A new drug policy for the 21st Century

The War on Drugs has caused immeasurable harm. We need to tackle drug abuse like a public health issue, writes Natalie Sharples.

August 18, 2018
11 min read

Photo: Mary Crandall, Flickr

Canada’s historic vote to legalise cannabis is yet another nail in the coffin of the ‘so called’ War on Drugs, conceived in the 70s by  President Nixon. ‘So called’ because it was deliberately conceived to obscure what it really was: not a war on substances at all but a war on black people and the anti-war left. As John Ehrlichman, an advisor to Nixon told journalist Dan Baum in 1994  “We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalising both heavily, we could disrupt those communities.”

Like many 70s throwbacks, the racist legacy of the war on drugs lives on. Black and Minority Ethnic communities continue to be disproportionately targeted by, and suffer as a result of the enforcement of harmful drug laws. In the UK and the US young people from black and Asian communities are far more likely to be charged with drug offences, despite similar levels of use as the rest of the population.  In London, black people are charged with possession of cannabis five times more often than their white peers.

As was Nixon’s intention, criminalisation and prohibition affects the marginalised the most. People in already vulnerable situations are sometimes forcibly coerced into participating in illicit drug markets, and the consequent criminalisation they face locks them into poverty and can inhibit their access to social services and employment opportunities.

Prohibition and enforcement is bad for public health. Not only has it completely failed to prevent drug use –  last year, 2.1 million people aged 16-59 in England and Wales used cannabis – but as drugs are completely unregulated anyone can buy them, including children. When they do, they have no idea what they contain or their strength.  It’s like going to a pub where any one of any age can order a pint – and they would not know if they were getting a pint of beer, wine or vodka. It also means there is no way to stop the use of adulterants and or heavy metals, pesticides or other harmful products that sometimes make it into the final product. Even if the war on drugs had set out to do what Nixon claimed, or to create ‘a drug free world’ which today remains the stated goal of global drug policy, even on its own terms it would have failed spectacularly.

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The harmful impacts of the war on drugs are not restricted to communities in the UK and US. Imagine being a small, subsistence farmer growing coca or opium poppy as the only source of your family’s income. Imagine then watching as your crops and therefore your family’s security, are destroyed in minutes, by a government crop eradication programme. The loss of income from eradication pushes families further into poverty, making it harder for them to access healthcare or buy food, creating a vicious cycle in which they are increasingly dependent on cultivating drug-linked crops to counter the poverty they are pushed into by eradication.

The war on drugs is often frighteningly literal. It has bred an arms race that has resulted in hundreds of thousands – if not millions – of unnecessary deaths, as cartels struggle for territory and markets in increasingly volatile places. In Mexico alone 23,000 people were murdered in 2016 as a result of this war on drugs.  It remains a key – although often unacknowledged – factor in the current staggering numbers of killings surrounding the country’s elections.

Strict drug laws have further unintended consequences. Some opioid medicines come from the same family as heroin. This means that governments can make morphine unavailable for those in severe pain. As a result of these policies, 90% of AIDS patients and 50% of cancer patients living in low and middle income countries, have access to just 6% of the morphine used globally for pain relief. A similar thing happens with  Ketamine – an essential anaesthetic used in resource-poor settings – which is also at risk of being placed under strict restrictions stemming from prohibition.

There are many other negative impacts of the war on drugs. From the environmental damage caused by crop eradication to the incarceration of women who  disproportionately find themselves locked up for low level drug offences. It is also a staggering waste of money. The cost of enforcing the war on drugs is at least $100 billion a year. This rivals the size of the global aid budget (about $130 billion). If redirected, that money could help provide healthcare, education and clean water to people across the world. It’s important to emphasize that this figure is for enforcement alone. If were drugs were regulated, controlled and taxed the figure could be mind-blowing.

Approaching half a century after it was first conceived, time is finally running out for this failed war. Across the world countries and jurisdictions are waking up to the harms of prohibition and taking an alternative track. From Portugal, which decriminalised all drugs in 2001, to Bolivia whose innovative approach implemented in collaboration with grower’s unions, allows farmers to grow allotted amounts of coca to maintain their livelihoods.

On cannabis especially the shift is even clearer. Uruguay was the first country to bring in a recreational market in 2013, moving to legalised cultivation in 2014, and last year became the first country in the world where its sale is legal across the entire territory. Spain has decriminalised cannabis for personal use and allows non-profit ‘cannabis social clubs’ to produce cannabis for their members. The Netherlands has also decriminalised, and has a de facto legal cannabis market through the ‘coffee shop’ system – although in this system the production of cannabis remains illegal and it is still necessarily sourced from the criminal market.

What is perhaps more surprising is that despite the US being the ostensible leader of the ‘war on drugs’, US states have been among those at the forefront of this move. Nine US states have now legalised cannabis for recreational purposes – and the results so far are generally positive: confounding critics whilst bringing in additional tax income to fund public services.     

This is just the start: the Canadian government’s bill to legalise recreational cannabis is currently going through the house, making it the first G7 country to legalise cannabis. It will shortly be followed by New Zealand, which is set to hold a referendum on legalising cannabis in the next few years.

Whilst the ranks of reformers are growing rapidly, no leader has yet acknowledged the inequities of the War on Drugs quite as eloquently as Prime Minister of Antigua & Barbuda, Gaston Browne.  In his recent ground-breaking speech he called out the purpose of prohibition to “serve the racist, political and economic interests of the global powers at that time” as he apologised to the Rastafarian community for its impacts, and called for reparations for the harm inflicted upon them.

The myth of the war on drugs has been well and truly shattered. We now need to build an approach fit for the 21st century

So what needs to happen?

Moving from prohibition to regulation prompts many trade-offs and considerations, such as how to balance priorities between collecting the maximum tax revenue, decimating the illegal market and public health. The most important thing is to ensure public health is at the forefront of considerations.

First, we need to put drug policy in the hands of people with the expertise and mandate to prioritise health and harm reduction. That means moving responsibility for drug policy to the Departments of Health and International Development.

Second, we need to ensure better access to harm reduction services and decriminalise the possession of all drugs for personal use in the UK. This will ensure people have adequate access to treatment, support, and harm reduction services, including opioid substitution treatment, supervised consumption spaces and needle and syringe exchanges. It will reduce the stigma attached to drug use and the threat of criminalisation, removing further barriers people who use drugs face in accessing the services they need.

A third step is to legalise and regulate the UK cannabis market. As cannabis is significantly less harmful than many other drugs, it makes sense to move to a fully regulated legal market now, like those in alcohol and tobacco. Legalising and regulating cannabis will enable the government to control the cannabis trade – ensuring benefits for public health, vulnerable communities and society. It will free up police resources, enable us to regulate and inform people about the strength of cannabis and reduce its use by young people. What’s more, it will also generate tax revenues to fund vital public services – at least 1 billion annually for the NHS, or put in other terms, enough to pay for every midwife in England, with money left over to fund drug education, harm reduction and mental health services. The first step in doing this will be to bring together people who use cannabis with experts, and decision makers to decide on the outcomes we want and how to measure them and then establish a Cannabis Regulatory Authority to implement them.

The UK also must play a role in  righting the wrongs of the war on drugs globally. A key first step will be to align drug policy with the Sustainable Development Goals, the global framework for sustainable development. Whilst the goals are problematic, their global recognition and endorsement means they provide a key framework around which to raise the profile of drug policy as an issue impeding efforts to reduce poverty and poor health around the world. In particular we need new metrics to measure drug policy that are aligned with the Goals.  

There is also  a strong case that some of the aid budget should be used to right the wrongs of prohibition globally. Progressive aid spending could include supporting evidence-based policy and innovation globally to establish drug policies that improve people’s health and human rights. Evidence from around the world – including from previous programmes funded by UK aid – show that harm reduction initiatives significantly improve the health and welfare of people who use drugs, particularly when accompanied by de-criminalisation. As well as funding such programmes, DFID should also drive innovation by funding and supporting countries seeking to establish legal regulation systems, or innovative new programmes like the coca control programme in Bolivia, and fund research with affected communities at national and local levels to drive innovation and evidence the impact of programmes and policies.

Most importantly the UK must use its political power to support countries who want to move away from prohibition. Countries in the global South seeking to explore new approaches have come under international pressure or even faced the risk of sanctions from more powerful members of the international community. As soon as it gets its own house in order, the UK government has an important role to play internationally in championing any progressive initiatives that exchange failed models of prohibition for legalisation, particularly in countries most affected by prohibition.

This is an idea whose time has come. Whilst we might wait a long time for our government to utter such powerful words as those spoken by Gaston Browne, the question of reform is when, not if. It’s time to  champion an approach that works for people and public health.

Natalies Sharples is Head of Policy and Campaigns at Health Poverty Action and is a member of the Labour International Development Task Force.