The prohibition paradox: Regulating alcohol and other drugs to reduce harm

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The prohibition paradoxRegulating alcohol and
other drugs to reduce harm
Ross Bell
Executive Director
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The prohibition paradox
Levelofharm
Prohibition
Free market
Regulation
Type of control
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DVD
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Prohibition and harm
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Types of harm

• Death
• Toxic effects
• Blood borne viruses
• Dependency/addiction
• Injury
• Malnutrition
• Fetal damage
• Neurological damage
• Depression
• Psychosis
• Unemployment
• Stigmatisation

• Marginalisation
• Criminalisation
• Family breakdown
• Community breakdown
• Lost productivity
• Workplace injury
• Health care costs
• Criminal justice system costs
• Criminal activity/black markets
• Theft
• Violence
• Political instability

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The War on Drugs (literally)
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The global drug trade is valued at US320 billion
per year If it were a country it would be the
21st economy in the world, after Sweden It is
greater than the world market for tobacco, wine,
beer, chocolate, coffee and tea combined (But
smaller than the wholesale market for oil)
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133 countries have abolished the death
penalty 64 still use it34 use it for drug
offences
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80 percent of the world population has either no
or insufficient access to pain relief
treatment Tens of millions of people around the
world including 4 million cancer patients and
800,000 HIV/AIDS patients suffer from pain
without treatment
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Expenditure on illicit drug policy
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Drug law inequalities

• Maori are 14.5 of population, but receive
• 43 percent of cannabis use convictions
• 55 percent of cannabis dealing convictions
• Maori are 3.8 times more likely to be convicted
  of cannabis use than Pakeha with the same record
  of cannabis use and other offending
• Males are ten times more likely to be convicted
  for cannabis use as females with the same use and
  offending record

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The free market and harm
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Social costs of harmful alcohol and other drug use
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Counting the dead
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Counting the dead (DALYS)
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Finding the balance

• Policies have unwanted side effects. Taxes
  create moonshining, regulation creates evasion
  and corruption, prohibition creates black
  markets, programs cost money and often create
  perverse incentives. Since all drugs are
  dangerous and all policies are costly, we ought
  to consider, for each drug and for all of them
  together, what set of policies would create the
  least onerous overall problem, adding together
  the damage done by drug abuse and the damage done
  by attempts to control it.
• Mark Kleiman, 1992, Against excess drug policy
  for results

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Finding the balance
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Can a public health approach provide balance?

• First, do no harm
• Aligning and balancing policy and legislation to
• Reduce harmful use
• Minimise negative health effects to the
  individual
• Limit secondary harms to society (e.g crime,
  violence)
• Possible approach to illicit drugs
• Interventions focusing on treatment not
  punishment
• Interventions other than criminal prosecution
• Wider range of interventions in criminal justice
  system
• Coherence with Alcoholism and Drug Addiction Act
• Greater provision of harm minimisation
  interventions
• Possible approach to alcohol (surprise,
  surprise)

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Eight Point Plan for Action on Alcohol-Influencing
the policy debate