The United Nations on Drugs: Alice in Wonderland Revisited

The most recent edition of The Guardian Weekly, a typically “progressive” news outlet, devoted a full page to the wildly speculative musings of Antonio Maria Costa, the outgoing director of the United Nations Office on Drugs and Crime.

Mr. Costa made three key claims, none of which have any compelling empirical support. First, he argued that making illegal drugs more freely available will lead to more “public health damage”.

But we have made tobacco more available to North Americans during the past 40 years, simply through increased urbanization and the consequent proliferation of retail outlets which sell the drug. And in the face of this increased availability, use has fallen dramatically. In Canada almost 60 per cent of adults smoked tobacco in the mid 1960s; today the figure sits at about 25 per cent, the consequence of aggressive public health education, and widespread support for non smokers’ rights initiatives. Criminal prohibition was not a part of the strategy.

Similarly, while adult cannabis use in the Netherlands is not penalized (in marked contrast to the UK, Canada and the United States), the Dutch rates of consumption are actually much lower than ours. Put differently, there is greater availability for potential users, without fear of harassment, and yet both Dutch youth and Dutch adults are much less likely to consume than the citizens of the UK, Canada and the United States.

Mr. Costa’s second point was that  “There are no ideological debates about curing cancer, so why so much politics in dealing with drug addiction”. It is bizarre to suggest that the voluntary consumption of mind-active drugs such as alcohol and marijuana is in any way analogous to an unwanted diagnosis of cancer. The best available data indicate that the overwhelming majority of consumers of these two substances do not become physically or psychologically dependent, nor do they suffer potentially life-threatening illnesses as a result of their use. Indeed, most consumers of both alcohol and cannabis view their consumption as consistent with good health and the enjoyment of a satisfying life.

Mr. Costa’s third point was tiresome and fundamentally wrong. He suggested that tobacco kills five million human beings every year, alcohol two million and illicit drugs about 200,000, and then went on to indulge in fear-mongering: to presume that with fewer controls the death toll from illegal drugs will skyrocket.

The problem that he faces, aside from the better data that contradict his claim, is that when we take rates of consumption into account, the loss of life from cannabis is insignificant, in contrast to the premature death caused by alcohol and tobacco abuse.  It’s just not as dangerous a drug, at least for most users in most circumstances – and it is, overwhelmingly, the most popular of all illegal drugs.

Yes, public health should be our agenda for drug control. But we must remember that the line between legal and illegal drugs has nothing to do with public health and everything to do with the global political, cultural and social history of the past century. We should be creating policies that are specific to each drug, not pretending that illegal drugs are a category apart. In the realm of the illegal, heroin, cocaine, and marijuana all produce quite different risks, in part as a result of dose and method of ingestion, and in part because of the physical consequences of their different pharmacologies.

The continuation of criminal prohibition is not the answer. We can demonstrate that rates of consumption of a drug as lethal and addictive as tobacco can be reduced without resorting to criminalization. Why are we continuing to waste costly police and enforcement resources on a drug as trivial as cannabis?

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