Prohibition doesn't work... what does "working" mean

October 09, 2017 The Noffs Team Comments

PROHIBITION DOESN’T WORK.. WHAT DO WE MEAN BY THAT?

“Prohibition doesn’t work.” We often hear this from advocates for harm minimisation and progressive drug policy. But what exactly does it mean?

We say prohibition has been ineffective, but what do we mean by that?

If we consider prohibition’s aims to be what it has actually achieved - mass incarceration for low-level drug offences, trillions spent policing communities, and increased stigma against drugs and people who use them, then prohibition has been very effective.

But we know that proponents of prohibition have asserted that its overall objective is to reduce drug use. And we know that this is why it is ultimately ineffective, because drug use has shown no signs of a decrease in the 40-plus years since the war on drugs was declared, and this is evidenced in expanding drug markets [1].

And within the context of harm minimisation, which has increasingly become an accepted framework for drug policy, prohibition’s focus on using law enforcement to criminalise is incompatible with harm minimisation’s emphasis on harm reduction.

HARM MINIMISATION

In 1985, Australia adopted harm minimisation as its official drug policy. This is a framework with a focus on public health and reducing harms. Harm minimisation recognises drug use as a societal reality and that the most important factor in addressing drug use should be reducing associated harms. [2]

There are three main pillars of harm minimisation:

  • Supply reduction
  • Demand reduction
  • Harm reduction

The means to achieve supply and demand reduction within a prohibition framework mostly involve using criminal law enforcement. Proponents of prohibition may claim that their efforts to reduce drug use are about reducing harms to users and the public, but there is often a disproportionate focus on the role of law enforcement and a ‘tough on crime’ approach; the negative effects of which usually include criminalising and stigmatising drug users.

Harm minimisation works within the philosophy that reducing harms to both drug users and the wider community is the most important aspect of effective drug policy. A harm minimisation framework places greater emphasis on the third pillar, harm reduction, and believes criminalising drug users contradicts that pillar.

Therefore, we can say that with a policy of harm minimisation in place, prohibition does not work because its focus on criminalisation has been shown to not only have little effect on reducing drug-related harms, but may actually increase them.

SAYING “DRUG USE IS BAD” IS BAD

If you have or might have children, and they ask you if drugs are harmful, you should say yes.

Children should not be taking any illicit drugs. Even over the counter pharmaceuticals can have adverse health consequences on growing bodies.

But beyond childhood, avoid blanket statements like “drug use is bad”. This statement, and versions of it, have been trotted out over the years by prohibition proponents, most recently by US Attorney General Jeff Sessions, who claimed “good people don’t smoke marijuana”. These types of statements achieve little else apart from demonising drugs and, by association, the people who use them. This is an unproductive consequence if we want to reduce drug-related harms and keep people as safe as possible.

We know that excessive, risky use of anything can be harmful. This is as true for methamphetamine as it is for coffee.

But we also know that decades of the war on drugs condemning drug use as bad - most notably via Nancy Reagan’s ‘Just Say No’ campaign - has not reduced drug use, and in fact rates of use continue to remain stable [3].

IT IS TIME TO LOOK BEYOND PROHIBITION

Harm reduction as a concept isn’t new, but it has often been watered down because it is always discussed and implemented in the context of prohibition. If we are to truly have an impact with harm reduction initiatives, they must be incorporated into a wider policy of harm minimisation.

We have seen positive results in countries like Portugal, whose groundbreaking 2001 drug law reforms have been referred to ever since as a successful model of decriminalisation. But that’s not all they are.

Portugal’s model is a true adherent to harm minimisation. Drug trafficking remains a crime, as part of supply reduction efforts, yet Portugal has used a combination of decriminalisation and a health-centred approach to drug use in order to reduce demand and harms [4]. The results have seen a reduction in levels of drug use to below the European average, particularly amongst youth, decreased rates of harmful and injecting drug use, and decreased rates of HIV and other blood-borne virus (BBV) infections [5]. None of this was achieved with prohibition; in fact, prior to 2001, when its drug laws were much stricter, Portugal was experiencing soaring rates of drug use, overdose, and drug-related infection.

We can use Portugal as an example of supply, demand and harm reduction working successfully within harm minimisation, where they failed under prohibition.

And if we want to look at the USA, a long-time adherent to prohibition, we’re currently witnessing unprecedented levels of harmful drug use, to the point where drug overdose is the leading cause of death for Americans under 50 [].

If we want to know the meaning of the statement “prohibition is ineffective”, comparing Portugal and the USA indicates prohibition to be ineffective on two fronts; it has failed to achieve the goal it claimed to have - reducing drug-related harm - and it has failed to achieve its true goal, reducing drug use.

[1] http://idhdp.com/media/362648/anj524424_rev2-wodak.pdf

[2] http://www.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front5-fa-toc~drugtreat-pubs-front5-fa-secb~drugtreat-pubs-front5-fa-secb-6~drugtreat-pubs-front5-fa-secb-6-1

[3] https://www.unodc.org/unodc/en/frontpage/2015/June/2015-world-drug-report-finds-drug-use-stable--access-to-drug-and-hiv-treatment-still-low.html

[4] http://www.tdpf.org.uk/blog/drug-decriminalisation-portugal-setting-record-straight

[5] http://www.maps.org/news/bulletin/articles/387-bulletin-spring-2015/5671-decriminalization-and-harm-reduction-in-portugal-an-interview-with-dr-jo%C3%A3o-goul%C3%A3o

[6] https://www.nytimes.com/interactive/2017/06/05/upshot/opioid-epidemic-drug-overdose-deaths-are-rising-faster-than-ever.html?mcubz=0







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