Editor's Page: Minimize the Harm

The objections heard most frequently to proposals for relaxing the current "zero-tolerance" approach, tend to be along the lines of "won't more people use drugs if we make them more available?"

It is by no means clear that more people would use drugs, or even that they would be more available, in a non-prohibitory environment. The sociological dynamics at work in drug use patterns are complex, and are likely to defy such simplistic analyses -- for example, many young people are excited by drugs precisely because they are illegal -- the "forbidden fruit" effect. It is fairly certain that the vast majority of Americans will not go out and get themselves addicted to dangerous drugs, just because they became legal where they were not before; the "nation of zombies" scenario frequently conjured up by drug warriors is baseless. However, reformers must admit that it is also not certain that there wouldn't be more people using these drugs than before, following decriminalization.

But the number of people using drugs -- or even the total quantity of drugs consumed -- is only part of the picture, not necessarily even the most important part. A report written by a RAND Corporation working group on drug policy, published last August in the American Journal of Public Health, pointed out that the fundamental value in a national drug strategy ought to be reduction of the total harm flowing from the production, consumption, distribution and control of drugs. Harm can be expressed as the product of total use and average harm per unit of use, and so can be lowered by reducing either component. Rhetoric and national drug policy has largely focused on use.

By focusing on use rather than harm, we miss the crucial point that drug use and drug addiction entail very different sets of consequences under different systems. A heroin addict in the US is placed in the most degrading of circumstances; but get that person into a methadone maintenance program, using a similar but legal drug, and the adverse consequences are substantially reduced -- in fact, it's a different world. Some countries actually have heroin maintenance programs; qualitatively they are much the same as methadone maintenance. The lesson in this is that prohibition intensifies the harm associated with drug use and addiction, by adding all the harms that come with criminalization, including uncertain quality, the economic burden of high-priced black market drugs, necessity of associating with armed criminals -- and of course, prison.

Conventional wisdom holds that drugs were made illegal in order to improve the physical, mental and social health of society. But the goal of promoting health is inconsistent with a system whose underlying goal is to increase harm. Prohibition can never be truly consistent with a public health philosophy.

From The Activist Guide, Issue #7, October '95, DRCNet Publications section, A Guided Tour of the War on Drugs home page.

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