Pubdate: Sat, 13 Oct 2001
Source: British Medical Journal, The (UK)
Issue: 2001;323:866 (13 Oct 2001)
Section: Letters
Website: http://www.bmj.com/
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Author: A R MacQueen

ARTICLE DRIFTED INTO COUNTERPROPAGANDA

Editor:

Drummond is quite right to criticise a "documentary" that attributes the 
damage done by injecting to adulteration by unscrupulous dealers.1 Why 
would dealers damage their client base? Injecting itself carries a risk of 
damage, and the legal benzodiazepines, especially temazepam in gel form, 
seem to cause the most damage.

He also is quite right to point out that tobacco and alcohol kill more 
people than illicit drugs. We should not let governments gloss over this 
inconvenient fact, nor their dependence on the income derived from sale of 
these dangerous drugs. But I fear Drummond drifts into counterpropaganda 
when he claims that legalisation would actually lead to an increase of 
addiction, when no one has that crystal ball. The Netherlands, with a more 
open and logical approach to cannabis, has the lowest rate of use in the 
Organisation for Economic Cooperation and Development, for example.2 The 
assertion that the governments of the Netherlands and Switzerland are 
considering a reversal of policy is just untrue. On the contrary, many 
European countries have already followed suit, or are preparing to do so.

"Legalisation" is also an emotive but unhelpful term here. It is not legal 
to use cannabis in the Netherlands, but the police overlook minor use, for 
example. There are many steps between rigid prohibition and open slather, 
and only those afraid of change seek to terrify others by using the term 
legalisation. Why not different strategies for different drugs, just like 
we have today for tobacco, coffee, paracetamol, insulin, and morphine?

There are other misleading statements. Britain is, in most people's terms, 
engaged in a war on drugs, no less so than the United States or Australia. 
Although some may agree that even poor treatment is to be preferred over 
good incarceration, others may ask why we need to treat a problem created, 
in the main, by our own laws. And heroin prescribing is vastly more 
effective at recruiting and retaining people who have failed repeated 
attempts at methadone, and at improving their health and social 
functioning.3 We surely do not wish to promote the "one size fits all" 
approach of the past?

As for any changes flooding our streets with yet more drugs, most clinical 
workers think that the place is going under already. More availability, 
lower prices, and higher purity of illicit drugs throughout the world 
suggest that a plentiful supply exists. When current strategies do not 
work, should we redouble our efforts, like the United States, or consider 
the possibility that the whole strategy is flawed?

A R MacQueen, clinical director Mid West Area Health Service, Alcohol and 
Other Drug Services, Bloomfield Hospital, Orange, New South Wales 2800

1. Drummond C. Drug laws don't work: the phoney war. BMJ 2001; 322: 
1551[Full Text]. (23 June.) 2. 
www.emcdda.org/infopoint/publications/annrep_00.shtml (accessed 8 Oct 
2001). 3. McClusker C, Davies M. Prescribing drug of choice to illicit 
heroin users: the experience of a UK community drug team. J Sub Sbuse Treat 
1996; 13: 521-531[Medline].
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