British Medical Journal endorses regulating, not criminalizing, drug use

The British Medical Journal last week published a special edition: ‘Drug users and HIV: treat don’t punish’. It had a series of excellent articles, including one by our friend Steve Rolles at Transform Drug Policy Foundation: An alternative to the war on drugs.

As Transform notes…

In a significant endorsement, the editor of the BMJ Fiona Godlee, in an editorial titled ‘Ideology in the ascendant’ , concludes by noting that:

“In a beautifully argued essay Stephen Rolles calls on us to envisage an alternative to the hopelessly failed war on drugs. He says, and I agree, that we must regulate drug use, not criminalise it.”

You can’t be more clear than that.

And she’s right — it’s a wonderful piece.

I’m going to quote a few passages, but you should go read the whole thing.

The criminalisation of drugs has, historically, been presented as an emergency response to an imminent threat rather than an evidence based health or social policy intervention. Prohibitionist rhetoric frames drugs as menacing not just to health but also to our children, national security, and the moral fabric of society itself. The prohibition model is positioned as a response to such threats, and is often misappropriated into populist political narratives such as “crackdowns” on crime, immigration, and, more recently, the war on terror.

This conceptualisation has resulted in the punitive enforcement of drug policy becoming largely immune from meaningful scrutiny. A curiously self justifying logic now prevails in which the harms of prohibition—such as drug related organised crime and deaths from contaminated heroin—are conflated with the harms of drug use. These policy related harms then bolster the apparent menace of drugs and justify the continuation, or intensification, of prohibition. This has helped create a high level policy environment that routinely ignores or actively suppresses critical scientific engagement and is uniquely divorced from most public health and social policy norms, such as evaluation of interventions using established indicators of health and wellbeing.

After talking about how movements for reform have grown in recent years, including actual efforts in decriminalization and harm reduction (the most that law will allow), he continues…

The logic of both, however, ultimately leads us to confront the inevitable choice: non-medical drug markets can remain in the hands of unregulated criminal profiteers or they can be controlled and regulated by appropriate government authorities. There is no third option under which drugs do not exist. The choice needs to be based on an evaluation of which option will deliver the best outcomes in terms of minimising the harms, both domestic and international, associated with drug production, supply, and use. This does not preclude reducing demand as a legitimate long term policy goal, rather it accepts that policy must also deal with the reality of current high levels of demand.

Rolles then goes on to talk about Transform’s After the War on Drugs: Blueprint for Regulation, which I’ve promoted here before (and which is free online). It’s an outstanding piece of work — the only legitimate report to actually lay out a post-prohibition set of workable models for drug regulation.

The British Medical Journal is one of the most influential peer-reviewed medical journals in the world. For it to warmly receive and endorse a full-throated call for legalized regulation of recreational drugs is a major step.