War on drugs
The war on drugs can be much more harmful to the general population than the drugs themselves. These are generally controlled drugs.
The war on drugs epitomises the way in which political sloganisation can overtake good sense.
In medicine and public health, the aim is generally to minimise harm.
Social panic about substance misuse, and publicity about the harms of such misuse (including e.g. deaths from overdose) led to a rush to criminalise the supply and consumption of substances such as opiates and stimulants. (Better established, socially normalised but sometimes much more harmful drugs such as tobacco, alcohol, and caffeine were not criminalised, although the prior example of alcohol prohibition in the USA showed the potential for social destabilisation where supply of an addictive substance easily produced was too rigorously constrained)
This process of criminalisation has had severe and harmful consequences - greater than, or exacerbating the harms caused by the drugs.
With no legal availability of drugs for non-medical use, and pressure on supply, drugs became a lucrative but illegal product, generating vast profits for criminals. The consequent arms war between police and criminals has caused a lot of damage: crime to pay for drugs; the adverse consequences for drug users who are criminalised (such as loss of esteem and social status, jobs, income, emprisonment, sexual assualts by police, forced into prostitution or other harmful occupations to pay their dealers...), restrictions on freedom and liberties imposed with the stated intention of fighting the war on drugs; people caught (quite literally as well as figuratively) in the cross fire between police and criminals; and so on.
Meanwhile, with no regulated supplies of drugs, users have been forced to purchase supplies from criminals - supplies which are often adulterated with harmful substances - or even infections such as anthrax. The concentrations are variable, so taking a safe, known dose is next to impossible - especially when users have to rush taking the drugs for fear of discovery, stigma, arrest and prosecution.
There is also the paradox that the easy legal availability of similar drugs on prescription can cause problems. This includes inflation in health care costs as many actively marketed preparations to the medical profession have cheaper alternatives. In particular chronic pain treatment can become problematical and can promote indirectly drug dependency and inappropriate patient and health care professional behaviour or interactions. . These interactions can include malicious patient complaints or at the other extreme cases such as the doctor murderer Harold Shipman. While it remains challenging to get the balance right, complete prohibition or discrimination in allowing access to health services for users of such drugs, and complete freedom of access to such drugs are wrong from an evidenced based public health perspective.
- Johns Hopkins-Lancet Commission on Public Health and International Drug Policy report.
- Sixty seconds on . . . the war on drugs (BMJ)
- “War on drugs” has harmed public health and human rights..." BMJ.
- More from BMJ.
- ↑ Booth MG, Hood J, Brooks TJ, Hart A. Anthrax infection in drug users. Lancet (London, England). Apr 17; 375(9723):1345-6.(Link to article – subscription may be required.)
- ↑ Volkow ND, McLellan AT. Opioid Abuse in Chronic Pain--Misconceptions and Mitigation Strategies. The New England journal of medicine. Mar 31; 374(13):1253-63.(Link to article – subscription may be required.)
- ↑ Csete J, Kamarulzaman A, Kazatchkine M, Altice F, Balicki M, Buxton J, Cepeda J, Comfort M, Goosby E, Goulão J, Hart C, Kerr T, Lajous AM, Lewis S, Martin N, Mejía D, Camacho A, Mathieson D, Obot I, Ogunrombi A, Sherman S, Stone J, Vallath N, Vickerman P, Zábranský T, Beyrer C. Public health and international drug policy. Lancet (London, England). Mar 23.(Link to article – subscription may be required.)
- ↑ Iacobucci G. Sixty seconds on . . . the war on drugs. BMJ 352.
- ↑ Iacobucci G. “War on drugs” has harmed public health and human rights, finds new analysis. BMJ 352.
- ↑ Smith R. The war on drugs. BMJ (Clinical research ed.). 1995 Dec 23-30; 311(7021):1655-6.
- ↑ Rolles SA. Should drugs be decriminalised? Prohibition is an ideologically driven failure. BMJ (Clinical research ed.). Nov 24; 335(7629):1060.(Link to article – subscription may be required.)
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