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Should drug possession and use be legalised?

Dr Chris Ford argues that legalising drugs will make drug use as safe as possible while Dr Matt Piccaver argues that legalising drugs could lead to worse health outcomes

Dr Chris Ford

YES 

The question is: what does a responsible society do? Does it dogmatically stick to a system that has led to millions of HIV infections, millions of overdoses and to an enormous source of income for some of the most violent criminals in the world? Or does it reform the system to improve health benefits and reduce inequality?

There will always be deaths from driving fast cars but there would be many more if we did not teach people to drive, make them pass a test and ensure the cars are safe to drive. It’s the same for drugs. Throughout history people have used a variety of substances to feel different. There is nothing to indicate that they will ever stop. But if drugs were legal we could ensure that this use is as safe as possible.

We know that the majority of people who try both legal and illegal drugs use them quite sensibly for recreational purposes. Almost half of all 15-16 year olds have used an illegal drug so it’s quite normal. The most damaging thing that can happen to this group is to get a criminal record – affecting travel, employment - not damage to their health.

For the minority where drug use does become a health problem, 30 years of caring for these patients in general practice made me realise that most of them came from backgrounds where poverty and marginalisation was rife. We need to address problem drug use here, not push these people into a criminal act, penalising them further for their background.

We live in a highly regulated society – for the most part a good thing. When you buy a bottle of beer you know exactly what it contains and how strong it is. This is not so in the completely unregulated market for widely used illegal drugs. Most of the health risks can be attributed to this – one simply does not know what a given sample contains or how strong it is. If drugs were legal, we would be able to regulate them and ensure that they are as safe as possible.

And they can be safe. It is widely accepted now that alcohol is as dangerous as almost any other drug and much more dangerous than the most commonly used drugs, as we GPs see in many of our patients. The arbitrary reasons that make some legal and others illegal was not for health reasons but can be traced back to the 1930s in the USA when drugs were associated with different people: Chinese people with opium, Mexicans and cannabis and African Americans with cocaine. There was a brief experiment with making the drug of choice (alcohol) of white people illegal but that was soon changed.

Leaving what are currently known as illicit drugs in the hands of gangsters and simply telling people that their products are illegal is not what a responsible society does. When almost half of all young people are doing something we must ensure that it is as safe as is possible. With drugs this will only ever be achieved by having a regulated market like we do for everything else. It won’t be perfect at first but the sooner we start the sooner we will see a reduction in unnecessary tragedies.

Dr Chris Ford is a GP and Clinical Director of International Doctors for Healthier Drug Policies (IDHDP

Dr Matthew Piccaver

NO

Illicit drug use is an international problem. We’ve seen the ‘war on drugs’ fought for decades. Homeless shelters are full of people addicted to drugs and suffering as a result.

The question is, would legalising drugs make them any less of a problem? I would argue not. Decriminialising or legalising all illicit drugs could potentially make them even more available, with the resulting health harms that come with increased drug use.

And increasing legality of drugs seems to be correlated with adverse health outcomes. In much of the US, the legal status of cannabis varies between legal, decriminalised, available for medical use and illegal. In general, since there has been a more relaxed attitude to cannabis, use has increased as have hospital admissions, the vast majority for psychiatric problems.

Closer to home, an experiment looking at depenalising possession of cannabis in Lambeth saw a decrease in criminality, but a significant and prolonged increase in hospital admissions for cannabis use amongst young men.

Us GPs see these health harms in patients coming to us with HIV and crippling addictions. Campaigners for legalising drugs argue that the current illegality of drugs could mean that users are driven away from accessing healthcare. Yet patient-doctor confidentiality is the cornerstone of our profession, and so the legal status of drug use should not be barrier to those seeking help.

Misuse of drugs should be seen as a healthcare issue, not a criminal justice issue, but we don’t need to legalise drugs to achieve this. Portugal took the step in 2001 of decriminalising the possession of all drugs for personal use. This reduced drug use, mainly because it brought drug use into the domain of health, rather than the criminal justice system. There is nothing that prevents us from doing this even with the law as it stands in the UK. 

Those in favour of legalising drugs suggest that the legal status of drugs doesn’t make a difference in the rates of drug use, which remain high. But according to the 2014-15 Crime Survey for England and Wales, illicit drug use for all age groups, and particularly the 16-25 year age bracket, have showed a slow steady decline. This is in the context of the current legal framework and legalising drugs could cause a damaging reversal of this trend.

Changing the legal status of drugs of abuse may imply that drugs are safe, when we all know they are nothing of the sort. For many, drug use may be seen as a harmless pursuit, but it’s a pursuit that can ruin lives. We should be cautious about relaxing the drug laws. Once that genie is released, there’s no way of putting it back.

Dr Matt Piccaver is a GP in Glemsford, Suffolk

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Readers' comments (8)

  • Yes. All the evidence in the sector says this reduces harm, allows better management and reduces overall societal costs.

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  • it's curious that both debaters have looked at this very much from the point of view of the individual drug user, or the doctor treating them.

    A vast amount of harm is caused - not just to the users, but to society overall - by the consequences of criminalisation. Illegal drugs are expensive (although cannabis and opium - and their analogues) can be produced at low cost if you don't have to worry about criminality. In order to fund their habits, people are forced into crime, prostitution, destitution. People involved start to carry knives and other weapons - and to use them. The consequences of this on the rest of us are that we become the victim of those crimes.

    In the process, young black men in poor areas, for example, get drawn in; and many who are not involved are taught to resent the police and to feel outside society by being stopped and searched when they haven't done anything wrong.

    In order to wage this war on drugs, crime fighting bodies wage an arms war on the drug pushers and smugglers, at great cost to the taxpayer, with a lot of collateral damage, and with very limited success.

    Even from an individual user's point of view (and that of the doctor caring for them): some might use more drugs if they're more accessible, but at least, if the drugs are regulated, they will be safe and free of the contamination common to street drugs, which can be cut with substances which are poisonous or contaminated with pathogenic organisms.

    Looked at from the point of view of society, the argument is overwhelmingly in favour of decriminalisation.

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  • I agree re: legalizing to reduce organized crime and regulate the product but more importantly I don't believe the government has the right to stop people taking drugs harmful or not. People have the right to make decisions about their own lives and what they do with their own bodies. It doesn't matter if it does lead to an increase in use or medical problems as a result. Most things in life carry a risk and a benefit and people make their own decisions. Its not up to government to dictate in these matters. Educate of the risks yes. Protect people from unscrupulous suppliers and getting things they didn't want. Yes and this can only be done by legalising and setting standards. Stop people from harming others. Yes.

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  • My son died of "recreational" drugs earlier this year having successfully completed rehab and been drug (and alcohol) free for over 6 months. I am sure that the behaviour of the Police triggered his relapse (he was on very long term bail without charge. When he died his desk was covered with his legal papers: as stressful as a GMC investigation). We need societal control, to eliminate criminality, and severely restrict (i.e. abolish) use by teenagers. Criminalisation clearly does not achieve this, but instead stimulates an uncontrolled market that targets the vulnerable. Tax "recreational" drugs like cigarettes & alcohol, restrict sale to adults, and the problem becomes manageable. As in all health matters there is no perfect solution but decades of criminalisation has seen an explosion of drug use and is evidently counterproductive.

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  • Year ago I said governments should make all "recreational" drugs free on production of a drugs "passport" so that we could monitor people, counsel them and be aware of the danger in society. Having seen families wrecked, users become psychotic killers and a real danger to others, I have changed my view and would adopt the zero tolerance position. Drugs are too dangerous to innocent non-users. And that includes antidepressants, some painkillers, and even statins affecting the brain? Does anybody know why we all have different cholesterol levels? Do alcohol and tobacco cause people to go berserk? Occult scurvy causes depression. How many prescribe vitamin C as an antidepressant? It s asumed that the old RDA was adequate. But it was never claimed to satisfy the needs of more than 95% of people. The rest were simply ignored. In the UK that would be 3 million people, permanently borderline sick.
    In the USA, where all the police are armed and keep weapons at home, has there been a single case of an alcohol enraged policeman running amok in the last 100 years?

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  • May I be forgiven for this addendum to my previous comment. I have just seen this abstract Lipids. 2004 Dec;39(12):1207-13.
    Increasing homicide rates and linoleic acid consumption among five Western countries, 1961-2000.
    Hibbeln JR1, Nieminen LR, Lands WE.
    The modern diet overbalanced 6 omega acids has been found to create violent behaviour. In my previous note I suggested that statins could, thinking about the bearing of plasma cholesterol on mood. Now I suggest that we should challenge the labelling of Sunflower oil in "Ingredients." It WAS sunflower oil in the seed! In the clear bottle it is potentially very dangerous as also rapeseed and corn oils. A justifiable exaggeration to make the point might be to think of so called "Sunflower oil" as sucking the vitamin E out of one´s brain?

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  • I watched Michael Moores latest film - where should we invade next. It is a really interesting film and gives a very interesting viewpoint. I found the racial aspect to drug legislation to be an interesting angle.

    - anonmyous salaried!

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  • Russell Thorpe

    Prohibition just doesn't work. It's obvious that the human race craves artificial stimulation and tthe present situation is akin to Canute trying to stop the tide. Well we are up to our necks in drugs and it's time to give up the "war". Decriminalise and there will be more addicts but at least they won't be running over granny's to take the £3 in their handbags. Some very rich powerful figures in the shadows do not want this to happen. One day it will.

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