The smoke and mirrors of prohibition

On Tuesday, a review of 2 decades of research into the effects of cannabis was released and pounced on by the media, who then broadcast the fact that smoking weed is ‘as hard to give up as heroin’, doubles the risk of psychosis and schizophrenia, and acts as a gateway drug into stronger substances. As part of this reefer madness I took part in Sky News debate on whether the UK is too soft on cannabis. Usually, evidence a that prohibited item or action is harmful or more dangerous than previously thought would justify its prohibition. But this isn't the case when it comes to cannabis, or the 'war on drugs' more generally. This is because many of the costs associated with the use and supply of illegal drugs are exacerbated—and sometimes even caused by—the act of prohibition.

Some forward-thinking countries across the globe have experimented with policies of decriminalization and partial legalization. From the legalization of cannabis in Uruguay to the decriminalisation of drugs for personal use in Portugal, each is an example of viable, harm-reducing alternatives to prohibition. Unfortunately, there remains little political will to see such changes in the UK, where the narrative remains  that evidence of harm equals justification for prohibition.

Most advocates of drug control cite health problems caused by drugs and their impact in the wider community as their biggest concern. This explains why Tuesday's report (with stats like '1 in 6 teenagers who regularly smoke cannabis become dependent on it') made such good news fodder. Certainly we have to tackle health problems caused with drug use, but pushing supply underground and criminalizing users has got to be one of the worst ways of doing it.

For example, a key argument against cannabis legalization is that it has grown much stronger over the decades, thanks to the intensive breeding of strains with a high THC content. However, this 'skunkification' can be understood as an effect of prohibition. Given that the punishment for getting caught with x amount of marijuana is the same whatever its potency, dealers have an incentive to source something which is measure for measure stronger, and buyers have the incentive to buy it. Just as liquor replaced beer during prohibition, the bud 'arms race' makes sense within a framework of crude legislation and illegality. There's certainly demand for less potent weed, but given competition between dealers and the fact that suppliers would need to grow and shift bigger volumes to make the same amount of money, there's little incentive to supply it—especially in an industry where there's little capacity to advertise the product.

In contrast, a regulated market can offer anything from mellow hash to super-skunk, as evidenced by a visit to any of Amsterdam's coffeeshops, where information about product, advice on what to expect and stringent quality control are also the norm. Decriminalization and the marketing of less potent strains not only allows users to find what suits them best, but could potentially reduce the harms and mental health issues which have been associated with today's super-strong cannabis.

Risks associated with other drugs are similarly exacerbated by prohibition. In an underground market it's difficult (and expensive) to be exactly sure of what you're purchasing, there's few routes of recourse or warning others, and accidents happen. In the last few years 'ecstasy' pills containing PMA—a compound with similar effects to MDMA but with a far high toxicity—have been poisoning clubbers and were directly responsible for 17 deaths in 2012. In Portugal, the decriminalization of the personal possession of heroin alongside innovative public health programmes has seen the number of new HIV cases amongst intravenous drug users plummet from over 1,000 in 2001 to 56 in 2012, with the total number of drug-related deaths falling from 80 to 16 in the same period.

Whilst drug use will always carry health costs, money raised by taxes on substances like cannabis or MDMA could contribute to the public coffer, and fund research and treatment centres for users. It's also worth putting these harms in perspective; the risk of death from illicit drugs is minuscule in comparison with lack of physical activity or a poor diet. Most recreational drugs are far less harmful to us than alcohol and tobacco—and in the case of ecstasy, apparently no more dangerous than horse riding.  And whilst dependency on a drug is no good thing, dependency alone doesn’t necessitate harm, as the UK's casual caffeine addicts demonstrate.

Source: http://www.nhs.uk/Tools/Pages/NHSAtlasofrisk.aspx

In fact, health isn't really the biggest issue when it comes to drug prohibition—crime is. It is staggering that we continue to expend resources every year maintaining a model which gives an industry worth hundreds of billions of pounds to cartels and criminal gangs who cause violence, fear and instability from Peckham to Michoacan. In fact, one of main reasons Uruguay legalized cannabis this year was to prevent a rise in organised crime there spiralling out of control.

Back home, the Home Office estimates that drug-related crime costs the UK £13.3bn a year. It's thought that between one third and a half of all acquisitive crime in the UK is drug-related, with three-quarters of heroin and crack users admitting to committing crime to fund their habit. However, dispensing with outright prohibition and instead treating addiction as a public health issue before ensnaring addicts in the criminal system can have significant benefits. For example, providing access to drugs like heroin in a controlled manner has been shown to significantly cut the level of crime users commit, and costs far less to fund each year than a prison sentence.

On top of this, the criminalization and subsequent marginalization of casual drug users is a catalyst for further criminality. From school expulsion to a criminal record, the sanctions imposed on individuals lead to lost opportunities and closed doors, particularly for the under-privileged. With other options ruled out, a further life of crime can be the most rational choice for some.

Decriminalizing drug use would also allow police to redirect their time and resources to more effective pursuits than booking stoners and stop and searches. Early indications post-marijuana legalization in Colorado suggest that crime is down 10% over the year and violent crime down 5%, thanks in part to freeing up police time for more serious offences.

There seems little reason for such a harsh and wasteful system as prohibition to still be in force across so much of the world. Of course, prohibitionists are also afraid of the 'normalization' of drug-taking culture and the message this might send (someone does, of course, have to do this). Many genuinely worry that legalization would lead to a spike in drug use, degeneracy and harm. Evidence from places like Portugal (where if anything, drug use has declined) simply hasn't hasn't borne this out, though. In fact, Release's survey of global drug laws concluded that a country's drug-enforcement policies have very little correlation with the levels of drug use and misuse in that country.

Libertarians and the curious can go one further, and ask if it would really be such a bad thing if drug use were to rise post-legalization. Some illegal drugs might make a good substitute for our legal ones: it's feasibly better if some people chose to stay at home and smoke a joint, or pop pills on a night out instead of drinking a bottle of vodka, scoffing kebabs and getting in fights. And there's also the important fact that's often overlooked in the 'sensible' drugs debate: that most people who've taken illegal drugs have enjoyed doing so. Pleasure is derived from them in the same way it is from alcohol, nicotine, chocolate and sex. Experiences with drugs will make some people's lives richer, and there's a strong case for allowing people to weigh up their personal costs and benefits to find this out.

Of course, this epicurean argument will never sit with Westminster politicians or the Daily Mail. But it shouldn't have to—the huge cost and the utter failure of prohibition should be enough to spark a genuine dialogue on alternatives.

In this respect, the UK seems caught in a strange place. A recent Observer survey found that 84% Britons think that the war on drugs is futile, and over half back the trial of Colorado-style cannabis legalization in this country. The Lib Dems also recently pledged to end jail sentences for drug possession. Yet just days after this announcement the mainstream media goes crazy for a 'definitive study' apparently equating cannabis with heroin, leaving it up to others to point out the that paper was a narrative review and thus not systematic, and was written by an author who wants to decriminalize cannabis and has called for liberalizing the international control system.

We'll never end up with a satisfactory solution to the drugs question until the media and politicians start discussing the topic with honesty. Perhaps the optimum solution isn't a libertarian paradise. But whatever it is, and whatever your political leanings—if you are concerned about the social cost of illegal drugs, it's high time to accept that prohibition has failed.

The latest attempt from the booze wowsers

We do love this latest attempt at justifying minimum alcohol prices:

Minimum alcohol pricing of 45 pence per unit would be 50 times more effective in targetting harmful drinking than current policies which only ban the selling of alcohol as a loss leader, research suggests.

Really?

Researchers at the University of Sheffield compared the effects of the two policies on public health using a mathematical model alongside General Lifestyle Survey data to estimate changes in alcohol consumption, spending, and related health harms among adults.

What did that model look at?

In their findings, published by bmj.com, they estimated that below cost selling would increase the price of just 0.7 per cent of alcohol units sold in England, whereas a minimum unit pricing of 45p would increase the price of 23.2 per cent of units sold.

They estimated that below cost selling would reduce harmful drinkers' mean annual consumption by just 0.08 per cent - or around three units per year. By contrast, a 45 pence minimum unit price would reduce consumption by 3.7 per cent or 137 units a year - a 45 times greater effect.

So they plugged the price change into their estimate of the elasticity of demand and found that....wait for it, wait for it....higher prices reduce demand and or consumption?

Gosh, do we really need a team of highly trained and expensive alcohol researchers to tell us that?

Unfortunately this latest paper fails to tell us the three things we'd actually like to know about minimum alcohol pricing.

This first being should we be attempting to reduce consumption in the first place? Current levels of booze taxation more than cover the public costs of boozing. There are, indeed, substantial private costs remaining: but those are being carried by the people doing the boozing which is just where they should be. Is there actually a reason or justification left for public policy action in this case?

The second is whether that rise in prices actually reduces harmful drinking, or just deters the occasional tippler from a small pleasure. There is, after all, fairly convincing evidence that the addict will always feed their addiction while the diletante is more amenable to price signals.

And thirdly, even if the above can be answered in a manner that leads to our wanting to increase the price, why on earth would anyone want to have minimum pricing? Not only is it illegal under EU law but it puts the extra cash into the hands of the retailers and manufacturers. Rather than into the Treasury as would be the case if prices were raised through higher taxation.  Minimum alcohol pricing just doesn't make sense.