Friday, November 25, 2016

Reform Ideas: Drug Policy

Let's look to the Dutch for clues on drug policy reform.


Drug policy in the Netherlands is based on two principles: 
1) that drug use is a health issue, not a criminal issue, and that 
2) there is a distinction between hard and soft drugs. 
The Netherlands is currently the only country to have implemented a wide scale, but still regulated, decriminalisation of marijuana. It was also one of the first countries to introduce heroin-assisted treatment and safe injection sites. From 2008, a number of town councils have closed many so called coffee shops that sold cannabis or implemented other new restrictions for sale of cannabis, e.g. for foreigners.

It is interesting that the Dutch have backpedaled so much on marijuana policy, with stricter regulations. To some extent, their country became the site of marijuana tourism, which also attracted foreign (Russian) organized crime. The purpose of decriminalization in the Netherlands was always INCREASED surveillance of its usage, not some sort of radical or romantic abandonment of the rules. It is important to understand that northern Europeans have a relatively low tolerance for disorder.

Importing and exporting of any classified drug is a serious offence. The penalty can run up to 12 to 16 years if it is for hard drugs, or a maximum of 4 years for importing or exporting large quantities of cannabis. Investment in treatment and prevention of drug addiction is high when compared to the rest of the world. The Netherlands spends significantly more per capita than all other countries in the EU on drug law enforcement. 75% of drug-related public spending is on law enforcement. Drug use remains at average Western European levels and slightly lower than in English speaking countries.

The Dutch are still very strict about hard drugs and their trafficking. Interestingly, drug use rates in the Netherlands are not so different from other prosperous European societies, and are actually lower than in the US or the UK. 

An even longer Wikipedia article on Dutch drug policy.



The drug policy of the Netherlands officially has four major objectives:[1]
  1. To prevent recreational drug use and to treat and rehabilitate recreational drug users.
  2. To reduce harm to users.
  3. To diminish public nuisance by drug users (the disturbance of public order and safety in the neighborhood).
  4. To combat the production and trafficking of recreational drugs.
By contrast, most other countries take the point of view that recreational drug use is detrimental to society and must therefore be outlawed.



Some observations:

-- The article refers to "recreational drug use". But consumption of alcohol, cigarettes and caffeine are forms of recreational drug use. Marijuana, cocaine, meth, etc., should be classified as "untraditional" recreational drug use. (However, tobacco and caffeine are themselves relatively recent additions to the European menu of "traditional" recreational drugs, alcohol being the ancient, established favorite.) 


-- Recreational drug use can refer to either hard or soft drugs. The Dutch tolerate the soft stuff, but not the hard stuff.


-- As the concentration of THC has doubled in the marijuana in the Netherlands, it is becoming difficult to keep marijuana classified as a "soft" drug. It has become quite powerful.


-- Because the Netherlands became the first country to regulate marijuana, it became the center for drug tourism. This backfired somewhat, and has brought organized crime and some measure of disorder to the Netherlands. The country kind of became an international joke.


-- Cities like Amsterdam have become dependent on this drug tourism. 


-- The Netherlands is historically a maritime capitol. That means that it is a major conduit for global illegal drug trafficking. Focusing law enforcement efforts on hard drugs and legalizing soft drugs is a rational response to this.


-- The Netherlands is relatively tolerant of soft drug use, but is very intolerant of drug trafficking.


-- The Dutch are nevertheless failing to stem the flow into their country of hard drugs.


-- "Despite the high priority given by the Dutch government to fighting illegal drug trafficking, the Netherlands continue to be an important transit point for drugs entering Europe."


-- "In a study of the levels of cannabiscocaineMDMA, methamphetamine and other amphetamine in wastewater from 42 major cities in Europe Amsterdamcame near the top of the list in every category but methamphetamine."


-- However, despite the relatively high level of hard drug use among the Dutch, the country does not suffer as much from their effects as do other countries.


-- "The Netherlands spends more than €130 million annually on facilities for addicts, of which about fifty percent goes to drug addicts. The Netherlands has extensive demand reduction programs, reaching about ninety percent of the country's 25,000 to 28,000 hard drug users. The number of hard drug addicts has stabilized in the past few years and their average age has risen to 38 years, which is generally seen as a positive trend. Notably, the number of drug-related deaths in the country remains amongst the lowest in Europe."


-- One gets a general sense of ambivalence from the Dutch population on drug issues. The Dutch can seem simultaneously liberal and conservative toward soft drugs. For example:


-- "A November 2008 poll showed that a 60% majority of the Dutch population support the legalisation of soft drugs. The same poll showed that 85% supported closing of all cannabis coffeeshops within 250 meters walking  distance from schools." 

What are the advantages of Dutch drug policy?

Comparatively few drug deaths, seemingly due to high investments in treatment.


Where does Dutch drug policy seem to fail?

Hard drug use rates in the Netherlands are not much different from the rest of western Europe, despite shifting resources away from policing soft drugs in order to persecute the trafficking of hard drugs. Also, permissiveness toward soft drugs has led to unintended consequences (e.g., drug tourism). 


It seems essential to emphasize that the Netherlands has long been a maritime power and center of commerce, making the country vulnerable to drug smuggling. This seems to be one major impetus for the Netherlands' novel approach toward soft drug use. It could be that a more conventional approach to soft drugs might have had worse outcomes, namely, higher usage rates of hard drugs and, consequently, more deaths.

This invites a contrast with another small country that is commercial power, but which has a radically different approach toward drug trafficking.

Singapore drug policy.


Narcotics laws established by the Misuse of Drugs Act are very strict. Anyone caught with more than 15 grams (0.53 oz) of heroin(diamorphine), 30 grams (1.1 oz) of cocaine or morphine, 250 grams (8.8 oz) of methamphetamine, or 500 grams (18 oz) of cannabis faces mandatory capital punishment, as they are deemed to be trafficking in these substances.[20] The stated quantities are the net weight of the substances after they have been isolated by laboratory analysis. Between 1991 and 2004, 400 people were hanged in Singapore, mostly for drug trafficking, one of the highest per-capita execution rates in the world.[13] Persons caught with amounts of controlled substances less than the quantities that would warrant the mandatory death sentence may be spared from the gallows. They may, however, still face harsh penalties ranging from long terms of imprisonment to a maximum of 24 strokes of the cane (for males).

That's some serious tough love.

But does it work?



And what does it mean for a policy to 'work'? That is, the Dutch model is based on public health concerns -- specifically, limiting drug deaths. The Singaporean approach, in contrast, might have a different, if largely unstated, agenda. 

More on the criminal code of Singapore:


Although the legal system of Singapore is a common law system, the criminal law of Singapore is largely statutory in nature. The general principles of criminal law, as well as the elements and penalties of common criminal offences such as homicidetheft and cheating, are set out in the Penal Code.[1] Other important offences are created by statutes such as the Arms Offences Act,[2] Kidnapping Act,[3] Misuse of Drugs Act[4] and Vandalism Act.[5]

The criminal law of Singapore is statutory, meaning it derives from laws imposed by the political system, not from the precedents established by judges over the course of legal history (as in common law). 

In addition, there is a perception that Singapore society is highly regulated through the criminalization of many activities which are considered as fairly harmless in other countries. These include failing to flush toilets after use,[6] littering,[7] jaywalking,[8] the possession of pornography,[9] the sale of chewing gum,[10] and sexual activity; such as oral and anal sex between men.[11] It has been claimed that one of the results of such heavy regulation is that Singapore has one of the lowest incidences of violent crimes in the world.[12] A catchphrase recently used in a police anti-crime campaign was "Low crime does not mean no crime".

Draconian drug laws are not so much a public health policy as they are a way of preventing violent crime. Even activities that children are scolded for or that were considered "deviant" in 1950s America are severely punished as a way of instilling an overall spirit of discipline in society. This keeps all crime in check. 


Singapore retains both corporal punishment (in the form of caning) and capital punishment (by hanging) as punishments for serious offences. For certain offences, the imposition of these penalties is mandatory. More than 400 people were executed in Singapore, mostly for drug trafficking, between 1991 and 2004. Statistically, Singapore has one of the highest execution rates in the world relative to its population, surpassing Saudi Arabia.[13] Science fiction writer William Gibsonfamously described Singapore as "Disneyland with the death penalty".


"Disneyland with the death penalty." That phrase caught on instantly. 

This points to another policy objective of Singapore's harsh drug laws: Not just drug use or violent crime is at issue, but social engineering. Singapore is a world-class success story because it has transformed the behavior of its inhabitants radically, from multi-ethnic farmers and workers to highly educated, highly disciplined urban capitalists. 


One problem with this is, according to Gibson, Singapore's total absence of creativity and character.


https://en.wikipedia.org/wiki/Disneyland_with_the_Death_Penalty


But is that criticism fair or accurate?


Here is a 2016 list from "Business Insider" of the most creative societies.


http://www.businessinsider.com/most-innovative-countries-in-the-world-2016-8/


1. Switzerland.

2. Sweden.
3. UK.
4. US.
5. Finland.
6. Singapore.
7. Ireland.
8. Denmark.
9. Netherlands.
10. Germany.
11. South Korea.
12. Luxembourg. 
13. Iceland.
14. Hong Kong.
15. Canada. 

From a 2015 list (from a different organization) of most creative countries:


https://www.weforum.org/agenda/2015/10/most-creative-countries-in-the-world/


1. Australia.

2. US.
3. New Zealand.
4. Canada.
5. Denmark and Finland.
7. Sweden.
8. Iceland.
9. Singapore.
10. Netherlands.

Singapore ranks among the most creative countries on these lists.


However ... it seems that the kind of creativity that is being measured on these lists is corporate technical problem-solving. (This is precisely Gibson's criticism.)


In fact, the northern European and Asian countries on these lists are notorious for their absence of spontaneity and their regimented educational regimes. 


However, corporate-style creativity is better than none, perhaps. There are countries in the Middle East that are neither economically vibrant nor famous for their daring literary and artistic creativity.


Singapore's draconian drug policy serves multiple purposes, from reducing addiction and related problems, to lowering violent crime, to altering, pacifying and "modernizing" the overall behavior of its citizens (if they can be understood as "citizens", rather than as mere residents or workers). 


Singapore also long harbored greater ambitions. As an authoritarian state that prevented chaos but respected personal rights and the rule of law, Singapore would be a non-totalitarian model of development for China and other countries. The colonial Anglo-Saxon ideal of lawfulness and liberty without democracy or civil society marches on in Singapore.


What of the distant future? 


The Muslim world is a warning, a cautionary tale. It teaches us is that subversive intellectual forms of creativity are necessary because every culture and social order eventually plays itself out and falls apart and dies (or becomes a kind of zombie culture, like Islamic countries). 


The groundwork for future transformation needs to be laid while a civilization is at its vibrant peak, because when it inevitably enters its decline, its creative energies are already exhausted. Something new needs to be made now, for the future.


This is precisely the task of science fiction as a literary genre (Gibson's craft). 


Learning from the Netherlands and Singapore, what kind of public policies would promote the kind of subversive cultural creativity Gibson champions, while maintaining order and promoting development? Again, not radical change now, but in the future, when civilization begins to burn out and crumble. More importantly, how to do this without causing a reactionary backlash?


***


This is on the topic of legal punishment in Singapore, in particular, on the punishment of caning.



Caning is a widely used form of legal corporal punishment in Singapore. It can be divided into several contexts: judicial, prison, reformatory, military, school, and domestic or private. These practices of caning are largely a legacy of, and are influenced by, British colonial rule in Singapore.[1] Similar forms of corporal punishment are also used in some other former British colonies, including two of Singapore's neighbouring countries, Malaysia and Brunei.

It is interesting how there is a continuity between contemporary Singapore and its colonial history across the board, from the laws and system of government to the economy of Singapore. 

Of these, judicial caning, for which Singapore is best known, is the most severe. It is reserved for male convicts under the age of 50, for a wide range of offences under the Criminal Procedure Code, and is also used as a disciplinary measure in prisons. Caning is also a legal form of punishment for delinquent servicemen in the Singapore Armed Forces(SAF) and is conducted in the SAF Detention Barracks. Caning is also used as an official punishment in reform schools.


In a milder form, caning is used to punish male students in primary and secondary schools for serious misbehaviour. The government encourages this but does not allow caning for female students, who instead receive alternative forms of punishment such as detention.


In Singapore, caning is directed exclusively to young men who violate the law. This seems to be the single biggest preoccupation of any legal system -- what to do with young men. 

Another form of behavior modification in Singapore is mandatory military service, which removes young men from society in the prime of their lives and regiments their behavior, keeps them under tight surveillance and gives them a sense of teamwork and camaraderie. In a society like the United States, this might be seen as insidious conformity, but in societies like South Korea, it is seen as period of personal growth, an added bonus to the requirements of national security. In Singapore, it is national security that is the fortunate byproduct of conscription, which primarily serves domestic purposes.

Men who have been caned before described the pain they experienced as "unbearable" and "excruciating". A recipient of 10 strokes even said, "The pain was beyond description. If there is a word stronger than excruciating, that should be the word to describe it".[42] Most offenders struggle violently after each of the first three strokes and then their struggles lessen as they become weaker. By the time the caning is over, those who receive more than three strokes will be in a state of shock. During the caning, some offenders will pretend to faint but they cannot fool the medical officer, who decides whether the punishment continues or stops. Offenders undergo a lot of psychological distress before and during the caning: They are afraid of not only the physical pain, but are also worried about whether they can prevent themselves from crying out because crying means that they would lose face.[24]


Caning is a physically traumatic experience, but it is also socially humiliating, since it is conducted in public, which seems to be the real punishment. That might work better in a "shame-based" culture like that of east Asia than in the United States. 

Malaysia has caning as a punishment for criminal offenses, which derives from British colonial history. Malaysia also, in a separate court system, uses caning as punishment of Muslims (by Muslims) for breaking religious law. This sharia-inspired caning is very mild in its implementation compared to caning in Singapore.


Contemporary Western societies can look upon the use of capital and corporal punishment in Asian societies as backward, even barbaric. 

But from what I've read about the American legal and prison systems, any such criticism coming from the United States is outrageous. It is the Americans who have a barbaric system of vengefulness. (Americans make up 5% of the world's population, but comprise 25% of all prisoners.)

Going against a political correctness that would condemn Singapore as a quasi-colonial police state or "Disneyland with the death penalty", perhaps we should take the bad with the good and respect Singapore. Singapore delivers a high standard of living to its inhabitants, which might be more than can be said about many or most societies, even the most affluent societies. That is to say, Singapore is a fundamentally RESPONSIBLE society, and that is the highest possible virtue. It's difficult to identify another society that is in the morally superior position to criticize Singapore.

Among other important evaluative criteria, the practical effects of physical punishment in terms of deterrence and recidivism rates need to be compared to such rates in the US. As they say, sometimes one must "be cruel to be kind". 

In particular, a moral disdain for sharia, at least in its milder forms, seems uncalled for.

The deeper critique of Malaysia and Singapore might be found not in their legal systems, but in their educational systems. 

Singapore ranks at the top of recent global educational ratings.


One important difference between the educational systems of Singapore and Malaysia is the adoption of the English language, which is the language of instruction in Singapore. Singaporeans see English as a complement to their culture and heritage, whereas Malaysians generally see the English language as a threat. If Singapore's political system and culture is closed, it's educational system is remarkably open and confident. This might suggest a developmental model, not just for China, but for the tradition-bound world of Islam, and other traditionalistic societies. 

Switzerland


So many of the articles on Singapore end up comparing the country to Switzerland. So here is Swiss drug policy:



The national drug policy of Switzerland was developed in the early 1990s and comprises the four elements of prevention, therapy, harm reduction and prohibition.[17] In 1994 Switzerland was one of the first countries to try heroin-assisted treatment and other harm reductionmeasures like supervised injection rooms. In 2008 a popular initiativeby the right wing Swiss People's Party aimed at ending the heroin program was rejected by more than two thirds of the voters. A simultaneous initiative aimed at legalizing marijuana was rejected at the same ballot.

Heroin is basically legal in Switzerland for those who seek treatment. 

I remember seeing a segment on TV, where a woman in a Swiss town walked off the street into a small former store front (it looked like it had once been a pastry shop) and a government health worker gave her a small piece of heroin, which she promptly injected right there. This store front had no real security, it kept the heroin in a pantry, IIRC. Apparently this policy did not lead to greater heroin use. Moreover, it had the effect of putting drug dealers out of business, and lead to a reduction in petty crime like burglary and prostitution. 

It is interesting that the Swiss hand out free heroin, yet marijuana is still illegal.

Here is a case where the Swiss allowed open dealing of drugs in one park. It reminds one of the episodes in "The Wire" where drug dealing was allowed in an abandoned neighborhood ("Hamsterdam"). 


Between 1987 and 1992, illegal drug use and sales were permitted in Platzspitz park, Zurich, in an attempt to counter the growing heroin problem. However, as the situation grew increasingly out of control, authorities were forced to close the park.


In the Swiss case, this was a nightmare experience.

https://en.wikipedia.org/wiki/Platzspitz_park


During the 1980s, heroin addicts would frequently gather at the park, and attempts to disperse them merely resulted in them regrouping elsewhere. Thus in 1987 the authorities chose to allow illegal drug use and sales at the park, in an effort to contain Zurich's growing drug problem. Police were not allowed to enter the park or make arrests. Clean needles were given out to addicts as part of the Zurich Intervention Pilot Project, or ZIPP-AIDS program.[2] However, lack of control over what went on in the park caused a multitude of problems. Drug dealers and users arrived from all over Europe, and crime became rampant as dealers fought for control and addicts (who numbered up to 20,000) stole to support their habit. The once-beautiful gardens had degraded into a mess of mud and used needles, and the emergency services were overwhelmed with the number of overdoses, which were almost nightly. Platzspitz, or Needle Park as it was then known, became a source of embarrassment to the Swiss government and in 1992, police moved in to clear up the park.


Sounds like an example of "How not to do it". 

But the way it is being done now sounds better.


http://www.reuters.com/article/us-swiss-drugs-idUSTRE69O3VI20101025


Some 70 percent of the 20,000-30,000 opiate or cocaine users in Switzerland now receive treatment, one of the highest rates globally, said Dr. Ambros Uchtenhagen, who helped pioneer heroin substitution and chairs the Research Institute for Public Health and Addiction at Zurich University.


"The number of drug injectors with HIV has been reduced by over 50 percent in 10 years. Overdose mortality among injectors has been reduced by over 50 percent in the decade," he said. "Delinquency related to drugs has been reduced enormously."


Family doctors now prescribe about 60 percent of opiate substitution treatment in Switzerland and the Internet was vital in informing users about access to treatment, Uchtenhagen added.




The Swiss policy of distributing heroin and keeping marijuana illegal is in some respects the reverse of the Dutch policy. Yet both countries have enviably low death rates from hard drugs -- as does Singapore. 


So there is more than one way to skin a cat.

Sweden


Sweden's drug policy has turned conservative over the past two generations.



Sweden's drug policy has gradually turned from lenient in the 1960s with an emphasis on drug supply towards a policy of zero tolerance against all illicit drug use (including cannabis). The official aim is a drug-free society. Drug use itself became a punishable crime in 1988; personal usage does not result in jail time if it is not in combination with driving a car.[12] Prevention includes widespread drug testing, and the penalties range from fines for minor drug offenses up to a 10-year prison sentence for aggravated offenses. The condition for suspended sentences could be regular drug tests or submission to rehabilitation treatmentDrug treatment is free of charge and provided through the health care system and the municipal social services. Drug usage that threatens the health and development of minors could force them into mandatory treatment if they don't apply voluntary. If the usage threatens the immediate health or the security of others (such as a child of an addict) the same could apply to adults.

The Swedes have turned against all recreational drug use, soft and hard, but with a strong emphasis on treatment.

The United Nations Office on Drugs and Crime (UNODC) reports that Sweden has one of the lowest drug usage rates in the Western world, and attributes this to a drug policy that invests heavily in prevention and treatment as well as strict law enforcement.[14] The general drug policy is supported by all political parties and, according to opinion polls made in the mid 2000s, the restrictive approach received broad support from the public at that time.

It could be that the "medical marijuana" model -- which seems really like recreational marijuana in disguise -- that the US is gradually adopting might be a mistake if Sweden's success is any indication. Zero tolerance might be preferable. 



But how much effort and money does the US put into treatment?

Free wine for old alcoholics in a treatment center in Ottowa, Canada.


The recommended treatment for chronic alcoholism is abstinence. But at the Oaks - a permanent home for those who once lived on the streets -residents are given a measure of wine at hourly intervals. It is called the Managed Alcohol Program, and aims to change the drinking behaviour of inveterate addicts. 

At exactly half past the hour, what's known as "the pour" begins. A measure of Californian white - 13% alcohol, made on the premises - is measured into a jug from a draft tap behind the counter. One at a time, the wine is dispensed to nearly 50 alcoholics. For the first pour at 7.30am, most residents get a kickstarter of 7oz - nearly 200ml, a larger-than-average sized glass of wine in Europe. For the rest of the day until 9.30pm, they are given 5oz - just over 140ml.  

A surprising number of the residents in treatment are native peoples (Inuits).

The program originated around the year 2000. 

Ottawa's Managed Alcohol Program - or MAP - was designed to address the needs of homeless people who had tried to stop drinking and failed. The scheme was the brainchild of a group of health professionals around 15 years ago.


"The thought was that if we could stabilise the craziness of their lives, the day that begins with the search for alcohol and all the complications that occur with that, then maybe we could make inroads with their mental health, addiction to alcohol and their physical illnesses," says Dr Jeff Turnbull, one of those early innovators, and the chief of staff at Ottawa Hospital.
The catalyst was a chronic alcoholic called Eugene.


"We found him outside with frostbite. He wouldn't stay inside during that freezing weather because of his addiction to alcohol. So we said, wouldn't it be safer if we just got him some wine and allowed him to drink that? Eugene responded very quickly. He stayed inside the shelter, his frostbite got better and we saved his toes."


The program saves money as well as lives.

Lifelong alcoholics are an enormous drain on public resources.


"One of our clients was in the emergency department 191 times in the six months preceding coming onto the MAP," says Dr Turnbull. "And that was just in our hospital. He could've been in other healthcare facilities during that time as well."


No one study about the MAP has crunched the numbers fully, but it is not unrealistic to assume that the city of Ottawa has saved millions of dollars.


"There's a profound reduction in 911 calls, hospital emergency visits, paramedic and police encounters," says Dr Turnbull. 

The war against drugs in the Philippines


The police there have murdered several thousand drug dealers and users in a short period of time.

Here is a harrowing photoessay.


Is there an alternative to this? 

Drug treatment is more expensive than bullets, and not all countries have resources for either treatment or interdiction. But is this necessary? Or is it a violent, simplistic fantasy?

'Soft' drugs versus 'hard' drugs

The Netherlands makes a distinction between 'hard' recreational drugs and 'soft' recreational drugs; Sweden makes no such distinction, and has a "zero tolerance" policy.

This distinction between 'hard' and 'soft' recreational drugs might be bogus, but scrapping it entirely might be wrongheaded.

It might be better to conceive mood-altering drugs as existing on a continuum, and better described as 'harder' and 'softer' in relation to one another in terms of harmfulness.

Here is an article on how caffeine may hinder creativity. It also describes how the drug works.


When we drink a caffeinated beverage, the caffeine quickly crosses the blood-brain barrier—an interface of sorts between the brain and the body’s circulatory system, designed to protect the central nervous system from chemicals in the blood that might harm it—and proceeds to block the activity of a substance called adenosine. Normally, a central function of adenosine is to inhibit the release of various chemicals into the brain, lowering energy levels and promoting sleep, among other regulatory bodily functions. When it’s blocked, we’re less likely to fall asleep on our desks or feel our focus drifting. According to a recent review of some hundred studies, caffeine has a number of distinct benefits. Chief among them are that it boosts energy and decreases fatigue; enhances physical, cognitive, and motor performance; and aids short-term memory, problem solving, decision making, and concentration.

Caffeine is perhaps the least harmful of the mood-altering recreational drugs. 

Yet consuming more than two cups of coffee a day by either the mother or father prior to conception significantly increases (doubles?) the probability of a miscarriage. 


All of these mood-altering recreational drugs are unhealthy to various degrees, which is why serious athletes avoid all of them. 

Marijuana is classified by the federal government as a Schedule 1 drug, along with heroin. That's ridiculous. 

But alcohol is not even considered a mood-altering recreation drug, even though it causes more harm than all illegal drugs combined. That's even more ridiculous.


Alcohol and marijuana might be best understood as existing somewhere in the middle of the spectrum of harder and softer drugs, between caffeine on one end and heroin on the other end. Alcohol would be the harder, compared to marijuana.

Here is an article on the corporatization of marijuana.


IIRC, it touches on two of the most recent of four historical attitudes toward marijuana.

1. Traditional ban. Marijuana was seen as stimulating violence (actually alcohol does that, marijuana makes people passive) and being a gateway drug (not true, prescription drugs like opioids are the actual gateways to harder drugs). 
2. 1960s Counterculture. Marijuana was seen as benign and liberating, and a cure for so many social ills (we can make everything from clothes to gasoline out of hemp, and this will actually help the environment). This perspective is likewise a fantasy.
3. Corporate. The alcohol and tobacco industries are heavily investing in marijuana production and marketing. This essentially makes legalization a done deal. (And, no, this has nothing to do with the public good.)
4. Health care. The unspoken assumption among health care professionals who are going along with medical marijuana is that the marijuana industry will grow and replace alcohol consumption, leading to a huge reduction in violence, accidents and mayhem. But no one is sure about this, because there is currently some overlap among people who consume alcohol and those who use marijuana; use of the two drugs is not entirely mutually exclusive. While alcohol consumption might decline with increased use of marijuana, those who consume both would be at greater risk. (IIRC, the article states that 15% of Americans consume around 80% to 90% of the alcohol. That's one out of seven Americans drinking almost all that booze in liquor stores and supermarkets.)

So there are at least a couple of rhetorical and conceptual strategies that should be considered:

1) The sharp distinction between hard and soft recreational drugs should be more nuanced, and drugs should be situated along a spectrum of harmfulness.

2) Consequently, the distinction between supposedly benign legal and supposedly dangerous illegal drugs needs to be understood as fiction. Alcohol and prescription drugs are potentially very dangerous, and marijuana usually less so (but still unhealthy).

There is one further distinction that should be reinforced, not discredited or questioned. This distinction is the division between public and private realms, which is not usually brought into play in these discussions on drug policy, but might be very useful. It has bigger implications for how tradition should be placated in public policy. 

Death penalty for drug dealing?


Philippines' President Rodrigo Duterte's anti-drug war has seen thousands of drug dealers and addicts murdered in a short period of time.


His popularity ratings are 80%.

When the New York Times recently ran a photo-essay showing the corpses of the victims, email from Filipinos poured in, mostly praising the Duterte. Here is some of that, with more grim photos.


Duterte is widely seen as a crude but honest country boy going up against the establishment. He would seem to fit the mold of an authoritarian populist, but globalization is not the cause of discontent that got him elected. According to the comments, for the past decade (perhaps for decades), the Philippines has descended into becoming a narco-state, in which the rich have gotten richer and the poor poorer. The previous administration in particular lived in denial about how drug lords and their henchmen had taken over the slums. With drug addicts now getting murdered by police, more addicts are seeking treatment. 

One of the distinctions in drug policy is made between drug trafficking and illegal drug use. Duterte in the Philippines is not making any such distinction. In contrast, in Switzerland there is a two-pronged approach between strong enforcement against trafficking, and supplying small amounts of drugs to those who seek treatment.

Perhaps in a developed country, the Swiss model is more appropriate than the Filipino model. Interestingly, the Swiss have seemingly reversed the Dutch attitude toward being tolerant toward 'soft' drugs and not tolerating 'hard' drugs; in Switzerland, marijuana is still illegal, whereas heroin is handed out in clinics. 

At this stage in the US, marijuana seems to have full momentum toward mainstream acceptance, so the option of criminalizing marijuana might not be available in the US for long; the US is evolving more toward the Dutch model, at least in that sense. 

How to deal with trafficking hard drugs?

By hard drugs, one might use the criteria of drugs that 
1. cause overdoses (like heroin), and/or 
2. lead to addiction upon first-time use (like meth). 

Marijuana would not fit this definition of a hard drug. (It might be better understood as a 'medium' drug, like alcohol. Coffee and cigarettes would be soft drugs.)

It could be credibly argued that the death penalty is appropriate for dealing in hard drugs because hard drug use is essentially a terminal illness. That is, distribution of hard drugs could be seen a form of homicide, or at least negligent homicide. 

However, there is the reality of life in an affluent, developed society, with its softer mode of existence. There was recently an editorial by a prison physician who came out against the death penalty because whenever his medical staff would carry out a lethal injection, they would become permanently demoralized, and he would need to find new volunteers for later executions. Executions are no longer hangings carried out by guards and police or professional executioners. Likewise, society has changed, and the deterrent effect of executions may now be outweighed by the pall that executions cast over a modern society. 

On the other hand, mass incarceration is too expensive. The US has 5% of the world's population, and 25% of the world's prisoners. That is fiscally irresponsible. 

By way of a conclusion, there could be a compromise on penalties for the dealing of hard drugs. The initial focus should be on rehabilitation. But for those who are repeat offenders, there should be the death penalty. 

One challenge with this policy is that the greatest damage to public health comes from the selling of prescription drugs like opioids. And those drug companies are fully aware of the damage they cause.

Here is the 2009 documentary "The Oxycontin Express", about the sale of oxy in south Florida. There are all sorts of businesses (physicians, pharmacies) legally promoting oxy to addicts, not just knowingly, but deliberately. (When the government finally cracked down on oxy, addicts shifted over to heroin, hence the current heroin boom in the US. A lack of treatment options might be at fault.)


It is easy to forget that tobacco consumption is also a form of drug addiction.


Nicotine is the most powerful alkali. IIRC, the nicotine from one cigarette would kill a man if it was directly injected into his bloodstream. 


Among other things, nicotine erodes cartilage in the face, and the body responds by pumping the body full of natural pain killers (endorphins) that are supposedly 1,000 times more addictive than heroin. That is why it is so difficult to kick tobacco addiction.

Should the smoking of tobacco in public places be banned?


Smoking bans (or smoke-free laws) are public policies, including criminal laws and occupational safety and health regulations, that prohibit tobacco smoking in workplaces and other public spaces. Legislation may also define smoking as more generally being the carrying or possessing of any lit tobacco product.

The primary rationale for banning public smoking is that its effects are imposed on those who do not smoke.

The rationale for smoking bans posits that smoking is optional, whereas breathing is not. Therefore, proponents say, smoking bans are enforced to protect people from the effects of second-hand smoke, which include an increased risk of heart diseasecanceremphysema, and other diseases.[2][3] Laws implementing bans on indoor smoking have been introduced by many countries in various forms over the years, with some legislators citing scientific evidence that shows tobacco smoking is harmful to the smokers themselves and to those inhaling second-hand smoke.

Public support for such a ban varies according to the type of public space.


A 2007 Gallup poll found that 54% of Americans favoured completely smoke-free restaurants, 34% favoured completely smoke-free hotel rooms, and 29% favoured completely smoke-free bars.[52]

Another Gallup poll, of over 26,500 Europeans, conducted in December 2008, found that "a majority of EU citizens support smoking bans in public places, such as offices, restaurants and bars." The poll further found that "support for workplace smoking restrictions is slightly higher than support for such restrictions in restaurants (84% vs. 79%). Two-thirds support smoke-free bars, pubs and clubs." The support is highest in countries which have implemented clear smoking bans: "Citizens in Italy are the most prone to accept smoking restrictions in bars, pubs and clubs (93% – 87% "totally in favour"). Sweden and Ireland join Italy at the higher end of the scale with approximately 80% of respondents supporting smoke-free bars, pubs and clubs (70% in both countries is totally in favor)."

Here we come to the issue of the distinction between the public and the private.

Public and private spaces exist along a continuum. There are purely public places, like public libraries and public parks that are open to the public; and there are purely private spaces, in particular the home.

But there is a diverse hybrid public-private realm as well. Government offices closed to the public exist somewhere in the middle of the spectrum, as do private businesses and clubs that are open to the public (e.g., coffee shops, restaurants). 

With regards to a smoking ban, one type of relevant space would be those that are open to children. Any space that allows children, for example, restaurants, might be considered so inclusive that it would merit the banning of tobacco products. This would include open-air places like parks and beaches.

But bars exclude children, although some patrons are not tobacco users. One might expect that places like bars that exclude children might be given greater allowance to permit the use of tobacco, although that allowance would not be total. 

It gets complicated. The home is a purely private place, but tobacco smoke drifts into other areas. 
Also, vaping does not impose the same health hazards on bystanders as does tobacco smoke does; neither does chewing tobacco. But these are filthy habits in the eyes of many, and it is akin to visual blight to see people engaged in activities like vaping and chewing tobacco (and spitting). These might be activities for the home.

Likewise, advertisements for tobacco products can be seen to constitute visual and noise pollution. 
Along these lines, a strong argument could be made that the use of tobacco in public, even outdoors on sidewalks and so forth, should be banned. (It also encourages littering, with smokers leaving their garbage all over.)

If people want to vape or chew tobacco in their homes or in bars, that might be permissible. 

[Note that there is an element of social bias against tobacco use today: The lower classes and the upper classes in the US smoke cigarettes, although the upper classes carefully hide their habit (Obama is a smoker, as are most successful liberal movie actors); the American middle classes (liberal and conservative) abhor tobacco.] 

Let's look at the prohibition of alcohol in the 1920s in the US, and attitudes toward that policy. 

Here is Ken Burn's PBS special on Prohibition:


Note that the first episode is entitled "A Nation of Drunkards".

In interviews with libertarians, Prohibition is described in matter-of-fact terms as the single greatest policy fiasco in American history.

But the documentary itself is more nuanced than that. There was seemingly an epidemic of alcohol abuse at the turn of the century as the US industrialized rapidly and men lost the sense of independence they might have once had as farmers; the tavern became a refuge from a humiliating reality. There was also a reaction on the part of small-town, Protestant America against mass immigration, especially against groups like the Germans and the Irish. 

It is true that Prohibition was singlehandedly responsible for making a marginal urban phenomenon like organized crime a mainstream presence. 

But Prohibition does seem to have driven down the level of alcohol use and abuse.

Here is one graph (which I cannot vouch for) which describes historical alcohol consumption in the US.


I am trying to understand how to manage alcohol in terms of the public/private distinction that might be useful in regulating cigarette smoking. 

But the problem is not second-hand exposure, as it is with tobacco smoke; the problem is potentially destructive consequent behavior.

So people may drink relatively safely in private spaces like the home or a bar, but the problem is when they leave those spaces. The self-driven car might be a great breakthrough in terms of limiting damage.

The greater issue might be the mode of consumption of alcohol, which is in part a cultural phenomenon. Malcolm Gladwell argues that it is not how much people drink in total, but how they space it out over the course of the day. In particular, Italian immigrants in the US would drink alcohol with every meal, but would rarely be inebriated.


The overwhelming majority of Italian-American men in New Haven drank. A group led by the director of the Yale alcohol-treatment clinic, Giorgio Lolli, once interviewed a sixty-one-year-old father of four who consumed more than three thousand calories a day of food and beverages—of which a third was wine. “He usually has an 8-oz. glass of wine immediately following his breakfast every morning,” Lolli and his colleagues wrote. “He always takes wine with his noonday lunch—as much as 24 oz.” But he didn’t display the pathologies that typically accompany that kind of alcohol consumption. The man was successfully employed, and had been drunk only twice in his life. He was, Lolli concluded, “a healthy, happy individual who has made a satisfactory adjustment to life.”

By the late fifties, Lolli’s clinic had admitted twelve hundred alcoholics. Plenty of them were Irish. But just forty were Italians (all of whom were second- or third-generation immigrants). New Haven was a natural experiment. Here were two groups who practiced the same religion, who were subject to the same laws and constraints, and who, it seemed reasonable to suppose, should have the same assortment within their community of those genetically predisposed to alcoholism. Yet the heavy-drinking Italians had nothing like the problems that afflicted their Irish counterparts.  

Per capita alcohol consumption by country:


The Irish rank #21. 

The Italians rank #87.

The US ranks 48th, the Russians 4th. 

Pakistan, a Muslim country, is at the bottom of the list, at #191.

What's going on?

Basically, countries in which people either drink less or drink plenty but without inebriation are more civilized.

The definition of 'civilization' as it is meant here is provided by the great sociologist Norbert Elias.


The first volume, The History of Manners, traces the historical developments of the European habitus, or "second nature," the particular individual psychic structures molded by social attitudes. Elias traced how post-medieval European standards regarding violence, sexual behaviour, bodily functions, table manners and forms of speech were gradually transformed by increasing thresholds of shame and repugnance, working outward from a nucleus in court etiquette. The internalized "self-restraint" imposed by increasingly complex networks of social connections developed the "psychological" self-perceptions that Freud recognized as the "super-ego."

The second volume, State Formation and Civilization, looks into the causes of these processes and finds them in the increasingly centralized Early Modern state and the increasingly differentiated and interconnected web of society.

The Italians since the Rennaissance had courtiers and other self-disciplined elites whom they could imitate; the Irish did not have anything. 

The case of Pakistan, an impoverished and pathetically stagnant country, is problematic. It raises the question: Can one be too civilized? 

The great Chinese poets, Li Bai, was reputed to have been a great drunkard.


There is a long and sometimes fanciful tradition regarding his death, from uncertain Chinese sources, that Li Bai drowned after falling from his boat when he tried to embrace the reflection of the moon in the Yangtze River.

There might be a connection between mood-altering recreational drug use and creativity. Too little tolerance toward drug use, and a society will stagnate (Islam); too much drug use, and the society will collapse (opium in China).

A map of alcohol consumption rates by country:


Poor countries (e.g., Ireland) may have consumed more alcohol, which made them poorer -- and thus more easily conquered by colonizers (e.g., England). (This made them turn to alcohol even more.) 

But impoverishment and colonization was also the fate of countries that consumed the least alcohol (the Muslim world). 

A summary of a few lessons from the drug wars:

1) rehabilitation for dealers and treatment for users are priorities;
2) severe punishment is due for repeat offenders (traffickers);
3) private, but not public use of drugs is permissible; and
4) moderate use of mood-altering recreational drugs is better than high use or no use.

Gambling is literally a drug, and is a chemically addictive activity.


Note that for gambling addicts, engaging in the activity itself has the same powerful rewarding effect as winning at it.

There seems to be a strong genetic component. What is a pleasant pastime that some people choose to engage in is, for others, an all-consuming demon. That is, Christian (Catholic, more precisely) notions of "free will" may well describe the experiences of many folks who gamble casually, but as brain scientists point out, this concept of freedom of choice does not apply to those who are addicted to gambling. Gambling in the case of addicts is better understood as a physical disease than as a spiritual weakness or a lack of gumption. 

Some types of gambling are more addictive than others.

The more randomized a game, the more addictive it is.

This is known as a "variable ratio" (VR) schedule of reinforcement.


Games of pure chance are therefore particularly addictive.


Such games of pure chance include games that are governed entirely by the mechanisms of:

-dice;
-spinning wheel (e.g., roulette, slot machines);
-randomly generated numbers and/or characters (e.g., lotteries, bingo); and
-coin flip or card draw.

In contrast, games of pure skill are the least addictive.

There is really only one game of pure skill -- chess. (In Asia, there is go.)

(Chess is not associated with gambling for money, but rather with the obsession to win by the players.)


Many or most games, in fact, exist along a continuum of chance and skill. 

But this is not how they are perceived. There is a tendency to classify games into "either/or" categories, when, in fact, most games are mixed.


In a number of countries like Germany, whether a game is considered of skill has legal implications with respect to whether money bets on the game's outcome are considered gambling or not. For example, poker is legally considered a game of chance in Germany (thus only allowed in casinos), whereas skat is considered a game of skill and competitions with money prizes are allowed.

Contract bridge is closer to chess as a game of skill, although there is some element of luck; it is boring and difficult and is dying out in terms of popularity. Blackjack, at least as played by the average senior citizen, is very nearly a game of chance; when it is played by a professional who counts cards, it is a game of great skill that also involves some chance. 

Here is the great challenge in regulating gambling

Games of pure chance (lotteries) or of near-pure chance are perceived by the general public as relatively wholesome. (?!)

In contrast, games of partial chance and skill (poker, backgammon) are somehow widely regarded as sordid. 

In terms of addiction, this is completely backwards and irrational. (It might be due to the way that the elderly flock to games of pure chance, and gangsters, professional gamblers and wannabes gravitate to games of mixed chance and skill.)

Policy recommendations on gambling:

1. Ideally, games of pure skill like chess and go would be taught to all in the schools and universities. It would be a part of the regular curriculum.

Here is a 2012 documentary on a school in Brooklyn that hired a teacher to teach chess to members of the chess club. The game has had a transformative effect on the school.


2. All games of pure chance should be banned, even in casinos and the internet. Lotteries and slot machines would be strictly forbidden anywhere and everywhere.

3. Games of mixed or partial chance and skill (poker) would be allowed in casinos or perhaps in casual, social (private) wagering. 

4. Also, card counting is not illegal, but it is forbidden by casinos. Card counting should be considered a legal right to be exercised by skillful and talented sportsmen, and the government should crack down on gambling establishments that discourage skill and encourage chance and addiction. 

A NYTimes editorial on the decline of the death penalty.


The Florida decision is the most recent sign, in a year full of them, that the morally abhorrent practice of capital punishment is sliding into the dustbin of American history — where it should have been long ago.
...
The total abolition of capital punishment, however, will depend on the Supreme Court’s reading of the Eighth Amendment’s ban on cruel and unusual punishments. So far, only one current member of the court, Justice Stephen Breyer, a regular critic of the death penalty, has expressed openness to examining this question. This month Justice Breyer took aim at the practice again, in a dissent from the court’s decision not to hear an appeal from a death-row inmate in Florida.
Pointing to the facts of several recent cases that had come before the court, Justice Breyer asked whether the death penalty itself — plagued by arbitrariness, racism, decades-long delays and faulty execution-drug protocols — violates the Eighth Amendment. The people who end up being executed, he wrote, “are not the ‘worst of the worst,’ but, rather, are individuals chosen at random, on the basis, perhaps of geography, perhaps of the views of individual prosecutors, or still worse on the basis of race.”

Historically, the death penalty was a common practice in almost every single human society. 

The point is that what is "cruel and unusual" is historically situated. At one time capital punishment was neither cruel nor unusual because pretty much every society did it. It was very usual, and therefore was not considered cruel.

Cultural and moral relativism seems to be a feature of political correctness, but liberals seem to lose their historical and global perspective when it is convenient. Suddenly, something that everyone once did uncritically is understood to be "morally abhorrent" in all times and all places. Suddenly, moral absolutism becomes politically correct.

What's really happening is that in a prosperous, developed modern country, death is not something anyone wants to think about. We imagine death to be an abstraction that happens to elderly people in hospitals. We buy our food already wrapped in plastic rather than harvest it ourselves.

In terms of drug policy, there are practical ramifications for the increasing (and recent) unpopularity of capital punishment. It is impractical to lock up drug dealers for decades, and as an alternative to incarceration, capital punishment does have a strong deterrent effect (at least, according to the government of Singapore). 

So what to do? 

My guess is that in a prosperous, developed society, the government should displace drug dealers -- that is, take away their business. The government should provide a minimal supply drugs to addicts if the addicts seek treatment (e.g., the Swiss model). The government should also harshy persecute dealers (although I don't know how....). 

Are bars obsolete and doomed?

With the societal shift to the internet, the United States Postal Service is in bad shape financially as First Class mail has become less popular.

One initiative is to allow USPS to ship alcoholic beverages.


Merchants are not happy with this prospect.


Logistically, it is difficult to ship glass bottle filled with liquid, especially carbonated beverage.

One might guess that in the future, USPS would ship marijuana, instead.

Ironically, it might be local merchants who in the future would use drones for home delivery of alcohol.

At that point, the existence of bars or other public businesses that rely primarily on the public consumption of alcohol would become problematic. 

Moreover, although the prospect might now seem unrealistic, in the future, any and all public consumption of alcohol, even in restaurants, might become illegal.

At that stage, as attitudes change, drinking "to excess" might also become illegal, even in a purely private space (the home). 

Is there a Constitutional right to drink alcohol?

No.

Should those who break the law while under the influence of alcohol therefore not be allowed to drink alcohol?


Well, here's a provocative but potentially transformative idea: If your alcohol use causes you to behave in a way that threatens public health and public safety, let's suspend your license to drink.

In the United States, everyone gets an unconditional license to purchase and consume as much alcohol as they want when they turn 21. If someone repeatedly drives recklessly and gets caught, their license to drive can be suspended or revoked. Shouldn't a similar approach be taken for reckless alcohol use?

The idea isn't as farfetched as it might sound. South Dakota, for example, has already tried suspending the "license to drink" for more than 30,000 alcohol-involved offenders -- with dramatic results.

This connects to another issue, the physiological reality that the human brain does not mature until the age of 25 or 30. 

Should the minimum drinking age be raised to the mid-twenties or 30?

And what about so-called 'medical marijuana' (recreational) usage? Should the sale of marijuana be restricted to those under 25 or 30 because the developing brain is harmed by marijuana use? 


However ... from societal point of view, this is the age group that will do anything to get high, legal or not. Is marijuana nevertheless a better alternative for this young age group than alcohol? That is, even if marijuana usage causes mental retardation, it does not cause mayhem and havoc the way alcohol does.