic powdered form of cocaine and crack. I can assure you from personal experience of dealing with those addicted to crack cocaine that it most certainly IS harmful to health and to wider society. The base form is still addictive if used regularly, and even weekend use can produce psychological dependence (Friday nights just aren’t the same without a couple of lines…)

    I don’t particularly have a problem with the general public being lied to about drugs. A good example is those ridiculous adverts that have been in the UK media recently where the makers seem to be confusing cannabis with amphetamine! Of course, most people who have used cannabis will realise they are absolute bunk, but if they have a preventative function in deterring a significant, impressionable proportion of the population from trying them then I don’t really have a problem with that. I wish we could the same with alcohol.

    Having read Ben’s book and articles avidly over a number of years, i’ve noticed that he frequently finds himself in logical positions where he has to say things such as: “I’ve nothing against eating healthily, but…” I agree that Gillian McKeith (to give her her full medical title!) is a bit of a charlatan, but if the woman can encourage healthy eating where several decades of evidence-based nutritional research has failed, then shouldn’t we indulge her a little? Similarly, if we can say that a society without drugs (including the legal ones) would be better and healthier than a society with them, shouldn’t we be indulgent with governments that exaggerate the risks by highlighting the ruination they cause to small minority of the population? We aren’t all intelligent, affluent and informed enough to indulge in moderation, and let’s not forget that the minority that spoil it for everyone cause a disproportionately large amount of acquisitive crime in this country.

    I’ll finish off with a final example of where misinformation is beneficial to society…How many pints of lager are required to take a person over the prescribed limit? Most people would say two wouldn’t they? The reality is frighteningly more, and most law-abiding people wouldn’t dream of going anywhere near a car if they had consumed that much alcohol. Yet who would argue that the misconception isn’t an incredibly good thing? (Perhaps you’d like to attempt to do this in a future article? If it resulted in the Government reducing the legal limit to be more in line with public expectation, who – apart from the irresponsible – could complain?)

    Scientific evidence will always be manipulated by Governments for public policy reasons. It might not make sense to an evidential absolutist, but hey…

  42. Skimmer said,

    June 16, 2009 at 9:37 am

    Decriminalisation has been implimented in Portugal and has REDUCED drug use www.time.com/time/printout/0,8816,1893946,00.html

    Pushers push.

    And I went to school in Northern Ireland were I never saw a tin traded within school grounds.
    The juvinile crack trade is much better organised becuase the margins are so much better thanks to prohibition.

  43. NeilHoskins said,

    June 16, 2009 at 12:24 pm

    All anti-prohibition arguments ignore the bleeding obvious: that I don’t want to live in a place that has druggies walking around in public. My views are doubtless coloured by the fact that I was once the victim of an assault by a bloke who was coked out of his head.

    If anything we should be doing what we can to reduce public alcohol consumption, not encouraging the public consumption of a wider variety of drugs.

  44. Jessicathejourno said,

    June 16, 2009 at 12:34 pm

    killary45, you’re jumping to conclusions that I’m having a hard time taking seriously when your premises don’t make sense. Cigarettes are legal, and exactly the situation you write about if they were illegal is what happens already – only a small proportion of the people offered them accept, and an even smaller proportion smoke more than one or two before giving it up in disgust. And cigarettes are highly physically addictive, which we all know cannabis isn’t. It’s like you’re comparing apples and oranges on different planets at different times. Wow!

    That having been said, the cigarettes themselves bring up an interesting point in terms of legalization, in that they’re legal almost everywhere, and yet an illegal market in cigarettes continues to flourish and to be behind a fair amount of social rot and organized criminality. The flourishing illegal cigarette market points to the conclusion that if the sort of brainless, kneejerk governmentalizing that Ben is decrying in this article isn’t a good way to approach the problem of substance abuse and its associated social ills, there’s no reason to automatically assume that making the substance legal is the answer. It isn’t with cigarettes – either from a health or a criminal perspective.

    But if we consider past efforts to ban alcohol, we can argue legalizing it probably WAS the right harm-reduction move. Hmm. Not as simple as all that, then.

    I think an important difference is that cigarettes are a market where it’s worth taking illegal risks to undercut the legal trade (tobacco can only be grown in commercially interesting ways in select climates and soil conditions, and the majority of its users have a real physical dependency) whereas alcohol isn’t (its normal users don’t have a physical dependency, and all you can make it in your bathtub, baby!)

    In that spirit I don’t know why anybody would imagine the opium market would turn warm and cuddly if it was legalized. There’s no way legitimate vendors could price it cheaply enough for it not to be worthwhile for illegal vendors to try to undercut them in aggressive and dangerous ways. And despite the political organization of coca growers and despite the pretence that those utter Friday night snorter-bores who can’t shut up about themselves no matter how uninterested the room is don’t have a very real problem, I have my doubts on the score of the processed cocaine market, too. In both cases, the growing area being too limited, the legal price will never be low enough for illegal prices to not look good, so it will always be an attractive market for organized criminality.

    None of that applies to cannabis, of course, which you can grow in your back garden even in Canada or northern Europe. Or at least it shouldn’t apply to cannabis – I don’t think it’s a coincidence that we didn’t see serious organized crime involvement in the cannabis industry before people started demanding and fetishizing super-asskickin’ wheelchair strains that leave you incapable of anything besides playing video games and jacking off, that need hydro and fancy fertilizers and other expensive infrastructure demanding illegal investment.

  45. Teapot said,

    June 16, 2009 at 12:44 pm

    These are almost certainly misquotations, but keeping the spirit of the originals:

    “Gangsters hail prohibition of alcohol!”
    ‘This is really great for us’, says Al Capone.
    – The Onion, “Our Dumb Century”

    “As a drug enforcement officer he had met countless addicts over the years and had concluded that only one type of addict needed to be put behind bars. The money addicts.”

    – Charles Stross, in “The Clan Corporate”

  46. hrhpod said,

    June 16, 2009 at 1:08 pm

    I treat coke in the same way as champagne – I buy some for special occasions, use it, enjoy it and then leave it alone for months on end, with no ill effects that I’ve noticed.
    Where’s my commercial?

  47. thepoisongarden said,

    June 16, 2009 at 2:09 pm

    43.NeilHoskins

    You seem willing to ‘ignore the bleeding obvious’ which is that many of those advocating the end of prohibition are not ‘encouraging the public consumption of a wider variety of drugs’.

    You assume that the only alternative to ‘drugs are illegal – no-one should use them’ is ‘drugs are legal – everyone should use them’.

    Try thinking about ‘drugs are legal – no-one should use them’.

    In the LEAP video linked to above, one of the former police officers says making drugs legal won’t cure the drugs problem but it will cure the crime and violence problem so you can devote a lot more effort to the drugs problem.

  48. BKrapcha said,

    June 16, 2009 at 2:45 pm

    #19 Then we decriminalize it all, and look what happens to society:

    From the April 7, 2009 Scientific American article “Five Years After: Portugal’s Drud Decriminalization Policy Shows Positive Results

    “”Now instead of being put into prison, addicts are going to treatment centers and they’re learning how to control their drug usage or getting off drugs entirely,” report author Glenn Greenwald, a former New York State constitutional litigator, said during a press briefing at Cato last week.”

    and

    “”Drug decriminalization did reach its primary goal in Portugal,” of reducing the health consequences of drug use, [Peter Reuter, a criminologist at the University of Maryland, College Park]says, “and did not lead to Lisbon becoming a drug tourist destination.”"

    Difference between decrim & legalize, from same article:

    “Drug legalization removes all criminal penalties for producing, selling and using drugs; no country has tried it. In contrast, decriminalization, as practiced in Portugal, eliminates jail time for drug users but maintains criminal penalties for dealers.”

  49. Skimmer said,

    June 16, 2009 at 3:29 pm

    Neil Hoskins you raise a fair and honest point. All drugs legal or illegal are vices, and all vices have their attached (often major) problems. But you can’t wish those problems away. Regardless of the legal injunctions imposed prostitution and drug use aren’t going away, girls will get assaulted in private rooms by maladjusted punters, and random members of the public will suffer at the hands of overly aggressive arseholes no matter what we do.

    Still, I’d rather that the girls and you can turn to a criminal justice system that isn’t drowning under prohibition cases.

    Plus the girl will have much better odds if shes working in a legal, established industry rather than an industrial estate, and all of us will have better odds if the junkies can fund their addictions without sticking needles in our faces.

  50. killary45 said,

    June 17, 2009 at 10:09 pm

    “All in the Mind” BBC Radio 4 this week, available on Listen Again, looks at the how the system works in Portugal and compares it the UK. It is well worthwhile listening to. The Portugal decriminalization is not quite as I imagined. Those caught in possession of drugs, or under the influence, are classified as having a health problem. They have to attend a course of treatment and if they do not they can receive a big fine. Drug traffickers are still prosecuted there.

  51. Skimmer said,

    June 18, 2009 at 8:52 am

    Thanks, I’ll take a listen when I get home.

    I’d love to know the reason why drug use was reduced. Likely to be a combination of effective treatment, and a reduction in the ‘glamour’ of it all, but that’s just a guess.

    However, by criminalising supply you’re still leaving the trade in the hands of the Al Capone’s, and skewing the incentives towards strong concentrated drugs that can be easily smuggled. Strong bathtub spirits where the product available during alcohol prohibition because they were so much easier to move than gallons of beer.

  52. timboson said,

    June 18, 2009 at 10:26 am

    Great stuff Ben, as always very informative.

    Personally I believe we should legalise it, tax it and use the proceeds for educating people so they can make an informed decision, and healthcare for the percentage of people who always become addicted to a substance.

    Very interesting about Portugal, BKrapcha #48, I never knew.

  53. dslick said,

    June 18, 2009 at 6:00 pm

    speedkermit – sorry, but I don’t want my government lying to me about anything by exaggeration, omission, or in any other way shape or form. I’d prefer to have the unadulterated facts — which on important issues, should be actively sought out on my behalf by the government, rather than actively suppressed — and make up my own mind. You want to trust other people whose interests might not be consistent with yours to decide for you that something is a problem (e.g., Iraq) and then start lying to you about it for “your own good”?

  54. John Stevenson said,

    June 21, 2009 at 5:16 am

    @43

    You already are – by far the biggest source of street violence is alcohol.

    Because it involves selective allocation of limited resources to target the bogey-man of the moment, prohibition often makes the situation worse.

    The classic example is the ‘success’ of Australia’s attempts to limit the supply of heroin, a drug that has very few negative side-effects if administered in pure form (overdoses and other health issues from heroin arise from the erratic quality of an illegal supply – addicts prescribed heroin in the UK before its super-criminalisation lived balanced and productive lives).

    The limiting of the supply of heroin led to an explosion in the use of crystal meth, a drug far likelier to set its users off on violent rampages than heroin.

    The paradox is that those calling for severe drug prohibition are often also the same stripe as those demanding free markets in everything. Yet if people who want to get off their races had true free choice the evidence suggests they would pick far ‘nicer’ highs than alcohol and crystal meth.

    Give me a world where those who can’t handle reality (or want a temporary holiday from it) escape using cannabis or heroin any day.

    @44

    Heroin is dirt cheap to produce and opium poppies not hard to grow. Tasmania supplies a large proportion of the world’s opium and has a climate similar to France.

    The market for cigarettes is seriously unbalanced by taxation, which massively inflates the street price of legal tobacco products and has the unpleasant side-effect of addicting governments to a revenue stream based on letting a handful of drug barons slowly kill a proportion of its population. The USA, for example, earned almost $15,000 million from tobacco taxes in 2006; yet the previous year all the states spent $541 million on anti-smoking measures while the tobacco industry spent around $13,000 million on marketing.

    The elephant in the room is the reported increase in street violence and disorder since pub opening hours were deregulated in the UK, and the problems that the police say center around late-opening very large pubs in Sydney. This should give pause to those of us who’d legalise everything, because it indicates that some groups of people really can’t be trusted to behave responsibly in a free market: allow the suppliers of substances with socially harmful side-effects open slather and they will find ways to exploit the weak-willed.

  55. JustCurious said,

    June 22, 2009 at 8:47 pm

    Hi Ben,

    I’m guessing you didn’t want to extend this discussion into legal, prescription drugs, but what the hell, I’m burning with curiosity about this, so will go ahead and ask about it here, anyway. (And besides, drugs is drugs, right? They all make you happy, after all).

    It’s just I came across this report recently, suggesting that SSRI’s are damaging to motor neurones in the brain, and that this needs to be investigated further:

    www.dovepress.com/effects-of-selective-serotonin-reuptake-inhibitors-on-motor-neuron-sur-peer-reviewed-article

    I’d be interested to know how seriously you think this ought to be taken? Looks like the authors did concede that the experiments in rats were not directly equivalent to human physiology, but it does look quite dramatic, all the same.

    If you could use a few seconds to offer your feelings about this, I’d be very grateful indeed. Cheers.

  56. JustCurious said,

    June 22, 2009 at 8:52 pm

    Oh yeah, sorry, another link:

    www.dovepress.com/getfile.php?fileID=4844

  57. heavens said,

    June 23, 2009 at 11:10 pm

    I wonder:

    If you legalized (not just decriminalized) addictive psychotropic drugs — sold like cigarettes, for example — could we force the manufacturer of the “dangerous product” to pay for drug rehab for all their customers? If someone is high as a kite, or tripping on a hallucinogen, and gets into a car wreck, can we make the drug maker to cover the full costs?

  58. DrJG said,

    June 24, 2009 at 10:25 pm

    Hmmm. I don’t want to seem to be supporting UK or US drug policy, but a lot of the arguments used by their critics don’t, to my mind, stand up very well either.

    Yes, I see more harm from alcohol and tobacco than from drugs. But then again, a lot more of my patients drink or smoke than use illegal drugs. I see little sense in smoking, but, just like the suppressed WHO report claims for cocaine, most alcohol “users” suffer little harm. And I say that as someone whose father’s alcoholism was probably the biggest single influence on their childhood. Ultimately, though, I would say that the arguments for stricter controls on alcohol and tobacco are stronger than those for relaxing controls on other substances.
    Nor am I convinced by arguments based on the negative consequences of Prohibition in the US. I do not accept that experiences gained from banning a drug which had been widely and legally used for many generations can be safely applied to a situation where there has been no prolonged or widespread legal use, if any. Yet, should legalization be tried and turn out to have severe negative consequences, it could prove a very difficult cat to re-bag.
    I have read many earnest and well-meaning articles blaming all the harm from opiate use on its restriction. They almost make it sound as if the times of the London Opium dens were some forgotten halcyon days, which is patent tosh. Opium and its relatives were brought under legal controls for very good medico-social reasons.
    I will agree that poverty and drug use made, in Victorian times, and continue to make a very damaging cocktail, but the world of the rich and famous is littered with examples which prove that great damage can still be caused to those wealthy enough
    a) not to need to turn to crime to fund their habit, and
    b) with far better social networks to afford some protection from the consequences of their use. Amongst my own patients, some have continued to hold down steady jobs to “pay their way” but if anything they are more likely to report the harm their habits cause them than those who fund it through crime and show more obvious outward signs.

    Finally, Ben recently commented on spurious figures for the “costs” of illegal downloads. If read many equally dubious figures for how much money is “wasted” on fighting the illicit drug industry and the organized crime which lies behind so much of it. These figures only make sense if one is going to claim that the criminals are in it largely due to a commitment to maintaining the supply of drugs as a service, rather than committed to getting money from whatever crime pays best. Lets be a bit more realistic about this, take away one source of illicit profit, and few criminals are going to go straight, most will find some other niche, so the potential savings in law enforcement do not actually materialize, they just get diverted to another department.

    No, I don’t like the deliberate suppression of information and evidence, but I’m not ready to accept that evidence as the last word on the subject.

  59. mikey2gorgeous said,

    June 29, 2009 at 9:48 am

    @Justcurious: the study you describe is IN VITRO – it’s done using chemicals directly onto cells in dishes. Also it is using other SSRIs than cocaine.

    It may have a bearing on cocaine use in humans but we cannot derive any conclusions from it because it is so unrelated. There are hundreds (thousands?) of systems in the body that balance & keep us going. Replacing dead cells, replenishing fluids & chemicals. The study you mention cannot take these into account.

  60. hatter said,

    June 29, 2009 at 11:07 am

    @heavens the producers, retailers and users would all be contributing taxes that would then go towards the costs of drug use.

    @DrJG the cat’s already well out of the bag. Has been for decades. Anyone who wants drugs can get them. The dealers don’t even ask for proof of age. Those criminals are not just going to go away, but prohibition has dramatically expanded high return criminal employment.

    @NeilHoskins I’m wondering where you do live? On a remote island perhaps? Maybe a very strict Muslim country? You won’t really find any western country that does not have druggies walking around. Especially when there’s a game on.

    I’ve been attacked by someone completely sober. I blame the lack of drugs. I don’t want to live in a country with sober people walking around.

  61. Helen said,

    June 29, 2009 at 7:09 pm

    #41 In reply to Speedkermit, as a member of the public myself, I strongly object to the general public being lied to, even if it is supposedly for our own benefit.

    It’s a slippery slope. If we give politicians a mandate to lie to us whenever they believe it is for our own good, then who are they accountable to? Who watches the watchers?

  62. JustCurious said,

    July 1, 2009 at 10:53 am

    Sorry Ben, that was very anti-social of me to post off-topic like that, it’s just that I’m a bit new to the site, so got carried away with the prospect of being able to ask you a question about the research.

    However, tell you what, here’s a more interesting and relevant question:

    How do you think the overall safety record of street drugs like heroin and Cocaine, might compares with SSRI’s?

    For starters I guess you can say that street drugs don’t usually cause movement disorders – or do they? George Monbiot was quoting your article the other day, and seemed to agree that the health risks from heroine/cocaine were pretty minimal.

    What are your thoughts on this. Regards.

  63. prescott said,

    July 3, 2009 at 7:11 pm

    Nobody is free of cancer, I hope soon find a cure and to fight this disease now, because it is tedious to go to therapy all the time and drugs to treat the disease are very strong opioids such as hydrocodone, Lortab, vicodin medicines of very high content of acetaminophen and codeine considered hallucinogenic drugs, then imagine how much pain, really hope there will be a solution as quickly as possible for this …..

  64. Chenneth said,

    July 16, 2009 at 10:59 pm

    Fantastic article. I teach at a college and I teach the ‘truth’ about drugs… this is completely against what the establishment would like but I just don’t tell them. Sad though that I should have to resort to this kind of subterfuge just to get a point across. I also use the ‘Should drugs be legalised’ debate to highlight the importance of critical thinking and using evidence to back up arguments.
    Is this the right way forward?

  65. wayscj said,

    November 21, 2009 at 6:30 am

    ed hardy ed hardy
    ed hardy clothing ed hardy clothing
    ed hardy shop ed hardy shop
    christian audigier christian audigier
    ed hardy cheap ed hardy cheap
    ed hardy outlet ed hardy outlet
    ed hardy sale ed hardy sale
    ed hardy store ed hardy store
    ed hardy mens ed hardy mens
    ed hardy womens ed hardy womens
    ed hardy kids ed hardy kids ed hardy kids

  66. Pharmwizard said,

    December 28, 2009 at 1:46 pm

    A rather wise man said: “Not all drugs are bad…in fact, some of them are damned good.”

You must be logged in to post a comment.