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As the ideologically driven nonsense that underpinned the Drug War becomes increasingly apparent and the need for drug law reform gathers momentum, it is important to recognise some of the subtle approaches and ideas expressed towards a drug reform model could well result in Prohibition 2.0. An approach that fails to fundamentally address the fallacies of prohibition, perpetuates the drug apartheid and uses the medical profession and civil society as enforcers rather than the police, armed forces and customs.
What are the signs that could open the door to Prohibition 2.0? Well here are some common statements which on first impression, may appear to offer good support to a reform agenda, but on closer scrutiny these statements seriously risk replicating misinformation, and could open the door to new forms of state control, coercive treatment and punishment for people using the ‘wrong’ drugs.
- Drugs are dangerous that’s why we need strict regulation.
- Drug users shouldn’t go to prison, Drug Court is an effective alternative.
- We must accept our drug laws are out of date and need reforming.
- Drug use is not a crime problem it’s a public health problem.
- Soft drugs like cannabis should be decriminalised.
- NPS should be regulated, while unapproved NPS should be illegal to possess.
- People with substance use disorders should be forced to get treatment.
- Drugs that are legalised should only be available from approved suppliers.
- Tackling drug use through the criminal justice system was wrong we must tackle drug use through public health approaches.
- The drug war was a mistake but the state must protect people from the risk of addiction with strict controls over possession and supply.
- People diagnosed with substance use disorders cannot risk using drugs.
- Drug testing has an important role in public health and safety.
- Drug use is a problem we can’t eradicate so we must minimise it.
- Drug use isn’t a police problem it’s a medical issue.
- Only a small proportion of people use drugs and we are going to have to learn to accommodate them.
- We need to change drug laws not because drugs are safe, but because drugs are harmful and people are not being protected by current drug laws.
- Addiction is a brain disease so it shouldn’t be a criminal offence.
Perhaps most worrying is some reformers are calling for drug REGULATION, but this simply means state laws and policies to manage and control drugs (which is what we already have albeit done badly). Regulation is a broad and vague rally call to get behind. While it is more specifically understood as state overseen production, distribution, sale, advertising, labelling, storage and use of drugs, (which for example already happens for opiates), regulation may also continue to make the possession of certain drugs illegal. Substances that are unapproved and/or deemed unsafe by the state may, as in the case of the New Zealand model of regulation, be an offence to possess. This is prohibition by any other name, and replicates the present system of bifurcation.
Julian Buchanan, Associate Professor, Institute of Criminology, Victoria University of Wellington, Aotearoa, New Zealand.
The most vulnerable need advocates to campaign on their behalf: The New Zealand experience of naloxone
No naloxone available? No excuse.
No excuse either for drug agencies failing to formally lend their support for naloxone distribution to users, families, and friends.
Getting naloxone into the community was recommended by the World Health Organisation, and some countries like the USA, Australia, Scotland, Wales have made excellent progress, but here in New Zealand it has been difficult to get naloxone on the drug policy agenda let alone into the community, despite the fact that Coroner data indicates that every week someone dies of an opioid overdose.
Why should this be so difficult when naloxone has no abuse potential, is relatively cheap, easy to administer and is so effective at reversing overdose? Unfortunately, the failure to deliver a humane and effective drug policy has little to do with a lack of evidence, understanding or science, but much more to do with a lack of interest, care or regard for people who use illicit drugs, and people who inject drugs (PWID) tend to be the most marginalized. Naloxone distribution is a vital life saving service for PWID.
Numerous opportunities have existed in New Zealand to ensure naloxone is available to users, families and friends. In August 2013 sixty-seven agencies were represented at an invitiaton-only National Think Tank Event led and coordinating by the New Zealand Drug Foundation. After two days debating priorities, values and strategy, to shape the future of drug policy in Aotearoa, the NZ Drug Foundation produced a 12,000 word vision statement, that became known as the Wellington Declaration – but surprisingly in this comprehensive document outlining drug policy priorities naloxone didn’t even get a mention.
A year later in August 2014 in it’s Matters of Substance Magazine, rather than present a robust case for naloxone distribution in New Zealand, the NZ Drug Foundation Magazine framed Naloxone take-home as a contestable issue, open to debate. They offered arguments for and against naloxone. This included some spurious arguments against naloxone distribution including “there could be an unintended consequence from widening availability of naloxone” and “people could become less cautious about their drug use because they know life-saving treatment is close at hand”.
In October 2014 after a new government was elected the NZ Drug Foundation prepared a twenty page Briefing Paper to Parliament which was designed to identify key drug policy priorities to enable ‘opportunities to make real reductions in drug related harm‘ (p.3). The document emphasised the need to secure New Zealand representation at the United Nations international meetings (see below), and specifically highlighted the need to tackle deaths caused by huffing solvents, but astonishingly made no reference or representation to the new government concerning fatal opioid overdoses nor did it mention the need to distribute naloxone to users, families and friends.
With this lack of formal commitment to naloxone distribution from the lead NGO organisation for drug users/drug agencies in New Zealand, it was hardly surprising that when the new government eventually rolled out its five year Drug Policy Strategy 2015-2020 on 28th August 2015, the policy document made no mention of naloxone whatsoever. Interestingly, the new drug policy did, as promoted in the NZ Drug Foundation Briefing Paper, prioritise a commitment to ensure New Zealand would be represented at international UNGASS meetings (p.22).
Belatedly, Matters of Substance published a better informed and considered magazine feature on Naloxone after the embarrassing ‘for or against’ debate, the Foundation produced a stand alone Naloxone Background Paper. However, while this discussion paper includes some excellent sources and appeared to offer a robust argument for reducing overdose, it also undermined the campaign with some odd statements and inclusions, such as “Due to the controversial nature of drug harm reduction and naloxone access”, and it confusingly recommends consideration for: “legal protection from arrest for drug possession and/or the act of injecting someone for people who administer naloxone in an emergency situation”, [my highlight in red], as well as recommending “reclassifying naloxone as restricted medication” rather than pharmacy only, largely it seems, to ensure that anyone who accesses naloxone must receive training. The briefing paper also aired some odd arguments against naloxone: “There may also be views that wider access is not necessary with naloxone already available in hospitals and with advanced paramedics” and it further “[naloxone] will lead to greater risk taking behaviour”.
There are other disconcerting aspects buried within what might otherwise give the impression of a solid report arguing for greater naloxone distribution, such as the omission of data concerning the high percentage of overdose deaths that occur before the medics arrive, for example, a London study by Hickman et al (2007:320) found that when an ambulance was called the person who overdosed was already dead before the arrival of the ambulance in 85% of cases. Had this information been understood and included in the NZ Drug Foundation background paper they would surely have given greater emphasis to ensuring naloxone is in the hands of People Who Inject Drugs (PWID), their friends and family, but the report seems to prioritise naloxone training over naloxone distribution. The recommendations in the paper also includes loop holes that seem to almost invite a piecemeal approach to distributing naloxone, by suggesting various components of naloxone distribution could be seen as possible ‘separate options’ for consideration.
a London study by Hickman et al (2007:320) found that when an ambulance was called the person who overdosed was already dead before the arrival of the ambulance in 85% of cases
While this paper was primarily about the role of naloxone to reduce overdose death, it was an ideal opportunity to mention closely related strategies known to reduce OD deaths in New Zealand, such as the benefit of allowing prescribing injectable drugs in New Zealand to people who continually inject rather than restrict them to oral methadone which is then invariably injected, or the effectiveness of Drug Consumption Rooms in reducing overdose. Here’s a link to the report that includes my highlighted concerns and critique.
Despite the absence of any clear formal commitment to wider naloxone distribution, the campaigning in Aotearoa NZ must continue for naloxone take-home, and indeed for other strategies to reduce overdose and drug policy harm, including: drug checking; prescribing injectable opioids to opioid injectors; a Good Samaritan Law to end arrests for possession and manslaughter when co-users call for emergency help; end the risk of criminalisation for possession of needles and utensils in New Zealand (unless proven to be obtained from the needle exchanges); and establishing Drug Consumption Rooms.
In view of this failure to put naloxone on the formal agenda, it was somewhat incongruous see the Director of the NZ Drug Foundation on International Overdose Day showcase a persuasively well-argued newspaper article (with no sense of irony or doublespeak), asserting that New Zealand must do more to tackle overdose and distribute naloxone. If the New Zealand Drug Foundation had proactively promoted the need for naloxone, it could have been quite different. It’s New Zealand Drug Foundation, in its pivotal drug policy advisory role, that needs to do more to tackle overdose and push for naloxone distribution.
It is hard to understand given the insights clearly displayed in their newspaper piece on International Overdose Day why the New Zealand Drug Foundation have omitted naloxone from important documents (the Wellington Declaration & subsequently the Harm Reduction Briefing to Parliament), and why they haven’t campaigned when and where it matters, for naloxone take-home from the outset. Staff from the NZ Drug Foundation did however, as promoted and prioritised in the harm reduction Briefing to Parliament, go to Vienna and New York (see here) and engage in the inertia of the UN drug control system that is committed to a ‘drug’ free world.
With an alternative emphasis on national drug policy reforms in New Zealand rather than international networking, important drug policy harms could be tackled. Key drug policy issues that need tackling here in New Zealand include:
2. There is no naloxone take home.
3. There is no injectable maintenance prescribing.
4. There is no heroin prescribing.
5. There is no Good Samaritan law.
6. There are no Drug Consumption Rooms / Supervised Injection Facilities.
7. Unemployed people on state benefits are drug tested and lose benefits if they repeatedly test positive for illegal drugs.
8. People with life limiting illnesses are criminalised if caught self medicating with cannabis.
9. The Police and Air Force scour the countryside every year digging up millions of dollars worth cannabis plants.
10. The Alcohol and Other Drug Treatment Courts adopted from the USA and based on an abstinence and disease model of addiction that uses scram bracelets and random alcohol and drug testing, have had their five year ‘pilot’ extended a further three years.
11. New legislation to enforce Compulsory Assessment & Compulsory Treatment of Addiction came in force in February 2018.
12. The Psychoactive Substances Act 2013 made possession and supply of all NPS an offence – unless approved by the state (none have been approved).
13. Housing NZ have fuelled a needless moral panic about methaphetamine contaminated houses and awarded over $50m to companies to decontaminate houses.
The 2016 and 2017 CND and UNGASS meetings predictably delivered no tangible positive outcomes or progress. It’s now International Overdose Awareness Day 2017 and New Zealand users, families and friends are still struggling to gain access to naloxone. Distribution has been agreed in principle, but procrastination concerning the cost and production of additional health education material to accompany the naloxone have stalled distribution.
Having failed to even mention naloxone in the weighty 2013 Wellington Drug Policy Declaration, and failed to mention it in the 2015 Briefing to Parliament, the urgent need for naloxone was finally acknowledged in the New Zealand Drug Foundation December 2017 Briefing to Parliament;
While nations like New Zealand, inexcusably fail to deliver easy to implement drug policy reforms at a national level, and instead invest considerable energy on high maintenance, but low outcome international drug policy reform gatherings, serious harms continue. A growing number of drug reformers are recognising the need for genuine policy transformation. It is time to stop talking the talk and start delivering outcomes, one in particular Low Threshold, Easy Access, Naloxone Take Home.
In the meantime, people who use illicit drugs in New Zealand are needlessly suffering, some are dying. No naloxone take home – no excuse.
It is literally a matter of life or death.
Dr Julian Buchanan, is a retired Associate Professor, Victoria University of Wellington, Institute of Criminology
31st August 2015 on International Overdose Day. (updated 5th January 2018)
We need to tackle the folly and futility of drug prohibition, in which we have created an irrational and unscientific bifurcation of drugs. An archaic system that favours, promotes and culturally embeds the use of some drugs, while fiercely policing, prohibiting and punishing the use of other drugs.
The 1961 UN Single Convention on Narcotic Drugs and the drug laws it has spawned, are deeply flawed, misinformed and misguided, they are an abuse of human rights and civil liberties. The realisation of this historic mistake and the momentum to end this draconian regime has gathered pace in recent years. While the US government has been a driving force defending and upholding drug prohibition, it is ironically the people of the US who are challenging the regime by voting to legalise cannabis. This is seen as a major step change by drug reformers to bring an end to prohibition, however, I question how Inviting cannabis to enjoy the privileges of other favoured drugs (alcohol, caffeine and tobacco) will tackle the wider and fundamental problem of drug prohibition.
Ironically, the legalisation of cannabis might actually bolster prohibition. The global and united drug reform movement could be undermined by an unintended consequence of privileging cannabis to join the elite drugs and subsequently ‘divide and rule’ to maintain the bifurcation process. No doubt, and understandably, after the decades of oppression suffered by cannabis users, legalisation of their drug of choice will be met with a celebration of the new found freedoms and privileges, but possibly also by a lack of interest to fight to end the prohibition of all drugs. Indeed, further, it could give rise to a new momentum against ‘drugs’ or ‘hard drugs’ – as recently liberated cannabis users redefining themselves as herbalists or sensible recreational users of ‘soft’ drugs.
I want to see cannabis legalised and sensibly (rather than strictly) regulated – in a way that avoids the oppression inherent in prohibition, and in a way that avoids the commercial exploitation we’ve seen in tobacco and alcohol. However, this is not something we should do for one or two selected substances, while maintaining and uphold the madness of prohibition again others. I’m an abolitionist, and I want to see all drugs legalised and regulated – there is no place for law enforcement and prohibition, personal drug consumption is not an issue per se, and if it does become a problem it is a social and health issue not a police matter.
Selectively privileging particular drugs based upon their popularity, to join alcohol, caffeine and tobacco as commercial products is not the way forward, it’s simply an extension of the principles of prohibition. Granting pardons for particular drugs is a dangerous and uncertain pathway towards drug reform. Instead, we should challenge the very foundations of prohibition and fight for the decriminalisation of every drug as a first step towards a comprehensive process to abolition, once this is achieved we urgently engage in the difficult and complex process to explore how best to legalise and regulate all drugs.
Julian Buchanan 27th April 2015
Julian Buchanan, Associate Professor, Institute of Criminology, Victoria University of Wellington, New Zealand
It is widely assumed that the so called ‘war on drugs’ (the war between drugs), has been a disastrous failure, and faced with mounting evidence and criticism, governments would eventually seek legislative and policy change. Not so. The evidence presented to argue for the end of prohibition is largely based upon an analysis of the inability of drug prohibition to reduce the supply and demand for banned substances, supplemented by a critique outlining the widespread harms caused by prohibition. However, with a different agenda and focus, it might be that this ‘evidence’ in terms of the failure to dent supply and demand, has over time (fifty years), become secondary to other government, business and organisational interests.
Seen in a different light, the Drug War has been a major success, providing considerable opportunities and benefits:
- It protects the market share and status of the privileged, promoted and culturally embedded legal drugs: alcohol; caffeine; tobacco; sugar and pharmaceuticals.
- It provides the police with excellent powers to easily stop, search, arrest, interrogate and prosecute.
- It successfully attracts significant additional funding for police, armed services, customs officials and security services.
- It provides justification for military action and invasion of other countries.
- It provides excellent opportunities for significant additional resources for the police/state through the seizure of assets.
- It provides excellent business opportunities and raw material (people) for the ever burgeoning penal industrial complex.
- It provides considerable opportunities for new technology development and sales, in the invasive and expanding drug testing industry.
- It provides considerable opportunities for new technology development and sales, in the avoidance of drug detection industry.
- It provides the drug rehabilitation business with an endless supply of illicit users, who must always abstain, and forever be in recovery.
- It provides excellent opportunities for the state to easily target, monitor, control and punish the poor, indigenous people, Black and minority ethnic groups and people of colour.
- It provides politicians with a societal scapegoat, and the chance to rally support and votes by getting ‘tough’ on a socially constructed enemy within: the ‘addict’ hooked and controlled by the ‘demon drugs’.
- It provides the news media with easy, cheap dirty stories and pictures of the apparent horrors associated with illicit drug use.
- It provides a much needed distraction from the serious problems caused by the more harmful, addictive and culturally embedded legal drugs – alcohol, tobacco, sugar and pharmaceuticals.
- Internationally, it rallies otherwise disparate nations together by finding common ground to fight a shared war against a global enemy, ‘drugs’.
- It provides the Banks with massive investments from money laundering.
- It provides researchers and academics will a constant and reliable stream of funding sources for endless prevalence studies and evidence to uphold prohibition propaganda such as reefer madness, gateway theory, crack babies and krokodil.
- It allows governments to detract attention away from the key structural drivers behind most chronic addiction (inequality, stigma, exclusion, poverty and blocked opportunities) and instead, misleadingly shift attention towards the supposed demonising and devastating power of the illicit drug.
- It provides a lucrative illegal market that enables gangsters and drug cartels to make incredible untaxed profits.
- It provides an attractive and unquestionable dogma for religious groups to ‘say no’ to drugs, avoiding the complexities of science, reason and rationale, and indeed the contradiction in respect of sugar, caffeine, tobacco and alcohol.
- It provides excellent careers for drug enforcement officials and drug policy entrepreneurs and careerists, facilitating endless debates, inquiries, international travel, networking and conference events, particularly via the United Nations.
If these are key drivers that sustain prohibition and maintain the ‘war between drugs’ then appealing to the groups that benefit from prohibition by providing endless research reports and campaigns to highlight the limited impact prohibition has upon supply and demand, or the negative unintended outcomes from criminalisation, may have limited political impact or sway given the benefits experienced by these powerful groups and organisations.
by Julian Buchanan, Associate Professor Institute of Criminology, Victoria University of Wellington, Aotearoa New Zealand, (updated 24th August 2015).
Thanks to @mhound and @ChurchOfBong for helpful suggestions!