(Picture from The Economist)

I saw a story on TV about a district attorney in San Francisco who is being accused of failing to prosecute criminals in general and drug users and traffickers in particular. That set me to musing about the American tendency to incarcerate people at the drop of the proverbial hat, which led me to consider the number of generally harmless people in both the US and Canada who are turned into “criminals” for minor offences against our drug laws.

I am one of those un-cool people who have never used Cannabis. Never touched methamphetamine, uppers, downers, crack cocaine or any of the other nasties that bedevil our society. The closest I’ve come to the opiod crisis is that I used to love a cough syrup called Tussionex when I had bronchitis, and it had a little codeine in it. Now, of course, no doctor will prescribe that cough syrup for fear I become an addict and as a result, my not infrequent battles with bronchitis leave me sleepless and sore from incessant coughing. The only recreational drug I’ve ever used is alcohol, and I think I can claim to be a pretty moderate drinker. All in all, I’m pretty much on the outside looking in at the recreational drug scene. 

My experience of smoking dope is that I’ve seen lots of it. When I was in University I quickly came to the realization that many of my peers were smoking up at every opportunity, and very few of them grew fangs and turned into demons. So, I gradually grew to fear “the gateway drug” a bit less. Nevertheless, I did observe a number of young people who went past the point of happy recreational use into habitual and damaging use of drugs, and as a result I suppose I rather automatically came to believe in the battle against drug traffickers as a necessary and difficult war for police agencies the world over.

It’s time to end that war. We’re not winning, and world experience is showing that there’s a better way.

There’s a fine article on This World in Data (thisworldindata.org) by Hannah Ritchie and Max Roser published in 2019 about deaths from drug use. The big killer? It’s not fentanyl, nor heroin, nor crack cocaine. No, the primary factors in drug related deaths remain tobacco and alcohol, and by a large margin.

The article distinguishes between direct deaths from “substance use disorders”, which translates to overdoses, and indirect as a result of substance related health risks.  World-wide they estimated 8.7 million deaths from tobacco risk related conditions, 2.4 million deaths from alcohol risk conditions, and 500,000 indirect deaths from “illicit drug” related conditions. These risk conditions include such things as “premature death from diseases and injury, including suicide, liver disease, hepatitis, and HIV”.

Direct deaths accounted for 168000 linked to alcohol abuse, and 128000 from “illicit” drugs. Illicit drugs are defined as those that have been prohibited under international drug control treaties, and include opioids, methamphetamines, cocaine and cannabis.

Here’s my first observation. The war on drugs, focusing on control of illicit drugs only, can never be very effective at preventing premature deaths when it’s focused on 1% of the problem. I suspect that we accept long slow wasting deaths from tobacco use and we accept alcohol abuse resulting in automobile accidents and liver failure and suicide because those deaths are a bit slower, and we can see them coming. Illicit drug overdoses, by contrast, tend to result in sudden deaths of otherwise healthy individuals, and we find that shocking and unacceptable.

We’re not really interested in talking about tobacco and alcohol risk deaths in this article. I’m just going to consider the acute overdose deaths associated with illicit drugs, which are really the focus for the laws on drug use and drug trafficking. 

I said there was world experience that showed us a better way. Consider the following data on deaths from drug use disorders which I generated from the Our World in Data information for 2019:

US –  200 drug deaths per million

Canada – 67 deaths per millio

Sweden – 47 deaths per million

UK – 40 deaths per million

France – 27 deaths per million

Germany – 20 deaths per million

Spain – 15 deaths per million

Czechia  -13 deaths per million

Netherlands – 10 deaths per million

Italy – 9.4 deaths per million

Mexico – 5 deaths per million

Portugal – 5 deaths per million.

Singapore – 2.8 deaths per million.

I have to confess that I didn’t painstakingly look through the data to find some country other than the US with a greater death rate than ours. But I was shocked to find that we were one of the world’s leaders in this dismal arena. When you have to look hard to find someone doing worse than us, it’s a bad situation.

In a listing of countries that have taken steps to decriminalize “possession of any drug”, you will find Germany, Italy, Czechia, Netherlands, Portugal, Mexico and Spain among others. You will not find Canada, UK, Sweden, France or the UK. In other words, all of the high death countries have strict drug laws and the low death countries, with the sole exception of Singapore, do not.  Maybe that’s just a coincidence, but I doubt it. Strict drug control laws are failing everywhere except in Singapore. 

We could emulate Singapore if we want to. But Singapore’s laws on drugs are draconian indeed – trafficking in drugs can be subject to the death penalty. Teaching someone how to grow marijuana, or possessing drug “utensils” are crimes in Singapore. And for Singapore nationals, leaving the city to get high elsewhere is bad bet – consuming drugs abroad is treated as if it had been done in Singapore, and random checks are conducted on travellers re-entering Singapore.

I’d prefer to treat Singapore as an outlier, with results that probably cannot be achieved in a less authoritarian and repressive regime. Instead we should try to follow the lead of the more progressive European countries.

None of this should come as a surprise to us. The Netherlands started decriminalizing drugs in 1972, so this process has been going there for 50 years. Portugal in 2001, Germany in 1994, Czechia in 2010, Italy in 1975. Portugal is an interesting example. An article on WorldAtlas.com reports that heroin use and addiction in Portugal had reached crisis stage in Portugal in the 1980’s and 1990’s. In 2001 they decriminalized all illicit drugs and began to “place the user in contact with people like doctors, lawyers and social workers who would assist them in seeking drug treatment and harm reduction services.” The report says “People in Portugal have since seen a huge drop in problematic drug use, and infections related to it like HIV, and hepatitis are going down. There are also fewer people dying from overdoses, and being incarcerated for drug use and associated crimes. Decriminalization in Portugal is working.”

Many of the countries which have decriminalized drugs are following a similar pattern – they refer people to counselling and harm reduction programs. 

The question is not “could that work here?” Of course, it could. The real question is what is taking us so long? At this point I should warn you that I’m entering into the realm of speculation, but I believe that some of the factors are these:

1. Momentum – policing agencies have programs and policies and money and people directed at stemming the flow of drugs into our country. These are good hard-working policemen, doing their best within the model they’ve been given. It’s difficult for them to accept that we’ve been barking up the wrong tree for quite some time. It is noteworthy that this attitude may be changing – the Canadian Association of Chiefs of Police is on record recommending decriminalization of small amounts of illicit drugs.
2. International influence – Like it or not, we are greatly influenced in this country by the giant neighbour to the south. And if you want votes in the United States, you need only to claim that you are tough on drugs and you’re likely to get elected. What are the chances that American law enforcement agencies would get badly upset by any dramatic changes to Canada’s basic policy on drug controls?
3. Distaste – We really don’t like drug addicts. They mess up our city streets, scare us and our children, spread disease and talk some really bizarre stuff that makes us uncomfortable. The notion of enabling drug abuse by setting up injection centres or providing Naloxone to drug users so they can reverse a bad opioid load leaves most of us, myself included, feeling a little squirmy.
4. Holier than Thou – A 2020 article published by the University of Alberta, written by William Schultz, Sandra Bucerius And Kevin Haggerty says “Tough-on-crime political rhetoric portrays hard drug use as a form of moral decay, associated with a lack of self-control.” And we feel that, don’t we? 

It’s time for a little more sympathy and understanding in our attitudes towards drug users. The University of Alberta article reported out on almost 1000 interviews with inmates and correctional officers in correctional facilities in western Canada. “Ninety-five per cent of all the men we interviewed in federal prisons and 97 per cent of all the women have been sexually or physically victimized before ever being charged with a crime. A disproportionate number have backgrounds defined by a string of traumatic events, such as suicides, lethal overdoses or the murder of a parent, child, partner or friend, or a major assault that leaves them with lifelong PTSD. For a disproportionate number of prisoners, using hard drugs is not a sign of rampant hedonism; it is a means to deal with the physical, emotional and psychological legacies of abuse, victimization and trauma.”

One of the impacts of decriminalizing drugs would be that we could stop throwing people into prisons. The UA article says “The continued criminalization of drugs ensures that an unending stream of men and women are incarcerated for drug possession and drug sales, and also influences a much wider group of prisoners who commit crimes to pay for their drugs or use violence as part of the illicit drug market.” Canada does not have an especially high incarceration rate – we lock up about 104 people per 100,000. But most of those incarcerated people are victims of their habit and we’d be better off treating them than imprisoning them. The USA is the most imprisoned population in the world, with 629 prisoners per 100,000. Think of the economic cost of keeping that many people behind bars, and think of the social costs of locking up people who needn’t be in prison and who could be, perhaps with a little help, functioning and productive members of society.

I play hockey in a league with a number of players who are quite a bit younger than I – some are in their 30’s, many in their 40’s. I hear these guys talking about cannabis edibles – gummies. They discuss the effects of taking a 3 mg dose, or a 1 mg dose, or the heavy impact of a 10 mg dose, and I am struck by the difference between that and the “good shit, man” evaluation of illegal weed that I heard in university. The average drug user who overdoses on fentanyl doesn’t plan on that happening. They buy a street drug which may or may not be juiced up with fentanyl. There’s no information about how active, how potent, the drug is, and mistakes happen. Fatal mistakes. If we de-criminalize drugs we can also regulate drug sales and use. We could licence all those pop-up cannabis shops to sell “illicit” drugs, but regulate that they identify exactly what’s in that product. We could have Health Canada warnings on products identifying the probable impacts of this dose on an average person. We could allow recreational drug users to learn through experience what doses give them the right mood-altering effect they are seeking without going too far. 

But, you say in shock, you’re encouraging the development of addicts! No, probably not. A Sage Journal review of drug policy and law in 2020 by Anne Katrin Schlag concluded “The results show that the majority of drug use is episodic, transient and generally non-problematic. The majority of people who have used various drugs in their lifetime have not done so in the past year. Only a minority become problem drug users.” Regulating drug use doesn’t encourage the development of addicts, it informs and controls the consumption of drugs by recreational drug users. The addicts are likely to be those people described in the UA article above who are medicating a deep psychic wound, and they are likely to become addicts in either a regulated, decriminalized world or in an unregulated but criminalized environment.

If you don’t have a licence and you sell an un-regulated black-market product, then you should be subject to criminal punishment. I think it will be important to distinguish between black-market drug dealers and responsible sellers of properly controlled drug products.

If we de-criminalize and regulate drugs, we could also lower the price – but there’s no urgent need to do that. Instead, we should have drugs purchased legally at lower cost from Mexican or Columbian government agencies and then taxed heavily when they are sold to cover the cost of support programs. We can get drug trafficking out of the hands of the criminals in Mexican cartels and into the hands of the criminals in our political parties.   I don’t pretend to have done enough research to have all the answers here. But I think it is obvious that Canada can learn from other countries in the world on this issue. It is estimated that close to 20% of Canadians have, at one time or another, used illegal drugs. If 20% of the country is giving it a shot, this behaviour really conforms to our societal norms, and the criminals are just the unlucky normal citizens who got caught. It’s time to leave the dark ages behind and bring in the drug control laws of progressive modern nations.