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

The ideological failure of prohibitionism, a 19th century totalitarianism

Mr. Rolles lays out the most credible, convincing and articulate case
for controlled re-legalization that I have read so far. The 2009
"Blueprint for Regulation" is remarkable and should be required reading
for drug policy makers.
I wanted here to bring an ideological and historical perspective to the

Originated in the US thanks to its settlement patterns,
prohibitionism is a 19th century totalitarian ideology of coerced societal
transformation. It is just as obsolete as the other major totalitarianism,
communism and fascism and just like them, it lost track of its original
intent. Prohibitionism was soundly rebuked in its original intent of
promotion of virtue and suppression of vice, where vice was alcohol abuse,
gambling, pornography, prostitution and homosexuality. Substance abuse was
added to the prohibitionist agenda almost by accident but it is the last
standing piece of this failed agenda. Drug prohibition survived and
thrived essentially as an alibi for discrimination against minorities and
thanks to an endless succession of moral panics from its onset and up to
this day. It survived and thrived because on its onset, there was no real
substance abuse issue in the US other than alcohol abuse and therefore
these substances didn't have any real constituency to support them.

Drug prohibition started in the US with the American century, and
throughout the century, the US used its growing power to impose its policy
to the rest of the world. Not only did the US invent the war on drugs, the
US is also the main consumer as well as the overwhelming weapon supplier
to the Latin American drug cartels, fueling the evil and violence it is
supposed to combat in the first place.

Prohibitionism violates the fundamental law of supply and demand in a
market economy and therefore, it led to the emergence of a thriving shadow
economy. The war on drugs and drug trafficking grew in symbiosis, feeding
on each other. The ever escalating repression lead to increasingly
sophisticated trafficking modalities in a cat and mouse race where the
drug business quickly adapts to market disruption and enforcement is
always one step behind, further plagued by the law of diminishing returns
which dictates that ever increased resources need to be allocated for
lower and lower results.

Analyzing the war on drugs narrative over its hundred years history,
one can only be struck by its ever escalating intensity, its never-ending
crescendo. 417 grams of cocaine were seized in 1938. 118,311 kg were
seized in 2005! Rothstein's victims could probably be counted on the
fingers of both hands in the 1920s. 500 murders were attributed to Lucky
Luciano's Murder Inc in the 1930 and 40s. That is barely the death toll in
an average month in Mexico alone in 2010. In 1930, Al Capone and his mafia
was ruling Chicago. Ruthless cartels are spreading mayhem and gory over
the planet from Ciudad Juarez to Bamako. Narco-states are growing like
cancer. Drug culture is permeating pop-culture.

After 100 years of ever escalating failures, policy-makers are still
proposing more of the same. The stated goal of the war on drug is still
complete eradication and total abstinence, which is about as realistic as
sexual abstinence as a policy for prevention of STD and teen pregnancy. In
fact, the war on drug is terminally addicted to its own policies and
inextricably tied to its arch-nemesis, its lifeline and its raison d'etre,
narco-trafficking. It would crumble and vanish if narco-traffic were to

Narco-trafficking is the creation of the war on drugs, its
antithesis, its arch-nemesis, its own distorted reflection. The mere idea
of legalization poses an existential threat to this highly dysfunctional

The most baffling though, is that the awareness is there of the dire
situation we are facing. In the foreword to the 2010 UNODC World Drug
Report, Antonio Maria Costa, Executive Director of the United Nations
Office on Drugs and Crime, states:

"Poor countries have other priorities and fewer resources. They are
not in a position to absorb the consequences of increased drug use. ... We
will not solve the world drugs problem by shifting consumption from the
developed to the developing world. ... We will not solve the world drugs
problem if addiction simply shifts from cocaine and heroin to other
addictive substances."

All that seems to be missing is the political courage to draw the
obvious conclusions.

Voices of dissent are rising louder and louder, including from within
the international community itself, challenging the folly of existing
Isn't time to ask the simple but fundamental question:
"Can organized society do a better job than organized crime at managing
and controlling psychoactive substances?" After all, the vast majority of
psychoactive substances, including the two deadliest, are already legal
and controlled.

Competing interests: I am currently writing a book about the war on drug failure and advocating controlled re-legalization with positions similar to Mr Rolles. I don't know if this constitutes a conflict of interest.

02 February 2011
Jeffrey Dhywood
free-lance writer
Hong Kong