Is it Time for a New Approach to Drug Use?

The United States claims to employ an evidence-based approach to battle drug addiction but the fact is that drug abuse deaths have been on a steady climb for the past two decades, with marijuana being the most commonly used illicit drug. Opioids, too are a serious concern, with around 2.1 million people in the country suffering from disorders linked to pain relievers. Instead of arrogantly continuing to employ a strategy that doesn’t work, we might learn from other countries whose statistics reveal that other methods may, in fact, be much more productive.

Take Switzerland, a country that had one of the largest open air drug markets in the world, as well as alarmingly high rates of drug use, drug dependence, HIV, and overdose deaths. Today, Switzerland has one of the lowest rates of drug related problems and overdose deaths. How did they manage such a feat?

Swiss drug prevention strategy is based on four fundamental pillars:

1. Treatment: Around 75 per cent of people with heroin use disorder are being treated through methadone maintenance or other maintenance therapies. There are no waiting list and methadone is paid for by compulsory national health insurance. An alternative treatment is Heroin Assisted Treatment (HAT), where patients are injected under medical supervision in a Safe Injection Facility. HAT is used when methadone treatment does not work. In the United States, less than 30 per cent of persons with heroin use disorder have received assisted treatment with methadone or buprenorphine during some years, despite the good success rate of these treatments.
2. Prevention: In Switzerland, prevention does not just mean stopping people from using drugs; it takes into the account that many young people try drugs at least once. Prevention programmes therefore additionally work on stopping the development of a drug habit (i.e. moving from low-risk to high-risk consumption). This takes a realistic view of the problem, guarding against the development of health problems. Attempts are made to improve the structures and general conditions in which children and the youth live.
3. Harm Reduction: Swiss harm reduction programs are federally funded, which they are not in the United States.
4. Law Enforcement: Switzerland’s National Drugs Policy states: “For existing drug users, repressive measures can represent a risk to health, in that they contribute to their marginalization. Law enforcement helps to reduce the negative impact of drug use by using the appropriate regulatory measures to enforce the ban on illegal drugs.”

Some of the reasons why the United States may continue to use ineffective drug policies, include the existence of multi-billion-dollar industries which have too much to lose. Those who profit most from the situation as it stands include organized crime (which makes $100 billion a year from illegal drug trafficking), the rehab industry ($34 billion annually), federal drug control spending ($25 billion annually) and the prison industrial complex (which made $75 billion in 2008). Billions of dollars are also made in asset forfeiture. Should we continue to allow material considerations to hold greater sway than human lives?