Hooked on Narcomyths
At the core of those lessons is the question of trade-offs: How much do the substantial reductions in crime and criminal justice costs (including the cost of police corruption) resulting from any loosening of criminal penalties, plus the benefits of safe-use programs, offset the costs imposed on families, individuals and neighborhoods from increased drug consumption?
And that, in turn, depends again and again on individual circumstances--on the details of the policy and the surrounding culture. The Dutch, for example, appear to have successfully depenalized marijuana possession without terribly significant increases in use, thereby reducing both the costs of incarcerating marijuana users and the associated human costs. In the mid-1980s, when passive depenalization--essentially, nonenforcement of laws against personal possession--became de facto decriminalization, marijuana became commercially available in coffee shops and use did drift up. But even that increase didn't drive up the use of hard drugs or increase drug-related crime. Other than producing an increase in patients seeking treatment for marijuana-related problems and occasional complaints from neighboring retailers about certain coffee shops, say MacCoun and Reuter, "we are unable to document any significant social harms accompanying increased cannabis use."
MacCoun and Reuter make clear that at times harm reduction can go badly wrong. After years of chasing an active heroin scene around its neighborhoods, Zurich established its so-called Needle Park (Platzspitz), thereby concentrating heroin users in one park near the main railroad station, in an effort to minimize petty crime and neighborhood nuisances, and to create a central location for providing health services to addicts. The experiment failed: It drew heroin users from far and wide, and turned the place into a "Hieronymous Bosch vision of a drug hell," which in turn was cited by prohibitionists everywhere as evidence that such ventures never work. But there were also gains: from AIDS outreach, which appears to have driven down HIV-positive rates, and from the efficient handling of medical emergencies. And while there were some notorious gang-related murders, crime rates were surprisingly low. Switzerland had a serious heroin problem before Platzspitz was created, but there is no evidence that overall use of heroin in the country increased as a result of it.
The book's general read of the overall European experience is that it has a lot to tell us about what is feasible. "The Dutch have shown that harm reduction can be used as a principle to guide decisions consistently; [it has] some successes to show and no disasters to hide. Italy has removed criminal sanctions for possession of small quantities of cocaine and heroin without experiencing much greater problems than their neighbors." Swiss trials (begun following the Platzspitz failure) "show that heroin maintenance programs can operate in an orderly and systematic fashion for the benefit of a substantial fraction of the clients." The authors also point out that American experience with the enforcement of prostitution laws indicates that the harms that theoretically follow from vice prohibition can be mitigated--though not eliminated--by selective enforcement. Indeed, despite America's moralistic views about prostitution and adultery, policing of prostitution has much in common with the discretionary policing of drug use in many European cities.
Conversely, however, MacCoun and Reuter also caution against excessive enthusiasm for the contention that regulatory policies are inevitably an improvement over outright prohibition. Recent US experiences with alcohol and tobacco illustrate the power of commercial marketing and the difficulty of maintaining or tightening regulatory controls in the face of that power. The evidence for both of those licit substances shows quite clearly that while "prohibition may cause considerable harm, eliminating prohibition does not mean eliminating drug-related harm." Put briefly, they contend that contrary to the libertarian enthusiasm for such a course, the alcohol and tobacco model has to be approached with a lot of caution. In the case of tobacco, for example, restrictions on promotion, product regulation and taxation have all been greatly attenuated by the industry's strategic use of political contributions and reframing of legal issues (e.g., making promotion of a dangerous product a free-speech issue).