What Would Drug Legalization Look Like?

What Would Drug Legalization Look Like?:

Suppose we decriminalized hard drugs — heroin, cocaine, and all the rest? The Indypendent ponders the scenario and how we could make it work:

For heroin, says Eric Sterling, the conundrum is how much use would spread if “the price goes down and the ease of acquisition goes up,” but if a legal scheme set the price too high or made the restrictions too inconvenient, users would go back to the illegal market.

He posits a system in which “addiction management” specialists would supply enough drugs to keep addicts from getting sick, but would not tolerate criminal behavior. Rehab and counseling would be available, and addicts might also be required to work or go to school.

Switzerland, which had close to the highest rate of heroin addiction in Europe in the mid-’90s — with an estimated 30,000 addicts out of about 7 million people — has had some success with heroin maintenance. In 1994, it set up clinics where addicts could shoot up three times a day. By 2007, the number of drug-related deaths had fallen by half, the number of new addicts dropped dramatically, the number of drug-related HIV infections declined, and the open-air drug markets had disappeared, according to a study by Peter Reuter and Robert MacCoun, public-policy professors at the University of Maryland and the University of California at Berkeley respectively.

“Safe injection facilities to use should be part of every public health system,” says Joyce Rivera, executive director of St. Ann’s Harm Reduction Corner in the Bronx. In her experience, heroin users with jobs can manage work and social responsibilities, adapting their drug use “to their available time to self-sedate.”

Cocaine poses the most complex issues. Occasional users can do it relatively safely, but hardcore users often tend toward extreme binges rather than regular-dose addiction. That would make maintenance impractical.

“There is no treatment for crack/cocaine,” says Rivera. “In fact, there is no maintenance other than meds (licit and illicit), acupuncture, or some form of stress reduction to counter the dysphoria associated with over-depletion of dopamine receptors.” But, she adds, “Dysfunctional crack and cocaine use dramatically declined from the ’90s without treatment.”

The British group Transform UK, in its 2009 study “After the War on Drugs: Blueprint for Regulation,” suggests trying to move the cocaine market to milder forms such as coca energy drinks and tea.

That’s not necessarily wishful thinking. A general principle of prohibition is that it makes the most potent forms of a drug the most value-for-weight profitable for dealers. For users, that makes it more cost-effective to shoot heroin instead of smoking opium, to smoke crack instead of chewing coca leaves, and to drink whiskey instead of beer.