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Saturday, October 16, 2021

The arguments for the decriminalisation of drugs

 Is it possible for Governments across the world to have a rational debate on the subject of the controlled legalisation of drugs?

Most of us take ‘mood altering substances’ whether alcohol, tobacco, marijuana (cannabis), cocaine or heroin to name but a few. They are all dangerous and account for disease and death. What is the rationale behind making some legal and others illegal?

Ever since the deaths of four of my patients from heroin use in the 1980s, during my time as a GP in Marlborough, UK – young people branded as criminals for the use of the drugs let alone the stealing and other crimes they were all involved in, in order to pay for the drugs – I have been convinced that by bringing all drug use into the public health arena rather than the criminal justice system, we would have a major impact on mortality and morbidity rates and of course on crime rates, including knife crime, and our prison population.

I have no doubt that my four patients would be alive today, having received the help they deserved within the National Health Service, if it were not for the fact that what they were doing was illegal and therefore they felt unable to seek that help.

Let’s consider some facts pertaining specifically to the UK:

o          In 2018 there were 7,551 alcohol related deaths and approximately 78,000 smoking related deaths.

o          In 2018 there were 4,350 deaths from heroin and morphine related substances

o          Only 8.6 per cent of adults between the ages of 16 – 65 use illicit drugs whilst over 80 per cent drink alcohol.

o          14 per cent of men and 15 per cent of women are in prison for drug related offences = 8.860 people and re-conviction rates are more than double for prisoners who reported using drugs in the four weeks before custody compared with prisoners who had never used drugs (62 per cent versus 30 per cent).

o          19 per cent of people reporting heroin use, said they had been introduced to and used heroin for the first time while in prison.

o          It costs £37,543 per year to keep a prisoner in jail at the taxpayers’ expense.

In 1974 an estimated 50 per cent of men (including myself!) and 40 per cent of women smoked. Now those figures have dropped to approximately 20 per cent for both men and women, precisely because of the public health measures that have been introduced.

Us older generation remember the days when during parties, dropping into the pub for a pint or even travelling by bus, train or air one would be surrounded by smoke and smokers. And yet that is a thing of the past precisely because of laws introduced as public health measures rather than the habit itself being outlawed.

There are signs of the beginning of a global change of attitude and decriminalisation has already taken place in several countries in the world. In the UK we are getting left behind.

In Portugal where drug use was decriminalised in 2001, the findings have been that there has been:

o          an increased use of cannabis.

o          decreased use of heroin.

o          increased uptake of treatment for drug related problems.

o          a reduction in drug related deaths.

In Portugal decriminalization has enabled earlier intervention and more targeted therapeutic responses to drug users and also increased collaboration across a network of services and the increased attention to adopting policies that work. This is perceived to be reducing the level of current and future drug use and harm.

To what extent is our attitude to drug users in the UK fuelled by the current illegality of what they are doing – “They’re all criminals and scroungers!”? And how far is it obstructing a proper pragmatic and human approach to their problems?

What will it take to persuade the Murdoch press and thus our politicians that decriminalisation of all drug use is the course we should take here in the UK and that by doing so we shall dramatically reduce the prison population and its cost at tax payers’ expense, and, with the provision of proper care for those with drug problems, reduce mortality and morbidity rates particularly among the young?

And think of the impact on criminal gangs that will be put out of business, on the need for ‘stop and search’ which has such an awful reputation particularly amongst ethnic minorities who are grossly and unfairly targeted by the police, and those young people persuaded by gangs to act as ‘drug lines’ to rural communities…. etc.!

Surely the rational approach is to accept that we all, at least most of us, take mood altering drugs in one form or another, all of which are dangerous if taken inappropriately, and that by bringing them all into the public health arena rather than the criminal justice system, and making these drugs legally available, but with controlled access, we shall be making our countries considerably safer and healthier places in which to live and work.

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