This piece is a reaction to an earlier piece on drug prohibition by Audrey Redford.

The writing is on the wall for drug prohibition: it has utterly failed to stop people from using drugs, and Americans in four more states just voted to simply legalize recreational marijuana.

Does this mean we should also legalize hard drugs like crack cocaine, heroin, and methamphetamine in the same manner? I think there is a better way.

Yes, prohibition does not work, but we need to take a more nuanced approach to decriminalizing and handling illicit drugs.

Yes, prohibition fails horribly.

I won’t dwell on this part for long. If you’re curious about the details of prohibition’s shortcomings, I encourage you to read my colleague Audrey Redford’s blog post.

In summary,

  • Prohibition does not stop people from using drugs or from overdosing on them.
  • Prohibition actually makes drugs more potent and dangerous.
  • Black markets for drugs mean that producers are more likely to lie to consumers about what they’re getting.
  • People are generally less safe.

So, what are we to do?

Given the dangers of prohibition, should we legalize hard drugs in the same way that’s occurring with marijuana? Should we allow people 21 and over to buy crack cocaine or heroin in a dispensary?

I’m skeptical of how much harm could be reduced by shifting from prohibition to direct legalization. Let’s be clear: all drugs are dangerous. Some of the most dangerous drugs are legal. For example, an average of six people die from alcohol poisoning every day in the United States. Furthermore, addictions harm not only the people using drugs but their families and community members as well.

While we don’t have a crystal ball telling us what will exactly happen in the US if drug policy were to change, we can look at policy results from other countries as a guidepost.

What is the best alternative to prohibition?

As of right now, the best example we have for an alternative to widespread drug prohibition is Portugal.

In 2001, Portugal decriminalized all drugs that were previously illegal. Fourteen years later, drug use and drug overdose death rates have dropped steadily. However, this does not mean they encourage drug use.

If a person in Portugal is caught with marijuana, cocaine, or heroin, he’s sent to a three-person “Commission for Dissuasion of Drug Addiction.” Usually consisting of a doctor, a lawyer, and a social worker, this panel attempts to convince the person to seek treatment for drug use. Ultimately, the decision is up to the drug user, and if he refuses there usually is no penalty.

Let’s look at the specifics from two studies:

  • While “recent drug use” generally increased between 2001 and 2007, this number dropped for children age 15–24.
  • Drug-induced deaths steadily dropped.
  • The most commonly used drug was marijuana.

Now compare that to drug use in the US:

  • Past-month drug use steadily increased during the time drug use was being measured in Portugal
  • The largest increase was for ages 18–25.
  • There has been a steady increase in heroin use, especially among ages 18–25.
  • The most common illicit drug uses have been marijuana and nonmedical uses of prescription painkillers (this includes years prior to state marijuana legalization).

Portugal was able to create feasible policy changes that positively affected drug use. A key feature is that policy makers still aim at reducing drug use and do not encourage recreational use.

What is the US to do?

While there may be difficulties in applying the Portugal model in a large country like the United States, we can certainly learn from Portugal. We can still maintain an attitude that drug use is harmful without having to resort to prohibition.

In the face of rising heroin use (especially among teens and young adults), Americans need to have a serious conversation about policies that actually work.