Thursday, January 9, 2020

America Can End Its War On Drugs. Here's How.

Decades into the war on drugs, the world doesn't have much to show for it. The US is now in the middle of an opioid painkiller and heroin epidemic that has killed tens of thousands each year, despite tough-on-crime policies enforced under the drug war. Mexico has suffered from tens of thousands of deaths annually as the black market for drugs finances drug cartels that are so powerful they can wage war against governments and conquer cities. And drug use and trafficking haven't declined by an appreciable amount for decades.

These circumstances led more than 1,000 world leaders, including Bernie Sanders, to call for an end to the "disastrous" war on drugs in a recent letter to UN Secretary General Ban Ki-moon.

But what exactly does it mean to end the war on drugs? (...)

Through interviews with some of the world's smartest drug policy experts and my review of the research, I put together three of the best ideas on dismantling the current system. These are by no means the only options for ending the war on drugs. But they are the ones that seemed, based on my reporting on the issue and data, to have the most merit.

There were some points of agreement. Experts agreed that, regardless of how legal regimes change, countries should boost public health programs for drugs, including treatment and prevention. And whether drugs have medical use, such as marijuana or hallucinogens, is also something that can be evaluated separately.

But there was a lot of disagreement about what legal regimes for drugs should look like. So here are the three plans that came from my conversations.

Approach 1: Pull back harsh enforcement, but keep criminalization (...)

Approach 2: Decriminalization, smart prohibition, and smart legalization (...)

Approach 3: Legalize and tightly regulate all drugs

The most radical approach — and one most Americans don't agree with — is legalizing and regulating all drugs. This is something no country has done in modern times, as many recreational drugs remain illegal to sell virtually everywhere in the world. So it's difficult to say for certain what would happen.

Still, there was one consistent group that drug policy experts and historians pointed me to when I asked whether anyone had a realistic legalization model: the Transform Drug Policy Foundation. While many don't agree with Transform's plan, it was consistently cited as the most detailed, evidence-based proposal.

Explaining his approach, Steve Rolles, senior policy analyst for Transform, said his group applied what we already know about other vice markets — particularly alcohol, tobacco, and gambling — to illegal drugs.

To be clear, this would not mean letting people buy any drug they want at the grocery store. "Different drugs would be regulated in different ways," Rolles explained. "The determinant of how you would regulate a drug would be what the risks and behaviors associated with that particular drug were. So the more risky a drug is, clearly, the more justification you have for more intrusive or intense regulation."

In its very detailed blueprint, Transform lays out its regulatory models based on tiers that ramp up restrictions based on a drug's dangers. Here's a quick summary of the five tiers, which divide up where and how the drugs would be available based on how potentially dangerous they are:

Medically supervised venues: Drugs put in this category, including heroin or amphetamines, would only be allowed with a prescription (typically for people with drug use disorders) and the direct supervision of a trained expert, like a doctor in a controlled facility.

Pharmacies: Drugs in this tier, such as MDMA, powder cocaine, or amphetamine, would only be dispensed through pharmacies with a prescription or over the counter. While it is currently the case that pharmacies focus on medical applications, the blueprint suggests that pharmacists could also act as trained and licensed gatekeepers for drugs used in recreational settings.

Licensed sales: Drugs in this classification, like marijuana and stimulant-based drinks, would be dispensed by licensed, regulated vendors. These sellers don't have to be for-profit entities; they could be nonprofits or government-controlled.

Licensed premises: These regulated establishments would dispense drugs, such as smoked opium, psychedelics, or poppy tea, much like alcohol is sold and consumed in bars today — although in some cases, as with psychedelics, the vendors would need training to help guide people through their experiences.

Unlicensed sales: Drugs in this category, like coca tea, would be available easily, much like caffeine.

Rolles emphasized that commercialization should be avoided. So even the drugs that are more accessible could still fall under strict regulations, such as a ban on marketing, taxes to keep the prices high, and even price controls. This could make up for at least part of the price drop that comes with the end of prohibition.

The new regulations could also be applied to alcohol and tobacco, as well as marijuana in states that already legalized the drug. (Rolles said he doesn't like that marijuana is moving to a commercialized legal model in parts of the US.)

But why go for legalization and regulation? There are two main reasons for this, Rolles argued: One, it completely eliminates the black market for drugs that enables so much violence around the world, particularly Latin America. Two, it could potentially make drug consumption safer.

The first point is relatively uncontroversial. It is clear that the war on drugs has had an enormously negative effect in several countries around the world, particularly Mexico in recent years. Again, a study found that violence from the drug war caused Mexico's life expectancy to stagnate — and, in men's cases, drop — after decades of increases.

On the second point, Rolles argues that legalizing and regulating drugs could make for safer drug use. So if people get their drugs from a regulated source, governments can ensure there's nothing that would make an already dangerous substance even more dangerous (such as fentanyl in heroin).

It may also eliminate the incentives in the black market to make drugs as potent as possible, since in a black market it's much easier to smuggle a highly potent pound of a drug (such as heroin) than it would be to smuggle a few pounds of something that's not as potent (such as smoked opium).

A similar black market phenomenon occurred during Prohibition, when the US banned alcohol from 1920 to 1933. During Prohibition, the market quickly went to spirits. After Prohibition, it has shifted toward wine and beer. (...)

"The idea that we're trying to promote in the blueprint is that a regulatory model can tilt the market the other way," Rolles said. "So the less risky, less potent products are more available, and the higher risk products are increasingly less available or not available at all." 

by German Lopez, Vox |  Read more:
Image: Shutterstock
[ed. See also: The rise in meth and cocaine overdoses, explained; and How the war on drugs has made drug traffickers more ruthless and efficient (Vox).]