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BMJ. 2007 November 24; 335(7629): 1060.
PMCID: PMC2094162
Should Drugs Be Decriminalised?

Prohibition is an ideologically driven failure

Stephen A Rolles, information officer

Califano's objections to legal regulation of illicit drugs are based on misrepresentation of the reform position bolstered by irrelevant, cherry picked, or misleading facts.1 A similar piece appeared in the Financial Times2 and was systematically critiqued in the paper's economists' forum.3 While Califano's rhetoric has since been moderated, and facts fine tuned, the conceptual flaws remain.

The example of Zurich's “needle park” misrepresents legalisation as heroin was never legally supplied. As an experimental tolerance zone it was a failure. Yet, Califano fails to mention that the government responded by legalising heroin. It set up clinics for long term users, where legally prescribed heroin was used under supervision. The success of this approach on key social, health, and criminal justice indicators led to its replication by many countries including Canada, Australia, and much of mainland Europe. The UK is piloting a similar scheme.

Califano relates Italy's high heroin addiction rate to its de facto decriminalisation for possession, but other countries with similar approaches have lower levels of addiction (Netherlands, Portugal), while the UK has a punitive approach yet higher addiction. Califano's grotesque conflation of Italy's decriminalisation policy with the spread of AIDS ignores the reality that supervised use of prescribed heroin with clean needles results in zero HIV transmission. Califano defends a policy that caused the tragic outcomes he identifies, while attacking advocates of responses that eliminate the problem.

Cheap illicit drugs are freely available under prohibition. Despite Califano's assertions, once an illicit market is established (and criminal profiteers will see to that) levels of use are mostly culturally determined and demand led. Problematic drug use is not driven by changes in availability or price.4

Califano doesn't understand that the huge profits offered by prohibition attract the violent gangsters now in control, while it is precisely because drugs are dangerous that they need to be regulated and controlled. They are too dangerous to be left in the hands of criminals.

Notes

Competing interests: None declared.

References

1. Califano JA Jr. Should drugs be decriminalised? No. BMJ 2007;335:967 (10 November.) [PMC free article] [PubMed]
2. Califano J. Drug legalisation is playing Russian roulette. Financial Times 2007 August 16. www.ft.com/cms/s/0/6190a922-4b91-11dc-861a-0000779fd2ac.html
4. Strategy Unit. Drugs project. Phase 2 report. Diagnosis a recommendations. www.cabinetoffice.gov.uk/upload/assets/www.cabinetoffice.gov.uk/strategy/drugs_phase2.pdf

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