Legalisation would be likely to result in increased use

BMJ 1996;312:636 (9 March)

Letters

Legalisation would be likely to result in increased use

EDITOR,--I strongly disagree with the numerous assertions byRichard Smith that legalising or decriminalising drugs is theanswer to the drug problem.¹ The first major misconception isthat legalisation or decriminalisation would result in an overalldecrease in the problems associated with drug use. As DuPontand I pointed out in our detailed consideration of drug policy,any reduction in the intensity of drug policy is likely to resultin an increase in drug use and associated problems.² An excellentexample of this is the drastic difference in the use of marijuanacompared with the use of alcohol and tobacco among adolescents.These drugs are all illegal for young people, yet the legaldrugs are far more heavily used.

Dutch drug policy is an excellent example of misguided drugpolicy. While Smith's editorial discusses drug use in the Netherlandsuntil 1985, drug use among Dutch males aged 12-18 increased277% from 1984 to 1992, and the number of users of marijuanarose 50% from 1991 to 1993.³ Crime has increased drastically,with shootings increasing by 40%, car thefts by 62%, and robberiesby 69%.⁴ That is understandable, since in the United Statesabout half of violent crimes are committed under the influenceof drugs.⁵

The reality that we face in the United States and elsewhereis that we have only partially fought a drug war. We need tobolster efforts to prevent drug use and to broaden the availabilityof treatment. In addition, we should put teeth into prohibitionand imprisonment. Drug dealers deal their drugs with minimalfear of imprisonment. Federal inmates imprisoned for traffickingin marijuana possessed on average 3.6 tonnes, while those imprisonedfor trafficking in cocaine possessed on average 83 kg. We shouldconsider even more stringent penalties for high level dealersand move towards pressuring casual users to refuse drugs throughthe use of drug testing and intervention.

Lastly, all of us need to sing from the same hymnal. Internationally,so many people are heading in so many directions that the publicdoes not know whom to follow. It is particularly important thatprestigious medical journals do not lead the public down a harmfulroad by proposing legalisation or decriminalisation.

Chairman International Drug Strategy Institute, 901 Garfield,Topeka, KS 66606, USA

Eric A Voth