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Drug Policy After the War

March 28, 2013
Safe injecting

Reuters

The “war on drugs” has failed, that much is clear, but what should replace it remains a subject of intense debate in the United States and around the world. In the U.S., a powerful voice arguing in favour of alternative approaches to current drug policy is the Drug Policy Alliance. The DPA seeks policy solutions that “reduce the harms of both drug use and drug prohibition” while “promoting safety and upholding the sovereignty of individuals over their own minds and bodies”. OpenCanada.org spoke to DPA Executive Director Ethan Nadelmann about the state of drug policy reform within and outside the U.S., and whether a new global approach to drugs is on the horizon.

Tell us about your motivation for founding the Drug Policy Alliance.

I’ve been passionate about this issue and convinced of the absurdity of the drug war since I was in college. I began to study and write about it in graduate school, first at Harvard and then while teaching at Princeton. I think the motivation to found the DPA was two-fold —my realization that there was a gap between what academic scholarly literature told you about drugs and drug policy and what the political system and the public believe; and my sense that what the world needed was not huge amounts of new research but the capacity to take that research out of the library stacks and use it in a way that would result in real political action. Then, it was my good fortune to one day get a phone call from George Soros inviting me to lunch. We hit it off, and I ultimately ended up being able to secure the resources and the partnership necessary to turn my ideas into meaningful political advocacy.

Considerable political resistance remains in the United States to implementing the types of approaches that the DPA advocates for such as legalizing cannabis, decriminalizing the possession of small amounts of narcotics, and legal access to illicit drugs for medical patients. Where is this resistance concentrated? 

The extent of the political resistance depends a lot upon the issue. There has been a remarkable transformation in public opinion on the marijuana issue – you now have a slight majority of Americans in favor of the regulation of marijuana. There is continuing opposition from law enforcement, even though many of them privately know the whole thing is ridiculous, which reflects the lack of a tradition of former police officials speaking their minds and engaging freely in the public debates on de-criminalization.

Another problem is inertia. People are just used to this stuff being illegal. The contrast to when we repealed alcohol prohibition in the U.S. in 1933 was that most Americans could remember when alcohol had been legal, so the notion of repealing prohibition wasn’t a jump into the unknown – it was an issue of going back to the way things were before but in a smarter, better way. Few people alive today can remember when marijuana was legal. The Washington and Colorado initiatives on marijuana are all the more striking for being real jumps into the unknown.

Another source of resistance is the prison system.  We’ve gone from 50,000 people locked up for drug charges in the 1980s to half a million today – clear evidence that the prison industrial complex or the drug prohibition enforcement complex is a massive part of the problem. The role that prosecutors and district attorneys play in the American adversarial criminal justice system is a huge part of this complex, and of the problems it creates. These individuals are drunk with power and are persistent advocates not just for tough sentencing, but also for filling prisons and keeping harm reduction policies on the sidelines.

A final source of resistance can be found when you look at what’s happening in parts of Europe and Latin America where there is growing support for the decriminalization and public health-centred approaches. While other countries may envy the United States’ dynamic marijuana reform policies and the transformation of public opinion, especially in tandem with the movement on gay rights and gay marriage, they don’t envy our approach to dealing with the few million people that are users or addicts with heroin, cocaine, or methamphetamines. We don’t have the same tradition of linking public health concerns and human rights that they do in places in Latin America and Europe, and to a lesser extent, Canada and Australia.

Those are serious sources of resistance to implementing alternative drug policy approaches in the United States. Globally, however, the trend does seem to be toward adopting health-centered policies. Does the available evidence suggest that this is the right path for drug policy reform to take?

If we look globally, there are three dynamic players on drug policy reform. The first is the Dutch, who led the way on the quasi-legalization of cannabis, that is the legalization of the retail but not the wholesale markets. The Dutch also had a pioneering role in harm reduction. When they saw HIV spreading among injecting drug users 30 years ago, they didn’t hesitate in implementing initiatives to get dirty needles off the streets.

The Swiss are next. Beginning in the early 90s, they were burnt out from chasing drug dealers and users all around town. They experimented with needle parks, but these stopped working well after a year or so. Then they tried the heroin maintenance approach: they provided clinics where people could get pharmaceutical grade heroin as well as all the other services that you would get in a good treatment program. They also played a pioneering role in safe-injection sites – they were the first to do this on a research basis. They later expanded it via local referendums, gradually taking it to the national level. The Germans, the Dutch, the English, and the Canadians followed suit.

The third country to make a serious impact was Portugal. Almost no one paid attention when the Portuguese passed the law ending the criminalization of possession, and declared that drug problems should be treated entirely outside the criminal justice system expect for the initial police stop. After ten years, a couple of evaluations came out. The first was by the Cato Institute, which emphasized decriminalization and its success. A second study by two scholars from the U.K. and Australia followed, which concluded that the success was due to combining decriminalization with a commitment to a public health approach. They looked at the data and found that overall, the number of people using drugs illegally in Portugal had only shifted slightly downwards but that all the negative consequences – fatalities, HIV/Hepatitis C transmission – had gone down. A serious reallocation of resources in the direction of public health had enabled Portugal to deal with addiction seriously.

Portugal’s economy is in such deep trouble now that it’s hard to say whether they can sustain this approach. Regardless, they tested a model and showed that it is worth pursuing. Their experience is something the DPA is committed to teaching people about it because it poses a fundamental policy and ethical challenge to the American model of dealing with drug addiction. Our assumption these days is that if you’re addicted to illegal drugs, the best and only way to get you clean is via the threat of criminal sanction, incarceration, probation, parole, and drug testing; essentially, by punishing you for having a disease. The Portuguese model is more effective at minimizing the individual and societal harms of drug addiction without relying on coercion. When you have that kind of evidence, what basis is there for persisting with the U.S. model? The approaches that these three countries have experimented with have been key to encouraging reforms around the world. When we set up the DPA in the 90s, the principle initiative was to educate Americans about what’s worked outside the United States, so that we can learn what might work at home.

When you look outside the U.S. to the various policy reforms being tested and implemented around the world, do you see the makings of a new, more health-centred, global drug policy?

What’s going on in Latin America is extraordinary. Former presidents are entering public policy debates on drugs and breaking the decriminalization taboo. Uruguay’s president is in the news for proposing the legalization of marijuana (although they’ve been using the Portuguese approach to decriminalization for years). We are seeing more and more people thinking about drug use through a human rights lens and speaking out in favour of this publicly. We are seeing judicial decisions in Argentina, Columbia, and elsewhere that say there is a constitutional imperative to enact policy reforms in line with human rights.

The bigger challenges are in Asia and Africa. Most of these governments are not on health-centred policy trajectories. West Africa seems determined to follow in the footsteps of Central America. Narco-states are developing. We see very little in the way of harm reduction. Asia is a bit more encouraging, even if the overall approach to drug use is highly punitive and moralistic. Indonesia, Malaysia, China, Vietnam, and Iran all have legal needle exchange programs, even though they operate in fairly repressive environments. But there’s no human rights language whosoever in these policies in Asia, and no linking of human rights to public health. So, there is some evolution, but from the DPA’s perspective, more regions have to progress before we can think about driving alternative approaches at the global level.

The United Nations General Assembly is scheduled to hold a drug policy summit in 2016.  Can the UN play a role in encouraging alternative approaches to dealing with drugs?

The discussion in 2016 is a significant opportunity. There is growing awareness in and outside the offices of the UN that the way in which the UN drug control conventions are being interpreted by the INCB (International Narcotics Control Board) is out of step and sometimes in conflict with other conventions involving health and human rights. In my opinion, the INCB should be abolished­ – it is archaic and has no intellectual standing or legitimacy left. International consciousness of its deficiencies is growing. Helen Clarke, former prime minister of New Zealand and current head of the United Nations Development Program, recently came out with a powerful statement about the harms of criminalization and the need for new approaches. The UN will not lead on transforming the way in which the international community approaches drugs, but it will, in time, help to legitimize the reform that takes place, just as it has helped to legitimize a criminal-sanction based approach for the past few decades.

 

Listen to Ethan Nadelmman’s talk The Rise and Fall of the Global Drug Prohibition Regime, part of the F. Ross Johnson-Connaught Speaker Series: