Drugs

Laws in developed societies regulate the production, supply, possession and use of recreational drugs – drugs taken for their effects on altering consciousness but not prescribed for medical reasons. Such laws present a puzzle both for liberalism and for public policy. For liberalism the problem is that while, as we noted in the last chapter, many liberals pay lip service to Mill’s dictum that the only justification for interfering with the liberty of action of any individual is to prevent harm to others (Mill 1962a [1859]), it is very hard to identify significant harms to third parties caused by the use of many currently illegal drugs. This, of course, is to leave aside harms that are the result of the existence of an extensive illegal market, which cannot themselves be used in an argument to justify such prohibition in the first place. We have already seen that public policy tends not to follow Mill’s

‘harm principle’ and all governments take it upon themselves to supervise individual lives in various ways to reduce the risk of individuals harming themselves. It is here, though, that the problem for public policy strikes. It seems, prima facie, reasonable that the stringency of regulation should be related to the harms any action or substance causes or threatens. However, some currently illegal drugs do far less harm to the user, and to third parties, than some currently legal substances, notably alcohol and tobacco. Yet despite the ever-increasing restrictions on public smoking, the

prospects of criminalizing the use of tobacco, or that of alcohol, or decriminalizing all drugs that are less harmful than alcohol, do not look bright. Hence it appears that societies do not in fact regulate drugs on the basis of the harm they cause. The actual basis of regulation is something of a mystery. Lest it be doubted that some currently illegal drugs do far less

harm than some currently legal drugs, consider the evidence presented by David Nutt in a short paper called ‘A Tale of 2 Es’ comparing the drug ecstasy (MDMA) and ethanol (i.e. alcohol) (Nutt 2006; see also STC 2006, ev110-17, and Nutt et al. 2007). David Nutt is now well-known as the former chair of the UK Advisory Council on the Misuse of Drugs, fired for his outspoken views and writings, including a comparison of the risks of taking the drug ecstasy and horse-riding (Nutt 2009). But his controversial writings pre-dated that episode, and a few years earlier he wrote a short paper claiming that, on average, alcohol causes 22,000 premature deaths in the UK each year while ecstasy causes 10. These figures are contestable but their order of magnitude is not. It is also true that there are many more users of alcohol than ecstasy, but even taking this into account alcohol is still, statistically, somewhere in the region of 200 times more likely to kill its users than ecstasy (and remember that one of the dangers of ecstasy is said to be that its illegal status means that it is sometimes ‘cut’ with other more toxic substances). Alcohol is also known to cause brain damage, especially among

very heavy users, yet the evidence that ecstasy has such effects is patchy and contested. The most notorious empirical study, in which it was ‘shown’ that injecting monkeys with MDMA led to brain damage (Ricaurte et al. 2002), was later retracted when, after failing to replicate their studies with an oral dose, the researchers discovered that the monkeys in the original experiment had actually been injected with methamphetamine (crystal meth) in error (Ricaurte et al. 2003). Despite this retraction, it is widely believed that there is clear scientific evidence that MDMA causes brain

damage, although as far as I have been able to tell there is no study that actually shows this, as distinct from what scientists predict the studies might show if they had actually been done. Nutt also suggests that alcohol causes a significant number of

road traffic deaths, incidents of violence, cirrhosis and heart damage, while ecstasy has none of these effects, and we might add, is protective against violence, spreading affection rather than aggression. Comparable stories can be told for cannabis and even LSD, which are believed by many scientists to be far less harmful to health than alcohol. This may seem surprising for cannabis, as there is a well-known association between cannabis use and some forms of psychosis. Yet the nature of the relation between cannabis and psychosis remains disputed, and it is clear that alcohol abuse can also lead to mental disorder, both temporary and longer term (on the relation between cannabis and psychosis see W. Hall and Pacula 2003, W. Hall 2006, Fergusson et al. 2006, and Hickman et al. 2007). One team of researchers suggests that the most dangerous thing about cannabis is that typically you need to ingest another substance to take it: tobacco smoke (MacLeod and Hickman 2010). To attempt to find whether there is a coherent basis for current

regulations I will first consider the deeper assumptions underlying drug policy, and then explore the (surprisingly small) philosophical debate concerning the regulation of drugs.