In a major development for Frontier Psychiatrists everywhere I wrote this article which was published on the Guardian newspaper Comment is Free website on Friday 11 September. Not that it really matters, but up until this point this blog was semi-anonymous, and this has comprehensively blown my cover…
The former president of Brazil, Fernando Henrique Cardoso, said last week that the war on drugs had failed and that there was a need for a new global strategy concerning illegal drug use with a shift toward decriminalisation. Although progress is glacial, his sentiments do appear to reflect a growing change in attitudes, the most concrete example of which has been Portugal’s 2001 decriminalisation of all drugs, giving it the most relaxed drug laws in the European Union.
Portugal’s move has not led to nightmare scenarios of out-of-control drug use or “drug tourism” and has allowed Portuguese healthcare to more effectively offer treatment programmes to its citizens. Should Portugal’s move become a trend, a future UK government may be tempted to follow suit. However, before taking steps that may increase the ease with which currently illegal substances may be possessed and consumed, the will must be found to tackle our crisis of excess alcohol use, a drug that is already legal and widely available.
Many people use alcohol moderately and sensibly. However, millions of us do not. The harm alcohol causes is so broad that it is hard to adequately summarise it. The problems with health and public disorder are well documented, but more invisible is the toll it takes on relationships and mental health. It affects young and old; today an article in the Lancet identifies alcohol as a major factor in teenage mortality.
Despite this, the government’s attitude towards alcohol use has been predominantly soft-touch and we have seen a relaxation of licensing laws as well as local councils that appear to think nothing of allowing so many bars in certain high streets that they become a virtual no-go area to all but the most intoxicated. The large commercial concerns that produce and sell alcohol have been allowed to go about their business largely unchecked and alcohol use is widely encouraged by virtually unrestricted advertising and pricing practice. Also unhelpful is the socially corrosive veneration of alcohol-related culture that is displayed by some influential institutions, including student unions and some radio stations, whose shows regularly encourage people to relate stories of alcoholic excess.
Decisive action is needed towards curbing alcohol misuse. A report this week from the BMA calls for alcohol advertising to be banned and for the trend of music festival tie-ins to be similarly prohibited. A reduction in the density of licensed premises in town centres is also recommended.
Alcohol pricing must more accurately reflect its cost to society with the introduction of minimum prices for alcoholic drinks. More broadly, public opinion makers need to become aware of the effects of the attitudes they propagate and on this issue seek to lead rather than follow. There is cause to be optimistic: the realignment of attitudes toward drink-driving and smoking in public places shows that major shifts in policy and public perceptions on drug-related issues are possible and can take place relatively quickly.
Follow-ups in CiF
The case for legalising all drugs is unanswerable 13 September 2009
Addendum 16 September 2009