Letter to forth.ie – ‘Losing our minds on drugs’

forthfp

Here’s a letter I’ve just sent to Forth.ie:

Dear Sir,

I read with interested your article ‘Losing our minds on drugs’ which discussed the recent furore surrounding the now controlled recreational substance mephedrone.  Your article correctly identified that much of the reporting concerning mephedrone’s harms was inaccurate and that subsequent government policy owed more to moral panic than level-headed analysis.  The rest of the piece bemoans that drug use is not the ‘relatively straightforward issue of civil liberty’ that it should rightfully be and criticizes doctors who would wish for medical expertise to override politics.

Whilst it may be attractive philosophically to consider that drug use is a ‘private behaviour’ and ‘no business of the state’, I would question whether this position is workable in practice.  The legalisation of all drugs that this supposes would have some benefits.  For instance a drastic reduction in crime might be expected.  For users there would be freedom from criminal dealers and purity of product.  However many drugs of abuse have effects on physical health which would presumably be addressed by state run healthcare systems.  Addiction is also a cause of unemployment.  Drug use can hardly be described as a ‘private’ matter if users are supported on benefits and after use care is socialized.

If we can agree that there should be some restrictions on substances of abuse then the question is how this should be settled upon.  The current UK Government approach is muddled.  The Advisory Council for the Misuse of Drugs (AMCD) exists to advise the Home Secretary about drug policy.  Recent form suggests that the Home Secretary is happy to listen so long as the AMCD is saying what he would wish to hear.  Drs Taylor and Carlin had been incorrectly informed that their opinions were of interest and rather than chastised for their ‘demand that medical expertise override politics’ might be forgiven for expressing their dismay at discovering otherwise.  The UK Government appears to have a moral agenda but one which they have wished to present as a having scientific credentials.

Finally, is it reasonable to invoke of the harms of legal drugs in the discussion of illegal ones?  You appear to think not.  It’s certainly simplistic to dismiss the need to control currently illegal drugs on the basis that alcohol is much more hazardous.  But can it be possible to make a true assessment of the harms of illegal drugs without comparison to those which many people currently know and use?   This presumably is an equation into which a user of illegal drugs enters regularly enters.

Yours etc.

Stephen Ginn MD

As seen on forth.ie

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5 Responses to “Letter to forth.ie – ‘Losing our minds on drugs’”

  1. Ania says:

    I do not understand one think. why so many people, who have normal life and we could say that they are happy but they are addicted to drugs?

  2. R says:

    I odn’t understand why your brain skps straight from “Legalised drugs will still cause some harm which may have to be picked up by healthcare and benefits systems” to “so if we both agree there should be restrictions on substances of abuse”. Have you heard of tax?

    Also, if I take some cannabis, I am not “abusing” that cannabis. I am using it. Abuse of drugs is something like taking codeine I was prescribed for migraine in order to get high. If I bought the codeine myself from a codeine seller which was sold to me as a substance for getting high, I’m not abusing it. I’m using it.

    The arguments for legalisation are if anything the result of thinking practically, not idealistically.

  3. I take your point that ‘misusing’ is an unfortunate term if you are in fact using a drug very carefully, but it just happens to be illegal. But if we were to ask someone in government or in the police they’d probably say that it’s not possible to merely ‘use’ these drugs as they are illegal. This is why I refer to illegal drugs in this way. It’s necessary to take some shortcuts when writing stuff like this, otherwise it’s very cumbersome to read.

    You slightly misquote me with respect to restrictions on drugs use. I am not suggesting that I have made a case for drugs being resticted by government so watertight that no one can disagree. In the piece I am merely wish to move the argument on to discussion of the issues around how a drug restriction regime should be decided upon should we be able to agree that some sort of action was necessary.

    By my reading the forth article made four points:

    1. the harms of mephedrone were being misrepresented
    2. doctors should not dictate policy – this is a place for govenment
    3. the use of drugs is a private matter and there is no need for state intervention.
    4. comparing alcohol and illegal drugs is not comparing like with like

    I agree with point 1.

    What I wished to say about point 2 is that the UK government has set up a drugs advisory council and then ignored its findings. Although I would consider it rather blinkered, I would in some ways prefer it if the Home secretary were to say ‘we have a moral objection to drugs. We’re not interested in any other opinions’. As the situation stands at the moment they have a moral agenda masquerading as an evidence based one. So I don’t think it’s fair to criticize doctors for wishing to make drugs policy when they had been led to believe that that was what their role on the ACMD was.

    Point 3. Is drug use a private matter? Forth says ‘yes’ but doesn’t tell us much about what this world would look like. I suggest that althought this would be preferable to the current situation in some ways (i.e. not criminalising whole sections of the population), how can drug use be truly private if the state is expected to pick up the pieces? I would count taxation as state interference/restriction albeit soft touch, so anti-forth so to speak.

    Point 4. I consider alcohol use a much bigger problem than illegal drug use. However invoking the problems of alcohol does not negate the need for a discussion of the harms of currently illegal drugs.

    Thanks for your comment, I appreciate a chance to debate.

  4. R says:

    Thanks for replying to my comment – I didn’t expect it :-) I think you’d probably be surprised that I actually agree largely with what you wrote in the article, and really only picked on a couple of things to mention.

    The use/abuse thing happens to be something that has always irritated me personally, as it seems to be an insidious usage which pushes the idea that using a drug for any reason other than doctor-approved treatment of illness is incorrect usage (acording to whoever it is that dictates correctness). It seems any drug use is abuse to these people, and the rest of us just quietly go along with it. Like the idea that the FACT want us to believe that downloading a film is the exact moral equivalent to stealing a DVD off the shelf, or indeed taking someone’s car or handbag, and will call people who download material “pirates”, when in the past only people who sold illegal copies were so called.

    I recognise that you are using “abuse” in the context of the term “substances of abuse”, which seems to me itself to be a cumbersome construction, albeit one needed for precision in medical contexts. Still, it bothers me that it’s used in relation to drugs like mephedrone, whose sole use and reason for existence is as a recreational drug.

    I see your point on number three, as you summarised it – taxation is, as you say, government restriction. I apologise for assuming that by restriction you meant legal consequences for use and sale – in my experience most who talk about drug restrictions (rather than regulation) seem to mean that, but I perhaps had not read you closely enough.

    An argument on whether certain very risky behaviours should be somehow taxed in order to pay for the harms caused is a massive one and probably too big and tangential to go into now. It might be interesting to see the tax paid on each cigarette or alcoholic drink as a little insurance premium. If so, it’d be easy enough to slip most recreational drugs into that system. Also, I’m willing to bet that treating it in that way would dramatically change the amount of tax on cigarettes, alcohol, and other substances/activities.

    I’m not sure what Forth’s general political slant is – some flavour of libertarian, I’m guessing, but a lot of its content is behind a pay-wall so it’s hard to tell – so I don’t know how to interpret that article. If they are extremely libartarian or anarchic then I suppose they would consider any taxation of drugs to be undesired state interference, but I’m thinking of tax levied for purposes of paying for dealing with health and other problems, not the government’s current system of deciding tax levels, which seems to be two parts behaviour-modification through pricing to three parts gratuitous fund-raising which disappears into the coffers to one part vindictive moralising. I haven’t anywhere been able to find, for example, the exact amount of money raised through tobacco taxation compared to the amount tobacco use costs public services.

    (One thing I’ve always wondered about debates on drug laws is whether people advocating legalisation would suggest absolutely all drugs, for example, antibiotics, should be legalised for anyone to buy.)

    On point 4, there is also the fact that it’s pretty much impossible to prevent people getting access to alcohol. Unlike specific plant-derived drugs, like cocaine, and drugs created in laboratories, like mephedrone, it’s so incredibly simple to make alcohol from stuff that’s lying around that you’re just not going to be able to get rid of it, so you’re probably better off letting people buy vodka, cause it’s at least not going to be full of methanol. So the question of harm caused by alcohol is I think separate.

    Sorry if none of the above makes much sense – it all seems coherent to me right now, but who knows what I’ll think in the morning :-) Also, I’m sorry that you feel I mis-represented your position. Looking at what I wrote, it is pretty brusque. Must learn to control that!

  5. Zara says:

    The public policy concerning drug use and the legal status of narcotics is hypocritical as long as it allows certain drugs (alcohol, tobacco) and outlaws others (cocaine, marihuana) based solely on arbitrary criteria and without any regard for scientific research and common sense. If certain drugs are forbidden because they are considered a health risk then alcohol and tobacco should be outlawed immediately because it’s been proven they’re far more dangerous and addictive than say marihuana or MDMA, both illegal substances. My point of view is that all drugs should be made legally obtainable by persons over the age of 18: this way there’s no discrimination, drug-related crime or unnecessary deaths due to impure chemicals. I doubt they’ll be a significant increase in problematic use (alcohol is freely available yet most people are clearly not addicted or unproductive because of excessive drinking) and there will always be healthcare expenses due to improper use of drugs, regardless of whether they’re made legal or not. At the very least it’s naïve to think people will abstain from certain types of behaviour just because the law rejects them. Now there are large expenses due to healthcare for addicts or drug related accidents, plus huge expenses in terms or law-enforcement (manpower, means) and the judicial system’s war on drugs. If all drugs were to be made legal those expenses would cease to be necessary and the money could be used for more worthwhile causes such as economic growth measures, fighting poverty (a major cause of drug use) and rehabilitating addicts. In the long run this would do more to combat the problem of drug abuse (take away the underlying causes for drug abuse and you will greatly reduce the rate of abuse itself) than the hypocritical and ineffective policy we have now.

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