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Pike, Brigid (2012) To prohibit or not to prohibit – that is no longer the question. Drugnet Ireland, Issue 41, Spring 2012, pp. 7-8.

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In the past two decades drug policy researchers have sought to move away from the polarised, and increasingly unproductive, debate between those supporting the prohibition of psychoactive substances under the UN conventions and those arguing for legalisation, or some form of decriminalisation. Some of the key themes highlighted by these researchers are outlined below.1 

Acknowledge the complexity
As long ago as 1993, Mark Kleiman argued that debates about prohibition versus legalisation or treatment versus enforcement represent deeply held beliefs about human nature and the human good, which could not be ignored, but that more attention to practical detail would improve the discussion.2 He emphasised the complexity of the issue: there is a large variety of psychoactive substances (including alcohol and tobacco), drug users and drug use settings, and a wide range of policy response options, including laws and programmes, and between them they result in a potentially infinite variety of outcomes. He concluded: ‘Public policy toward drugs involves so many unknown, almost unknowable facts and so many complicated issues of value that any certainty about which of two alternative policies is the better is likely to be misplaced.’ (Chapter 13).
 
More recently Robin Room and Peter Reuter,3 discussing whether or not international drug conventions protect public health, concluded: ‘The cultural positions of different drugs vary enough to preclude universal policies on how to deal with all illicit or indeed licit drugs. From the perspective of public health, we need to move towards a control system that is more aligned with the risks that different drugs pose to users and shows an understanding of the effects of different regulatory approaches on drug use and harm.’ (p. 90)
 
Focus on harm rather than evil
Reviewing the arguments in favour of prohibition and legalisation respectively, Robert MacCoun and Peter Reuter concluded that the prohibitionist arguments were significantly less complex than the opposing arguments, and that it was this very complexity that had served to polarise the debate.4 They argued, moreover, that this allegiance to ‘prevalence reduction’, and the notion that the only defensible goal for drug policy is to reduce the number of users, hopefully to zero, had prevented two more moderate strategies from receiving serious attention from the political mainstream – ‘quantity reduction’ (reducing the quantity consumed by those who continue to use drugs) and ‘harm reduction’ (reducing the harmful consequences of drug use when it occurs).
 
Maximise the public good
Six experts in the drug policy field have devised a tool to help policy makers to organise the major public drug policy options in terms not only of their ‘effectiveness’, e.g. in terms of individual benefit, but also their potential to maximise the ‘public good’.5 The ‘public good’ is defined as ‘social benefits such as better public health, reduced crime, and greater stability and quality of life for families and neighbourhoods’.

 

The effect of drug policy options on the public good and individuals (Strang et al. 2012: p. 79)

The authors argue that this tool, comprising a four-tiered pyramid of policy options, is useful in the identification of interventions, even though the specific problems and the most appropriate type of interventions will vary over time and between societies and geographical locations. They comment: ‘A comprehensive public policy approach would implement evidence-based measures at each level of intervention and maximise the synergy between these levels. Long-term benefits of these policies would thus increase for whole communities as well as for individuals.’ (p. 80)
 
Shift the goalposts
British drug policy researchers have recently explored how drug policy makers might improve the likelihood of achieving desired policy outcomes by reviewing the prevailing paradigms and considering a change in the aims and objectives of drug policy accordingly. For example, on the assumption that the control of drugs is related to prevailing conceptions of freedom, Toby Seddon suggests that the drugs problem might be best viewed as a regulation and governance problem. In place of a legislative framework that seeks to use the criminal justice system to reduce or eliminate the use of drugs, he suggests that in a post-modern world characterised by networked and polycentric governance structures, a hierarchy of regulatory interventions might be more appropriate – ranging from ‘persuasion’ at the base, depending on dialogue to secure compliance, to higher levels where interventions become more punitive and demanding, depending on the drug and the context.6 Alternatively, Alex Stevens suggests that drug policy might be addressed within the context of a country’s equality policy, on the grounds that the distribution of drug-related harm is determined as much  by how welfare policy distributes risks and benefits, as by the degree of ‘strictness’ of drug policy.7
 
Acknowledging that the traditional approaches to drug control used in the 20th century are no longer effective, as they are unable to keep pace with the changes in substances and market mechanisms, a new report has called for a new approach to policy making:8
The issue is one of framing. If drug policy is framed as “a war on drugs” then it is either won or lost and requires a level of national sacrifice (wars are won or lost). If it is framed as the “drug problem” then there is an implicit assumption that there is a “solution” (problems have solutions). An alternative way of looking at the issue is to use systems thinking and consider drug policy as a “wicked issue” to which there is no solution, and no winners or losers. Instead, one seeks an improvement to policy that will be supported by people who otherwise disagree about what is wrong and what the goals of policy are. (p. 12)
 
Based on the output from ‘soft-system workshops’ attended by a variety of stakeholders, the authors identified three broad principles for improving drug policy: (1) focus on achieving outcomes where there is consensus, (2) ensure a more balanced decision-making process and debate, and (3) consider other regulatory options for control.
 
1. The authors cited in this article have all participated in annual conferences of the International Society for the Study of Drug Policy (ISSDP). For more information on the ISSDP, see www.issdp.org 
2. Kleiman MAR (1993) Against excess: drug policy for results. New York: Basic Books.
3. Room R and Reuter P (2012) How well do international drug conventions protect public health? The Lancet, 379 (9810): 84–91.
4. MacCoun RJ and Reuter P (2001) Drug war heresies: learning from other vices, times & places. Cambridge: Cambridge University Press.
5. Strang J, Babor T, Caulkins J, Fischer B, Foxcroft D and Humphreys K (2012) Drug policy and the public good: evidence for effective interventions. The Lancet, 379 (9810): 71–83. For an account of a previous study on drug policy and the public good, to which five of these six authors contributed, see Pike B (2010) Using scientific knowledge to inform drug policy. Drugnet Ireland, (34): 11–12.
6. Seddon T (2011) A history of drugs: drugs and freedom in the liberal age. Abingdon: Routledge.
7. Stevens A (2011) Drugs, crime and public health: the political economy of drug policy. Abingdon: Routledge.
8.  Birdwell J, Chapman J and Singleton N (2011) Taking drugs seriously: a Demos and UK drug policy commission on legal highs. London: Demos.
Item Type
Article
Publication Type
Irish-related, International, Open Access, Article
Drug Type
Substances (not alcohol/tobacco)
Intervention Type
Policy
Issue Title
Issue 41, Spring 2012
Date
April 2012
Page Range
pp. 7-8
Publisher
Health Research Board
Volume
Issue 41, Spring 2012
EndNote
Accession Number
HRB (Electronic Only)

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