Drug WarRant

The inestimable Transform Drug Policy Foundation has done it again.

Their newest report is A Comparison of the Cost-effectiveness of the Prohibition and Regulation of Drugs (pdf), which is that, plus a kick in the pants.

In a field where governments have gone out of their way to avoid and even prevent useful efficacy studies, Transform is stepping up to bat and doing (to the best of their ability) the work that should be done by the prohibitionists — actually looking at whether prohibition is cost-effective. And the result of their extremely conservative analysis (they even chose to not include a number of potentially controversial topics such as tax income or improved safety in drug preparation) shows that a regulated legalization of cocaine and heroin would save money over prohibition in all of four usage change models (50% decrease in use, no change in use, 50% increase in use, 100% increase in use).

But this report not only is a powerful jumping off point for future study, it is a scathing indictment of all the weasels who have defended prohibition by saying that legalization would be too “expensive” to even consider while refusing to justify the cost-effectiveness of prohibition or prove any actual deterrence — the UK Government, the UNODC, the US Government, and yes, even the prohibition apologists.

Despite being such an important issue, there has never been a cost-benefit analysis at the level of sophistication required, either of prohibition (its legislative instruments and their enforcement) or of policy alternatives, carried out anywhere in the world and certainly not for the UK. Furthermore, and disappointingly, the comparatively scant relevant research that has been undertaken by Government departments has frequently been suppressed.

The whole report is full of useful information and quotable material, so what I discuss here will only be a taste of some of the things that particularly caught my attention.

The report takes some important space to address the important understanding that drug policy causes harm.

Yet despite these issues being apparently understood and frequently acknowledged at the highest level, in the majority of political, media and public discourses no such distinction is made between the harms that result from drug use per se and those that are either entirely or partially the result of policy, specifically the overarching policy paradigm of prohibition. The result is that both sets of harms are conflated and then simplistically blamed on drugs or, by default, drug users. The failure to disaggregate drug use harms from drug policy harms or, specifically, prohibition harms, is a major obstacle to meaningful evaluation of existing policy and consequently, to the rational development of potentially more effective policy responses. […]

This conceptual problem has also had direct political consequences. Logical fallacies flow from this error, such as the inclusion of the epidemic of HIV/AIDS amongst injecting drug users as an example of ‘drug harms‰ to defend the prohibitionist status quo. In this case a specific drug-related harm that is almost exclusively the result of the high risk behaviours, rituals, products and environments that stem directly from prohibition and the default underground drug cultures it creates, is perversely being used both to justify the continuation of the very policy that has fostered it in the first instance, and also to argue against the policy that would largely eliminate it.

There’s a fair amount of discussion about the lack of evidence for the deterrence factor that all prohibitionists claim is the holy grail of criminalizing drugs (and the notion that regulated legalization would open the flood-gates to an entire population of drug-addicted zombies).

The relatively small amount of independent research that has been done in this area suggests that the law and enforcement are, at best, marginal factors in drug taking decisions. This especially holds true for the socially excluded groups who are most vulnerable to problematic use, including young people, those with mental health problems, and those from socially deprived communities. Dependent users of heroin and crack in particular, who are both highly likely to have a criminal record already and whose demand is generally resistant to any interventions, are also – as discussed above – the population creating the vast majority of social and economic costs. Thus the group that creates most of prohibition‰s costs are also the group least likely to be susceptible to its deterrent effects.

One of the things not specifically figured into Transform’s cost-effectiveness study is the significant potential health savings from regulated legalization.

One concept that this paper does not explore nor attempt to cost is the impact that the shift from illicit to legally regulated supply might have on patterns of use in terms of shifts in choice of drug and preparation of drug. One observed effect of prohibition is that the economic pressures of the illicit market tend to cause increased concentration of available drug preparations, which are more profitable per unit of weight. Just as under alcohol prohibition the trade in beers and wines gave way to more concentrated, profitable and dangerous spirits, the same trend has been observed over the past century with opiates — from opium (smoked or in drinkable preparations) through to snorted, smoked and injectable heroin, and more recently with the cannabis market being increasingly saturated with more potent/profitable varieties. With coca-based products the transformation has been dramatic from coca leaf, through coca based
drinks (tea, wines, and other drinks, once including Coca Cola) through cocaine powder and ultimately to smokable crack.

It seems likely that users, if a range of drugs and preparations are available, will tend to make rational decisions and shift towards the less harmful drugs, less harmful preparations and less risky behaviours and modes of administration. This phenomenon was observed following the repeal of alcohol prohibition when the market shifted away from spirits back towards beers and wines. Such a shift would be actively promoted and encouraged by a public health guided policy involving targeted education about drug risks combined with differential application of regulatory controls i.e. stricter controls (e.g. higher prices, restricted availability) for more dangerous drugs or preparations. Evaluating potential impacts of such approaches is beyond the remit of this paper but is again a potentially useful arena for future study.

Good stuff. A must-read for all policy leaders and politicians dealing with drug policy. It’s a challenge and a starting point for a difficult, but essential field of study.

Many of the “academics” in this country have said that such study is impossible, so there’s no point in discussing legalization. The truth, however, is that justifying prohibition without undertaking such study is irresponsible and dishonest.
Update: The UK Government actually managed to prove both its incompetence and its inability to read with its response:

But a Home Office spokesman said: “Drugs are controlled because they are harmful. The law provides an important deterrent to drug use and legalisation would risk a huge increase in consumption with an associated cost to public health.

“The legalisation of drugs would not eliminate the crime committed by organised career criminals; such criminals would simply seek new sources of illicit revenue through crime. Neither would a regulated market eliminate illicit supplies, as alcohol and tobacco smuggling demonstrate.”

I’m watching a documentary about the musical Hair, and it included this quote:

The hippies really had a philosophy of their drugs. There were good drugs and bad drugs. Bad drugs shut your mind down — alcohol, cocaine, heroin. Good drugs opened your mind up — pot, peyote, LSD.

Discuss.

Updates to yesterday’s post
“bullet” A big thanks to Dano regarding the postponement of Ammiano’s legalization bill (AB 390). A note from Dale Gieringer posted at Mendocinocountry’s Blog says:

Contrary to the article by Richard Johnson, Assemblyman Ammiano did NOT withdraw his bill AB 390 (which is for legalization, NOTŠ decriminalizationŠ). I just spoke with him today, and he is pursuing it vigorously.
He had it extended into a two-year bill in order to give us more time to lobby the legislature. The Speaker had been pressing to kill the bill quickly by bringing it to an early hearing in a hostile committee. At Ammiano‰s request, the bill was kept alive and postponed for extended consideration. Hearings are expected next January or December.

“bullet” Regarding the Holder attribution in the New York Times:

And with marijuana sales central to the drug trade, Mr. Holder said he was exploring ways to lower the minimum amount required for the federal prosecution of possession cases.

I asked reporter Ginger Thompson whether Holder had been talking about distributing or importing rather than possession.
Her reply:

Thanks very much for your query.
Mr. Holder said he thought that too few marijuana possession cases were prosecuted by the federal government, and that he was exploring lowering the minimums to prosecute more.

Still clueless as to what that really means, but I hold to my analysis from yesterday.

This isn’t the first year that Illinois has discussed medical marijuana. So you’d think that the media would be better able to report on it by now.
“bullet” Charity Bonner reports in the Elgin Courier News.

According to the U.S. Drug Enforcement Administration, the pill [Marinol] has been found to relieve nausea and vomiting associated with chemotherapy for cancer. The USDA says the drug is a safer alternative since it does not contain the chemicals or carcinogens found in smoked marijuana. The USDA also reported that some states that have legalized medical marijuana, such as California, have seen an abuse of the system.

Dear Charity,
The U.S. Drug Enforcement Administration is the DEA, not the USDA. The USDA is the United States Department of Agriculture. Neither the DEA nor the USDA are trained in medicine or have any reason to be commenting on the medical efficacy of drugs.
“bullet” In another article about medical marijuana in Illinois, the Southtown Star’s Maura Possley does a decent job, but is then sabotaged by her headline writer with “Springfield legislators weighing dope proposal”
Really? Dope proposal?
It made me wonder whether, if they wrote an article about breast cancer, they’d title it “Springfield legislators weighing hooters proposal.”
And you wonder why newspapers are shutting down…

“bullet” “Why is AB 390 being delayed until next year?” No idea.
AB 390 is the bill for legalizing marijuana in California, introduced by Ammiano.
This page suggests that the first hearing was cancelled by the author, and other sources do say that it has been delayed until next year. It could be that he wanted to get more ammunition together, or more co-sponsors, or see what happens with dispensaries, or he simply knows that it doesn’t have a chance of passing now, so he’s extending its life to get more coverage next year.
If anybody has better information, I’d love to hear it.
“bullet” What’s going on with this report in the New York Times about AG Holder’s meeting with the AG of Mexico?

And with marijuana sales central to the drug trade, Mr. Holder said he was exploring ways to lower the minimum amount required for the federal prosecution of possession cases.

You got me.
Eric Sterling thinks that somebody (possibly the NY Times) confused “possession with importation, distribution, or possession with intent to distribute.” Which makes sense, because using federal prosecutors to go after mere marijuana possession would be a particularly stupid thing for Holder to suggest as a means for assisting with the Mexican drug war.
I’ve got an email out to the reporter, but I haven’t heard back yet.
I think Eric’s right on this – it’s the only thing that makes sense. Now that doesn’t make us particularly happy, because we don’t feel that marijuana should be illegal at all, so any proposed increase in enforcement seems terrible. And yet, I’m not particularly surprised.
What’s Holder supposed to do? The only solution related to the Mexican drug war that would actually make any difference is off the table — legalization. This administration is not going to suggest legalization as a solution. Period. We never expected them to. If you can’t suggest a real solution, what do you have left? You have to make a big show about there being some aspect of prohibition that hasn’t been done, or hasn’t been done enough, or enough in the right way, and pretend that it’ll make the difference (even though you know full well that it won’t).
It’s not like Holder can say “Well, with all those people dying, we’re just going to keep on doing what we’ve been doing. Maybe a little less.” Of course not — he’s got to at least appear to be kicking some ass and making a difference, even though what he’s suggesting, upon closer examination, appears to be nothing more than finding some marijuana smuggling offenses and prosecuting them in a federal court instead of a state court — like that could possibly have any effect.

I was busy traveling this weekend, and exhausted from driving back from Chicago in a blinding snowstorm (in April?) last night, so here’s al I’ve got for you. Carlos Santana tells President Obama: “Legalize Marijuana.”

What else is going on?

“bullet” Maia Szalavitz: Is the Media Finally Getting it On Drug Policy?

For years, virtually every internet discussion of drug policy has been dominated by drug policy reformers and outright legalization advocates–but this growing sentiment amongst the most educated and connected went unreported.
Maybe the MSM is finally waking up–they can no longer simply create and re-enforce conventional wisdom. When the facts about drugs are only a few clicks away, the propaganda loses its luster.
Given that the vast majority of journalists have smoked pot and at least a third of those in their 40’s or up have probably taken cocaine without significant problems, does it really make sense for them to go on carrying water for the drug warriors, worrying about “the children” and infantilizing their audiences by repeating myths that many must know themselves to be untrue?

“bullet” David Sirota in the Denver Post: This is the truth on drugs … any questions?

Indeed, as federal agencies acknowledge alcohol’s key role in deadly illnesses and domestic violence, their latest anti-pot fear mongering is an ad campaign insisting Ö I kid you not Ö that marijuana is dangerous because it makes people zone out on their couches and diminishes video gaming skills.
(This is your government on drugs: Cirrhosis and angry tank-topped lushes beating their wives are more acceptable risks than stoners sitting in their basements ineptly playing Halo … any questions?).

“bullet” Will Wilkinson in The Week:

My name is Will Wilkinson. I smoke marijuana, and I like it.

“bullet” Out of The Cannabis Closet at The Daily Dish:

“I am a self made multi-millionaire with three houses in three states including a ski house in Colorado and a penthouse apartment in Manhattan. I’m happily married and keep fit by running 15 miles a week and working out regularly. I support the arts and other charities heavily. I oftentimes work long hours and manage a crew of about 70 people. I have been a weed smoker for as long as I can remember. Recently I received a glass bong as a present. Tonight my friends and I are going to rip huge tubes of sweet OG kush and get high as shit. Then I will take my responsible millionaire ass and plant it in front of the TV for a long night of xbox and candy eating. I will laugh uncontrollably and have a fantastic time. These nights of Xbox and reefer is one of the best things in my life… And I got a pretty damn good life.”

“bullet” DrugSense Weekly
“bullet” “drcnet”

Reminder: Glenn Greenwald will be at the Cato Institute tomorrow (Friday) at noon Eastern to talk about his paper: Drug Decriminalization in Portugal: Lessons for Creating Fair and Successful Drug Policies. Peter Reuter will be responding, and Tim Lynch, moderating.
If you can’t get to the Cato Institute, you can watch the event live here.
The paper itself is now available to read online at Cato or you can download the pdf.
It’s a fascinating paper.
It’s amazing how little we have discussed Portugal and their drug policies in the states. I would imagine that is, in part, a function of how unfamiliar we are with the language. Fortunately, Glenn is fluent and bridges that gap for us.
Decriminalization in Portugal really works. It’s certainly not what I would wish for an end goal here – I want to see regulated legalization, not merely decriminalization. Yet what Portugal has in place is far superior to our criminalized approach. It’s more effective, it’s smarter, and it’s more… human. We can learn a lot. In particular, we can learn that moving away from criminalization will not result in the social breakdown that is the warped fantasy of prohibitionists.
So what led Portugal to pursue decriminalization?

… decriminalization was driven not by the perception that drug abuse was an insignificant problem, but rather by the consensus view that it was a highly significant problem, that criminalization was exacerbating the problem, and that only decriminalization could enable an effective government response. […]
Since Portugal enacted its decriminalization scheme in 2001, drug usage in many categories has actually decreased when measured in absolute terms, whereas usage in other categories has increased only slightly or mildly. None of the parade of horrors that decriminalization opponents in Portugal predicted, and that decrminalization opponents around the world typically invoke, has come to pass. In many cases, precisely the opposite has happened…

Glenn does a nice job of breaking down the statistics, and comparing them to the rest of the European Union, also noting that both drug-related disease and drug-related mortality rates have decreased since decriminalization.
So how does this work?
They worked very hard to take it out of the criminal justice system, recognizing that the criminal justice system is the worst place to turn to help people. Drug possession is still illegal, but being caught with up to 10 days supply of any drug is merely an administrative action, not a criminal action.

…police officers are required to issue citations to the offender, but they are not permitted to make an arrest. The citation is sent to the commission, and the administrative process will then commence.

Enter the Dissuasion Commission, which will hear from the alleged offender and

“gather the information needed in order to reach a judgement as to whether he or she is an addict or not, what substances were consumed, the circumstances in which he was consuming drugs when summoned, the place of consumption and his economic situation.” […]
… the overriding goal of that process is to avoid the stigma that arises from criminal proceedings. Each step of the process is structured so as to de-emphasize or even eliminate any notion of “guilt” from drug usage and instead to emphasize the health and treatment aspects of the process.
The alleged offender, for instance, can request that notice of the proceedings not be sent to his home in order to preserve privacy. Commission members deliberately avoid all trappings of judges, and the hearing is intentionally structured so as to avoid the appearance of a court. Members dress informally. The alleged offender sits on the same level as the commission members, rather than having the members sit on an elevated platform. Commission members are legally bound to maintain the complete confidentiality of all proceedings. At all times, respect for the alleged offender is emphasiezed.

Wow. Can you imagine that? Respect for drug users.
What does the Commission do then?

In 2005, there were 3,192 commission rulings. Of those, 83 percent suspended the proceeding; 15 percent imposed actual sanctions; and 2.5 percent resulted in absolution. That distribution has remained constant since the law’s enactment. Of the cases where sactions were imposed, the overwhelming majority merely required the offenders to report periodically to designated locales.

Identify the people with real problems and try to help them. Talk to the others and let them go.
How bizarre this is compared to what we see every day in the U.S.
If you can, check out the session with Glenn tomorrow (Friday), and report back here. I’d love to see it, but unfortunately, I’m in meetings at that time.