Macho madness over cannabis: flawed drug policies in both hemispheres

I spent a week over the summer lecturing in New Zealand where I had the chance to speak with a number of politicians, lawyers and health professionals who were engaging in a review of their drug and alcohol laws under the leadership of their Law Commission. This independent body has made sensible recommendations that would reduce drug and alcohol related harms by providing more just laws but is experiencing a similar stonewall response from their government as we have from ours in the UK.

I had assumed that New Zealand was a land of mature attitudes and common sense and so was surprised to discover that, pro rata, New Zealandhas a greater proportion of its population in prison than we do [2 – v - 0.15%] and a greater conviction rate for cannabis possession [roughly 30 per thousand –v- 25 in the UK]. The current government [National Party] is conducting a policy of increasing police interventions and building more prisons to deal with the increase in criminals, seemingly oblivious that much of the “crime problem” is of their own making. Hopefully they won’t reach the absurd position of the USA where over 0.7% of the population is imprisoned, mostly for drugs and other minor offences that have statutory sentences e.g. a 3rd cannabis conviction can lead to someone spending the rest of their life in jail [The Economist 24th July 2010].

Why does any country criminalise the personal use of cannabis?  The fundamental purpose of the law is to optimise the quality of life in society and justification for drug laws is usually couched in terms of reducing personal and social harms from drug use [e.g. the UK MDAct 1971]. So does criminalising cannabis users reduce harms?  Of course not, especially if we take into account the proven harms that a criminal record brings. Moreover the huge costs of policing and criminalisation are economically damaging.

The MDAct was brought into law in 1971 yet since then cannabis use in the UK has increased 20 times [Rawlins et al 2008] despite heavy sanctions of up to 5 years in prison for possession for personal use, and increasing numbers of convictions to 160,000 per year [Lloyd and McKeganey 2010]. But have cannabis harms increased with the increase in use? The UK government’s figures for hospital admissions for cannabis related illness suggest about a thousand per year [Rawlins et al 2008]. In contrast, alcohol use which has about doubled in the same 40 yr periodis associated with and rising epidemic of harms that lead to over 1million hospital episodes in 2009 [NHS statistics].

There has been much media concern over the increase in schizophrenia that cannabis is supposed to be causing yet this 20-fold increase in use has not been accompanied by an increase in either schizophrenia of psychosis, whereas the 2 fold increase in alcohol intake has lead to death rates from liver disease increasing year on year [Leon and McCambridge 2006 Lancet] so that within a decade, liver deaths will outnumber deaths from heart disease so becoming the biggest killer in the UK .

Given the harms of alcohol are much greater than those of cannabis, why do so many countries persist in the prohibition/criminalisation route for cannabis users? This is particularly relevant because of the growing evidence from a number of countries e.g. The Netherlands [cannabis in coffee shops], Australian states [decriminalisation of cannabis for personal use] and Portugal [abolition of criminal sanctions for personal use of all drugs ] are viable policies that have major public health benefits – and are also more just. The answer is complex reflecting a mixture of ignorance denial and deliberate obfuscation on the part of policy makers. However an important factor is the macho model of politics initiated by the USA/UN “War on Drugs” which deludes many politicians into believing that being “hard” is necessary and a voter-winner, a view they hold even in the face of contradictory public opinion [Nutt 2009].

Sadly, I found this attitude just as prevalent in the New Zealand parliament as in the UK, where in 2009 the then Home Secretary Alan Johnson famously said in the House that he was “big enough, strong enough, bold enough” to sack me for saying cannabis was less harmful than alcohol. We need voters to make it clear to future MPs and political leaders that policies based their desire for political machismo rather than evidence will not be acceptable.