On June 17, 1971, US President Richard Nixon declared drug abuse “America’s Public Enemy Number One.” It was ten years after the United Nations Convention prohibited the production and supply of various substances. Nixon offered a worldwide offensive in order to wipe out this “enemy” and related supply problems.
This is the reason why this date is usually chosen to mark the start of the “War on Drugs”.
What is this strategy about? In the first place, in an approach to criminalize the use and possession of drugs. Second, in a global interventionist policy to curb the production of these substances, particularly in Latin America as the main supplier of drugs to the United States and other Western countries.
The results of the War on Drugs
This strategy, continued by Ronald Reagan and still active today, has resulted in a high number of people incarcerated in the US for drug use, possession or trafficking, particularly African-Americans and Hispanics. But it has also had consequences in Latin America and, above all, in Central America, due to political and military interventionism to end the powerful cartels that produce and transport drugs from countries such as Mexico or Colombia.
Fifty years later, it is estimated that the US has spent more than a billion dollars in the war on drugs. Various Central American countries experience constant instability and political corruption, as well as conflicts and citizen insecurity derived from drug trafficking battles, with thousands of deaths in cases such as the one in Mexico. Meanwhile, North American and Western countries continue to lead the consumption of alcohol and other drugs, in a clear failure to control supply.
It is therefore not surprising that in recent years there has been a growing consensus around the failure of the war on drugs, with various entities advocating policies focused on health. In the words of Kofi Annan, former president of the United Nations, “measures based on repressive ideologies must be replaced by more humane and effective policies based on scientific evidence, public health principles and respect for human rights.”
Returning to that day in 1971, it is interesting to remember that Nixon proposed something else, which went largely unnoticed: a new organization of government agencies responsible for the rehabilitation of people with addictions, with the goal of working together on research and education.
From criminalization to the construction of a health model
The proposal to create a new health model is based on two pillars. On the one hand, the decriminalization of consumption. On the other, the implementation of health strategies. Its effectiveness and efficiency are the model to follow.
One of the examples of decriminalization is that of Portugal. At the end of the last century, this country decriminalized petty drug possession. But, in addition, it deployed a health and harm reduction model with programs to substitute heroin for methadone and including care for consumers in the health system. Users stopped being treated as criminals by the institutions to move to the health sphere, with very positive results.
Unfortunately, some measures were reversed and this model still requires improvements in areas such as damage reduction. However, this clearly more humanized approach has managed to reduce stigma and has facilitated recovery.
The other necessary strategy is the development of a social and health support network for consumers. This must include both evidence-based prevention strategies and access to effective treatments.
But what is evidence-based prevention? These are adequately evaluated and validated preventive strategies and programs, of proven efficacy, in accordance with international standards. In recent years we have seen the success of ambitious experiences such as ‘Planet Youth’, which, more than a program in itself, is a methodology for developing programs.
How does this model work? First, an assessment of the specific needs of each community is carried out. Next, multiple effective preventive actions adapted to these needs are deployed, in which local and regional institutions are integrated.
Depending on the community, these measures may include: training in prevention for health personnel, police officers and other professionals, increase in the offer of healthy leisure and free cultural activities for young people, schools for parents, information points in nightlife areas, curfews for minors under certain ages, etc. Its application in different countries of the world (including Chile) represents a good working model.
How to improve this health model
We know that supply control strategies (price increases, access limitation, availability reduction or state control of supply) are effective measures to reduce problematic drug use and consumption. But they are not the only strategy.
We must also deploy prevention programs with a social and community character and based on evidence. Also harm reduction strategies, health care and effective and accessible treatments. For this, it is necessary to have institutions committed to these objectives, at the local and national level, but also internationally since, of course, resources are needed.
In addition, these strategies must be implemented first in Western countries (main consumers), in order to reduce the demand for substances. But also in Latin America. Political instability, corruption, institutional weakness, lack of resources or functional illiteracy in the most vulnerable areas are major obstacles to addressing addiction problems in many countries. But even in these contexts, with the right means, prevention, and particularly community prevention, can be effective.
Prohibitionism and drug war strategies do not seem to yield good results after decades of billionaire investments and incalculable social damage. Control measures are necessary, but they should not be the only strategy.
Addictions are a public health problem and as such require health measures. This more humane approach allows consumers to be protected and rehabilitated, offering them effective remedies and rebuilding their communities to give them a better future.