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

Drugs Policy - The Great Game ?

Why do governments maintain the pretence of possible victory in the
war on drugs?

The retiring president of the Royal College of Physicians, Sir Ian Gilmore
, is reported as saying: “Everyone who has looked at this in a serious and
sustained way concludes that the present policy of prohibition is not a
success” (1) The ex president’s email endorsed the recent BMJ article
from the Transform Drugs Policy Foundation (2) Nicholas Green QC, the
chairman of the Bar Council for England and Wales, said it was “rational”
to consider “decriminalising personal drug use”. (3)

Ken Clarke has recently noted that Prison does not work (4) Personal
observations in Dorset lend
support to this view. A recent undercover police sting led to many arrests
for drug dealing. However the
local supply of heroin is unaffected. The reason is that that people who
use heroin are a mutually
supportive community. When one is broke another whose benefits have
arrived subsidies both. The
favour is returned in due course. An undercover agent penetrating this
network then provides evidence
to convict numerous “dealers”. However the headline tough on crime
convictions are illusory as no
criminal masterminds are involved. Another example from our local Verne
Prison on Portland where half
the inmates are foreign drug mules. Their incarceration for 5 year terms
is futile as Latin America’s slums
yield fresh recruits eager to pay family medical bills or threats of
reprisal from the real drug lords, who
remain safely away from justice.

The medical evidence is that the whole war policy is a costly failure, in
personal illness and national
finances. Why no change in approach?
Perhaps this is part of the great game. The poppy fields have proved
useful in foreign policy ever since
the Opium wars involving British traffickers (AD 1839-42 1856-60) (5).

Occasionally the covert use of
funds is exposed to the light of day. The Iran Contra affair involved drug
deals.(6,7) Truth is stranger
than fiction in this web of intrigue, and the casual dismissal of any
complicated deal as being a
conspiracy theory is exposed and the charges comprehensively
substantiated. The Taliban ceased
the opium trade in 1991 but the UK/US invasion has restored supplies and
increased production. One
explanations could be that the gains to the international and banking
interests of states trumps the clear
warnings of their doctors and judges. Let us hope the forthcoming moves
away from long term harm
minimization to short timescale cures in the UK will not serve to increase
the addiction problem and its

1) BMJ 2010;341:c3360

2) Daily Telegraph 20/7/10

3) The Independent 22/7/10

4) Hanes, William Travis; Frank Sanello (2002). Opium Wars: The Addiction
of One Empire and the Corruption of Another

5) Kerry Committee Report

6) McCoy, Alfred W. (May 1, 2003). The Politics of Heroin: CIA Complicity
in the Global Drug Trade. Lawrence Hill Books

7) When Wars Collide: The War on Drugs and the Global War on Terror
Strategic Insights, Volume IV, Issue 6 Naval Postgraduate Institute

8) Source: United Nations,


Opium Poppy Cultivation in Afghanistan
11)	Year                         Cultivation in hectares               
Production (tons)
12)	1994                                 71,470                           
13)	1995                                 53,759                           
14)	1996                                 56,824                           
15)	1997                                 58,416                           
16)	1998                                 63,674                           
17)	1999                                 90,983                           
18)	2000                                 82,172                           
19)	2001                                 7,606                            
20)	2002                                 74,000                           
21)	2003                                 80,000                           
22)	2004                                131,000                           
23)	2005                                104,000                           
24)	2006                                165,000**                         

Competing interests:
One session a week in NHS clinic supporting people with a heroin replacement programme

Competing interests: Opium Poppy Cultivation in Afghanistan10) 11) Year Cultivation in hectares Production (tons)12) 1994 71,470 3,40013) 1995 53,759 2,30014) 1996 56,824 2,20015) 1997 58,416 2,80016) 1998 63,674 2,70017) 1999 90,983 4,60018) 2000 82,172 3,30019) 2001 7,606 18520) 2002 74,000 340021) 2003 80,000 360022) 2004 131,000 420023) 2005 104,000 3800 24) 2006 165,000** 6100**

17 August 2010
Jon M Orrell
Royal Crescent Surgery, 25 Crescent Street, Weymouth, Dorset DT34BG