The war on drugs has failed. Now what?
A BMJ editor shares five key readings to understand drug policy and the urgent need for reform
More than forty years ago, Richard Nixon introduced ‘the war on drugs’ — a series of new policies to discourage the production and sale of illegal drugs. Now with 50,000 Americans fatally overdosing per year, BMJ editor Richard Hurley say it’s time to admit it : We failed.
Richard recently participated in a ‘Figure 1 on 1’ in which he answered questions from the healthcare community. He shared five resources to help healthcare professionals learn about drug policy and decriminalization. His entire Figure 1 on 1 can be read on Figure 1. Here are the highlights.
1. Why we must listen to statistics and evidence
The opioid epidemic in the U.S. is a critical issue. Richard says, “it’s such an issue that the Surgeon General released a first report on substance misuse recently. 80 people a day are dying from opioid overdose.”
To learn more, Richard recommends reading an article written by Michel Kazatchkine, UN secretary general special envoy on HIV/AIDS in Eastern Europe and Central Asia. The piece delves into how prohibition can prevent access to harm reduction treatment, including methadone, for people who inject drugs.
Recommended read — Reasons for drug policy reform: people who use drugs are denied evidence based treatment
2. How Portugal is leading by example
“Portugal decriminalised personal possession of all drugs 15 years ago”, explains Richard, “but there are still civil penalties for drug possession. Drug supply remains a crime.” This essay by two UK parliamentarians shares “some good evidence about what happened”.
Why should we look to Portugal to see how the rest of the world might move forward? Richard says, “Portugal remains compliant with UN treaties that say that all countries must enforce ‘prohibition’. Portugal prohibits drug use but through an administrative rather than criminal justice process. The process puts health first. The U.S. is in breach of its UN treaty obligations by allowing states to legalise supply of cannabis — this is certainly not ‘prohibition’ …”
Recommended read — How changes to drug prohibition could be good for the UK — an essay by Molly Meacher and Nick Clegg
3. What government fears most
Despite growing public acceptance of new drug policies, governments remain hesitant to be the first to pass new laws. He says, “It was interesting what Ed Morrow at the UK RSPH [Rollins School of Public Health] said — that the public and the media are much more comfortable with the idea of decriminalisation for example, but ‘The conservative parts of government don’t want to look soft on crime. The reticent part of government is scared of a voter backlash that doesn’t exist in the way it once did’.”
The BMJ feature quoting Ed Morrow is a resource to learn about changing public opinions and why government lags behind.
Recommended read — Doctors, their leaders, and the drug policy debate
4. Who offers public support for drug policy reform
When asked “Do you think medical professionals en masse will ever defend decriminalisation?”, Richard responded: “They already are. WHO [World Health Organization] supports decriminalisation of personal possession. The BMA [British Medical Association] and the RSPH [Rollins School of public Health] in the U.K. have called for reform. International Doctors for Healthy Drug Policies (IDHDP) campaigns for reform.”
Richard suggests that healthcare professionals learn more about IDHDP on the organization’s website. IDHDP believes physicians are among the most respected and trusted members of communities and could use this to influence other professionals and the general public to support health-based drug policies.
Recommended read — International doctors for healthier drug policies (IDHP)
5. Why solutions need to be grounded in evidence
Richard advocated evidence-based medicine as the best approach to drug policy. A dietitian asked, “What do you think of current methadone regimens? I feel they are just swapping one addiction for another and making a lot of money for the drug companies.” Richard responded, “There’s good evidence that ‘swapping one addiction for another’ reduces crime and HIV transmission and saves lives — let’s base treatment on what works to maximise health and minimise harm, rather than moralising about whether drug taking or addiction is ‘right’ or ‘wrong’.”
He recommended reading his BMJ editorial called The War on Drugs has Failed for more information. In it, he posits that the effectiveness of prohibition laws must be judged on outcomes. And too often the war on drugs plays out as a war on the millions of people who use drugs, and disproportionately on people who are poor or from ethnic minorities and on women.
Recommended read — The war on drugs has failed: doctors should lead calls for drug policy reform
Log in to Figure 1 to read the whole Q&A, participate in more live chats with healthcare leaders, and see cases from around the world. Interested in learning more about Figure 1? Email us at communications@figure1.com
