Global War On Drugs 'Has Failed' Say Former Leaders

[crazy canuck]

Why do you guys assume that under a medical model, presently-illegal drugs would be covered by government insurance plans?

There are plenty of medications that patients have to pay 100% for, ie are not covered.

If it isnt then that defeats one of the main benefits of legalization.  The reason there is so much crime around drugs is because people need to steal/commit other crimes to get money to feed their addiction. 

[crazy canuck]

Having a prescription doesnt mean your medication is covered.

True, it depends on what medications are covered by whatever insurance scheme your particular jurisdiction uses.  But the point is for legalization to work it would have to be covered.

[Jacob]

-because something is prescribed, and legal, it is destigmatized.  Plenty of nice middle class kids would never take a hit off of a crack pipe, but they may be much more willing to take some Oxys after their friend describes how good they make you feel - and they come in a nice safe pill form.

Plenty of nice young middle class kids already do. I know a not small number of people with respectable careers who manage to do I don't know how many hundreds of dollars worth of designer pills on a regular basis. Other than the drug use (and selling to each other), they don't do anything criminal to support their lifestyle. It's not the law that stops kids or doesn't stop them from using drugs.

-once something can be prescribed, it can be over-prescribed.  Drug seeking clients are a huge problem for front line physicians and pharmacists - and they all know who the easy sources for prescriptions are

This is a significant concern, but one that I think can be addressed through appropriate regulation.

-if you make such prescriptions to hard to access, then you haven't done anything to shut down the illegal sources.

Obviously you have to find the right balance there, but I think the guarantee of a controlled dosage and a safe environment for administering the drug may well be attractive to a number of users.

-and it's easy enough to sell to others.  Again, there's a booming black market in pills.

So it's unlikely to get any worse

-You start loading pharmacies with cocaine and heroin, and they're going to be robbed / stolen from a lot more.

Nothing says that regular pharmacies are the best way to distribute the drugs, even under a medical model. Also, presumably if it's easier to obtain the drugs, addicts will be less likely to commit crimes to get their fix.

[Malthus]

As I said before I don't have a problem with treatment programs (indeed I support them), and in particular treatment programs that such as methadone that involve prescribing less harmful drugs.

But the whole concept of "medicalizing" hard drugs?  I don't think it's the answer.

One of the fastest growing addictions in the west is addictions to prescription medication.  Oxycontin is the most well known name, but any number of prescription drugs are being abused.  And the fact these drugs are legal and being prescribed doesn't make them a whole lot less damaging.

It is true that it will do nothing for the problem of addiction. No model is going to fix that. The "medical model" will not make people not be addicts - but then, neither does the "criminalization" model.

I disagree thought that "the fact these drugs are legal and being prescribed doesn't make them a whole lot less damaging". While addiction to drugs is in and of itself damaging, a primary cause of actual acute mortality associated with drugs has rather directly to do with their illegal status - mainly, the fact that many are contaminated and/or of uneven potency (particularly a problem of course with injected drugs). Having a pharma model will at the least solve that.

-because something is prescribed, and legal, it is destigmatized.  Plenty of nice middle class kids would never take a hit off of a crack pipe, but they may be much more willing to take some Oxys after their friend describes how good they make you feel - and they come in a nice safe pill form.

I don't think that this is going to be a serious concern. Certain drug use is always going to be stigmatized no matter what (for example, injectibles). I can't see middle-class kids sticking themselves with needles even if they were legal.

-once something can be prescribed, it can be over-prescribed.  Drug seeking clients are a huge problem for front line physicians and pharmacists - and they all know who the easy sources for prescriptions are

Sure, but mostly because physicians must tread the line between prescribing for legitimate pain control and merely maintaining an addiction (with the latter being unethical).

The model being proposed would allow for express addiction maintenance being a legal, legitimate and ethical medical choice. That ought to cut down the drug-seeky patients pestering multiple docs.

-if you make such prescriptions to hard to access, then you haven't done anything to shut down the illegal sources.

Why make it hard to access?

-and it's easy enough to sell to others.  Again, there's a booming black market in pills.

Again, that's because in order to get the "good" pills, you need to have a medical indication - which does not include addiction maintenance.

-You start loading pharmacies with cocaine and heroin, and they're going to be robbed / stolen from a lot more.

Pharmacies already deal with issues relating to the storage of narcotics. Why would the situation get *worse* if these drugs were now easier to obtain? Rather the reverse will happen - you will undercut the incentive to steal, because the stuff is relatively easily available by addicts.   

[Barrister]

You guys can't even agree with each other.

Malthus says that under "medicalization" middle class kids won't get caught up in legal pills, while Jacob says they already are.  Jacob agrees that over-prescription can be a problem, while Malthus does not.

[Malthus]

You guys can't even agree with each other.

Malthus says that under "medicalization" middle class kids won't get caught up in legal pills, while Jacob says they already are.  Jacob agrees that over-prescription can be a problem, while Malthus does not.

You mean we aren't group minds, all thinking alike? 

[Razgovory]

Over prescription is a problem at the local mental health place I go to.  A doctor there recently got canned for it, he was essentially seduced by some some chick and gave her anything she wanted.  Methadone, Benzos, you name it.

[Malthus]

Over prescription is a problem at the local mental health place I go to.  A doctor there recently got canned for it, he was essentially seduced by some some chick and gave her anything she wanted.  Methadone, Benzos, you name it.

Heh, reminds me of the Simpsons - Dr. Nick Riviera. 

[Camerus]

I think BB brought up a number of good points. 

Ultimately, to my mind the biggest concern is that "medicalizing" drugs would simply make their use and abuse much more widespread.  As I've said before, I'd likely have tried, say, cocaine if it were not for the fear of buying street crap and facing criminal penalties, and I am not alone in that.

[garbon]

As I've said before, I'd likely have tried, say, cocaine if it were not for the fear of buying street crap and facing criminal penalties, and I am not alone in that.

Do you think you'd quickly become an abuser though?

[Malthus]

I think BB brought up a number of good points. 

Ultimately, to my mind the biggest concern is that "medicalizing" drugs would simply make their use and abuse much more widespread.  As I've said before, I'd likely have tried, say, cocaine if it were not for the fear of buying street crap and facing criminal penalties, and I am not alone in that.

My argument with BB is that all of the actual evidence, gleaned from places where such changes have been tried, appears to suggest the opposite.

http://www.theglobeandmail.com/news/world/americas/war-on-drugs-a-failure-international-panel-declares/article2045400/

Decriminalize or give legal access to some drugs to undercut organized crime

The report praises the way Portugal and Switzerland approached their drug problem.

In 2001, Portugal decriminalized the use and possession of all illicit drugs. In the ensuing decade, there was a slight rise in drug use but at the same pace as other countries where drugs remained criminalized.

Since 1994, hard-core addicts in Switzerland are able to get measured doses of heroin at government-approved clinics. The Swiss program has been credited with reducing crime and ending Zurich's infamous "Needle Park." As junkies found legal sources for their addiction, the report says, criminal suppliers became less visible and heroin less accessible for casual or novice users.

[Barrister]

All of those are much less far-reaching than what you suggested.

I was interested in the last few words you quoted - my biggest concern about giving addicts an easy supply is that you make the drug more accessible to new users.

[Valmy]

you make the drug more accessible to new users.

That is called sending your kid away to college.

[Malthus]

All of those are much less far-reaching than what you suggested.

I was interested in the last few words you quoted - my biggest concern about giving addicts an easy supply is that you make the drug more accessible to new users.

What I'm saying is that, in places where changes to the drug legislation have been attempted, actual evidence suggests that the evils that you are anticipating did not in fact occur - this, based on the latest study of exactly the question under discussion. Though of course I'm open to any facts that contradict this.

The problem here is that there is a huge asymmetry in the evidence - our model has been tried, and is a self-evident failure; other models have been tried, with better success. Why are we clinging to our failed model, when there is no hard evidence it works, and lots of hard evidence it doesn't? Why reject other models, which have been shown to have better outcomes? Sure, they ain't perfect, but they are better than what we do. 

[DGuller]

The problem here is that there is a huge asymmetry in the evidence - our model has been tried, and is a self-evident failure; other models have been tried, with better success. Why are we clinging to our failed model, when there is no hard evidence it works, and lots of hard evidence it doesn't? Why reject other models, which have been shown to have better outcomes? Sure, they ain't perfect, but they are better than what we do.

Rejecting our current model means admitting that the hard work of all the Strixes out there was for naught, and ultimately pointless.  It also means legalizing something people don't approve of, which is never a smart political move.