Blueprint for legalization and control

One of pillars of the prohibitionist propaganda is the claim that legalization of the currently illicit drugs would create an addiction epidemic of biblical proportion, but this stickiest of prohibitionist fallacies doesn’t withstand closer examination. On the contrary, as I demonstrate in great lengths in my recently released “World War-D”, the current prohibitionist regime increases the harmful consequences of drug use and generates a whole set of harms of its own, chief among them, the narco-violence that is spreading like cancer all over the world. In fact, a properly regulated marketplace would not only wipe out narco-violence, it could contain and reduce substance abuse and dramatically reduce its societal harm. Focus should be placed on the real issue, which is problem use: abuse and addiction. Moderate use should only be addressed insofar as it may lead to problem use.

(Excerpts and comments from “World War D – The Case against prohibitionism, roadmap to controlled re-legalization” http://www.world-war-d.com/) – get

By Jeffrey Dhywood – jd@world-war-d.com

Pragmatic strategies for containment of abuse and control of psychoactive substances in a properly regulated marketplace

At the root of all the evils unleashed by drug prohibition and the War on Drugs are the illegal trade and the illegal marketplace it created and nurtured, out of which most other harms derive. Moreover, prohibition-induced harm far outweighs usage-induced harm. Consequently, the primary goal of any substance abuse reform should be black market reduction. With proper international coordination, the black market can be marginalized to the point of not being a significant threat.

Formulating clear and realistic objectives

In order to design effective strategies, it is critical to have clear and realistic objectives. Therefore, I propose the following hierarchy of goals:

To greatly reduce, dismantle and, if possible, eliminate the illegal drug market. To reduce the presence and influence of organized crime. To reduce drug-related crime. The dismantling and elimination of the illegal drug market requires the dismantling of the prohibition system that created it in the first place. Elimination of the illegal drug marketplace will not eliminate organized crime, but it will weaken it substantially.
To reduce harm to existing users through safe and controlled legal access. To reduce the number of abusers/addicts; to reduce drug related deaths; to improve the health of remaining users/addicts; to improve their social integration.
To reduce or eliminate the financial burden placed on taxpayers by the consequences of drug use and drug prohibition. To achieve taxpayer neutrality.
To control and greatly minimize access to minors; eliminating access to minors altogether might be a laudable goal, but it is about as realistic as absolute sexual abstinence to reduce teen pregnancy.
To reduce initiation, especially among minors. Long-term improvements are predicated on substantially curbing initiation.
To reduce harm caused by problematic users to their proximate environment and to society at large.
To prevent as much as possible moderate, responsible users from becoming problem users. To place reasonable access restrictions to the most damaging substances for new users and casual users.
To acknowledge the legitimacy of the non-medical use of psychoactive substances and the potential danger of their abuse.
To respect the civil liberties and lifestyle choices of informed, consenting adults as long as these choices do not intentionally endanger others. To end discrimination against users of psychoactive substances.

I believe these are realistic and attainable goals provided that the right policies are put in place. Unlike the fairly rigid prohibitionist model, there should be a lot of flexibility in the application of drug reform to allow for experimentation and adaptation to local realities. It should be obvious by now that those who wish to use psychoactive substances will go to great lengths to satisfy their desire and it is far more advantageous for society to satisfy their need than to let the black market take care of it. The guiding concern shouldn’t be whether it is moral or immoral to provide psychoactive substances to those consenting adults who which to use them, but what is the least harmful way to do it.

Policies shouldn’t be set in stone, but should rather be a work in progress, especially in the initial stage. Containment of abuse and reduction of the spread of use of the most dangerous substances should be the top priorities in the initial phase. Last but not least, regulations and policies should be practically and efficiently enforceable. Unrealistic goals based on faulty premises typically have disastrous unintended consequences for which society bears a heavy cost. Drug policies should strive to minimize the potentially harmful consequences of drug use and not create a whole set of far worse harms of its own.

A properly designed controlled legalization should be based on some basic facts and observations:

People have used psychoactive substances for medicinal, ritual and recreational purpose since the dawn of humanity and are not likely to give it up anytime soon.
The vast majority of psychoactive substances are already legal and more or less efficiently controlled. Such is the case for caffeine, nicotine, alcohol and prescription drugs. The legal status of particular substances does not appear to be related to their harmful potential. The regulatory framework for legalization is already in place and would just require adjustments.
The younger the age of onset of use of any psychoactive substance, the higher the potential for abuse in later life. People who haven’t used any substance by the time they reach their early 20s are very unlikely to ever abuse. Postponing the age of substance initiation is therefore the most efficient way to contain and reduce abuse. Paradoxically, under the prohibitionist regime, minors often have easier access to illicit drugs than adults. They are primary targets of drug dealers and foot soldiers and cannon fodder of narco-trafficking, especially in developing countries.
The prohibitionist regime pushes users towards the most dangerous substances and the most dangerous modes of administration. A properly regulated marketplace would nudge users towards the least dangerous substances by placing barrier of access commensurate to the potential harm of each substance and each mode of administration.
The accelerated industrialization of emerging countries brought about rapid and largely chaotic urbanization, causing social dislocation and breakdown of traditional norms. This in turn lowers barriers to deviance, providing a fertile ground for criminal elements to flourish and for the spread of substance abuse. As a result, illicit drug use is on the rise in most of the world, fueled in part by the global youth culture, permeated by drug culture from its pop stars to its sports stars.
The problem is exacerbated in transiting countries, as many drug transactions are paid in kind, feeding the local drug market, creating one where it previously didn’t exist. Thus, narco-violence in transiting countries is increasingly related to control of local markets rather than control of transiting routes. Latin America has been hit particularly hard, with casualties exceeding 50,000 in Mexico alone over the past 6 years, while all of Central America, especially Guatemala, Honduras and Salvador, is engulfed in narco-violence.
Emerging countries cannot afford to spare their already stretched resources on implementing efficient prohibitionist policies when even developed countries, despite all theirs resources, have been unable to do so.
Bottom line: Organized societies should be capable to do a far better job than organized crime at managing and controlling the currently illicit substances.

Understanding the illegal drugs market place

For all practical purposes, the illegal drug market place operates like a network marketing system. It is all based on contacts with each link usually knowing only those immediately before and after him; protection and secrecy increase as you move up the supply-chain. The substances reach the end-consumer through convoluted circuits with myriads of interconnected intermediaries where the last link in the supply chain are typically heavy users and addicts, who often resell to casual users in order to subsidize their habit. Just like with alcohol or tobacco, heavy users and addicts represent 80 to 90% of the market, depending on the substance. In the case of illegal drugs, heavy users and addicts supply 80 to 90% of the casual users, and do most of the recruiting and initiation. They are also, by far, the weakest link in the supply-chain. Removing heavy users and addicts from the supply-chain can shrink the market by over 90%. In order to fill the void, mid to low-level wholesalers, the typical suppliers to heavy users and addicts, and used to operating in relative shadow, would need to reach out to casual users or try to recruit initiates, an unreliable marketplace, and one filled with the most perils.

Trying to put all heavy users and addicts behind bars is not the solution though. It would be (and has been) an extremely costly exercise in futility. One key part of my proposed strategy consists in effectively and inexpensively removing heavy users and addicts from the supply-chain.

In order to remove abusers and addicts from the supply-chain and in order to reduce recruiting and initiation, abusers and addicts should have subsidized access, preferably conditioned to administration on premises in specialized establishments. This is, by far, the most efficient way to drastically reduce initiation, especially if high barrier of access are placed on casual use of the most damaging substances.

Such a strategy has the added benefit of reaching out to a frequently marginalized population. Once contact is established, it becomes possible to nudge the problem user towards treatment and bring him back to less harmful behavior and patterns of use or even abstinence altogether.

Strategic choices

Based on the acceptance that people will use mind-altering modalities, policies should nudge users towards the least harmful substances and the least harmful modes of administration, according to local conditions and cultures. Chewing coca leaves or drinking coca teas is vastly preferable to snorting or injecting cocaine. Ingesting or smoking opium is vastly preferable to injecting heroin. Marijuana is a relatively harmless substance that should have never been bundled with heroin, cocaine or metamphetamines. Regulation should reflect the differences between substances and modes of administration.

Therefore, regulations should differentiate between hard drugs (heroin, cocaine, metamphetamines) and soft drugs (cannabis/marijuana, coca leaves and preparations, opium in Asia).

Soft drugs should be regulated similarly to alcohol and tobacco, with added restrictions on advertising and packaging and adequate taxation to cover societal cost of abuse, but not to the point of reigniting the illegal marketplace. Taxation should follow international norms to avoid inter-countries smuggling.

Within hard drugs, differentiation should be made between injection, inhalation and other modes of administration. Hard-drugs should generally be dispenses through a prescription model.

Legalization and regulation is only the first step towards reducing the harms linked to substance abuse and addiction. It must be accompanied by efficient prevention and treatment policies.

Global legalization under a multi-tier “legalize, tax, control, prevent, treat and educate” regime is not only possible, it is the only long-term solution to this seemingly intractable problem. Far from giving up, and far from an endorsement, controlled legalization would be finally growing up, being realistic instead of being in denial, being in control instead of leaving control to the underworld. It would abolish the current regime of socialization of costs and privatization of profits to criminal enterprises, depriving them of their main source of income and making our world a safer place.

Weakening the global narco-traffic through global legalization will not solve all crime and violence problems, but it will relieve some pressure and remove a major source of corruption and lawlessness, allowing reallocation of resources to the most harmful criminal activities.

For a more detailed expose of the proposed roadmap to legalization and control, I refer my readers to the closing chapter of “World War-D”.

10 goals for controlled re-legalization

As the drug policy reform movement gains traction around the world, it is critical that it reaches beyond its activist core and constructively address the legitimate concerns of the general public, as without its support, we are doomed to failure. The burden of proof is clearly on the drug-reformists side, as they need to overcome 100 years of official propaganda, moral panicking, fear mongering and brain washing. It is critical to be well informed, realistic and pragmatic, with clear objectives. This is one of the purposes of “World War-D”.

Therefore, I propose the following hierarchy of goals for controlled re-legalization:

To greatly reduce, dismantle and if possible eliminate the illegal drug market. To reduce the presence and influence of organized crime. To reduce drug-related crime. The dismantling and elimination of the illegal drug market requires the dismantling of the prohibition system that created it in the first place.
To reduce harm to existing users through safe and controlled legal access. To reduce the number of abusers/addicts; to reduce drug related deaths; to improve the health of remaining users/addicts; to improve their social integration.
To reduce or eliminate the financial burden placed on taxpayers by the consequences of drug use and drug prohibition. To achieve taxpayer neutrality.
To reduce initiation, especially among minors. Long-term improvements are predicated on substantially curbing initiation.
To control and greatly minimize access to minors; eliminating access to minors altogether might be a laudable goal, but it is about as realistic as absolute sexual abstinence to reduce teen pregnancy.
To reduce harm caused by problematic users to their proximate environment and to society at large.
To prevent as much as possible moderate, responsible users from becoming problem users.
To place reasonable access restrictions to the most damaging substances for new users and casual users.
To acknowledge the legitimacy of the non-medical use of psychoactive substances and the potential danger of their abuse.
To respect the civil liberties and lifestyle choices of informed, consenting adults as long as these choices do not intentionally endanger others. To end discrimination against users of psychoactive substances.

I believe these are realistic and attainable goals provided that the right policies are put in place. Unlike the fairly rigid prohibitionist model, there should be a lot of flexibility in the application of drug reform to allow for experimentation and adaptation to local realities. It should be obvious by now that those who wish to use psychoactive substances will go to great lengths to satisfy their desire, and it is far more advantageous for society to satisfy their need than to let the black market take care of it. The guiding concern shouldn’t be whether it is moral or immoral to provide psychoactive substances to those consenting adults who which to use them, but what is the least harmful way to do it.

Modes of administration – evolutionary adaptive gaps

Humans are (so far) the most evolved species within the ecosystem of planet Earth, and the end result of a long evolutionary process going back to the primordial soup, out of which, as the dominant theory goes, all forms of life differentiated and evolved. It is increasingly apparent that the competition-driven Darwinian model is incomplete and that evolution is driven just as much by cooperative interaction as by competition, the yin and yang of evolution. Cooperation as a major force of evolution may have escaped evolutionists because of its ubiquity: for billions of years, life on our planet consisted of unicellular organisms that eventually congregated to form unicellular systems and then multicellular organisms. Interactive cooperation allowed the division of labor and the creation of specialized cells that eventually congregated in organs, allowing further specialization and differentiation, thus speeding up the evolutionary process. Just imagine survival of the fittest ruling the cells of your brain or your liver! Likewise, the major driving force of social systems, whether in the animal or human kingdom, is not competition, but interactive cooperation.

All life forms co-evolved interdependently in competitive symbiosis in which the vegetal kingdom plays a critical and distinctive role in the evolution of the animal kingdom. The vegetal kingdom provides directly or indirectly to the animal kingdom not only its food, but also its medicine, as well as substances that affect its mind, and may have been key to some critical evolutionary steps. This is indeed one of the great wonders and mysteries of life, and a powerful testimony to the prevalence of cooperation in the evolutionary process. The affinity between plants like poppy and cannabis and some of the most fundamental systems of brain activity, the dopaminergic and the cannabinoid system, both found in even the most primitive animal species, is nothing short of remarkable. Likewise, alcohol, as we will see in the chapter dedicated to that substance, is not only present in interstellar space, it was most likely one of the ingredients of the primordial soup theorized to be at the origin of life.

Humans co-evolved with psychoactive substances of natural origin in symbiosis with the vegetal kingdom. However, concentrates and extracts, such as distilled alcohol, heroin, cocaine, or amphetamines, or purely synthetic drugs, as well as direct routes of administration such as injection or inhalation, are novel features of our environment. As such, they create an evolutionary adaptive gap and are inherently pathogenic, although their use may be safe and warranted in some circumstances.[1]

Psychoactive substances can cross the blood-brain barriers and can be absorbed via various pathways. The digestive system, via the oral route, is the overly prevalent channel of administration of food and other substances in the animal kingdom, and is set up to withstand a wide variety of ingests. Furthermore, substances absorbed through the digestive system take a relatively long time to reach the brain as they are partly metabolized within the digestive system and the liver before they can reach the brain, which they do gradually. Therefore, ingestion is always the least dangerous and least addictive form of administration for a given substance.[2] The digestive administration process can be modulated to a certain extent. Thus, substances taken on an empty stomach reach the brain much faster than when they are taken with a meal.

The lungs, on the other hand, were designed to absorb air, and not much else. Even the smell of roses and other olfactory environmental signals are meant for the olfactory system located within the nose cavity, and not for the lungs. The lungs having a fractal structure, their total surface area is about the size of a tennis court, allowing fast and efficient oxygenation of the blood. Absorption through the lungs is extremely fast and powerful. Substances than can be absorbed through the lung tissue promptly reach the brain. Smoked heroin, cocaine or methamphetamine reach the brain within seconds of inhalation and peak within minutes. However, as we will see in a further chapter, cannabinoids and THC are different as they are strongly lipophilic. Their access to the brain is delayed upon inhalation, and the maximum “high” of cannabis is reached within 15 to 30 minutes.

As for veins, they were never designed to be punctured. Thus, it shouldn’t come as a surprise that intravenous injection is the fastest, most powerful and most damaging form of administration. Nasal absorption is notably slower than inhalation but still quite powerful and fast acting. Still, the nasal tissue is not meant to absorb anything more than infinitesimal doses of subtle and not so subtle aromatic substances ranging from utterly repulsive to sublime, from skunks to roses. Sublingual absorption is another fast track to the brain that is about on a par with nasal absorption. Chewing, such as chewing coca leaves or tobacco, involves a substantial amount of absorption through sublingual and other buccal mucosae.

Recreational drug users are motivated by the hedonistic reward provided by the substance. For most psychoactives except psychedelics, the intensity of the hedonistic reward depends in large part on the acuity of the peak intensity and the speed to reach this peak. A gradual rise of psychoactive concentration in the brain allows it to somewhat adapt to the substance and to modulate its effects to a certain extent, smoothing out its most damaging effects. A steep peak, on the other hand, doesn’t allow any adaptation; the more intense the peak, the more acute its effect. The most acute peaks create a surge of pleasurable sensation, the “rush” described by many injecting addicts, that they crave intensely. The steeper the peak, the more intense the rush, the more acute and disruptive will be the effects on the brain, causing a homeostatic imbalance which results in chronic dysregulation of the brain reward mechanisms and the brain’s neurotransmission in general.

Routes of administration that result in the rapid entry of a substance into the brain and/or faster rates of delivery have a greater effect on the neurotransmission systems in the brain, especially the reward systems, producing sensitization. Hard liquors are more damaging than beer or wine, especially on an empty stomach. Smoked opium reaches the brain faster and is more addictive than ingested opium. Injection and inhalation of active ingredients such as amphetamine, heroin or cocaine have the quickest entry and fastest rates of delivery. Therefore, they represent the most drastic evolutionary gap and have the most damaging effects.

Set and setting, expectation and intentionality affect the neuronal epigenetic environment. As such, they may influence the effects of particular substances. Thus, ritualistic use of tobacco where the plant is used with veneration and respect is vastly different from chain smoking of industrial cigarettes. Likewise, chronic pain sufferers under long-term opiate medication can usually discontinue without much problem once their medication is not needed anymore.[3] The absence of secondary reinforcers in the case of pain medication probably plays a critical role in preventing addiction. Nowhere is the set and setting more important than in the use of psychedelics.

[1] Randolph M. Nesse* and Kent C. Berridge, “Psychoactive Drug Use in Evolutionary Perspective,” Science 278, 63, 1997.

[2] Cannabis is somewhat an exception as ingested cannabis has stronger psychoactive effects than smoked cannabis (see Chapter 10).

[3] http://www.nida.nih.gov/researchreports/heroin/heroin3.html.

A good video introduction to the endocannabinoid system

I highly recommend this short video Visualization of the endocannabinoid signaling system

Leanne does a great job at explaining how the endocannabinoid system operates as a retrograde signaling system. This is why cannabinoids act quite differently from other psychoactive substances. It may be why cannabinoids do not create physical dependance (as opiates or alcohol).

Drug Policy Reform World Brief

Drug policy reform in the making

Europe

Residents of Switzerland and the Basque Region of Spain can legally grow MJ for personal use since January 1^st, 2012.

Denmark: The City Council of Copenhagen voted for legalizing marijuana. In the proposed scheme, cannabis products would be available in restricted quantities in government-run specialized stores. The government would also regulate production.

http://www.telegraph.co.uk/news/worldnews/europe/denmark/8899243/Copenhagen-votes-to-legalise-marijuana.html

http://eudrugpolicy.org/node/108

Poland: On December 9 the new Polish drug law came into effect and liberalized the drug policy. According to the new rules, the prosecutor will be able to dismiss the criminal charges if the offender possessed only small amount of drugs for personal use and he finds that punishment is not necessary.

Poles were asked about the idea of legalizing marijuana possession for personal use. On December 12th 2011, 67% of respondents answered yes, while only 32% said no – and about 1% of respondents were undecided. These results show that the public attitudes to drug policy liberalization are changing rapidly in Poland.

In the US:

Four states have asked federal officials to reclassify marijuana (Washington, Colorado, Vermont and Rhode Island.

MJ legalization initiative will be on the ballot in 2012 in Colorado, Washington, and probably California.

UK: The widely respected “The Lancet” published on January 6, 2012 a three-part Series of articles on drug use and addiction: http://www.thelancet.com/series/addiction

According to the Lancet, estimated 149—271 million people used an illicit drug worldwide in 2009. To give you a better idea, if drug users were a country, it would be the 5^th largest country in the world.
Some of its key findings:

The international drug control system has not ensured adequate medical supply of opioids, particularly in low-income and middle-income countries, but also in some high-income countries.
The system has not effectively restricted the non-medical use of controlled drugs, and illicit drug production, manufacture, and use is now a global issue. Illicit drug use accounts for a substantial and increasing global burden of disease.
The system’s emphasis on criminalisation of drug use has contributed to the spread of HIV, increased imprisonment for minor offences, encouraged nation states to adopt punitive policies (including executions, extra-judicial killings, imprisonment as a form of treatment, and widespread violations of UN-recognised human rights of drug users), and impaired the collection of data on the extent of use and harm of illicit drugs, all of which have caused harm to drug users and their families.
The international system precludes policies that are more aligned to the risks of drug use and the adverse consequences of prohibition, such as the regulation of producers, consumers, and the conditions under which drugs are used.
Policy experimentation requires changes to the international treaties, which are possible in principle but unlikely in practice. Other options include renunciation of the treaties and re-accession with reservations, or adoption of a new treaty.

Bottom line on medical MJ

Bottom line on medical marijuana: prohibition is the worst possible form of control and create immense collateral damage. Medical marijuana has been a welcome relief — and a diversion, whose limits are sticking out more and more everyday. It also created a grey marketplace were some flourished.

All psychoactive substances, whether legal (alcohol, caffeine, tobacco, etc), prescription or illegal work the same way. Our neurons don’t read labels and couldn’t care less about legal status. Patterns of use are similar for all psychoactive substances: a small percentage will abuse while the vast majority use responsibly, and regular moderate use is often good for health (true for caffeine, alcohol, coca leaf, some prescription drugs, and probably MJ or opium). Moderate use of opium was the general rule for thousands of years as opium was one of the basis of medicine (and still is, ironically – opiates still are the best pain-management tools around).

The war on drugs is also a cultural war, touting alcohol, the dominant psychoactive substance of Western civilization, against the dominant psychoactive substances of Andean or Eastern civilization: coca leaf, cannabis and opium; meanwhile, the western-dominated pharmaceutical industry is flooding the planet with a new generation of psychoactive substances in its (so far very successful) attempt at medicalization of normalcy. This, by the way, is one of the dominant theme of my just released ” World War-D: the case against prohibitionism. A roadmap to controlled re-legalization.”

The only viable long-term solution to the drug issue: global re-legalization under a multi-tiers “legalize, tax, control, prevent, treat and educate” regime with practical and efficient mechanisms to manage and minimize societal costs.

Far from giving up and far from an endorsement, controlled legalization would be finally growing up; being realistic instead of being in denial; being in control instead of leaving control to the underworld. It would abolish the current regime of socialization of costs and privatization of profits to criminal enterprises, depriving them of their main source of income and making our world a safer place.