Intended for healthcare professionals


An alternative to the war on drugs

BMJ 2010; 341 doi: (Published 13 July 2010) Cite this as: BMJ 2010;341:c3360

Are we in danger of losing the plot on drugs

A major criticism of Stephen Rolles of the Transform Drugs Policy
Foundation(ref 1) is that he has failed to consider data from the United
States as part of his analysis but instead chosen to concentrate on much
smaller countries, such as Portugal and Switzerland.

Statistics available from the United Nations Office on Drugs and
Crime show that consumption of cocaine has fallen by seventy five per cent
in that country in the last twenty years (ref 2). If we are to conclude
that the war on drugs has been a failure then this needs to be explained.

Another curious omission from the Transform Drugs Policy
Foundation's proposed regulatory framework for psychoactive drugs
of abuse is that crack cocaine. Most law enforcement officials would
probably agree that levels of crime associated with this drug are as much
a consequence of its mode of delivery and pharmacological properties as
they are of the need to fund its purchase. If we are to follow Mr Rolles
suggestion, and make powder cocaine available through "specialist
pharmacies", then by default we have also facilitated the
availability of crack cocaine as the one is easily made from the other.

Finally, the suggestion that heroin addicts must necessarily turn to
crime in order to fund their habit is misleading and probably twenty years
out of date, as I suspect Mr Rolles well knows. A reasonable estimate of
a typical addict's consumption would probably be 30 to 50 gms of heroin a year (ref 3). This would be consistent with
the most reliable estimates of the total UK market(ref 4) and, at current
street prices, would amount to an annual expenditure of £3-5,000;
roughly equivalent to a nicotine habit of two to three packs of cigarettes
per day. And of course we are currently supplementing this with the
provision of large quantities of methadone, freely available on the NHS.

(ref 1) An alternative to the war on drugs. BMJ 2010; 341:c3360

(ref 2)

(ref 3) Reuter et al. The world heroin market; can supplies be cut?
OUP 2009. Page 265

(ref 4) Home Office Online Report 16/06. Measuring different aspects
of problem drug use: Methodological developments (2nd edition). Editors
Nicola Singleton, Rosemary Murray, Louise Tinsley.

Competing interests: No competing interests

30 August 2010
Nigel J Keegan
Investment banker and medical practioner
None stated