The issue of legalising and regulating drugs has at last become a serious subject of debate among medics in the UK.
The reason? A passionate editorial in influential London-based medical journal The BMJ that calls on doctors to .
In the article, editor-in-chief Fiona Godlee and features and debates editor Richard Hurley urge the profession to lead a rethink of the war on drugs. 鈥淒octors and their leaders have ethical responsibilities to champion individual and public health, human rights, and dignity and to speak out where health and humanity are being systemically degraded,鈥� they write.听
Advertisement
Their plea follows hard on the heels of a call from the UK鈥檚 Royal Society for Public Health and Faculty of Public Health 鈥� to which The Times newspaper suggested in an editorial that they hadn鈥檛 in fact gone far enough and that we should 鈥渕ove gradually towards legalised supply chains鈥�.
Welcome call
All these calls are massively welcome in an area still treated as taboo by senior politicians in both major UK parties 鈥� the Conservatives and Labour.
This is despite the country now having the highest rate of drug-related deaths in Europe, at more than 10 times that in Portugal, where decriminalisation and a health-based approach were adopted 15 years ago. England and Wales together see , equivalent to seven families bereaved every day.
Though the reasoning for a shift from a prohibition-based to a health and controlled trade-based system is well known, the headline economics of criminalising producers, suppliers and users bear repeating. Enforcing the , just shy of the global aid budget. And the result is a criminal market with an estimated annual turnover of more than $330 billion.
Even the acknowledges that the euphemistically titled 鈥渃ontrol system鈥� it oversees to fight drug crime has created 鈥渕ajor unintended consequences鈥�, including the diversion of resources away from health and towards enforcement. The upshot is that millions of people all over the world become sick and die when they shouldn鈥檛. Prohibition kills.
Push for results
So what is the place of medics in campaigning for reform? Will the government listen and, more importantly, will it act?
Harm-reduction services in response to the emergence of HIV are a great example of a case in which a health lobby achieved a substantial shift in policy that saved tens of thousands of lives. This pushed then UK prime minister Margaret Thatcher to fund provisions, including needle exchange and free condoms, that reduced levels of HIV in the country to among the lowest in the world.
At the same time, though, the UK has continued the drug war to such an extent that . It is the government鈥檚 dirty little secret 鈥� some of the harmful effects that it works to minimise are the very effects that criminalisation causes, a factor that it has historically failed to acknowledge.
A fatal 鈥渃ode of silence鈥� shared by professionals and politicians alike is finally being broken, and it will be increasingly difficult for the government to trot out its oft-repeated .
All is not well 鈥� and, in the absence of political leadership, health bodies are rising to the challenge and raising the alarm. But reform will require sustained and growing pressure, and we look forward to seeing members of the 鈥� professional bodies for various medical specialities in the UK 鈥� also joining the campaign for change.
Ultimately, health professionals need to assert their rightful place at the head of national and international drug policy, with science and medical ethics as their trump cards.
