Re-establishing the primacy of a public health / harm reduction approach

'After the War on Drugs, Tools for the Debate' part 10

Once the meaning of control and regulation is made clear, it becomes much easier to grasp that the response to illegal drugs need not be any different to our current response to legal drugs (see ‘fault-lines within existing policy’ ), or for that matter any other issue in the public health arena. Making the case for a public health-led response is crucial to getting the reform message across. It is a concept people are familiar with and understand (in relation to, for example, tobacco policy), and it helps direct the emphasis of the discourse towards evidence-based policy making and harm reduction – and away from the ideological dream of achieving a ‘drug free society’.

The fact that certain drugs are currently dealt with via the criminal justice system is a quirk of the history of prohibition, and not the conclusion of any kind of rational analysis or evaluation. Drugs, quite simply, are primarily a public heath issue and should be dealt with as such by the relevant public health agencies (see principles of drug policy).

Prohibition not only undermines public health efforts to reduce drug harms (by diverting budgets to enforcement and stigmatising the most vulnerable problem users with criminality) it actually increases harms associated with use by encouraging high risk behaviours (e.g. injecting/ sharing needles), it stifles access to accurate safety information, and ensures that dangerous drugs are of unknown strength and purity.

Public health interventions can be shown to be effective (e.g. needle exchanges, treatment programmes, controls on tobacco advertising), criminal justice interventions generally cannot.

Illegal drugs are unique in the public health arena in attempting to use criminal law as the primary method of educating the public. We have a whole range of alternative methods for public health education in schools, workplaces, public spaces, media and the home that can be shown to be more effective (and don’t involve making criminals out of a third of the country).

If the case for a public health-led response can be made effectively, it can only lead in one direction – away from irrational ideological commitments to prohibition and towards evidence based regulation and control. Once you have people thinking along these lines you are well on the way to winning them over.

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