Saturday 21 April 2018

Mind and meaning: Decriminalising Drugs

Minister: Aodhán Ó Ríordáin
Minister: Aodhán Ó Ríordáin

Patricia Casey

The Minister of State for the National Drugs Strategy Aodhán Ó Ríordáin is considering decriminalising heroin, cocaine and cannabis. In other words, possessing small amounts for personal use will no longer be an offence.

Recently the Justice, Defence and Equality committee heard evidence from various stakeholders on this issue. A number of groups working in the frontline gave evidence. Most were in favour of the measure and Portugal was held up as the model we should aspire to.

Two psychiatrist colleagues working at the coal face of the drug problem are Dr. Eamonn Keenan and Dr. Gerry McCarney, and they gave important evidence to the Committee as representative of the Irish Hospital Consultants Association.

The background to this proposal is that there has been a huge escalation in our national drug problem. This suggests that the current policies are not working. The view is that if the criminal element were removed by making drugs legally available, then the gangland disputes and murders that are now rampant would be greatly reduced. Yet this is not exclusively an Irish or even a European problem, but an international one.

So, the argument goes that in order to reduce drug-related crime, we should remove criminal penalties for using the drugs mentioned above while penalising those distributing or selling these substances.

Portugal is the model that is cited for this experiment. There, in 2001 there was a change of policy and drugs were decriminalised. Anybody in possession of them is given a small fine and sent to a drug treatment service. They have invested heavily in such facilities and those who abuse drugs are regarded as needing healthcare rather than punishment. The question is, does decriminalisation work for addicts and for society?

In his evidence Keenan said: "The Portuguese model is viewed by some as an unqualified success but there are divergent views on this. For example, the Cato Report said it was a resounding success, while the APLD report considered it a failure.

"Both reports have been objectively reviewed and both appear to be very selective in the data which they chose to report. It has also been argued that the policy of decriminalisation may result in more people entering treatment. Two other factors need to be considered in relation to this.

"First, the commissions for the dissuasion of drug addiction, CEDTs, in Portugal, mandated that approximately one third of the people referred to them had to enter treatment because they were deemed to be addicted to the possessed substance.

"There is evidence that some measures of the level of drug-related harm deteriorated after the new policy was introduced in Portugal. There was an escalation in deaths linked to substances other than heroin. There was also an escalation in cannabis use among teenagers."

McCarney made the very interesting point that "Indeed, the rate of cannabis use in Portugal has increased to the extent that it is now only a little below the rate for Ireland. Therefore, we have an increasing pattern of drug use among young people in Portugal, whereas the Irish statistics for school-age children are on the way down".

Both encouraged caution and both indicated that there was a danger of cherry picking the outcome data to suits ones ideology.

Sweden is an interesting example also. There, drug use levels among students are lower than in the early 1970s. Life-time prevalence and regular drug use among students and among the general population are considerably lower than in the rest of Europe.

According to a UN report published in February 2007, this appears to have been achieved by a determined policy of "zero tolerance" to drug abuse, the criminalisation of drug abuse and the compulsory treatment of drug abusers coupled with harsh penalties for suppliers. And this from the country that had the most liberal approach to drugs in the 1960s, such as the now infamous Stockholm Experiment in which amphetamines and opiates were freely available on prescription.

In Ireland we had a situation which amounted to a quasi-experiment when a legal loophole allowed for the sale of certain psychoactive substances.

Headshops sprung up in every town and sold what became known as "legal highs". During that time the numbers of people using these soared and with it the numbers attending the emergency departments with psychotic reactions. I was seeing several each week and their throughput into and out of our psychiatric unit rocketed.

A particularly vulnerable group were those with pre-existing mental illness who saw this as permission to take drugs, that destabilised their condition. We should not forget that cocaine and cannabis do cause psychotic reactions and cocaine is highly addictive, like heroin. Cocaine is particularly associated with violence and during withdrawal, feelings of darkness and despair.

So in asking the State to now make these legal we are requesting that it makes available substances which it knows cause harm. Indeed the libertarian argument breaks down here since those who are damaged by drugs require treatment (even if nobody else becomes addicted) and this impacts on the taxpayer and so on all our citizens.

Like Sweden we may have to decide if we should provide free drugs or be drug free.

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