Sir Ian Gilmore’s comments on “decriminalising” drug use while still regulating drug sales are welcome. I read the former president of the Royal College of Physician’s words this week between seeing patients in a south London drug dependence clinic.
The first patient was a young woman, barely coherent under the influence of prescribed benzodiazepines (anti-anxiety medication and sleeping tablets).
Next was an affable chap who has been on prescribed diamorphine for more than a quarter of a century, while running a successful business and leading an upright suburban life.
As pointed out in the 1970s by the American research of Norman Zinberg, the effect of drugs is determined by “drug, set and setting” - the action of the drug, the mindset of the person using it, and the social context. When discussing how to regulate drugs, we must clarify the particular problems that drug policy is seeking to address.
Some of the many faces of drug use were shown in the Channel 4 documentary series, Our Drugs War. Residents of a bleak housing estate claimed in the film that 60% of inhabitants were on heroin. Watching, it was hard not to nod wisely and conclude that deprivation, unemployment, and social and family breakdown have been the fertile breeding ground for heroin addiction.
This part of the series also interviewed people about the former “legal high”, GBL, revealing a different face of our drug epidemic. For the most part people using GBL are young, often privileged, employed people who use a range of drugs as part of their party lifestyle.
In university towns, this type of drug use is commonplace if not without risks, including overdose fatalities. I have seen charming, privileged and formerly hardworking young people who found themselves dependent on GBL neglecting friends, family and work commitments and experiencing severe withdrawal symptoms when they try to stop.
And then there is alcohol, with per capita consumption in the UK having risen over the last two decades - and with it, deaths from liver disease.
It is hard to avoid the conclusion that there is a high demand for drugs across the UK. So availability becomes a key determinant of consumption. Historically, alcohol and tobacco have been regulated by licensing and taxation.
Taxation is surprisingly effective; there is consistent data that even addicted people reduce consumption when the price of their chosen drug goes up.
However, successive UK governments have been reluctant to use taxation and licensing to restrict the harm associated with alcohol (and tobacco), justifying the position on the grounds that the use of alcohol is a matter of “personal responsibility” rather than an area for intervention by the nanny state. Yet they have been glaringly inconsistent in dealing with the use of other psychoactive drugs, regarding that not as a matter of personal responsibility but as criminal behaviour.
Prohibiting the use of certain drugs has proved moderately ineffective (GBL can still be ordered online for next-day delivery). Instead, this strengthens the link between crime and drugs, and breeds disrespect for the law.
Most aspects of modern life require a mix of personal responsibility and regulation.
Licensing laws and taxation are not “nannyism” but prudent measures to restrain excess. Similar regulation of other drugs may offer a more constructive approach than the current legal restrictions. Given the plentiful availability of black-market drugs, it is hard to imagine such a policy being worse than our existing regime of classification.
This article first appeared in The Guardian
