Treat drug users not as criminals, but as patients who need care By Fernando Henrique Cardoso

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By Fernando Henrique Cardoso
December 27, 2010

The war on drugs is a lost war, and next year there must be a shift from punishment to new policies based on public health, human rights, and commonsense. These were the core findings of the Latin American Commission on Drugs and Democracy that I convened, together with the former presidents Ernesto Zedillo of Mexico and Cesar Gaviria of Colombia.

We became involved because the violence and corruption associated with drug trafficking threatens democracy in our region. The prohibitionist approach, based on repressing production and criminalising consumption, has clearly failed.

After 30 years of massive effort, prohibition's only achievement was to shift cultivation and drug cartels from one country to another, the so-called balloon effect. Latin America remains the world's largest exporter of cocaine and marijuana. Thousands of young people continue to lose their lives in gang wars. Drug lords rule by fear.
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The illicit drug trade will continue for as long as there is demand for drugs. Instead of sticking to failed policies that do not reduce the profitability of the drug trade – and thus its power — we must redirect our efforts to the harm caused by drugs to people and societies, and to reducing consumption.

Some kind of drug consumption has existed throughout history in the most diverse cultures. Today drug use occurs throughout society. All kinds of people use drugs for all kinds of reasons: to relieve pain or experience pleasure, to escape reality or enhance their perception of it.

The approach recommended in the commission's statement does not imply complacency. Drugs are harmful to health. They undermine users' decision-making capacity. Needle-sharing spreads HIV/AIDS and other diseases. Addiction can lead to financial ruin and domestic abuse, especially of children.

Cutting consumption as much as possible must, therefore, be the main goal. But this requires treating drug users not as criminals to be incarcerated, but as patients to be cared for. Several countries are pursuing policies that emphasise prevention and treatment rather than repression, and refocusing their repressive measures on fighting the real enemy: organised crime. A growing number of countries are moving away from a purely repressive model.

Portugal and Switzerland are compelling examples of the positive impact of policies centred on prevention, treatment and harm reduction. Both countries have decriminalised drug possession for personal use.

Instead of leading to an explosion of drug consumption, as many feared, the number of people seeking treatment increased and overall drug use fell.

When the policy approach shifts from criminal repression to public health, drug users are more open to seeking treatment. Decriminalising consumption also reduces dealers' power to influence and control consumers' behaviour.

We recommend evaluating from a public-health standpoint and, on the basis of the most advanced medical science, the merits of decriminalising possession of cannabis for personal use. Marijuana is by far the most widely used illicit drug. There is a growing body of evidence suggesting that the harm it causes is at worst similar to the harm caused by alcohol or tobacco. Moreover, most of the damage associated with marijuana use, from the indiscriminate incarceration of consumers to the violence and corruption associated with the drug trade, is the result of current prohibitionist policies.

Decriminalising cannabis would thus be an important step in approaching drug use as a health problem and not as a matter for the criminal justice system.

To be credible and effective, decriminalisation must be combined with robust prevention campaigns. The steep and sustained drop in tobacco consumption in recent decades shows that public information and prevention campaigns can work when based on messages that are consistent with the experience of those they target.

Tobacco was made less glamorous, taxed, and regulated; it has not been banned. No country has devised a comprehensive solution to the drug problem. But a solution need not require a stark choice between prohibition and legalisation. The worst prohibition is the prohibition to think. Now, at last, the taboo that prevented debate has been broken. Alternative approaches are being tested and must be carefully reviewed.

In the end, the capacity of people to evaluate risks and make informed choices will be as important to regulating the use of drugs as are laws and policies that are more humane and efficient. Yes, drugs erode people's freedom. But it is time to recognise that repressive policies towards drug users, rooted as they are in prejudice, fear and ideology, may be no less a threat to liberty.

Fernando Henrique Cardoso was president of Brazil from 1995 to 2002. He is co-chairman of the Latin American Commission on Drugs and Democracy. Copyright: Project Syndicate, 2010.

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