The Oxford English Dictionary defines drugs thus – 1. A medicine or other substance which has a physiological effect when ingested or otherwise introduced into the body. 2. A substance taken for its narcotic or stimulant effect, often illegally. Drugs are not, however, a homogeneous group. Moreover, they are highly dose dependent and extremely context dependent. The prohibition of certain drugs, most notably cannabis, has been extremely arbitrary and has a long historical record of being subject to political expediency. For instance, on what basis was the decision to make cannabis illegal in most countries around the world, but not alcohol and/or tobacco? Certainly not from the point of harm caused, since cannabis has been evidentially shown to cause substantially less harm individually and to societies than tobacco or alcohol. How does the so-called War on drugs and the blanket prohibition of certain drugs impact on the daily lives of people and how does it relate to the UN SDGs?
UN SDG Goal 3: Ensure healthy lives and promote well-being for all at all ages, states
“Ensuring healthy lives and promoting the well-being for all at all ages is essential to sustainable development. Significant strides have been made in increasing life expectancy and reducing some of the common killers associated with child and maternal mortality. Major progress has been made on increasing access to clean water and sanitation, reducing malaria, tuberculosis, polio and the spread of HIV/AIDS. However, many more efforts are needed to fully eradicate a wide range of diseases and address many different persistent and emerging health issues.”
Professor David Nutt, the former chairman of the UK Advisory Council on the Misuse of Drugs (ACMD) makes the following observations in his article Hypothesising an alternative; Applying the scientific process to drug policy,
“I strongly believe that we should focus on public health approaches to the drug problem, and decriminalise the possession of drugs for personal use, for the following simple reason; – If users are addicted then they are ill, and criminal sanctions are an inappropriate way to deal with an illness. If they are not addicted then criminalisation will almost always lead to greater harms to the user than the effects of the drug. …There is good evidence that decriminalisation does not radically increase drug use and can reduce some measures of harm, as shown by a balanced review of the first ten years of the Portugal experience of decriminalisation…An increase in the availability of some drugs may actually lead to a reduction in the use of other more harmful drugs, so reducing net harms to society…Regulating access to drugs such as cannabis as in the Dutch model reduces the need for users to go to dealers. So it minimises their exposure to people whose main goal is to get their clients onto the most addictive substances such as heroin and crack…Approaches which explicitly reject an evidence-based public health approach, but instead focus on incarceration and criminalisation of addicts, continue to utterly fail, at enormous financial and human cost (my emphasis)”[i]
Narcotic usage requires some form of regulation, but this must be evidence based and not stem from ignorance, prejudice or a politician’s knee-jerk reaction, taking into account the addictiveness of the substance, the possibility of causing mental / emotional problems, the difference between effective level and LD-50 level[ii], local patterns of historical usage and the appropriateness of the substance in the local environment. Those individuals who are genetically predisposed to addiction might well merit different sets of regulation, or at the very least more education and counselling, than the general population
Opiates require a greater level of control than, say, cannabis since opiates are by their very nature intrinsically physically addictive in a way that cannabis is not, or at least not with the majority of people. Alcohol consumption requires rules both concerning harming oneself & family through excessive use and for performing various tasks, most obviously driving a car. Cannabis also requires a different set of regulations again, the Dutch model and the Portuguese model being the two most effective models that have emerged since the post-war II period, as it is intrinsically non-physically addictive and has no-overdose level. Legalised / decriminalised cannabis or other recreational narcotics can also create employment and provide tax-income for states.
In addition to the libertarian aspect of a radical rethinking of narcotic regulation there is also an extremely large therapeutic side to many substances and practices. In the Shamanic traditions of North & South America, Central & Northern Eurasia, and some parts of Africa (The Gabon for example), various types of psychoactive mushroom, cacti and plants containing DMT or similar compounds are used to heal trauma and / or gain direct access to non-ordinary states of reality. In the West research has indicated that MDMA used in conjunction with psychotherapy is the single best form of treatment for PTSD. Dr Ben Sessa, a consultant psychiatrist in adult addictions has this to say about MDMA in his TEDx talk in Bristol July 2016.
“I’m going to propose today that MDMA could be [as] important for the future of psychiatry as the discovery of antibiotics was for general medicine 100 years ago…MDMA has some fascinating qualities, indeed I would suggest that if you were to invent a hypothetical drug to treat trauma it would be MDMA. The way it works in terms of receptors and subjective psychological effects ticks all the right boxes…but perhaps the most important thing about MDMA and the most important clinical tool is the ability to provide a sense of empathy and understanding and emotional security. It can hold a patient in a place where they can think about and access their trauma in a way they’ve never been able to do before.”[iii]
And yet soldiers coming back from war, who often suffer high rates of PTSD, alcoholism and homelessness are normally denied access to MDMA assisted psychotherapy because MDMA is illegal in most countries. This is not only true for soldiers but also for victims of sexual abuse who commonly suffer from PTSD. Nutt provides support for Sessa’s position concerning the therapeutic use of particular narcotics within a therapeutic setting and the necessity for more research when he states,
“Badly enacted prohibition also severely limits research so denies the possible therapeutic benefits of drugs such as MDMA for treating PTSD and psilocybin for treating depression and the anxiety of cancer… It is now time to begin to introduce a more rational evidence-based approach to drug policy to minimise harms. We must consider all drugs, including alcohol, as part of the problem to be tackled.” [iv]
Psychoactive substances such as ergot (active compound Lysergic Acid), Ayahuasca (DMT), Iboga and Magic Mushrooms have been part of human culture since before the rise of Sumer and possibly much longer (30,000 + years). Shamanism, scientific in that it involves experimentation, observation, repetition and conclusions based on an evaluation of evidence, has long been vilified in the European tradition, first by the Romans and later the Catholic Church. However, artist Alex Grey, writer Aldous Huxley, Nobel Prize winner Kary Mullis, or any number of musicians would be able to testify to the positive inspirational qualities of the entheogenic experience; indeed, they have all left a body of work that would be substantially less impressive had they not experimented with psychoactive substances. The so-called War on Drugs has only succeeded in bolstering the arms industry, damaging the environment (such as the clearing of rainforest for cocaine production), destroying cultures, taking innocent lives and enabling sociopaths. It is time to either admit that these always were its true purpose and to abandon it completely.
[ii] Effective level is the amount necessary for an effect to be felt. LD-50 is the dosage level that would kill 50% of test subjects of a particular weight and mass. Thus a drug with a small difference between effective level and LD-50 level is intrinsically more dangerous than one with a large difference.
[iv] Op Cit Nutt