Sunday, March 25, 2007

Why not a drug policy just like our anti-smoking efforts?

What if we treated other problem drugs like tobacco?
The province’s latest move to ban smoking in enclosed public spaces was a reminder of how successful we’ve been in dealing with tobacco use.
Watch an old movie and everybody is smoking. Even 20 years ago, people smoked at work, in bars. The people who asked for the non-smoking rooms in hotels were kind of weird and often disappointed.
Smoking was still cool and socially acceptable.
But we decided smoking was bad - addictive, gives you cancer and a brace of other illnesses.
Taxes made it more and more expensive, until it got hard to deny you were hooked. Not many people would happily spend $60 a week unless there was addiction involved.
Life insurance cost more. You couldn’t smoke at work. Restaurant smoking areas kept shrinking. People started to talk more and more about the fact that 40 per cent of hospitalizations are smoking-related.
And then, finally, there was another big shift. Smoking became largely a mark of loserdom. Not entirely - tautly wounded artists and blues performers still get away with it. But broadly, smokers are people you would be less likely to hire.
In a relatively short time, we took a deadly drug that was almost completely accepted, used by a majority of adults and highly addictive, and slashed its use.
We could have made tobacco illegal, like drugs, 20 years ago. But we chose a different approach - managed use, with education and financial penalties to decrease smoking.
And it’s worked quite well.
So why not try the same approach with drugs, or at least some of them?
What if we say heroin and cocaine are like tobacco - things we really wish people wouldn’t use, but that we still accept some probably will.
Under that approach we would commit a lot of resources to making sure people didn’t start, as we did with smoking. We’d target kids, but also vulnerable adults.
We’d make a big effort to help people quit.
And for people who wanted to keep using, we would prescribe heroin or cocaine or working substitutes they could pick up at a clinic. (The current half-hearted, restrictive methadone program really doesn’t count.)
What are the downsides? It feels wrong to provide a drug like cocaine to people, for one thing. You could argue that others - young people - might see the practice as condoning drug use. (Though we’ve managed to allow controlled sale of tobacco products while condemning its use.)
Against those are negatives, look at what we would gain.
The people being prescribed drugs wouldn’t have to stealing to get the money to buy them. Police estimate up to 90-per-cent of break-ins and thefts are drug-related.
Organized criminals would lose a huge market. There would still be demand, but not enough to make the business so attractive.
Instead of spending their days and nights scrambling for money and drugs, users would have time to think about work and developing more stable lives.
Based on similar efforts in other countries, a significant number would seek treatment. During a prescribed heroin trial in Switzerland, not only did crime by users plummet but about seven per cent quit during their time in the program.
Since people wouldn’t be using in alleys and dodgey settings, we’d save a fortune in health costs.
People with both mental health problems and addictions would get a chance to reduce the chaos their lives and deal with their mental illness.
And all the while we’d follow the path set by the anti-smoking campaign.
About 55 per cent of adults smoked in 1965, compaed witrh 15 per cent in B.C. today. Only about two per cent of Canadians are heroin and cocaine users. If we could make the same relative gains, the number of addicts would be tiny.
That’s a long list of benefits, with few costs.
Yet we push on with tactics and strategies that have failed to deal with prohibited substances for almost a century. We fight to reduce supply, unsuccessfully, and create crime and chaos and costs.
For whatever reason, we tried something different with tobacco. Maybe the big companies had too much clout for prohibition to be tried, or there were just too many smokers. But we didn’t ban cigarettes or arrest people. We worked on reducing demand.
And it worked. Why not for other drugs?


Anonymous said...

Our New canadian Government is doing their hardest to screw up the safe injection site. They are passing around some study from the UN that they say are making us look bad. The UN has a lot of sub committees but I notice they have litle to say about the poppy crops in aphganistan and other sources of a lot of junk.

Anonymous said...

Paul, I don't think that your proposal would lead to any significant reduction in drug use. Our policies on tobacco use have worked by making it more and more difficult for people to smoke. At this point, only the most clueless and most recalcitrant continue to use tobacco. In the case of illegal drugs, the prohibitions are already at the point where the desire to use the drugs must outweigh utterly draconian penalties (legal, economic, social, and otherwise.) What you're proposing would loosen off those penalties. We could possibly get more people off drugs by offering them an easier way out, but I'd suggest that there are a lot of the reason that a drug addict becomes a drug addict is because of the person.