3. The development and implementation of drug policies should be a global shared responsibility, but also needs to take into consideration diverse political, social and cultural realities. Policies should respect the rights and needs of people affected by production, trafficking and consumption, as explicitly acknowledged in the 1988 Convention on Drug Trafficking.
The UN drug control system is built on the idea that all governments should work together to tackle drug markets and related problems. This is a reasonable starting point, and there is certainly a responsibility to be shared between producing, transit and consuming countries (although the distinction is increasingly blurred, as many countries now experience elements of all three).
However, the idea of shared responsibility has too often become a straitjacket that inhibits policy development and experimentation. The UN (through the International Narcotics Control Board), and in particular the US (notably through its ‘certification’ process), have worked strenuously over the last 50 years to ensure that all countries adopt the same rigid approach to drug policy – the same laws, and the same tough approach to their enforcement. As national governments have become more aware of the complexities of the problems, and options for policy responses in their own territories, many have opted to use the flexibilities within the Conventions to try new strategies and programs, such as decriminalization initiatives or harm reduction programs. When these involve a more tolerant approach to drug use, governments have faced international diplomatic pressure to ‘protect the integrity of the Conventions’, even when the policy is legal, successful and supported in the country.
A current example of this process (what may be described as ‘drug control imperialism’), can be observed with the proposal by the Bolivian government to remove the practice of coca leaf chewing from the sections of the 1961 Convention that prohibit all non-medical uses. Despite the fact that successive studies have shown19 that the indigenous practice of coca leaf chewing is associated with none of the harms of international cocaine markets, and that a clear majority of the Bolivian population (and neighboring countries) support this change, many of the rich ‘cocaine consumer’ countries (led by the US) have formally objected to the amendment.20
The idea that the international drug control system is immutable, and that any amendment – however reasonable or slight – is a threat to the integrity of the entire system, is short-sighted. As with all multilateral agreements, the drug conventions need to be subject to constant review and modernization in light of changing and variable circumstances. Specifically, national governments must be enabled to exercise the freedom to experiment with responses more suited to their circumstances. This analysis and exchange of experiences is a crucial element of the process of learning about the relative effectiveness of different approaches, but the belief that we all need to have exactly the same laws, restrictions and programs has been an unhelpful restriction.
The implementation of the war on drugs has generated widespread negative consequences for societies in producer, transit and consumer countries. These negative consequences were well summarized by the former Executive Director of the United Nations Office on Drugs and Crime, Antonio Maria Costa, as falling into five broad categories:
- The growth of a ‘huge criminal black market’, financed by the risk-escalated profits of supplying international demand for illicit drugs.
- Extensive policy displacement, the result of using scarce resources to fund a vast law enforcement effort intended to address this criminal market.
- Geographical displacement, often known as ‘the balloon effect’, whereby drug production shifts location to avoid the attentions of law enforcement.
- Substance displacement, or the movement of consumers to new substances when their previous drug of choice becomes difficult to obtain, for instance through law enforcement pressure.
- The perception and treatment of drug users, who are stigmatized, marginalized and excluded.21
4. Drug policies must be pursued in a comprehensive manner, involving families, schools, public health specialists, development practitioners and civil society leaders, in partnership with law enforcement agencies and other relevant governmental bodies.
With their strong focus on law enforcement and punishment, it is not surprising that the leading institutions in the implementation of the drug control system have been the police, border control and military authorities directed by Ministries of Justice, Security or Interior. At the multilateral level, regional or United Nations structures are also dominated by these interests.
Although governments have increasingly recognized that law enforcement strategies for drug control need to be integrated into a broader approach with social and public health programs, the structures for policymaking, budget allocation, and implementation have not modernized at the same pace.
These institutional dynamics obstruct objective and evidence-based policymaking. This is more than a theoretical problem – repeated studies22,23 have demonstrated that governments achieve much greater financial and social benefit for their communities by investing in health and social programs, rather than investing in supply reduction and law enforcement activities. However, in most countries, the vast majority of available resources are spent on the enforcement of drug laws and the punishment of people who use drugs.24
The lack of coherence is even more marked at the United Nations. The development of the global drug control regime involved the creation of three bodies to oversee the implementation of the conventions – the UN Office on Drugs and Crime (UNODC), the International Narcotics Control Board (INCB), and the Commission on Narcotic Drugs (CND). This structure is premised on the notion that international drug control is primarily a fight against crime and criminals. Unsurprisingly, there is a built-in vested interest in maintaining the law enforcement focus and the senior decisionmakers in these bodies have traditionally been most familiar with this framework.
Now that the nature of the drug policy challenge has changed, the institutions must follow. Global drug policy should be created from the shared strategies of all interested multilateral agencies – UNODC of course, but also UNAIDS, WHO, UNDP, UNICEF, UN Women, the World Bank, and the Office of the High Commissioner on Human Rights. The marginalization of the World Health Organization is particularly worrisome given the fact that it has been given a specific mandate under the drug control treaties.
1. Break the taboo. Pursue an open debate and promote policies that effectively reduce consumption, and that prevent and reduce harms related to drug use and drug control policies. Increase investment in research and analysis into the impact of different policies and programs.25
Political leaders and public figures should have the courage to articulate publicly what many of them acknowledge privately: that the evidence overwhelmingly demonstrates that repressive strategies will not solve the drug problem, and that the war on drugs has not, and cannot, be won. Governments do have the power to pursue a mix of policies that are appropriate to their own situation, and manage the problems caused by drug markets and drug use in a way that has a much more positive impact on the level of related crime, as well as social and health harms.
2. Replace the criminalization and punishment of people who use drugs with the offer of health and treatment services to those who need them.
A key idea behind the ‘war on drugs’ approach was that the threat of arrest and harsh punishment would deter people from using drugs. In practice, this hypothesis has been disproved – many countries that have enacted harsh laws and implemented widespread arrest and imprisonment of drug users and low-level dealers have higher levels of drug use and related problems than countries with more tolerant approaches. Similarly, countries that have introduced decriminalization, or other forms of reduction in arrest or punishment, have not seen the rises in drug use or dependence rates that had been feared.
DO NOT RESULT IN SIGNIFICANT INCREASES IN DRUG USE
In July 2001, Portugal became the first European country to decriminalize the use and possession of all illicit drugs. Many observers were critical of the policy, believing that it would lead to increases in drug use and associated problems. Dr. Caitlin Hughes of the University of New South Wales and Professor Alex Stevens of the University of Kent have undertaken detailed research into the effects of decriminalization in Portugal. Their recently published findings26 have shown that this was not the case, replicating the conclusions of their earlier study27 and that of the CATO Institute28.
Hughes and Stevens’ 2010 report detects a slight increase in overall rates of drug use in Portugal in the 10 years since decriminalization, but at a level consistent with other similar countries where drug use remained criminalized. Within this general trend, there has also been a specific decline in the use of heroin, which was in 2001 the main concern of the Portuguese government. Their overall conclusion is that the removal of criminal penalties, combined with the use of alternative therapeutic responses to people struggling with drug dependence, has reduced the burden of drug law enforcement on the criminal justice system and the overall level of problematic drug use.
Comparing Dutch and US Cities
A study by Reinarman, et. al. compared the very different regulatory environments of Amsterdam, whose liberal “cannabis cafe” policies (a form of de facto decriminalization) go back to the 1970s, and San Francisco, in the US, which criminalizes cannabis users. The researchers wished to examine whether the more repressive policy environment of San Francisco deterred citizens from smoking cannabis or delayed the onset of use. They found that it did not, concluding that: “Our findings do not support claims that criminalization reduces cannabis use and that decriminalization increases cannabis use… With the exception of higher drug use in San Francisco, we found strong similarities across both cities. We found no evidence to support claims that criminalization reduces use or that decriminalization increases use.”29
The state of Western Australia introduced a decriminalization scheme for cannabis in 2004, and researchers evaluated its impact by comparing prevalence trends in that state with trends in the rest of the country. The study was complicated by the fact that it took place in a period when the use of cannabis was in general decline across the country. However, the researchers found that this downward trend was the same in Western Australia, which had replaced criminal sanctions for the use or possession of cannabis with administrative penalties, typically the receipt of a police warning called a ‘notice of infringement’. The authors state:
“The cannabis use data in this study suggest that, unlike the predictions of those public commentators who were critical of the scheme, cannabis use in Western Australia appears to have continued to decline despite the introduction of the Cannabis Infringement Notice Scheme.”30
Comparisons Between Different States in the US
Although cannabis possession is a criminal offense under US federal laws, individual states have varying policies toward possession of the drug. In the 2008 Report of the Cannabis Commission convened by the Beckley Foundation, the authors reviewed research that had been undertaken to compare cannabis prevalence in those states that had decriminalized with those that maintained criminal punishments for possession. They concluded that:
“Taken together, these four studies indicated that states which introduced reforms did not experience greater increases in cannabis use among adults or adolescents. Nor did surveys in these states show more favorable attitudes towards cannabis use than those states which maintained strict prohibition with criminal penalties.”31
In the light of these experiences, it is clear that the policy of harsh criminalization and punishment of drug use has been an expensive mistake, and governments should take steps to refocus their efforts and resources on diverting drug users into health and social care services. Of course, this does not necessarily mean that sanctions should be removed altogether – many drug users will also commit other crimes for which they need to be held responsible – but the primary reaction to drug possession and use should be the offer of appropriate advice, treatment and health services to individuals who need them, rather than expensive and counterproductive criminal punishments.
3. Encourage experimentation by governments with models of legal regulation of drugs (with cannabis, for example) that are designed to undermine the power of organized crime and safeguard the health and security of their citizens.
The debate on alternative models of drug market regulation has too often been constrained by false dichotomies – tough or soft, repressive or liberal. In fact, we are all seeking the same objective – a set of drug policies and programs that minimize health and social harms, and maximize individual and national security. It is unhelpful to ignore those who argue for a taxed and regulated market for currently illicit drugs. This is a policy option that should be explored with the same rigor as any other.32
If national governments or local administrations feel that decriminalization policies will save money and deliver better health and social outcomes for their communities, or that the creation of a regulated market may reduce the power of organized crime and improve the security of their citizens, then the international community should support and facilitate such policy experiments and learn from their application.
Similarly, national authorities and the UN need to review the scheduling of different substances. The current schedules, designed to represent the relative risks and harms of various drugs, were set in place 50 years ago when there was little scientific evidence on which to base these decisions. This has resulted in some obvious anomalies – cannabis and coca leaf, in particular, now seem to be incorrectly scheduled and this needs to be addressed.