Julian Buchanan

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Treating drugs as the problem when prohibition is the problem.

When promoting drug reform we should reject the deeply entrenched anti-drug narratives that have dominated drug discourse, these narratives are often rooted in fallacy, distortion and sweeping generalisations. Instead, drug reform must maintain integrity and ensure arguments are firmly rooted in reason, rationale, science and evidence. We need to be clear, there is no global drug problem – we are struggling with a global drug policy problem, and the cause of the problem isn’t gangsters – it’s governments. Drugs can pose risks but it’s prohibition that makes drugs dangerous not drugs per se.

 

 

 

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A tweet posted by the Transform Drug Policy Foundation to 27.5k followers

 

 


Transform do some great work building solid reliable evidence and they have campaigned tirelessly for drug reform, but the underlying assumptions and messages in this particular tweet/poster are disappointing, they encapsulate some worrying aspects within the drug reform movement. There are three significant flawed premises in the tweet/poster. Let me unpack them separately:

 

1. ‘Drugs are not safe they are potentially dangerous’.

The key message that ‘drugs’ are not safe and potentially dangerous is misleading and inaccurate. It perpetuates prohibition propaganda that fuels the fear and hype that demonises ‘drugs’. By comparison while cannabis has never killed anyone, water, salt and peanuts can all be lethal for consumption in certain situations and quantities, but I’d feel uncomfortable if an organisation starting asserting that water, salt and peanuts are not safe, potentially dangerous and need to be controlled. So what about ‘drugs’– is the reform movement seriously suggesting having an unregulated coffee, or an unregulated glass of wine, chewing khat or coca leaves or smoking unregulated homegrown cannabis is somehow unsafe and potentially dangerous?

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There are circumstances where almost any activity (eating habits, riding a bike, watching TV, hillwalking etc.) can be potentially risky, but to generalise and assert these activities are inherently dangerous and unsafe per se is misleading and wrong. Let us be clear people can be harmed by some drugs, but we must also acknowledge most harm is exacerbated by prohibitive and intolerant drug policies, and the level of risk posed by different drugs varies enormously according to the interplay between the substance, the person (set) and the environment (setting).

The broad-brush notion that drugs per se are unsafe and potentially dangerous is an exaggerated, misleading and inappropriate blanket assertion that belongs to the language of prohibition, it’s the sort of propaganda that has clouded rational debate and informed discussion on ‘drugs’ for many decades, and in my opinion these stereotypical misrepresentations (even if said to gain support for policy change), should have no place in reform discourse. The term drugs refers to a diverse range of substances, so applying any sweeping statement to describe their potential risk is meaningless, and particularly misleading when most dangers are created by prohibitionist driven drug policies. It could be argued that at every appropriate opportunity drug reformers should be challenging the prohibitionist misinformation, including the notion of ‘drugs’, not adopting it. ‘Drugs’ is a convenient socially constructed concept consolidated in the 1961 UN Single Convention on Narcotic Drugs to falsely separate state approved psychoactive substance (alcohol, caffeine, tobacco and pharmaceuticals), from state unapproved psychoactive substances (drugs), it is simply a list of substances that has no science or evidence base to support it.

“…notion that drugs per se are unsafe and potentially dangerous is an exaggerated and misleading assertion
…propaganda that has clouded rational debate and discussion on ‘drugs’ for decades”

 

Bad drug policies rooted in prohibition, propaganda and punishment have made these unapproved drugs potentially dangerous to consume, people could be arrested and get convicted which could seriously damage life opportunities for employment, housing, insurance, relationships and travel. Tough law enforcement creates necessarily secretive environments so it becomes more difficult to seek assistance and to check the quality, content and purity of what you are taking, but these risks are product of ill-conceived drug policy, they are not an inherent consequence of ‘drugs’.



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2. ‘No drug is safe when unregulated and sold by gangsters’.

When drug use and drug markets have become particularly unsafe and potentially dangerous, it is not because the state hasn’t intervened, but it’s because of state intervention; by imposing severe law enforcement and military measures to prevent the use of some drugs, while promoting other drugs such as pharmaceuticals, alcohol, caffeine, tobacco and sugar. The idea that without strict government regulation the daily activities of growing, producing, buying, selling and exchanging goods and services is unsafe and will inevitably drift into the hands of gangsters, who’ll manage business with guns, knives and baseball bats is ludicrous and insulting. It is not a lack of regulation, but it is the extreme and fiercely imposed law enforcement measures that have created a hostile and violent environment within which a lucrative prohibited drug business operates.

“…arguably the only thing that connects drugs and gangsters is prohibition.”

 

The suggestion that unregulated substances and gangsters are inextricably linked to drugs is wrong. Indeed, arguably the only thing that connects drugs and gangsters is prohibition. Prohibition, like it did with alcohol in the 1930s, has spawned gangsters, drugs have not spawned gangsters. The present criminal sub-culture that surrounds the illicit drug market has everything to do with fierce law enforcement and prohibition, and little to do with the product on sale. Unregulated drug markets such as the Silk Road website are not dissimilar in principle to Amazon, TradeMe or eBay, not ideal and certainly not perfect, but with user reviews, feedback and ratings, it can hardly be described as a market dominated by violence, threat and gangsters.


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3. ‘The answer is to regulate drugs’

Of course, I want to see a clean legal supply of regulated drugs available for sale, that is desirable in any drug reform – but rallying behind the state to deliver ‘regulation’ is a vague concept to support. It’s simply a call for government control to regulate drugs so they are available in certain circumstances, which is actually what is already in place. For example, opiates are already a ‘regulated’ drug, they are available to buy as panadeine, paracodol or codeine in pharmacists in most countries, opiates are also strictly regulated and used widely in medicine. Under regulation most opiate products are illegal to possess and supply, and anyone caught in possession faces serious charges.

 

 “…’regulation’ is a vague concept to support.” 

 

While regulation could mean the state may approve and legally regulate a much wider range of drugs, while still prohibiting a small group of so-called dangerous drugs, the state may also continue to prohibit possession of unregulated drugs. Under a Regulation model that prioritises quality control, the state may insist that Big Pharma are the only state approved dealers and therefore it would be an offence to be in possession of any drug from an unregulated source – and that could include home grown cannabis for example. Regulation can so easily result in Prohibition 2.0.

Strict regulation is needed for businesses not people, but even then, government has a poor record of regulating the pharmaceutical (Fentanyl the source of many fatal overdoses is a regulated drug), alcohol and tobacco industry, so placing hope in the State to sensibly regulate ‘drugs’ in a manner that protects human rights and promotes harm reduction is at best optimistic. The risk is that the state who have resolutely maintained a draconian and austere system of drug prohibition for five decades will pursue a model of regulation that will punish possession, production and/or cultivation of unapproved drugs for personal use.

 


Conclusion

In my view, an open invitation for state regulation is likely to continue to result in disproportionate law enforcement measures imposed on the poor, the indigenous and minority groups for possession of ‘unapproved’ drugs.  Before we even begin the tricky process of asking the state to regulate drugs we must first and foremost, rally reform to abolish Prohibition and restore the human right to possess, produce and/or cultivate any drug for personal use without threat, punishment, or incarceration by the state. Once this is secured then we have a strong foundation to begin to secure a suitable model of regulation, although at present the detail of the desired model for regulation is worryingly vague.

“…abolish Prohibition and restore the human right to possess, produce and/or cultivate any drug for personal use without threat, punishment, or incarceration by the state.”

If, in an attempt to win support for drug policy change, we collude with these myths: that drugs per se are inherently unsafe; that drugs per se are potentially dangerous; that drug are sold by gangsters; and that state regulation and control is the solution to the problems caused by state prohibition; then we sabotage human rights based reform by perpetuating myth, misunderstanding and misinformation, and we embark on a journey that is more likely to lead to Prohibition 2.0. Regulation could be to Prohibition what Jim Crow was to Slavery.

 

Julian Buchanan
September 2017

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Seventeen Disconcerting Facts About Drug Testing

 

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What does a drug test actually tell us?


  1. Drug testing identifies substance ‘use’ rather than any substance disorder/problem. This misguidedly widens the net of concern, which should be directed towards the person with a drug problem not towards the recreational user.

  2. Most people with a chronic drug problem have endured damaging personal and social circumstances before drugs became an issue and need considerable help and support in life, more generally. Drug testing can lead to a pre-occupation on drug presence, and this narrow focus risks overlooking the real underlying issues, which if not addressed, will almost certainly lead to drug problem relapse.

  3. Women drug users with child care responsibilities are often forced to undertake regular or even daily drug tests to prove they are ‘drug’ free, this disproportionately focuses attention on drug presence rather than fitness to parent. Regular positive drug tests are then used wrongly as evidence as to why the child should be ‘looked after’ by the state. Any assessment of a mothers parental capability to care for her child should never be reduced to a drug test.

  4. A pre-occupation with drug testing by key stakeholders can result in a paradigm shift in which abstinence and so-called ‘clean’ drug tests become the desired measure of any successful outcome. Not only does harm reduction get marginalised in the process, but the messy and challenging process of rehabilitation and social reintegration may be forgotten in the satisfaction that the person appears to be drug free.

  5. Around 30-70% of young people in most western countries have used illicit drugs and the vast majority manage to avoid: a criminal record; a drug problem; harm to themselves or harm to others. Widespread random drug testing in schools, at the roadside, in employment, on benefit claimants etc., will only waste resources and result in capturing mainly non-problematic drug users who then risk being ascribed damaging labels as ‘deviant’ or ‘addicts’ that will pose serious damage to future life opportunities (education, employment, travel, insurance, housing etc) and in relationships.

  6. Resources for public and voluntary services are limited and money that could be used to deliver much needed harm reduction services is wasted on expensive drug testing for people who don’t use drugs, or those who use drugs in a non-problematic recreational manner.

  7. Random drug testing of pupils, students and children often accompanied by police and sniffer dogs as a health promotion strategy is misguided. Cultural behavioural change is not achieved through policing, confronting and punishing, but it is facilitating by meaningful, culturally relevant, reliable information exchange, harm reduction education, relationships and peer dialogue.

  8. The most widely used illicit drug (cannabis) is much less harmful than the promoted legal drugs alcohol and tobacco, it is therefore, untenable or indeed hypocritical to pursue drug testing and punish cannabis use and not drug test and punish alcohol and tobacco use.

  9. Drug testing regimes with sanctions, such as random drug tests in schools to exclude students who test positive, create a ‘cat and mouse’ game in which an adversarial relationship is established, both sides then seek to out-smart the other with new technology or deceptive techniques. The winners in this game are the drug testing businesses and underground laboratories; but the losers are honesty, trust and communication.

  10. Tougher drug testing regimes to stamp out illicit drug use, such as drug testing in employment, have spawn the proliferation of new synthetic designer ‘legal’ highs to avoid detection (such as Spice). However, once these new drugs have been detected and subsequently outlawed the drug testing ‘net’ widens, then new legal highs are further developed and the never ending spiral continues. These ‘legal highs’ may be considerably more dangerous than commonly used illicit drugs.

  11. Some drugs such as cannabis can stay in the body for over four weeks whereas drugs like cocaine can be out of the body within 48 hours. Random drug testing regimes (such as those in prisons) have inadvertently pressurised people to switch from the less harmful cannabis to the more dangerous heroin, spice or cocaine.

  12. Drug testing concentrates attention towards illegal drug use and unhelpfully firms up the misguided bifurcation between licit and illicit substances. It is not the use of any illicit drug that warrants attention but rather the misuse of any drug legal and illegal that should warrants attention. The legally promoted drugs (alcohol, caffeine, tobacco and sugar) can pose serious risks, sometimes greater than their illegal counterparts.

  13. A positive drug test may reduce the risk of people who are intoxicated from using machinery, driving a car or flying a plane, however, testing positive for a drug doesn’t necessarily mean that the person is intoxicated or impaired – for example cannabis can be detected a month after not using, so a positive drug test could result in misguided concern, and unfair dismissals.

  14. Some maintenance opioid substitute prescribing regimes rooted in harm reduction engage in regular drug testing, but as a consequence of a positive drug test for illicit drug use some automatically suspend or even terminate prescribing.  The use of drug testing in this manner transforms what was a low threshold harm reduction prescribing philosophy into a punitive abstinence only regime.

  15. A positive drug test indicates drug presence but not necessarily drug impairment, but as in the case of drug driving government campaigns are often conflating drug presence with drug impairment, ascribing much more to drug testing than it is telling us. Association does not mean causation.

  16. A positive drug test may be incorrect due to a small percentage of ‘false positives’ caused by equipment failure or human error, and conversely ‘false negative’ can occur.

  17. An accurate positive drug test still maybe misleading. It is assumed that the person has taken illicit drugs when those drugs may have been ingested legally. For example, consuming poppy seeds in bread can lead to a positive drug test for opiates, or if the person took a paracodeine tablet for a headache they’d show positive for opiates.

 

 

Julian Buchanan

JulianBuchanan@gmail.com

 

Are reformers seeking to abolish prohibition or tweak it?

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‘Like the abolition of the Atlantic slave trade, the ending of the South African Apartheid, or the collapse of the Berlin Wall – Prohibition must also fall, it cannot be adapted or amended.’ 


Drug reform should not, as some seem to think, be about improving or tweaking existing government drug policy, it should instead seek to end and dismantle an iniquitous & destructive system of prohibition that wreaks havoc on individuals, families, communities & countries. Prohibition is rooted in lies, misinformation and racism, to protect power, privilege and vested interest. It’s a regime that is fiercely upheld and brutally enforced by the state; a system that encourages and promotes legal substances while vilifying all banned substances, substances which the state insists we refer to as ‘drugs’.

While I am keen to see an end to this draconian system, I am uneasy with some of the dominant approaches in the drug reform movement, and I’m worried and dubious about what they might achieve. I suspect these approaches are driven largely by people who have enjoyed privilege, well intentioned good people, but people with limited experience or understanding of the devastating disproportionate impact drug prohibition has upon the poor, the indigenous, ethnic minority groups, people of colour, and those forced by the sheer poverty of their life circumstances to grow, manufacture and/or sell ’drugs’.

‘Let us be clear, people can be harmed by drugs, but most harm is caused by prohibitive and intolerant drug policies.’

Too many drug reformers embrace drug policy fallacy when seeking policy change, for example they claim: ‘It is because drugs are dangerous we need regulation’; or ‘drugs are dangerous but criminalisation is worse’; or ‘cannabis maybe harmful but…’ or ‘harm reduction is needed because drugs are dangerous’. What these reformers are inadvertently doing is supporting and consolidating the ideological misinformation and propaganda of prohibition to gain support for step change policy improvement. While it probably arises from a genuine and pragmatic attempt to lever change and gain credibility with prohibitionists, I think it is an irresponsible and dangerous position to take, it’d be like the Women’s Movement saying: ‘Women might not be good bricklayers – but sexism is wrong’. It appears to support change, but it’s not only inaccurate, it is subliminally reinforcing the very discrimination and misinformation it claims to be challenging.

Let us be clear, people can be harmed by drugs, but most harm is caused by prohibitive and intolerant drug policies. Because of prohibition, there are no quality controls of ‘drugs’, so people have little or no idea of the strength of the drug or of what substances it might be mixed with. Because of the life long consequences of a drug conviction, users are driven to using in private or sometimes isolated places where they are less likely to be seen, placing them more at risk. If, as a result of not knowing the strength of the drug, or of unwittingly consuming a toxic substance users get into difficulties, they are less likely to seek help, or delay seeking help for fear of criminal charges, stigma and shame.

‘we need reform not because the state failed to take control of drugs, but BECAUSE the state tried to control our drug use.’

It is drug policy rooted in prohibitionist propaganda that causes most drug related dangers, not drugs per se. Prohibitionist drug policies are lethal, they are killing people. The misplaced risks ascribed to ‘drugs’ rather than drug policy, has made many governments afraid to deliver harm reduction services such as Needle Exchanges, Heroin Assisted Treatment, Drug Consumption Rooms, Event Drug Checking and Naloxone distribution, because they fear they might be colluding with the use of  inherently dangerous substances.

Tackling prohibition by reinforcing the false premise “Drugs are Dangerous” is at best weak and apologetic, but worse will lead to reform policies that reflect that misplaced and exaggerated sense of danger. It’s not that drug are inherently dangerous, it’s a drug policy built on prohibition, abstinence and intolerance that is dangerous. Drugs, like driving cars, eating peanuts, horse rising, cycling, drinking fizzy drinks and playing the lottery all have risks but only a small minority get into serious difficulties. Indeed, the term drugs describes a socially constructed category of substances included on a United Nations list for political and economic reasons, there is no science, evidence based rationale or pharmacology support the decision. The substances listed are diverse and extremely different from each other so any sweeping statement of risk applied to them all is rendered meaningless.

Although there is an urgent and long overdue need for serious drug policy change, I don’t ‘buy into’ diluting the truth, engaging in spin or using slight of hand to achieve reform – this has been a pathway well-trodden by ideologically driven abstentionists and prohibitionists. I am also opposed to the dodgy pragmatism that suggests we need to appease, engage or win over prohibitionists by using their language. Tony Blair, when in opposition and ostensibly seeking to deliver criminal justice reform, used the slogan ‘Tough on Crime, Tough on the Causes of Crime’ – but the message that stuck was ‘tough on crime’ – the focus on the underlying causes got lost in translation, and the Criminal Justice System became more punitive. Drug reform is desperately needed, but it must not be compromised or poisoned by incorporating prohibitionist language, thinking or propaganda. Reform can, and needs to be, successfully built upon evidence, science and rationale to lead a transformative change in drug laws and policies. To end prohibition and build new drug policies we need an open, frank, informed and mature conversation, not a coy, shadily negotiation to broker a deal.

‘rallying behind ‘Regulation’ is like rallying behind a call for ‘Laws and Policies’ for drugs. It is vague and unspecific.’ 

Like the abolition of the Atlantic slave trade, the ending of the South African Apartheid, the collapse of the Berlin Wall – prohibition must also fall, it cannot be adapted or amended. The present Drug Apartheid system will be remembered as one of the great atrocities in human history – it needs exposing and abolishing – not tweaking to result in some deeply flawed Jim Crow styled reform.

Some of these reformers call for ‘Regulation’, of course, I want to see a clean legal supply of regulated drugs available for sale – but rallying behind ‘Regulation’ is like rallying behind a call for ‘Laws and Policies’ for drugs. It is vague and unspecific. For example, opiates are already a ‘regulated’ drug, they are available to buy as paracodeine/paracodol in some pharmacists, opiates are strictly regulated and used widely in medicine, but otherwise opiates are illegal to possess and supply, and anyone caught in possession faces serious charges – so regulation can take many forms and can continue to result in disproportionate law enforcement imposed on the poor and minority groups for possession of unapproved drugs.

Strict regulation is needed for businesses not people, but even then, governments have a particularly poor record of regulating the pharmaceutical, alcohol or tobacco industry, so placing hope in state to appropriately regulate ‘drugs’ is probably optimistic. The risk is that the state will seek to regulate people by punishing possession of unapproved drugs. People do not need to be regulated over what they choose to ingest in their body, law enforcement has no right to impose penalties for what they consume, they need respect, advice, guidance and reliable information to help them make an informed choice, and this can be supported by strict regulation of the drug industry including advertising, sponsorships, number of outlets, location of outlets, labelling, quality controls, strength etc.

Remember too, we need reform not because the state failed to take control of drugs, but BECAUSE the state tried to control our drug use. For five decades drug prohibition has claimed to be protecting society from the threat posed by ‘dangerous drugs’, and as a result governments have escalated the ‘war on drugs’ effort, including; crop spraying, military action, stop and searches, arrests, incarceration, sniffer dogs in schools, ever more intrusive drug testing and they have imposed severe sanctions for those caught in possession of ‘drugs’ (exclusion from housing, education, travel, insurance, employment, benefits etc). Yes, regulation could positively deliver a clean legal supply of state approved drugs, but it could also be used to uphold an enforcement regime that outlaws possession of  ‘unapproved unregulated’ drugs, thereby delivering Prohibition 2.0.

Paramount in any drug reform must be the restoration of the human right over our body to ingest what we choose, without threat or punishment from the state, this must be central and non-negotiable to any reform strategy, however, I don’t think the vague notion of seeking ‘Regulation’ will deliver this.

Julian Buchanan
August 2016

Drug Testing: Misleading Simplicity Masking Complex Issues


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The Wider Social Context

Our sophisticated techy gadgets, gismos and latest ‘apps’ make life easier, simpler and quicker. Our technology driven society monitors, measures and controls almost every aspect of daily life. The Internet tracks our lifestyle, values and interests, bar codes scan our shopping habits, CCTV cameras our movement, GPS/mobile phones track our precise location – this mass of data provides greater surveillance, knowledge and certainty for a world with an insatiable appetite for the measurable, tangible and controllable.

But the real world is not so certain or quantifiable; it is blurred, complex and messy. The apparent ‘evidence’ and ‘facts’ we possess are more contested than we would like to acknowledge. The trend to simplify social problems is both seductive and dangerous. In recent decades there has been a growing tendency to stifle debate on complex issues to reduce discussion to simple binary opposites, such as, ‘you are either for us, or against us’.

In respect of recreational drug use, this resulted in a crude unscientific bifurcation, in which unapproved substances (such as LSD, heroin, cannabis and cocaine) are presented as dangerous, immoral and likely to lead to addiction, whereas approved and promoted substances (such as caffeine, alcohol and tobacco) risks are minimised and use is normalised, indeed rarely are they even considered as ‘drugs’. Despite the mounting evidence concerning the risks posed by these state approved and promoted drugs, alongside the relative safety, by comparison, of some illicit drugs, the over-simplistic misinformed binary approach dominates law, policy and practice.

People who regularly enjoy state approved drugs take offence at being considered a ‘drug user’. If they develop physical, social and psychological problems with legal drugs are never referred to as ‘addicts’, junkies or problem drug users. Despite the fact that more people are killed by tobacco and alcohol than all the other illegal drug deaths combined, it is illicit drugs that will not be tolerated and drug testing is a key weapon to deter and eradicate the use of unapproved drugs.

 

The Appeal of the Drug Test

Legal and illegal drugs can for a small proportion of people result in serious health and social problems – in rare cases with devastating and fatal consequences. It is understandable that a concern to prevent such tragedies creates an interest in a possible role for drug testing. The technology appears to offer some tempting evidence and insight. There are a growing number of companies selling a wide range of equipment to test saliva, hair, perspiration, blood and urine for a variety of drugs. It’s a burgeoning industry with strong connections with law enforcement, often managed by ex-police officers.

Drug testing has long history of use with the substitute prescribing, initially used for safety reasons to ensure that people issued with a clean legal supply of opioids had actually been using opiates. However, some prescribing regimes continue to use drug testing on its long term patients, as a punitive tool to impose sanctions for any on-going use of illicit street drugs.

More recently drug-testing technology has been incorporated as a central tenet of Drug Courts and positive tests invariably lead to warnings, breach and sometimes short periods of imprisonment. Drug testing has become popular with some employers – a positive result may lead to suspension or termination from employment. Some countries (like USA and New Zealand) drug test welfare benefit claimants and stop payments if the person continues to test positive for illegal drugs. In some countries, like Sweden, drug testing is used in schools and colleges, in the USA parent groups advocate randomly drug-testing their children – there appears to be an endless range of circumstance when a drug test may ‘apparently’ prove useful.

When faced with a complicated situation of determining and responding appropriately to drug misuse a positive drug test appears to offer conclusive proof – clear evidence upon which straight talking and tough sanctions can be imposed. This measurable and quantifiable certainty of a drug test, in an era dominated by ‘punitive populism’ and simplistic approaches must have appeal, but sadly it can also undermine any attempt to engage effectively with the complexity of the issue, indeed it can do more harm than good.

What Does a Positive Drug Test Actually Tell Us?

A positive drug test provides an illusion of clear evidence, fact and truth. The illusion occurs because the results of the test are not 100% reliable and can be contested. First, the test could produce a ‘false’ positive, or for that matter a ‘false’ negative. Errors and misreading’s can be caused by human error in the testing process, or by faulty testing equipment. While this is not usual, there really should be no room for error given that the outcome could result in loss of liberty, loss of employment, damage to personal relationships and considerable repercussions in later life. Secondly, the result may not be a ‘misreading’ but it could be misleading – the person may accurately show positive for an illicit drug, but it might be a drug which was consumed as a herbal supplement or medication, for example, a person who takes a paracodeine tablet for a severe headache would test positive for opiates. It would then be misleading to assume the person was ‘back on heroin’ even though they tested positive. Thirdly, relying upon the apparent ‘truth’ of a drug test can be flawed because negative test results may be achieved via kits readily available from the Internet that mask the presence of the illicit drugs. So a positive or negative drug test isn’t necessarily a definitive outcome, it could be a contested and/or misleading outcome.

However, it could be argued that in most cases they provide useful and fairly accurate information. Well let us assume that the test is indeed accurate – what does it actually tell the parent, teacher, employer, court or drug worker? Imagine you had a drink problem and at a later date you test positive for the drug alcohol, what does it indicate – it doesn’t tell us how you took the drug (it could have been a sherry trifle), where you took the drug, why you took the drug, when you took the drug or who you took the drug with. Most important, a positive drug test would give no real insight as to whether or not you have an alcohol problem. It is important to be absolutely clear drug use is not indicative of drug misuse, and a positive result will not indicate why or in what circumstances the drug was ingested.

These contextual details are much more important than the apparent ‘factual’ detail of the presence of a drug in your body. At best drug testing technology is only able to provide contested ‘evidence’ that a person is (or is not) free from a particular drug. This crude indicator risks decontextualize and over-simplifying the issue of illicit drug use. Thinking can easily drifts into binary measure of:

  • you are either drug free or a drug addict;
  • you are either telling the truth or you are lying;
  • you are either co-operating or being deviant;
  • you either want help or you don’t want help.

Armed with a ‘hard copy’ evidence of a positive drug test gives those in power and authority confidence to impose sanctions and punishments upon the ‘outsider’ or ‘deviant’ based upon what masquerades as indisputable evidence. This approach is not only deeply flawed, it can also have a number of serious adverse and unintended consequences.


17 Negative Consequences of Drug Testing:

  1. Drug testing identifies substance ‘use’ rather than any substance disorder/problem. This misguidedly widens the net of concern, which should be directed towards the person with a drug problem not towards the recreational user.

  2. Most people with a chronic drug problem have endured damaging personal and social circumstances before drugs became an issue and need considerable help and support in life, more generally. Drug testing can lead to a pre-occupation on drug presence, and this narrow focus risks overlooking the real underlying issues, which if not addressed, will almost certainly lead to drug problem relapse.

  3. Women drug users with child care responsibilities are often forced to undertake regular or even daily drug tests to prove they are ‘drug’ free, this disproportionately focuses attention on drug presence rather than fitness to parent. Regular positive drug tests are then used wrongly as evidence as to why the child should be ‘looked after’ by the state. Any assessment of a mothers parental capability to care for her child should never be reduced to a drug test.

  4. A pre-occupation with drug testing by key stakeholders can result in a paradigm shift in which abstinence and so-called ‘clean’ drug tests become the desired measure of any successful outcome. Not only does harm reduction get marginalised in the process, but the messy and challenging process of rehabilitation and social reintegration may be forgotten in the satisfaction that the person appears to be drug free.

  5. Around 30-70% of young people in most western countries have used illicit drugs and the vast majority manage to avoid: a criminal record; a drug problem; harm to themselves or harm to others. Widespread random drug testing in schools, at the roadside, in employment, on benefit claimants etc., will only waste resources and result in capturing mainly non-problematic drug users who then risk being ascribed damaging labels as ‘deviant’ or ‘addicts’ that will pose serious damage to future life opportunities (education, employment, travel, insurance, housing etc) and in relationships.

  6. Resources for public and voluntary services are limited and money that could be used to deliver much needed harm reduction services is wasted on expensive drug testing for people who don’t use drugs, or those who use drugs in a non-problematic recreational manner.

  7. Random drug testing of pupils, students and children often accompanied by police and sniffer dogs as a health promotion strategy is misguided. Cultural behavioural change is not achieved through policing, confronting and punishing, but it is facilitating by meaningful, culturally relevant, reliable information exchange, harm reduction education, relationships and peer dialogue.

  8. The most widely used illicit drug (cannabis) is much less harmful than the promoted legal drugs alcohol and tobacco, it is therefore, untenable or indeed hypocritical to pursue drug testing and punish cannabis use and not drug test and punish alcohol and tobacco use.

  9. Drug testing regimes with sanctions, such as random drug tests in schools to exclude students who test positive, create a ‘cat and mouse’ game in which an adversarial relationship is established, both sides then seek to out-smart the other with new technology or deceptive techniques. The winners in this game are the drug testing businesses and underground laboratories; but the losers are honesty, trust and communication.

  10. Tougher drug testing regimes to stamp out illicit drug use, such as drug testing in employment, have spawn the proliferation of new synthetic designer ‘legal’ highs to avoid detection (such as Spice). However, once these new drugs have been detected and subsequently outlawed the drug testing ‘net’ widens, then new legal highs are further developed and the never ending spiral continues. These ‘legal highs’ may be considerably more dangerous than commonly used illicit drugs.

  11. Some drugs such as cannabis can stay in the body for over four weeks whereas drugs like cocaine can be out of the body within 48 hours. Random drug testing regimes (such as those in prisons) have inadvertently pressurised people to switch from the less harmful cannabis to the more dangerous heroin, spice or cocaine.

  12. Drug testing concentrates attention towards illegal drug use and unhelpfully firms up the misguided bifurcation between licit and illicit substances. It is not the use of any illicit drug that warrants attention but rather the misuse of any drug legal and illegal that should warrants attention. The legally promoted drugs (alcohol, caffeine, tobacco and sugar) can pose serious risks, sometimes greater than their illegal counterparts.

  13. A positive drug test may reduce the risk of people who are intoxicated from using machinery, driving a car or flying a plane, however, testing positive for a drug doesn’t necessarily mean that the person is intoxicated or impaired – for example cannabis can be detected a month after not using, so a positive drug test could result in misguided concern, and unfair dismissals.

  14. Some maintenance opioid substitute prescribing regimes rooted in harm reduction engage in regular drug testing, but as a consequence of a positive drug test for illicit drug use some automatically suspend or even terminate prescribing.  The use of drug testing in this manner transforms what was a low threshold harm reduction prescribing philosophy into a punitive abstinence only regime.

  15. A positive drug test indicates drug presence but not necessarily drug impairment, but as in the case of drug driving government campaigns are often conflating drug presence with drug impairment, ascribing much more to drug testing than it is telling us. Association does not mean causation.

  16. A positive drug test may be incorrect due to a small percentage of ‘false positives’ caused by equipment failure or human error, and conversely ‘false negative’ can occur.

  17. An accurate positive drug test still maybe misleading. It is assumed that the person has taken illicit drugs when those drugs may have been ingested legally. For example, consuming poppy seeds in bread can lead to a positive drug test for opiates, or if the person took a para-codeine tablet for a headache they’d show positive for opiates.

Conclusion

While drug testing seems to offers seductive simplicity, the shortfalls, ambiguities and misuse of drug testing technology has arguably greater potential to mislead and distort rather than to inform. The future of drug prevention and drug treatment lie not with monitoring, coercion and punishments, but with listening, engaging and caring – drug testing sits firmly with the former and not with the latter. Drug checking by contrast is an important harm reduction strategy to check the contents of unknown substances to protect people from overdose or poisoning. Testing pills is quite different to drug testing people, one is vital and the other is a counter productive waste of money.

Julian Buchanan


  • This blog is based on a conference paper, the PowerPoint presentation which can be accessed here

Power, Democracy and Drug Reform: Challenging the ‘War on Drugs’

 

The so called ‘War on Drugs’ never existed. The idea that there is or has been a war against drugs is a lie,  it’s classic prohibition propaganda. There has never been a campaign against drugs. Let me explain. Society and governments have always appreciated the wide ranging benefits and pleasures derived from drugs. Drugs have never been as popular as they are now. The availability, promotion and use of pharmaceutical and legally approved drugs such as caffeine, alcohol, tobacco and sugar, has never been greater. However, prohibition propaganda has conveniently resulted in these drugs escaping under the radar of the prohibitionist drug discourse, and these substances are incorrectly, not perceived as drugs.

Rather than a War on Drugs, what we have is a Drug War, a hostile war waged by the proponents of approved drugs against anyone using unapproved drugs. More accurately, a process better conceptualised as a politically driven Drug Apartheid; an arbitrary and illogical separation, not of people, but of drugs. This distinction between these two sets of drugs has no rational basis, it has no science or evidence to support it, neither is it based on the risk of harm. Under the strictly enforced Drug Apartheid alcohol, sugar, tobacco and caffeine enjoy privilege, power and promotion, while unapproved drugs are outlawed and anyone found involved in possession, production or supply risks stigma, criminalisation and punishment, including life imprisonment and the death penalty. This brutal, inhumane and damaging system that impacts negatively on individuals, families, communities and nations, is perpetuated because society has been successfully indoctrinated (at a personal, cultural and institutional level), to believe a social construction of ‘drugs’.

Nutt, Legalisation, harm reduction, Drug reform, decriminalisation, addict, addiction, regulation, stigma

Anyone seeking to expose or challenge the drug apartheid, risks being ridiculed, and is vulnerable to public humiliation, as experienced by Professor David Nutt. The unwarranted and ill-founded attack on David Nutt was no isolated incident. Further, to deter any association with outlawed drugs, armed forces, customs officials, and police invest massive energy and resources, while magistrates and Judges impose some of the severest sentences available to the courts for drug violations. Such is the power of the drug apartheid, that a criminal conviction for using the ‘wrong drug’ results in life-long consequences for travel, employment, housing, relationship and opportunities. The ever increasing business opportunities and technologies, spawned from the drug apartheid, drug testing (urine, blood, hair, sweat, saliva, and waste water!), has enabled the oppressive regime to extend beyond law enforcement agencies, to the civil arena, so that surveillance, monitoring and sanctions to maintain the drug apartheid are now carried out by employers, benefit agencies, schools, colleges and even in homes by parents on their children.

This untenable and indefensible position, of outlawing some drugs and privileging others, was enshrined in the 1961 UN Single Convention, a law that is rooted in moral and politically ideology from the 1930s, 40s & 50s. The decision to isolate a group of substances was never based upon science, reason or evidence. Yet ironically, since it’s inception, drug reformers have tried to end this drug war by engaging ideologically driven politicians, governments and UN bodies with endless streams of evidence, inquiries, research, reports and debates.

This considerable drug reform effort, has for five decades (1960-2010), resulted in no significant drug law or policy change by any major advanced western capitalist country, – apart from some US state privileging cannabis for entirely different reasons. The vast array of campaigns, reports, research, presentations, inquiries, reviews, and publications have for decades been consigned to a vacuum, while the increasingly wealthy and all powerful multi-national companies with a vested interest in maintaining the drug apartheid, have worked closely alongside politicians and government agencies, to maintain drug policy inertia through propaganda, procrastination, misinformation and distortion. Indeed prohibition benefits many groups and organisations.

marijuana, weed, cannabis, legalisation, harm reduction, reform, drugs

A recent US opinion poll (the General Social Survey), that explores support for cannabis legalisation, indicates that for almost 40 years (1970-2007) public interest in legalising cannabis changed little, fluctuating between 16% and 33% during that period. However,  in the seven year period since 2007, support for legalisation has risen rapidly from 31% to 52%. How do we make sense of this dramatic shift?

One influential contributing factor over this period, has been the global and widespread increased access to the internet, and the mass engagement with social media such as Twitter, Facebook, Scoop.it, LinkenIn and YouTube. Social media provides an alternative source to information, evidence and peer exchange, and has I believe, played a significant part in enabling the wider public to gain access to independent, research based knowledge and reason, necessary to critically consider and question the basis of the Drug Policy Sham. In particular, the widespread dissemination of research evidence, facts and case stories (such as Charlotte Figi), about cannabis to the public, has resulted in long overdue, and much needed calls for decriminalisation and legalisation, to allow people suffering with life limiting illnesses, that fail to respond to medicine, to explore possible benefits from cannabis, and sensibly too, to allow recreational use of cannabis. Personal possession of cannabis should never have been outlawed, but neither should personal possession of any substance. Every person should in principle have totally rights over their own body and what they consume without threat of harassment, punishment or incarceration. The risks associated with personal consumption of any substance is a health and social care issue, not a law enforcement issue (if it’s an issue at all!).

The public acceptance of cannabis is a very significant shift, indeed, it could mark the ’tipping point’ – the start of the process that could see the end of the drug apartheid. But let’s be clear here, cannabis reform in the US is not occurring because fifty years of research, evidence and debate has finally persuaded politicians the drug war was a mistake, and the politicians are seeking legislative change. No, cannabis is being embraced, essentially because public insight and awareness has significantly increased since 2007, and there has been a shift in public opinion, that has resulted in serious electoral pressure upon politicians to enact cannabis law reform. The drive is coming from the grassroots, it’s not being led by politicians,  instead governments are being forced to change by the public and ballot box.

In an era where the interests and activities of multi-national companies and politicians are becoming increasingly enmeshed. An era where democracy seems unresponsive to the needs of the vulnerable, and shows little interest in the protection of the common good, another four decades of inquiries, reports, reviews towards incremental change, would be a grave strategic mistake. The leverage for drug reform will be found, not in trying to persuade politicians or the INCB, UNODC, UNGASS, CND to lead the way on incremental changes which fail to address the underlying fallacies, but rather, by winning over mass public support, by utilising social media to distribute evidence, developing well-informed community movements, regularly disseminating accurate information, sharing influential case studies and rallying a huge social movement and public outcry that demands political change and transformation. The Drug War fallacies spawned by UN, have created a global system of propaganda and prohibition. This system needs exposing and ending, it is misguided to imagine it can provide foundations that can be adjusted  and reformed incrementally to deliver drug legalisation.

drug reform, legalisation, decriminalisation, harm reduction, human rights

Human Rights and Harm Reduction must be central in all reform.

Despite this encouraging drug law reform development, in respect of cannabis, the attempts towards genuine global drug reform could easily be thwarted. If, as drug reformers, we are not clear in our arguments and strategies for reform, which should be firmly rooted in protecting human rights and promoting harm reduction, cannabis will simply be invited to join the other privileged legal drugs in the drug apartheid. This could be a positive outcome for: big business, who can extend their repertoire and profit from the commercial sale of cannabis; for the state, who can profit from taxes, as well as continue to utilise drug laws as a key control mechanism for stopping, searching, arresting and punishing the poor, indigenous and minority ethnic groups; and the business enterprises spawned from the drug wars, (the industrial penal complex, the drug testing industry and the drug treatment industries). In this pivotal period for drug reform, simply privileging cannabis and failing to address the fundamentally flawed system of drug control would amount to colluding with a corrupt system.

Some drug reform entrepreneurs may attempt to hail privileging cannabis as an incremental step in the right direction, but the widespread and growing public support for decriminalisation, (and ultimately the regulation of all drugs), could be dissipated by this tokenistic gesture to invite cannabis to sit around the table of the powerful. While alcohol, tobacco, caffeine and maybe cannabis enjoy privileged status, the scourge, oppression and madness of a drug apartheid, remains an affront to human rights, a system of punishment and control that will continue to haunt this generation and future generations to come, one that will be remembered shamefully in history. The international system of drug control is deeply flawed and damaging to individuals, communities and countries. There is no ‘World Drugs Problem’ what we have is a UN led World Drug Policy Problem. It needs naming, exposing and dismantling. There can be no minor adjustments, or so-called incremental steps to accommodate the status quo, abolition is what is required not compromise.

This period of history will be recalled for the needless self-inflicted harm, imposed across the globe by a drug apartheid, in which drug laws and drug policy have caused considerably more harm than the drugs ever could.

by Julian Buchanan, Associate Professor, Institute of Criminology, Victoria University of Wellington, Aotearoa New Zealand, 7th March 2015 (updated 26th April 2016)
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