Our Attitude Towards Drugs and Drug Users Needs Rethinking

I’ve been spending a good deal of time examining drug policy and our attitudes towards drugs, particularly in North America, over the last while. It’s a subject I’ve given a lot of thought to over the years but with vaping in the news so much the last half year or so, and with the laws around marijuana changing at breakneck speed (though arguably still not fast enough), it’s renewed my interest in delving deeper again. 

We, as a society, have decided that some drugs fall into the category of perfectly acceptable and others fall into the bad category and we’ve made rules around this distinction. It’s an arbitrary distinction for the most part: those drugs we widely use and enjoy are “good” (alcohol, caffeine, increasingly- marijuana, and some pharmaceuticals), others are “bad” (cocaine, heroine, street amphetamines- not to be confused with acceptable prescription amphetamines, etc.), while others still exist on a moving spectrum (nicotine and hallucinogens, for example). Any of these is subject to moving categories, depending on the mood of the day, though some are more thoroughly entrenched in their category. Alcohol and caffeine for example, just try even suggesting these move from the “good” category for a quick and nasty backlash. Though the impulse for prohibition hasn’t curbed, alcohol is well in the safe zone these days. As it should be, prohibition has never worked as supposedly intended. 

Who uses a particular drug guides our thinking. Alcohol and caffeine are widely used and not only accepted but celebrated. We love our alcohol and caffeine, so much so that we frequently combine them. Though alcohol is a potent drug, day drinking is completely acceptable- a shot of whisky or Bailey’s in your coffee, a mimosa to celebrate the start of a promising day, drinks at lunch. Acceptable if you are a certain color anyway, and of a particular social standing. If you have a home, a job (or money in the bank), and you are Caucasian you can pretty much drink any time you want and no one will bat an eye. That same practice is frowned upon if you are, say, Native American (of any social standing), or poor, or homeless. 

“Bad drugs” can even lose their bad qualities, used by the right people. Think a cocaine fueled bachelor party, micro-dosing in the intellectual crowd, college students using speed during finals. Not so bad. There are even trendy getaways to be planned, to the rainforest and other exotic locales, to experience the mind bending experience of hallucinogens that one can humble-brag about later on social media. Context is, apparently, everything. So it’s a moving line, this distinction we’ve made, but it exists. There are good and bad drugs, largely based on who is using them and how prevalent use is. 

Our answer to this has been to prohibit certain drugs and criminalize their use. (It’s useful to keep it in mind through the rest of this discussion: this is again largely applied in a discriminatory fashion. Rich, white kids can- generally- use cocaine without fearing criminal charges, black kids should be careful not to be caught in the same room as the drug. Them’s the rules, I don’t make them.) This despite the fact that prohibition and criminalization has not curbed use. Also despite the fact that it makes drug use considerably more dangerous, and helps criminal enterprises to thrive. It seems counterintuitive, that we would push something that we (somewhat) fear into the underground where we have absolutely no control. Until we understand that forced risk is our decided means of control. 

There is a belief that taking away freedom of choice, or narrowing the choice to a) what we want someone to do and b) death, will force people into the action we want them to take (in this case, not take the prohibited drug). But the evidence tells a different story, and somehow we’ve managed to convince ourselves that that is okay that some people will have to die in order to force our point. Let’s just pause here for a moment to absorb that: some people will have to die in order to force our point

That’s a stunning position to take but it’s one that, as a society, we’ve largely agreed upon. It doesn’t particularly divide along partisan or socioeconomic lines, religious or non-religious lines, between genders, educated versus uneducated. Enough of us agree that if a person chooses to use an illicit drug, they have made a decision so serious that whatever comes their way up to and including death is ultimately fair. This in spite of the fact that most of us use drugs of some kind or other and some of us are very enthusiastic about that use, connoisseurs if you will. 

It might surprise some people to learn that it’s not the use of illicit drugs that is inherently deadly: it’s the risks and the penalties that we pile on top of the drug use. When we hear that someone has overdosed, many of us envision someone who has taken too much of a drug- that they just carried on partying until they hit fatal levels. But that’s not the case for most drug-related deaths. Bad drugs, drug poisonings, are. Take the opioid crisis, for example. The leading cause of death related to opioid use is a toxic drug supply, namely that drugs are being laced with fentanyl. Vancouver’s mayor, Kennedy Stewart, recognized that fact when he called on Health Canada to allow for an exemption for pharmaceutical grade heroin to prevent deaths. There was a similar crisis during alcohol prohibition from drinking tainted liquor and more recently dozens of deaths in the United States have been attributed to tainted black market THC cartridges. The fact is that prohibition and criminalization does not prevent the use and distribution of drugs, it simply hands regulation of certain drugs over to the underground market and criminal enterprises. 

It also makes criminals of certain drug users and raises the level of risk involved in obtaining drugs. If John or Mary wants a bottle of rum, all they have to do is go to the store where they can safely purchase their untainted, regulated alcohol. If John or Mary wants cocaine they will need to find and hook up with a dealer, pay an inflated price for the product, hope that the product isn’t cut with anything dangerous or cut to the point of being useless, hope that they aren’t assaulted or robbed at or along the way, and hope (if they are poor or persons of color) that they don’t get arrested in the process. If anything does happen to them, they will have to deal with the repercussions because being involved in an illegal act means you can’t call for help without risking arrest. If they are arrested, they face jail time and a criminal record that will affect the rest of their lives- where they can live and work, the volunteer work they can do, barred from travel. If they spend time in prison, well, that’s a whole other article. Suffice to say time in prison carries far more long lasting consequences than any person should have to carry for simply doing drugs of any sort. 

Note that these scenarios don’t take into account what a person does when they’re on drugs: only the category of drugs that they are on. The drug that is in their own body, that they’ve chosen to consume. As someone who takes their independence very seriously, this public breach into the private sphere is deeply disturbing, and I say this as someone whose only drug use is limited to nicotine and small amounts of caffeine. But what (or who) I choose to put into my body is none of anyone’s business but my own, or it shouldn’t be. If you aren’t similarly unsettled, ask yourself why- why should your neighbours have a say in what you do with your own body? Why should you have a say in what they do with theirs? And where in the hell does any of us get off asking the government to intervene in someone’s private life?

We can’t fall back on the “for their own good” argument. It’s been proven false. Prohibition and criminalization have not saved anyone, nor discouraged use, or wiped out any class of drug. Drug cartels are doing very well. Illicit drug use remains more or less stable. Kids, your co-worker, your doctor, continue to be able to buy illegal drugs. New drugs continue to be developed. The drugs market is flourishing. Though difficult to put a number on, the global drug trade is estimated somewhere in the hundreds of billions a year. Cocaine and opiates alone were estimated at 153 billion by Global Research (that is, for comparison, 153 times higher than the lucrative criminal firearms trade) and that is conservative compared to Global Financial Integrity (GFI) estimates.

Further, we know that criminalization is applied unequally. We know this. We know that health outcomes, employment opportunities, housing stability, education, and life expectancy are all limited for marginalized communities. The only area that marginalized communities fare better in is the likelihood of arrest. So we’re taking an already disadvantaged group and slashing their future prospects even further while simultaneously protecting already privileged people from facing the same consequences. And the reason we most often give for letting people of privilege off the hook is that we don’t want to ruin the rest of their lives for a minor infraction. It’s institutional discrimination and worse, it’s largely accepted as fair. 

The fear that legalization would “encourage use” assumes that the reason more people aren’t doing cocaine is that it’s illegal. If you abstain from illicit drugs, is that why you’re not using cocaine, or heroin- because it’s illegal? But if it was legal you would squeeze in a stop at the dispensary between Starbucks and Trader Joe’s? Many people who make this argument know it doesn’t hold true for them, but they worry that their neighbour or friend or coworker is made of entirely different stuff. It’s a weird little patronizing tick that doesn’t hold up to scrutiny but like any tick is difficult to shake. 

 We stigmatize illicit drug users yet SAMHSA (Substance Abuse and Mental Health Services Administration) estimates that 28.6 million Americans aged twelve or older, or one in ten Americans, had used illicit drugs in the last month (in 2016). That means, save for us hermits, everyone knows someone who uses illicit drugs. And of those, only 10% struggle with addiction or uncontrollable use.  

As of 2017 (prior to the legalization of cannabis), Statista reported that 46.6% of Canadians had used cannabis, 10.4% had used cocaine, 3.7% used speed/methamphetamines/crystal meth, 14.3% used hallucinogens, 7.6% used Ecstacy, and 0.7% used heroin in their lifetime (“ever used”). According to Health Canada, in 2015 almost four million Canadians reported having used an illicit substance in the previous year (there were approximately 35.7 million Canadians in 2015, so not quite 12%). That’s a whole lot of people using illegal drugs. In Canada, the group with the highest rate of illegal drug use are those aged 15-24 years old. So those with the most life ahead of them are the ones at greatest risk from the known harms associated with the black market. 

Health Canada acknowledges that, “We know that people use substances for a lot of different reasons, including for personal enjoyment, to relax, socialize, or to cope with pain, stress or other problems. Most will do so without causing harm to their health or well-being.” So why must we, as a society, increase the risk to some people based on our arbitrary decision of good versus bad drugs? It’s easier to see people as one dimensional, as a threat to themselves and to others- a criminal deserving of whatever ends they meet. It’s moral posturing at best. It’s certainly not based on any expected outcome, or shouldn’t be given the evidence. 

We are spending considerable sums of money both on fighting the so-called war on drugs and on incarceration (mostly of drug users and low level drug sellers). We have not dampened demand or production of “bad” drugs in the least. We are enriching criminal organizations. And we are putting people at greater risk than need be simply for their choice of using one drug over another. If we weren’t so limited in our imaginations perhaps we could see our way clear to taking responsibility to regulate a market that is clearly here to stay. In the meantime, one family at a time is left to absorb the impact that our war on drugs is having. 

It shouldn’t be down to those in favour of decriminalization or legalization to make the case; the case has been made. The onus should be on those who would see us continue a punitive, costly, and deadly course of action to justify their position. (Leaving aside the moral grandstanding- please.) It is so infuriating to see safe supply and drug policy reform advocates on the back foot, having to make their argument from a defensive position. It is time for us to flip the narrative, flip it all the way over. All of the evidence, spanning decades, points to the danger and cost of prohibition and criminalization. This tough love approach is light on love and heavy on disastrous effects. Let’s have the proponents of this failed strategy make their case for preserving it with the same burden of evidence that harm reductionists have been required to all of these years.

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