Should drugs be decriminalised?
Recent government figures suggest that the UK drug treatment programmes have had limited success in drug rehabilitation, leading to calls for decriminalisation from some parties.
In this week's BMJ, two experts debate the issue.
A sensible policy of regulation and control would reduce burglary, cut gun crime, bring women off the streets, more than halve the prison population, and raise billions in tax revenue, argues Kailash Chand, a general practitioner in Lancashire. Yet politicians would never dare to suggest it.
Prohibition as a policy has failed, he says. It is the violent criminal gangs - and not the governments - that control this trade and it is their turf wars that fuel gun crime. The policy drives young women into prostitution and fuels crime among desperate low income addicts.
He believes that drugs could easily be regulated in the same manner that alcohol and tobacco are regulated and, more importantly, heavily taxed. The revenue generated could then be funnelled into education and other rehabilitation programmes.
Legislation would also mean that drug users could buy from places where they could be sure the drugs had not been cut with other substances, he adds. There would be clear information about the risks involved and guidance on how to seek treatment.
It is time to allow adults the freedom to make decisions about the harmful substances they consume, he concludes.
But Joseph Califano, Chairman of the National Center on Addiction and Substance Abuse at Columbia University argues that neither legislation nor decriminalisation is the answer. Rather, more resources and energy should be devoted to research, prevention, and treatment, and each citizen and institution should take responsibility to combat all substance misuse and addiction.
Decriminalisation will also make illegal drugs cheaper, easier to obtain, and more acceptable to use, he says. For example Italy, where personal possession of a few doses of drugs like heroin has generally been exempt from criminal sanction, has one of the highest rates of heroin addiction in Europe.
In contrast, Sweden offers an example of a successful restrictive drug policy. Faced with rising drug use in the 1990s, the government tightened drug control, stepped up police action, mounted a national action plan, and created a national drug coordinator. The result: Drug use is just a third of the European average.
Meanwhile, evidence that cannabis use can cause serious mental illness is also mounting.
Drugs are not dangerous because they are illegal; they are illegal because they are dangerous, he argues. Legalisation and decriminalisation - policies certain to increase illegal drug availability and use among our children - hardly qualify as public health approaches.