Five models for regulating illicit drugs

An article in the British Medical Journal neatly describes the circular logic of prohibition and then proposes models for regulation within legalisation or decriminalisation.

Writer Stephen Rolles first challenges several prohibition axioms including the belief that ending prohibition would increase drug use. He argues that the harms of prohibition are not only greater than the harms of drugs, but increase those harms.

He then describes the circular logic of the War on Drugs thus:

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.11 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,12 13 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.14 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. 

Later in the article, Rolles presents the five basic models for regulating drug availability proposed by the long-established UK lobby group Transform:

• Medical prescription model or supervised venues—For highest risk drugs (injected drugs including heroin and more potent stimulants such as methamphetamine) and problematic users

• Specialist pharmacist retail model—combined with named/licensed user access and rationing of volume of sales for moderate risk drugs such as amphetamine, powder cocaine, and methylenedioxymethamphetamine (ecstasy)

• Licensed retailing—including tiers of regulation appropriate to product risk and local needs. Used for lower risk drugs and preparations such as lower strength stimulant based drinks

• Licensed premises for sale and consumption—similar to licensed alcohol venues and Dutch cannabis "coffee shops," potentially also for smoking opium or poppy tea

• Unlicensed sales—minimal regulation for the least risky products, such as caffeine drinks and coca tea.

The article has been endorsed by the outgoing President of the Royal College of Physicians, Professor Sir Ian Gilmore and has sparked another anti-prohibition editorial in The Guardian which also cites leading Barrister Nicholas Green who says prisons are overcrowded with criminalised drug users who should not be there. Green, writing for the Bar Council, laments cuts to legal aid in the UK and offers decriminalisation as a more rational way to cut costs in the jail system.

People who unthinkingly repeat prohibitionist mantras -- especially authoritative academics talking to the media -- need to get with what's happening overseas, especially when it comes from such illustrious sources within their own profession. If they continue with their views, they need to rebut the arguments thus presented or be exposed as mere ideological charlatans,

[Numbered references are footnoted in the BMJ article]