It’s Time to Count the Costs, Europe!

June 21, 2012

Europe should explore alternative regulatory options for drugs

As the EU drug strategy (2005-12) expires this year, a new strategy is under preparation. The EU has no common drug policy: That is essentially the province of individual member states; so drug strategy always represents a delicate consensus among members. Part of this consensus involves common support for an evidence-based and balanced approach – and the EU communicates and represents this approach in a single voice, at sessions of the UN Commission on Narcotic Drugs (CND). Europe, the birthplace of harm reduction, is a progressive player in the international drug policy arena. In recent years, the EU Commission has been very supportive towards the involvement of civil society in decision-making. However, if we take a closer look at an assessment of the current EU drug strategy, the picture is not so bright. There are several findings that challenge the effectiveness of European drug policies – and these findings should be reflected in the new EU drug strategy.

In the “Draft Council Conclusions on the new EU drug strategy”, published at the end of May, the EU Council draws conclusions from an assessment of the current EU drug strategy. The assessment, conducted by RAND Institute (you can download it here!), said that there is limited available evidence as to the added value and effectiveness of EU drug strategy – there being only one area (harm reduction) where clear evidence of such added value exists. The growing availability of, and access to, harm reduction services, has arguably reduced the prevalence of HIV in Europe. According to the RAND evaluators, supply reduction interventions have had no measurable impact; and yet, European member states spend much more on supply reduction, than on all drug-related public health and social interventions combined. This should be a cause for concern and a reason to consider a radical shift in drug policies.

I think the conclusions of the Council do not appropriately address the real challenge, which is: Why do we still rely on supply reduction measures which, over decades, have not resulted in any measurable impact? Consumption patterns in the drug market are changing, but the supply of drugs is stable, as are their price and availability. Of course, one may say that we do not know what would have happened without current repressive policies, and this is true. But if we completely reject the possibility of alternative regulatory options, in assessing current policies, how can we ever know? It is a black-and-white fallacy to believe that there are only two options: current supply reduction interventions, on the one hand, or complete lack of any regulations, on the other.

The RAND report says that supply reduction measures are “relevant” to addressing the drugs challenges faced by the EU – but this statement is not based on any research data showing that supply reduction measures are fit for purpose –  that is, that they are able to reduce the size of the drug market. The report admits that no established indicators even exist, to measure success in this field. So instead, RAND carried out an online survey, and asked people – most of them working in supply reduction – if current measures are relevant or not. This does not amount to external evaluation, but self-evaluation; and we cannot accept the conclusion that supply reduction measures are relevant. Especially not, when we consider that there are no established tools to assess the regional and global unintended consequences of supply reduction policies.

The emergence of legal highs is one example of such unintended consqequences. As the EU Council puts it, “New and potentially harmful psychoactive substances, often being marketed as legal alternatives to internationally controlled drugs, are emerging at unprecedented pace, posing a risk to public health and safety.” However, the report does not mention the way in which repressive measures against illicit synthetic drugs markets contributed to the emergence of “legal highs” in the first place. The connection between the collapse of Ecstasy-markets and the emergence of Mephedrone is hard to ignore, as well as the spread of other legal highs after Mephedrone was banned in individual countries (Read my previous article!). There is a constant demand for these drugs in Europe, so even if governments succesfully suppress the availability of one drug, it will be soon replaced by another one. These rapid shifts in the drug market, caused by supply reduction interventions, have harmful unintended consequences – posing unknown risks for the user, and new challenges for service providers. 

If we repeatedly fail to achive a goal, we should consider the possibility that it is not because of our inadequate efforts  – but because the goal itself is inappropriate. We should ask ourselves the question: whether our main goal should be repression of all non-medical and non-scientific use of drugs – as stated in the UN drug conventions –  or to reduce the harms caused by the drug market. The evidence shows that most people who use illicit drugs do not correspond to the definition of a problematic drug user, as developed by the European Monitoring Center on Drugs and Drug Addiction (EMCDDA). If most people who use drugs are non-problematic, why not regulate the supply of drugs instead of repressing it? Why do a favour to organized crime, by allowing supply to be unregulated and untaxed?

Actually, the RAND report makes an indirect reference to this issue, when it says that the growing prevalence of the use of legal highs poses emerging health and research challenges, and stresses the need for “a wider conceptual framework for treating addiction and substance use”. A recent report of the European Economic and Social Committee (EESC) also emphasizes that, “Already in the medium term a comprehensive and coordinated policy on addiction to all psychoactive drugs, both ‘legal’ and ‘illegal’, is needed to ensure that individual policies do not work against one another.” A wider conceptual framework would mean measuring the risks of legal and illegal drugs according to the same criteria (similarly to David Nutt) – and acknowledging that alcohol and tobacco are much more harmful to society than most illicit drugs. It would be very hard to explain why one of the most dangerous drugs, alcohol, is legally regulated, while even simple possession of cannabis is criminalized in most member states.

I think the next EU drug strategy should not ignore the growing evidence, and should incorporate the goal of developing a framework and tools to assess and evaluate supply reduction policies, including any unintended consequences, and alternative policy options. In 2009 the EU Commission itself commissioned a report (conducted by Franz Trautman and Peter Reuter, two well respected researchers) on trends in the global illicit drug market; and this report drew the same conclusion on a global level as the recently-published RAND assessment did on the EU level –  i.e. that repressive measures were unable to achieve significant positive change, but had many undesirable side-effects. The next EU drug strategy should reflect the findings of this report.

Watch our video on the human rights costs of the global drug war!

The EU Council makes two positive references to civil society involvement in its conclusions. Indeed, civil society should be an important resource for decision-makers. There now exists a semi-formal framework for civil society involvement, in that the Civil Society Forum on Drug Policy works as an expert group of the EU Commission. In April, the CSFDP sent recommendations on the new EU drug strategy to the EU Commission and the member states. Among other things, this expert group of the Commission – of which I am a member – urged decision-makers to embrace the idea of a greater and more meaningful involvement of civil society, to integrate the assessment of the human rights impact of drug policies, and to address the underlying social, health and economic inequalities, stigma and discrimination behind problematic drug use. The Council’s conclusions do not reflect these specific issues – but it claims that the recommendations should be reflected in the strategy. Member states should make a commitment to create formal chanels of communication with civil society: My own country, Hungary, is a good example – having since 2007 4 civil society representatives with voting rights in its major national drug coordination body. However, involvement, on its own, is meaningless if governments do not listen to what civil society has to say.  

The current Count the Costs! campaign, initiated by civil society organizations, urges decision-makers to undertake a transparent review of the past 50 years of drug policies. We have identified seven areas where the global drug war has had significant unintended negative impacts: human rights, economic, environmental, public health, stigma and discrimination, crime, and development. Political leaders in Latin-America, acknowledging many of these unintended consequences, are now calling for an open debate on alternatives to current methods of international drug control. If Europe is still committed to its common values, such as human rights, security and prosperity, mutual respect and shared responsibility, it should not shy away from this call, but take the lead, and support the drive of Latin-American leaders for an open dialogue.

Peter Sarosi