What the UN Still Gets Wrong About Drugs
Instead of fighting the politicization of drug policy, the UN has failed to challenge the ideology and junk science that fuel the demonization of drugs.
Image by Frances Smith
This piece was published in partnership with The Influence.
"A Drug-Free World—We can do it!"
That's the slogan that was agreed upon and adopted as the United Nations' mandate when this body last convened in a major summit in 1998 to discuss global drug policy. Today, there is little question that global drug control has been misguided, overly punitive and largely ineffective, and has steered national drug policies in disastrous directions.
UN member states will come together again next week, from April 19-21 in New York, for another summit on drug control: UNGASS 2016. The question now is whether the UN can dispense with its old, unrealistic and harmful slogan and adopt a position in line with human rights and science.
The global drug control regime that member states must consider dates from 1961, and its age is showing. The UN drug conventions go out of their way to demonize drugs without reference to science—an approach ripe for abuse in punitive and discriminatory ways.
Marijuana is a prime example. It is described in the conventions as "particularly liable to abuse and to produce ill effect" and without any therapeutic value. That classification is not surprising in view of the ranting at UN meetings in the 1950s by the then-US drug czar, Harry Anslinger, that the "killer weed" marijuana was the "most violence-causing drug in the history of mankind" and its consumption was linked to immorality among "Negroes, Hispanics and jazz musicians."
Though some countries have in recent years stepped away from the UN's classification of marijuana, many retain laws that were influenced by the UN treaties. Across Africa and in much of Asia, in spite of acceptance of many traditional and cultural uses of marijuana, national laws are particularly harsh. In Kenya, for example, the law states that where an accused person can convince the court that the marijuana he or she possesses is for individual use only, the prison sentence can be up to ten years—in all other cases, it's up to 20 years.
Several countries have begun to recognize the misinformed view of the UN on marijuana regulation. Four states in the US and Uruguay have legalized recreational marijuana use by adults, and multiple US states and several countries around the globe have decriminalized possession. Some have changed marijuana policies because of concerns about racial discrimination in the enforcement of drug laws. For example, in the US at the state level, black people are about four times more likely to be arrested for marijuana than their white counterparts. At the federal level, Hispanics represent two-thirds of the individuals arrested for marijuana violations. This is despite the fact that blacks, Hispanics and whites all use the drug at similar rates.
Others have implemented policy changes because many assertions—taken as fact—made about marijuana several decades ago are simply inconsistent with evidence from research.
Statements made about the addictive potential of marijuana amount to pure hyperbole when considered alongside the evidence. It's true that about 9 percent of marijuana smokers will become addicted at some point in their life, but about 15 percent of alcohol drinkers and a third of tobacco smokers will become addicted over their lifetime. These developments highlight the fact that unless the UN takes a realistic look at its current drug regime, more and more countries will reject its guidance.
The UN should in theory provide a counterweight to the politicization of national drug policy. Instead, it has failed to challenge the ideology and junk science that fuel the demonization of drugs.
Methamphetamine is another example. It is heavily criminalized in most regions of the world. The UN Office on Drugs and Crime regularly bemoans the threat of methamphetamine use and encourages heavy law enforcement responses. But, from a chemical and a user perspective—as I have demonstrated in my own research and previously written—methamphetamine is nearly identical to the medicine Adderall. In fact, both drugs are approved in the US for treating attention-deficit/hyperactivity disorder (ADHD). Of course, Adderall is also used to treat narcolepsy and to facilitate wakefulness in soldiers, among many other things. Prohibiting methamphetamine by law inevitably creates a black market in which toxic adulteration of the substance is inevitable, leading to a great deal more danger than is caused by the substance itself.
Opioids are a third example. Over the past decade, the US and Canada have seen a steady increase in opioid-related fatalities. This phenomenon that has drawn attention as it shows up outside the urban environment, including in affluent white suburbs. But here too, the problem reflects a long history of bad decision-making, demonizing opioids and undermining their positive uses.
Lethal overdose on heroin alone is not common. The vast majority of these "overdoses" occur as a result of combiningopioids with another sedative, such as alcohol or benzodiazepines. In other cases, unsuspecting people may ingest street opioids adulterated with other compounds, including fentanyl—an opioid considerably more potent than heroin. Again, black markets formed by punitive drug laws enhance the likelihood of these negative outcomes.
The US can and should learn lots from some European countries where a wider range of services are available for people who become dependent on opioids (who are a small percentage of all opioid users). Part of overdose prevention in Europe is ensuring easy access to therapies using opioid medicines such as methadone and buprenorphine. Methadone therapy has a long record of success, but in the US, it is still highly stigmatized, and many people who need it simply cannot get it. In Switzerland, Germany and a number of other countries, the few people who are not helped by other therapy are even allowed to receive heroin by prescription, safely, in controlled doses of known strength, administered in a health facility. Studies have demonstrated the efficacy of this measure. But most countries are far from that kind of pragmatic policy, and the UN, in the past, has rejected it too.
Globally, it is clear that punitive drug policies have been used to further marginalize marginalized groups. African-Americans, Afro-Brazilians, Roma in parts of Europe and poor Filipinos, among many others, are all arrested and incarcerated for drug law violations at rates disproportionate to their numbers in their respective societies. This shameful use of drug policy should be universally condemned, especially in light of the fact that many of the policies are based on false assumptions about drugs.
The UN's founding principles include human rights, equitable development and human security. But it has sabotaged its ability to adhere to these principles with its tacit acceptance of ineffective and discriminatory drug policies and its rejection of pragmatic, scientifically sound approaches. The UNGASS 2016 drug summit presents an opportunity for this body to do the right thing by adopting a position on drugs that is consistent with evidence, decreases racial discrimination and enhances the humane treatment of people who use drugs.
Dr. Carl L. Hart is a professor of psychiatry at Columbia University. He is also the author of the book High Price: A neuroscientist's journey of self-discovery that challenges everything you know about drugs and society Follow him on Twitter.
Joanne Csete is an adjunct associate professor at Columbia University.