Legalise them all
James Linney condemns the timidity of Jeremy Corbyn and Diane Abbott
The role of the pharmaceutical industry in creating the opioid crisis in the US has been widely discussed.1 By misleading and bribing, big pharma flooded America with morphine-based pain-killers and thereby generated huge profits. But the consequences for the millions of Americans who became addicted has been disastrous. For many this has meant being forced to buy much cheaper heroin, often cut with unknown concentrations of much stronger opioids, such as fentanyl - the horrific result being tens of thousands of deaths every year due to overdoses.
Here I want to look at how the left can offer an alternative to this misery, how through the legalisation of all drugs we can immediately prevent overdose deaths and reduce other drug-related morbidities. As always, we must strive to use a scientific method and analyse what evidence there is available to us. I will therefore focus on the only country which has fully decriminalised all drugs for personal use: Portugal.
In 1974 Portugal’s relative isolation from the rest of the world ended with the revolutionary overthrow of the Estado Novo authoritarian regime. After Portugal’s eventual transition to ‘bourgeois democracy’ there came freer movement of goods, both legal and illegal. Its underdevelopment and sudden exposure to new markets led, in a short space of time, to a large influx of illicit drugs and by the 1990s Portugal had caught up with the rest of Europe in its rates of heroin use. By 1999 1% of the population was regularly injecting heroin and subsequently the rates of related blood-transmitted disease were sky-rocketing, with Portugal then having the highest rates of drug-related HIV deaths in the European Union.2
Perhaps it was the experience of the 1974-75 revolution and the continued presence of a militant working class movement and a relatively strong left, that provided the authorities with the space needed for Portugal to respond to its drug problem in a considerably more humane and sensible way than any other member of the European Union. In 2001 it became the first EU country to abolish all criminal penalties for personal drug use. It was still illegal to buy or sell drugs, but possession for personal use was no longer a criminal offence. It was an administrative one, which could still potentially result in a small fine. The law now permitted amounts of each drug estimated to be the equivalent of 10 days’ use for one person: for cannabis, 25 grams; cocaine, two grams; heroin, one gram; LSD or ecstasy, 10 pills.
Importantly, along with the change in law, there was also a change in attitude and culture. By no longer chasing the impossible goal of a drug-free land, the government was able to focus on harm reduction. More funding was made available for heroin users, including much better access to drug treatment clinics, clean needle exchanges and free drug kits (plastic pouches with single-use servings of filtered water, citric acid, a small metal tray for cooking, gauze, filter and a clean syringe).
Other western governments prophesied disaster when Portugal made this change. It would lead to soaring drug use, crime, harmful drug tourism, an increase in drug-related morbidity and general chaos on the streets, we were told - essentially the same arguments that our own government currently uses to dismiss a similar move in the UK. Yet in the 17 years since the law was changed the evidence has actually revealed a very different result.
In contrast to other European countries since 2001, in almost every category of drug, and for drug usage overall, the lifetime prevalence rates in Portugal have decreased.3 In 2016 Portugal had the lowest rate of deaths due to drug use in all of western Europe - just six per one million people,4 a tenth of the UK’s (60 per million) and a fraction of the US’s (185 per million). The proportion of HIV-infected drug users also plummeted from 52% in 2000 to 15% in 2010.
These are remarkable results, and Portugal’s example has been a part of the growing evidence base that is being used globally to call for a different way to tackle opiate addiction. Most drug treatment specialists now believe that harm reduction is far preferable to abstinence and there is a growing consensus in favour of decriminalisation. However, an important limitation in the Portugal example must be made: namely that there has been decriminalisation of drugs, not legalisation. Therefore, users are still reliant on buying drugs of which they cannot be sure of the precise contents. So there is still the risk of overdose from those mixed with toxins or much stronger opioids, as is often the case in the US. Only through legalising drugs can there be proper safety and quality testing. Yet, this aside, the Portuguese experiment undoubtedly provides some real evidence, upon which the argument for legalisation can be strengthened.
War on drugs
As is often the case though, there is a pathological disconnect between the scientific evidence and government policies. In America, apart from a handful of states where marijuana has been legalised, the mantra of ‘eradicating drug use’ remains the established status quo. Despite annual deaths from opioid overdose being roughly equivalent to the number of Americans who died during the entire Vietnam war, Donald Trump’s 2017 conference on the opioid crisis confirmed there was to be an escalation of Ronald Reagan’s failed ‘war on drugs’.
In the UK too we have seen the ignoring of, or silencing of, those medical practitioners who have been advocating a rethink in the way we classify and treat drugs. Readers will remember how David Nutt, the government’s chief drug advisor, was sacked in 2009, when he dared use scientific evidence to challenge the government’s decision to reclassify marijuana. He has recently said:
I strongly believe that we should focus on public health approaches to the drug problem, and decriminalise the possession of drugs for personal use, for the following simple reason:
If users are addicted, then they are ill, and criminal sanctions are an inappropriate way to deal with an illness. If they are not addicted, then criminalisation will almost always lead to greater harms to the user than the effects of the drug.5
Currently the only mainstream party advocating any change in drug policy is the Liberal Democrats, who have campaigned for the legalisation of cannabis. But what of Labour’s drug policy? In 2000 Jeremy Corbyn sponsored a bill in favour of decriminalising cannabis, but by the 2016 leadership contest his opinion had changed to favouring “decriminalising cannabis for medical uses” only and he stated he was against the legalisation of any hard drugs.6 Sadly, we have grown used to Corbyn’s compromises in an attempt to pacify the Labour right and his already pretty weak stance seemed to have taken a turn for the even more pathetic when we were recently informed by Diane Abbott: “It is not Labour’s policy to legalise cannabis.”7
This is not good enough and one of the left’s tasks in the Labour Party must be to challenge this failing. Not only must we not prevent treatment by stigmatising users as criminals; not only must the national health service follow Portugal’s example in providing far more resources for drug treatment clinics. We must go much further, with the NHS prescribing heroin in safe, controlled doses, whilst providing safe injection sites for those not able or ready to start heroin substitution medications.
For more than 50 years America, eagerly tailed by other western governments, has continued its ‘war on drugs’, which has simultaneously fanned the flames of violence between drug gangs and criminalised drug users instead of providing treatment. Two statistics that hint at the misery that has resulted are: 59,000 deaths from drug overdose in the US in 20168 and 29,000 murders largely due to drug gang violence in Mexico in 2017.9
The American government’s response to drugs also highlights one of capitalism’s own addictions: to punishment and more specifically to imprisonment. This remains one of its preferred methods of keeping the working class demoralised, impoverished and less able to organise. It has never been more urgent for the left to raise what is a basic demand for any self-respecting socialist: the legalisation of all drugs.
1. ‘Oxycontin is the opium of the masses’ Weekly Worker April 4 2018.