Monday, May 28, 2007

Sweden's drug policy: A reality check.

The following article, in a slightly edited form, appears in this month's druglink magazine.

Swedish massage

The perception that low drug use levels in Sweden are a direct result of the country’s tough anti-drugs policy is finding considerable traction in the UK. But, argues Steve Rolles, it is both simplistic and misleading.

Ian Duncan Smith is flagging up the success of Sweden’s drug policy in his new in his role as chairman of the Social Policy Review Group, currently overhauling Tory drug policy in the run up to the next General Election. David Cameron visited the country in February in an attempt to distance himself from his days of cannabis smoking. In the words of the Daily Mail he “praised the tougher approach in Sweden, which does not distinguish between cannabis and harder drugs such as heroin, and practices a zero-tolerance policy.”
In September last year the UN Office of Drugs and Crime produced a report titled 'Sweden's successful drug policy: a review of the evidence'. Launching the document, UNODC Director Antonio Costa repeated his catch phrase that 'societies have the drug problem that they deserve', noting specifically that “in the case of Sweden, the clear association between a restrictive drug policy and low levels of drug use, is striking”.
Sweden's 'successful' policy closely follows, in both letter and spirit, that espoused by the UNODC. Because Sweden has comparatively low European levels of drug use it is perhaps unsurprising that the UN’s drugs office chooses to proclaim the country as a model of good practice, especially given the backdrop of rising drug use globally. Sweden, perhaps not coincidentally, is the UNODC's third largest state funder (nine per cent) after the US (13 per cent) and Italy (11 per cent)*, and has the clearly stated and unambiguous aspiration to a 'drug free society'. This manifests in its tough zero-tolerance approach involving heavy handed policing, the widespread rejection of harm reduction principles, and a focus on coerced abstinence-based treatment.
However, by putting the emphasis so heavily on prevalence success, the UNODC conveniently brushes over some of the less positive aspects of Sweden’s drug policies. According to the country’s nascent user movement, the aversion to harm reduction (shared with the UNODC but notably not the WHO, and UNAIDS) has contributed to Sweden's drug death figures doubling from around 200 to 400 since 1990, placing it high in the Euro rankings. Problematic drug use has also almost doubled since 1980 to a level hovering around the European average.
Furthermore, Costa's suggestion that there is a obvious causal relationship between prevalence and UNODC-style drug control policy appears unsustainable. Various countries have comparable or lower levels of drug use than Sweden but have very different drug policies. Greece, for example, (according to the EMCDDA), has the lowest level of drug use in Europe but spends approximately one-fiftieth on per capita drug-related expenditure that Sweden does. Holland, also has well below the European average drug use, spends more than Sweden per capita, but has a tolerant / harm reduction-led policy that is the polar opposite of the Sweden UNODC model. Conversely, another repressively oriented country - third in the Euro drug-related expenditure tables - is the UK, which sits at the top of most European drug use prevalence tables. We have yet to see a UN report titled 'The UK’s unsuccessful drug policy: a review of the evidence', indeed if the UK Government buys into Costa's analysis they must be wondering what they have done to 'deserve' our high prevalence rates.
The alternative theory, one not based on the UNODC's public relations crisis and overtly political prerogatives, would be that levels of drug use are determined by a complex and highly localised interplay of multiple social, cultural, economic and demographic variables, and that government drug policies, specifically enforcement and prevention efforts, have, at best, only marginal impacts.
Dr Peter Cohen, Director of the Centre for Drugs Research at the University of Amsterdam, has argued that Sweden's low level of drug use and repressive drug policy, rather than being causally linked, are in fact both merely expressions of its historically temperance oriented culture, noting that Sweden also has historically low levels of alcohol, tobacco and prescription drug use. It is also worth pointing out that Sweden has low levels of social inequality, social deprivation, and unemployment, combined with a very high level of health and social welfare spending. There's a lot to admire about Sweden, but even they can play drug-war politics.

* since publication of this article a new UNODC annual report has been published with the UNODC funding rankings shifting slightly (see page 89). Creeping into the number one spot for individual state donors, coincidentally in the year the glowing Sweden report is published, is.....Sweden (9%). The US slips to number two (8%) and straight in at number three is.....The UK, at 7% - a shade under 11 million US dollars. Bargain.

Steve Rolles is information officer for Transform


Anonymous said...

A bit rich Steve, quoting Peter Cohen in support of your argument. Peter Cohen makes absolutely no secret of his own drug use and is one of Europe's most strident outright legalisers of all drugs. He has been promoting legalisation for years.

Anonymous said...

david, you divert from the point that uk has a terrible, failed policy...that is continuing along that road of corruption, organised crime and misery.
The ave age of a heroin user in holland is 48, something works what if you want to personally attack Mr Cohen in order to undermine the argument, are you some type of republican, or what?

Steve Rolles said...

I dont think ad hom attacks on the basis of drug use are a valid form of argument, and have nothing to do with the points being made in my article. Ive used drugs with you, albeit legal ones - the suggestion that someone's comments are invalidated by drug use is rather ridiculous, given its near universality.

I also dont see how someone supporting a particular policy position negates their ability to comment on policy debate - what kind of debate would it be if we did that? Given this is our blog - and our position is very public and clear, it seems a bit of an odd comment.

Remember that you are a 'strident outright' prohibitionist and weve been debating policy for years, more or less happily, despite our differences. The UNODC, ofcourse, could hardly be more strident and outright, and they are primarily who my comment piece is about. You are more than welcome on this forum as elsewhere but lets argue about the analysis not attack the people making it. Cohen's comment that i've cited strikes me as an entirely valid one - and I hope I have I have backed it up with strong evidence.

Id be interested to know what you think about the analysis.

Anonymous said...

It is a standard worldwide tactic of those who promote drug legalisation (like you) to quote each other. You have not dissapointed. You promote legalisation, Cohen does also. Anyone paying attention to Cohen should bear his position in mind. I have nothing against him personally, he is actually quite fun. Quoting Cohen however does nothing for your point. An innocent reading your comments might assume Cohen is a disinterested academic with something useful to say. He is nothing like that at all. And, do you have a real point? Sweden is far more succesful than the UK and much of Europe in limiting the harm from drugs legal or illegal. Sweden's position developed from an earlier liberalised policy. It developed from a groundswell of public opinion. As for the Netherlands, the Netherlands is a first-world country with a third-world drugs traficking and criminality problem. It is a drugs warehouse for much of western europe and a manufacturer for the world.Cohen is one of those who proselytyse about how the Dutch have everything right. They have not.

Steve Rolles said...

Im happy to quote people who's analysis I agree with, and in this case I thought Cohen had a valid point so cited it as i have on numerous occassions with numerous authors. Its not unheard of for political commentators to quote people. That doesnt mean I agree with everything they have said - but his point was a good one and I stand by it. Academics have views on lots of things and many dont share yours on the prohibition legalisation/regulation debate. I have lovingly compiled an archive of them infact.

you seem to be suggesting that if i quote people you disagree with that undermines my case - which I find a bit baffling, especially since you dont seem to think I have a case anyway. Can I also politely request that you stop 'outing' me as an anti-prohibitionist as if I have ever hidden or been sneaky about it. I hope that you would respect the fact that Transform is completely transparent in our organisational aims and dont attempt to disguise them. Theres no conspiracy, theres no sneakyness. Its all there on our homepage, in our mission statement and in our publications. I dont especially like the term 'legalisation' or 'legaliser' - for me legalisation is a process not an end point and doesnt usefully describe what a post prohibition world would look like or how drug markets would be legally regulated and controlled once thay had been wrestled back from the gangsters your chosen policy continues to enrich. One of the problems with the term is that it comes with a great deal of baggage, part thanks to misrepresentations by defenders of the drug war, and partly due to oversimplified and polarised media and political debate. Ive just written a soon to be published guide trying to clarify exactly this point that I holpe you will make the effort to read.

on the subject of sweden etc - I hope you will agree that:

1. overall prevalence is not the only measure of drug policy success.

2. determinants of drug use and misuse may be tad more complex than costa suggests.

3. there is no obvious correlation between tough policies and low levels of use/misuse.

I'm sorry that you dont see anything positive in Holland's experience relative to our own, I certainbly can from Swedens.

Anonymous said...

David said: "Sweden's position developed from an earlier liberalised policy."

Please, feel free to introduce me to what gains that particular move has achieved in terms of drug harms. Since 1988, when the use of drugs were criminalized in Sweden, prevalence has actually rissen. Drugs have never been this available and have never been this cheap as they are today.

Jocke from Sweden

Anonymous said...

" Sweden's drug death figures doubling from around 200 to 400 since 1990, placing it high in the Euro rankings. " My comment. Not true.
If one count with the same method as in the rest of EU is the prevalence 2 per 100 000 citizens 15-64 years old, a low number.

There was a rise in supply of drugs when Sweden become a part of EU 1995 (=almost no control at the boaders) Then, the use of narcotic drugs has fallen agin since 2000. Read more in Drug policy of Sweden in Wikipedia

Tino said...

Well Germany has more than 8 times the population of Sweden, but only 3 times as many drug deaths.

I used to think of Sweden as the perfect country, until I heard of their drug policy. Who wants to live in a country where police patrols the bars saturday night to single out drug offenders?

Aspiring a drug-free society is not much different than aspiring a jew-free or a muslim-free society. Its certainly a policy that segregates and discriminates against some minority.

Gustav said...

Having spent time living in the U.S., Taiwan, the Netherlands, and Sweden, I've seen several different political and cultural views towards drug policy. I have to caution against putting another country's entire drug policy on a pedestal as a model that the entire world should follow, as drug policy often follows specific socio-cultural developments, and every system has its ups and downs. That the international debate over drug policy basically comes down to either Sweden is good and the Netherlands is bad, or the Netherlands is good and Sweden is bad, is very sad to me, as these types of arguments over-simplify the issue and polarize people.
That being said, I have to say that after moving to Sweden (where I currently live) there are a lot of darker aspects to the Swedish drug policy that are downplayed by the Swedish prohibition groups:
1. The Swedish approach aims to make the life of people who use drugs more difficult in order to preserve the corrolation between drugs and a destitute life. This is why harm-reduction is so stringently opposed here, and the term 'harm-reduction' itself is mocked in the media.
2. Sweden does indeed have a high amount of drug-related deaths compared to other European countries, three times more than the Netherlands and this statistic was quoted in a recent Radio Sweden special called "Knarket".
3. The debate on drug policy in Sweden is not open. Recently Swedish singer Lykke Li had part of an interview censored from Swedish TV and Radio because she talked of the positive experiences she's had with recreational use of ecstasy. The Swedish TV and Radio said that they believe it is against their guidelines to portray drugs in a positive light.
4. As for the prevalance of drug use, it is growing in Sweden. Instead of rationally evaluating whether the repressive policy plays a part in this the EU and the open-borders are blamed, because part of the Swedish policy is the idea that it's the availability of drugs that causes more people to use drugs. This idea that availability = automatic use is a prevalant theme in Sweden and is also seen in many other policies here.