Australian&NewZealandJournalofCriminology2014,Vol.47(2)176 - PDF document

Australian&NewZealandJournalofCriminology2014,Vol.47(2)176–189TheAuthor(s)2014Reprintsandpermissions:sagepub.co.uk/journalsPermissions.navDOI:10.1177/0004865814524423 ArticleTheprosandconsofprohibitingdrugsDonWeatherburnNSWBureauofCrimeStatisticsandResearch,AustraliaInSeptember2012,agroupknownasAustralia21calledforarethinkontheprohibitionagainstillegaldrugs.IftheresponsefromAustralianFederal,State,andTerritoryGovernmentsisanyguide,thecallfellondeafears.Inrecentyears,evenscholarlydebateaboutthemeritsofprohibitionappearstohavesubsided.Thispaperacknowledgesthatsocialandfinancialcostsoftheprohibitionagainstillegaldrugsbutarguesthatprohibitionalsopreventsagreatdealofharm.Themultifariousnatureofdrug-relatedharmandthediffer-encesbetweenpeopleintheweightassignedtovariousharmsmakesitimpossiblesaywhatpolicybestminimizesdrug-relatedharm.KeywordsCannabis,decriminalization,depenalization,harmreduction,heroin,prohibitionIntroductionInSeptember2012,agroupknownasAustralia21calledforarethinkontheprohib-itionagainstillegaldrugs(Douglas&McDonald,2012).Callsofthissortdonotnor-mallyexcitemuchmediainterest,butthiscallreceivedplentyofattention.OnereasonfortheattentionwasthatAustralia21hassomeveryeminentpeopleonitsboard;includingaformersecretaryofdefence,aformerprofessorofepidemiology,andaformercommissionerofpolice.Anotherwasthatthereportemployedsomefairlydra-matictacticstogetitsmessageacross.Thecoverdepictedwhatappearedtotwoverydistressedparentsunderneathatitlewhichread:Theprohibitionofillicitdrugsiskillingandcriminalizingourchildrenandwearealllettingithappen(Douglas&McDonald,2012).ThebodyofthereportclaimedthattheWaronDrugshadfailed,thatthebiggestbene“ciariesofprohibitionarethoseinleaguewithorganizedcrimeandthosecorruptedbyitandthatpoliticianssupportprohibitionsimplybecausetheywanttolooktoughonlawandorder(Douglas&McDonald,2012,p.15).Thereportconcludedthat:ItistimetostopsloganeeringandinsistthatAustraliahaveaninformedpublicdebateaboutthealternativestoa Correspondingauthor:DonWeatherburn,NSWBureauofCrimeStatisticsandResearch,Level8,StJamesCentre,Sydney,NewSouthWales2000,Australia.Email:don_j_weatherburn@agd.nsw.gov.au policythathasfaileddisastrouslyandiscriminalizingouryoung(Douglas&McDonald,2012,p.23).Todate,thechallengethrowndownbyDouglasandMcDonald(2012)hasnotbeentakenup.NeithertheFederalGovernmentnoranyStateorTerritoryGovernmenthasoeredadetaileddefenceofprohibition.AsearchofAustraliancriminologyandhealthjournalsalsofailedtorevealanyresponsetothecallbyAustralia21.TheNationalDrugStrategymentionsprohibitiononce(inthecontextofsupplyreduction)butoersnocommentonthemeritsofprohibitionasameansofcurbingthedemandforillicitdrugs(MinisterialCouncilonDrugStrategy,2011).Thepurposeofthispaper,therefore,istodiscusstheprosandconsofprohibition.Inwhatfollows,thetermprohibitionreferstotheblanketprohibitionagainstuse,pos-session,sale,cultivation,manufacture,orimportofcertainspeci“eddrugs.Thetermdecriminalizationreferstothecompleteremovalofsanctionsfordruguseand/orpossession.Thetermpartiallegalizationreferstolawswhichlegalizetheprovisionofcertainotherwiseprohibiteddrugs(e.g.heroin)tocertainclassesofuser(e.g.heroin-dependentpeople)bycertainclassesofsupplier(e.g.medicalpractitioners).Sincethecaseagainstprohibitioniswellknownandeasiertostatethanthecaseinfavorofprohibition,webeginwithit.TheconsofprohibitionOneofthebiggestproblemswiththeprohibitionagainstillegaldrugsistheexpenseofenforcingit.In2005,Moore(2005)estimatedthatAustraliaspendssomewherebetween$432millionand$707millionannuallyondruglawenforcement.Despitethis,aboutonein10Australiansovertheageof14useanillicitdrugatleastonceayear.Nearly40%havetriedanillicitdrugatsomestageintheirlives(AustralianInstituteofHealthandWelfare,2011,pp.8…9).Incapacitationmakesitmuchhardertouseillegaldrugs,butthereisnoevidencethatimprisoningdrugusershasanyeectontheirwillingnesstocontinueusingillegaldrugs.Indeed,ifanything,theevidencesuggeststhatimprisonmentexertsnoeect(Spohn&Holleran,2002).Thereisplentyofevidence,ontheotherhand,thatacriminalconvic-tionorarecordofimprisonmentcanseriouslyhamperapersonsfutureearningsandemploymentprospects(Fagan&Freeman,1999;Good,Pirog-Good,&Sickles,1986;Hunter&Borland,1999;Sampson&Laub,1993).Becauseprohibiteddrugsareexpensive,dependentdrugusersoftenresorttocrimetofundtheirpurchasesofillegaldrugs.Ratesofoendingarefarhigheramongdrug-dependentoendersthantheyareamongoenderswhoarenotdependentonillegaldrugs(Blumstein,Cohen,Roth,&Visher,1986,p.74).Itisreasonabletosupposethattheywouldnotdothis,oratleasttheywouldnotdoitasfrequently,ifpartiallegalizationresultedindependentuserspayinglessforthedrugstheyconsume(Ribeaud,Thecrimecommittedbydruguserstoraisefundstopurchaseillicitdrugsisonlypartoftheproblem.AstheNSWPoliceRoyalCommissionsographicallyrevealed,prohib-itioncreatesincentivesandopportunitiesforcorruption.Thiscanunderminepublicfaithindemocraticinstitutionsandpubliccon“denceintheruleoflaw.Becausetheycannotresorttothelawtoresolvetheirdisputes,theprincipalsoforganizedcrimeoften 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endupresortingtoviolence.SomeoftheviolencenowbeingplayedoutinSouthWesternSydneyappearstofallintothiscategory(AAP,2013).Thetacticsemployedbypolicetodiscouragestreet-leveldruguseanddealingaresometimesinimicaltopublichealth.InterviewswithdruguserscarriedoutbyMaher,Dixon,Swift,andNguyen(1997)inthelate1990ssuggestedthatfearofdetectionandarrestsometimespromptedheroinuserstoshareneedlesandinjecttooquickly.Theformerpracticeincreasestheriskthatblood-bornevirusessuchasHIVandHepatitisCwillbetransmitted.Thelatterincreasestheriskoffataloverdose.Otherresearchershavecon“rmedthese“ndings(Weatherburn,Lind,&Forsythe,1999).TheprosofprohibitionSomuchfortheconsofprohibition.Wecomenowtothepros.Therearemanywaysofreducingtheharmassociatedwithillegaldrugs(e.g.providingcleaninjectionequipmenttoinjectingdrugusers),butoneofthesurestistoreduceorlimitaggregatelevelsofdrugconsumption.The“gurebelowillustratesthepointbyplottingthefallinmalelungcanceragainstthefallintheprevalenceofmalecigarettesmoking.AlthoughFigure1depictstherelationshipbetweencancerandsmokingprevalence,itisimportanttorememberthatheavyusersofmostdrugsaccountformostoftheharms.Ingeneral,therefore,drug-relatedharmismuchmorecloselytiedtoaggregatecon-sumption(i.e.quantityorweightconsumed)thanitistoprevalenceofuse.Prohibitioncouldbesaidtoconstrainaggregateconsumptionofillegaldrugsinthreeways:1.First,bylimitingthelegitimateopportunitiesforillicitdruguse;2.Second,byraisingthenon-monetarycostsassociatedwithdruguse;and,3.Third,bymakingdruguseexpensive. 60.0120.0140.030 Male smoking prevalence Male lung cancer incidence 0.020.0 cancer incidence per 100,000 pop.Smoking prevalence (%) Figure1.Malelungcancerincidenceandmalesmokingprevalence. Australian&NewZealandJournalofCriminology47(2) Inwhatfollows,wetakealookattheevidencebearingoneachofthesemechanisms,startingwithdeterrence.Restrictingthelegitimateoccasionsfordrugconsumptionhasasigni“cantandsome-timessubstantialeectondrugconsumption.Borland,Chapman,Owen,andHill(1990),forexample,foundthattheintroductionofabanonworkplacesmokinginAustralianpublicserviceocesreducedoverallratesofsmoking,particularlyamongheaviersmokers(25+cigarettesaday),whosecigaretteconsumptionsixmonthsafterthebanhadbeenintroducedhadfallenbyover25%.Similar“ndingshavebeenobtainedintheUnitedStatesbyFarrelly,Evan,andSfekas(1999),withthelargestfallcomingfromtheheaviesttobaccoconsumers.FichtenbergandGlantz(2002)latercon“rmedthese“ndingsinasystematicreviewof26studiesonworkplacesmokingbansevaluatedintheUKandtheUS.Prohibitingdrugusecanbethoughtofasreducingthelegitimateoccasionsofdrugusetozero.Ifthepatternfortobaccoisanyguide,wewouldexpectprohibitiontoreduceillicitdrugconsumptionandwewouldexpecttheeectstobemostpronouncedamongfrequentusersofillicitdrugs.Supportingthis,in2001,Weatherburn,Jones,andDonnelly(2003)askedarepresentativesampleof60018-to29-year-oldsinNSWwhethertheywouldusemorecannabisifitwerelegal.About16%ofthosewhohadneverusedcannabis,78%ofmonthlyusers,andmorethan90%ofweeklyuserssaidtheywould.Studiesexaminingtheeectsofchangestothelawconcerningdruguseandposses-sion,however,sometimespresentaverydierentpicture.In1987,theSouthAustralianGovernmentintroducedacannabisexpiationscheme,underwhichthosecaughtusingorpossessingsmallamountsofcannabisweregivenaninfringementnoticeanda“ne.Donnelly,Hall,andChristie(1998)examinedtrendsinthelifetimeandweeklypreva-lenceofcannabisuse,beforeandaftertheschemewasintroduced.Theyfoundnosigni“cantdierenceinthegrowthrateforweeklycannabisuse.Theprevalenceoflifetimecannabisuseincreasesigni“cantlyfasterinSouthAustraliathanintherestofAustralia;butnofasterthaninsomeprohibitionStates,suchasTasmania.Single(1989)conductedthe“rstmajorreviewofmarijuanadecriminalizationintheUnitedStatesandCanada.Heexaminedtrendsintheprevalenceofcannabisusein11USStateswherepenalsanctionsfortheuseandpossessionofsmallamountsofcannabiswereremoved,backintheearly1970s.Broadlyspeaking,hefoundnodierencesincannabisusetrendsbetweenStatesthatprohibitedcannabisuseandstatesthatdecri-minalizedit.In2001,alldrugpossessionanduseoencesinPortugalbecameadministrativeoences.HughesandStevens(2010)evaluatedthereformsandfoundthatthepreva-lenceofillicitdruguseinPortugalincreasedslightlyinthesevenyearsfollowingdecrim-inalizationbutcitedevidencesuggestingthatproblematicdruguse(de“nedasinjectingdruguseorlongduration/regularuseofopioids,cocaine,and/oramphet-amines)hadactuallydeclinedoverthisperiod.TheytookthisasstrongevidencethatthePortuguesedecriminalizationhasnotincreasedthemostharmfulformsofdruguse(Hughes&Stevens,2010,p.1008). Weatherburn Thesestudiesareoftencitedbyadvocatesofdrugdecriminalizationinsupportoftheirclaimthatdecriminalizationhasnoeectondrugconsumption.Actually,theyprovidemuchlesssupportthanisconventionallyassumed.Tobeginwith,thelegalchangesinquestionwerenotexamplesofdecriminalization.Theywereexamplesofdepenalization,thatis,theremovalorsofteningofpenalsanc-tions.InPortugal,forexample,itisstillpossibletobesanctionedfordruguseandpossession.Thesanctionsincludecommunityservice,“nes,suspensionsofprofessionallicenses,andbansonattendingcertainplaces(Hughes&Stevens,2010).Softeningpenaltiesisverydierentfromremovingthemaltogether.Thelawscapacitytoengendercomplianceisnotonlyorevenprimarilyafunctionofthepenaltiesattachedtonon-compliance(Licht,2008;Tyler,1990).Second,thefactthatdruguse(includingproblematicdruguse)didnotincreasefollowingdepenalizationdoesnotbyitselfshowthatdepenalizationhasnoadverseeects.Otherfactorsnotcontrolledforinthesesimplebefore-aftercomparisonsmayberesponsiblefortheresults.Depenalization,forexample,wouldnotbeexpectedtoexertmucheectifenforcementofprohibitionpriortodepenaliza-tionwasfairlyweakorifthepriceofillegaldrugsrosefollowingthepolicychange.Drug-relatedharmmightbeexpectedtoremainconstantorevenfallafterdecrim-inalizationifthepopulationofdruguserswasagingorifdepenalizationwasaccom-paniedbyanexpansionoftreatment,whichitwasinPortugal(Hughes&Stevens,Moresophisticatedstudies,whichtakesomeofthesefactorsintoaccount,havefoundevidencethatdepenalizationin”uencescannabisconsumption.SaerandChaloupka(1995,1998)andPacula,Chriqui,andKing(2003)foundtheimpactofdepenalizationonmarijuanasmokingintheUnitedStatestohavebeenpositiveandsigni“cant.SimilarpositiveeectsinAustraliahavebeenreportedbyWilliams(2004),ZhaoandHarris(2004),andDamrongplasit,Hsio,andZhao(2010).Thelatterstudyisparticularlynoteworthybecauseitcontrolledforthepossibilitythatcannabisusersmightmigratetodepenalizationstates.Thisgreatlyincreasedtheestimatedeectofcannabisdepena-lizationinAustralia(fromaround5to16.3%).Third,depenalizationsometimesbeenaccompaniedbyanincreaseincannabisuse.AsMacCounandReuter(2001)pointout,in1976,theDutchadoptedaformalwrittenpolicyofnotenforcingtheprohibitionagainstcannabispossessionwhereverthequantitiesinvolvedwere30gorless.Initiallythischangehadnoeectoncannabisuse.Fromthemid1980sonwards,however,thenumberofDutchcoeeshopssellingcan-nabisbegantogrow,andtheprevalenceofcannabisusegrewwithit.Fourth,evenitweretruethatdecriminalizingcannabisuseandpossessionhadnoeectoncannabisuseintheUnitedStatesorPortugalortheNetherlands,itwouldnotfollowthatdrugdecriminalizationingeneralhasnoeectonanyformofdruguseatanytimeorwithanygroup.Decriminalizationofdruguseandpossessionatatimewhenuseisrisingmayhaveverydierentlong-termeectsthanwhentheprevalenceofdruguseisatitspeak(Behrens,Caulkins,Tragler,&Feichtinger,2000;Caulkins,Dworak,Feichtinger,&Tragler,2000).Theeectsofdecriminalizinghighlyaddictivedrugs,suchasheroin(Anthony,Warner,&Kessler,1994)ordrugsthatincreasetheriskofviolentbehavior,suchasamphetamines(McKetin,McLaren,Riddell,&Robins,2006),maybeverydierenttothoseassociatedwithcannabis. Australian&NewZealandJournalofCriminology47(2) Fifth,thestudiesreviewedbySingle(1989)andthestudyconductedbyDonnellyetal.(1998)hadlittlecapacitytomeasurechangesindrugconsumptionamongexistingdrugusers.Thisisasigni“cantlimitationbecausewhatmattersmostfromaharmreductionviewpointisnotwhetherremovalofpenalsanctionspromptsnon-userstotrydruguse,butwhetheritincreasesconsumptionamongexistingheavydrugusers.They,afterall,accountforthevastmajorityofdrug-relatedharm.ThestudiesreviewedbySingle(1989)examinedchangesintheprevalenceofdruguseratherthanchangesinconsumptionamongregularusers.Donnellyetal.(1998)testedforchangesinconsumption,butthepoweroftheirstudytodetectthemwasfairlylimited.Theyonlyhada27%chanceofdetectinga3%pointincreaseinweeklycan-nabisuseoverall;anda15%chanceofdetectingadoublingofcannabisuseamongthecritical14-to29-year-oldagegroup(seeWeatherburnetal.,2003).Somestudies,itshouldbenoted,“nddepenalizationofcannabisuseonlyhaslimitedeects.Williams(2004),forexample,foundthatdepenalizationofcannabisuseinAustraliawasassociatedwithanincreaseintheprevalenceofuseonlyamongmalesovertheageof25.Shealsofoundnoeectofdepenalizationonfrequencyofuseamongexistingusers.The“rstofthese“ndings,however,wasnotcon“rmedbyDamrongplasitetal.(2010),whofounddecriminalizationinAustraliahadmorewidespreadeects.ThesecondishardtoreconcilewiththestatedintentionsofcannabisusersobservedinWeatherburnetal.(2003).Onbalance,mostoftheevidenceemanatingfromstudieswhichmakesomeattempttocontrolforextraneousfactors,doessuggestthatprohib-itionconstrainsillicitdrugconsumption.Non-monetarycostsWenowturntotheissueofnon-monetarycosts.Oneoftheconsequencesofprohibitionisthatitforcesdruguserstoexpendalotmoreeortobtainingthedrugstheywant.Theirburdensincludetheriskofarrest,thepossibilityofpoliceharassment,theriskofassaultbyotherdruguserswhowanttoripotheirstash,andtheriskofviolencefromdealerswhowanttoenforcepaymentofunpaiddebts.Thesenon-monetarycostshavebeensaidtoactasabrakeondrugconsumption,justasmonetarycostsdo(Moore,1972).Thishypothesisissupportedbyseveralobservations.Tobeginwith,whendrugusersareaskedwhytheyareenteringtreatment,twoofthefactorsmostfrequentlycitedarefearofprisonandtroubleswiththepoliceandcourts(Bammer&Weekes,1993;Tsogia,Copello,&Orford,2001;Weatherburnetal.,1999).AttheheightoftheAustralianheroinepidemic,forexample,Weatherburnetal.(1999)asked511heroinusersinSouthWesternSydneywhethertheywantedtreatmentforheroinuseor,iftheywereintreat-mentwhytheywhytheywerethere.JustfewerthanhalfthesamplesaidthatreducinginvolvementincrimeandavoidingtroublewiththepoliceandcourtswasveryTotesttheveracityofthisclaim,Weatherburnetal.(1999)dividedtheirsampleintothosewhowantedtreatmentandthosewhodidnot.Theythenregressedthelikelihoodofwantingtobeintreatmentagainstvariousmeasuresofcontactwiththecriminaljusticesystem.Theyfoundthatthehigherthenumberofcontacts,thegreaterthelike-lihoodofwantingtobeintreatment.Whentheyregressedtheprobabilityofbeingin 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treatmentagainstthesamefactor,theyfoundthesameresult.Importantly,theseeectsheldupinthefaceofcontrolsforage,gender,ethnicity,yearsofheroinuse,averagedailyheroinexpenditure,associationwithotherheroinusersandwhetherornottherespondenthaddependentchildren.Studiesofpolicecrackdownsonopen-airdrugmarketsprovideafurtherlineofevidenceontheissue.Falcatoetal.(2001)inSwitzerlandkeptarecordofthemonthlynumberofadmissionstomethadoneclinicsinZurichbefore,duringandaftertheclosureoftheLettendrugsceneinFebruary1995.ThiswasanareaaroundtheabandonedLettenrailwaystationwherelargenumbersofdruguserscongregatedafterthenotori-ousneedleparkinZurichwascloseddownin1992.Falcatoetal.(2001)foundthattheclosureofLettenincreasedtherateofentryintotreatmentwithoutproducinganyreductionintherateofretentionintreatment.Studieslikethesesuggestthatthenon-monetarycostsofdruguseactasabrakeonconsumption,inpartbecausetheyencouragedrugusersintotreatment.Totheextentthattreatmentreducesdrug-relatedharm,then,prohibitioncouldbesaidtodeservesomeofthecredit.MonetarycostsThisbringsustotheissueofmonetarycosts.Thesensitivityofdemandforaproducttochangesinitspriceiswhateconomistscallitspriceelasticity.Anelasticityof1.0meansthatwhenthepriceofacommodityincreasesby1%,consumptionofthecommodityfallsby1%.Anelasticityofzeromeansthatchangesinthepriceofacommodityhavenoeectonconsumption.Inthiscase,thosewhowantthecommoditysimplyspendmoremoneytogetwhattheywant.Itusedtobethoughtthatthepriceelasticityofaddictivedrugswouldbezeroorverysmall,andthatuserswouldrespondtohigherdrugpricesbycommittingmoredrug-relatedcrimetofundtheadditionalcostoftheirdrughabits.Thisturnsoutnottobethecase.Inhismeta-analysis,Gallet(2013)foundpriceelasticitiesofaround0.5toforheroinandcocaineand0.2to0.3forcannabis.Inotherwords,theavailableevidencesuggeststhata10%increaseinthepriceofheroinorcocainewouldreduceconsumptionbybetween5and6%,whilea10%increaseinthepriceofcannabiswouldreduceconsumptionbybetween2and3%.Theseeectsarecomparabletothosefoundforalcoholandtobacco(Gallet,2013).Ifprohibitionkeepsthepricesofheroinandcocaine10timeshigherthantheywouldbeinalegalmarket,thenitkeepsconsumptionofheroinandcocaineabout“vetimeslowerthanitwouldotherwisebe.Thisshouldhelptosuppressdrug-relatedharm,andtheevidencesuggeststhatitdoes.Dave(2005)examinedtheempiricalrelationshipbetweencocaineandheroinpricesandhospitalEDadmissionsfor21UScities.HefoundthepriceelasticitiesassociatedwithcocaineandheroinEDepisodeswere0.10,respectively.Healsoestimatedthata10%increaseinpriceswouldpreventabout11,000hospitalvisits,withsavingsofbetween$21and$47million.Itisnotnecessarytolookoverseasto“ndevidencethatdemandforaddictivedrugsispriceelastic.ThebestlocalevidencecomesfromtheheroinshortageinAustralia.AroundChristmas2000,thepriceofagramofheroinrosefrom$218to$320,whilethepuritydroppedfrom60%toaround20%.Adjustedforpurity,therealpriceofa Australian&NewZealandJournalofCriminology47(2) gramofheroinrosefromaround$360toover$1200.Withinsixmonthsofheroinpricestripling,medianweeklyexpenditureonheroinamongtheregularuserssurveyedbyWeatherburn,Jones,Freeman,andMakkai,2003fellby36%,from$550aweekto$350aweek.Thedropinexpenditurewasaccompaniedbyanextraordinarydropindrug-relatedharm.Intheperiodleadinguptotheheroinshortage,robbery,andtheftoenceswereallrising.Intheeightyearsaftertheheroinshortage,robberyratesfellby38%;burglaryby50%;motorvehicletheftby56%;andgeneraltheftby37%(AustralianBureauofStatistics,2009).Thefallinheroinconsumptionproducedhealthbene“tsaswell.Themostnotableandthemostimportanteectwasa67%reductioninfatalandnon-fatalopioidoverdoses.DeathsinAustraliaduetoopioidsdeclinedfrom1116in1999to386in2001amongthoseaged15…54years.HepatitisCnoti“cationsalsodecreased(Degenhardt,Day,Gilmour,&Hall,2006).Ofcourse,somecontesttheclaimthatdruglawenforcementcausedtheheroinshort-age(see,forexample,Dietze&Fitzgerald,2002;Wodak,2008).Itisfairtosaythattheevidenceonlawenforcementsroleincausingtheheroinshortageisinconclusive,althoughDegenhardt,Reuter,Collins,andHall(2004)presentacompellingcritiqueofalternativeexplanationsfortheshortage.Thequantityofdrugseized,however,isnotthemainwayinwhichprohibitionin”uencesdrugprices.ThemainwayisthroughwhatReuter(1983)hastermedthestructuralconsequencesofillegality(seealsoReuter&Kleiman,1986).Thehighpenaltiesassociatedwithdrugtracking,coupledwiththeriskofappre-hension,makedrugtrackingveryrisky.Likeinsurancecompanies,drugsuppliersseektocompensatethemselvesfortheserisksbydemandinghighpremiums.Thesepremiumsarepassedontodrugconsumersintheformofhigherprices.Thatiswhytheretailcostofdrugssuchascannabis,heroin,andcocainefarexceedsthecostsassociatedwiththeirproductionanddistribution.Oxycontin„alegalopioid,retailsforabout$1.30per80mgtabletonaPBSprescription.Bycomparison,acapofheroininSydneyatthemomentcostsabout$50.Evenatthisprice,thecapwillonlybeabout20…30%pure(Phillips&Burns,2012).ResearchintheUnitedStatessuggeststhattheblack-marketpriceofcocainein2002wasbetween2.5and“vetimeshigherthanthepricethatwouldprevailifthedrugwerelegalized.Theblack-marketpriceofheroinatthetimewasthoughttobebetweeneightand19timeshigherthanitwouldbeinalegalmarket(Grossman,Chaloupka,&Shim,2002).Increasinginvestmentinsupplysidedruglawenforcementmaynothelppushupthecostofdrugsonthestreet.However,evenifitdoesnot,themerefactthatdrugtrackingisillegalandpunishedwithseverepenaltiestendstokeepthepriceofillegaldrugsmuchhigherthanitwouldotherwisebe.This,inturn,keepsconsumptionanddrug-relatedharmbelowwhattheywouldbeintheabsenceofprohibition.Whatpolicyminimizesdrug-relatedharm?Wearrive,then,atthequestionofwhethersomeothersetoflaws(besidesprohibition)wouldproducethesameorbetteroutcomesatlower“nancialandsocialcost.ForAustralia21andmanyothersconcernedaboutthehighcostofprohibition,theanswerisanunquali“edyes.Theresponseisunderstandable.Prohibition 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inbothhumanand“nancialterms.Ourstatutebooks,however,arefulloflawswhicharewidely”outed,expensivetoenforceandharmfultothosewecatchandprosecute.Thelawsagainstmurder,insidertrading,environmentalpollution,corporatefraud,childsexualassault,andtaxevasionarejustafewexamples.Weaccepttheselaws,despitetheirfrailtiesandtheenforcementcostassociatedwiththembecausewethinkthesocialcostwouldbeevenhigherifweabandonedthem.Andthisisthenubofthematter.Thestandardagainstwhichweshouldjudgeanylawiswhethersomeothersetoflawswouldproducethesameorbetteroutcomesatlower“nancialandsocialcost.Somewouldarguethattheonlywaytoobtainananswertothisquestionistochangethelawandevaluatetheeects.Thisbeguilinglysimpleargumentglossesoverthefactthatlarge-scalepolicyexperimentscarryrisksthatarenotalwaysdetectableinsmall-scalestudies.Suppose,forexample,weprovideherointoalldependentusers.Thiswillimprovetheirhealthandwell-being.Butsincedependentheroinuseraccountforalargeshareofallheroinconsumption,providingfreeherointothemwillreducedemandforheroinintheillegalmarketcausingthepriceofillegalherointofall(Butler&Neil,1994).Thismayencouragenewusersintothemarketandcurrentuserstoconsumemore.Itmightbeobjectedthatnoneoftheseeectshavebeenobservedinevaluationsofherointrialstodate(see,forexample,Ribeaud,2004).Theexperimentaltrialsusedtotestthefeasibilityofherointreatment,however,havebeencomparativelysmallcom-paredwiththepopulationofheroinusers(Hall,1999).Theyare,forthisreason,unlikelytohaveimpactedonthemarketforheroin.Theriskofunintendedconsequencesalsoarisesinthecontextofdrugdecriminaliza-tion.ArecentstudybyAdda,McConnell,andRasul(2011)illustratesthispoint.Theyevaluatedtheimpactofalocalizedpolicingexperimentinwhichthosecaughtinpos-sessionofsmallquantitiesofcannabisintheLondonboroughofLambethwerecau-tionedorwarnedratherthanarrested.Theaimofthepolicywastoallowpolicetofocusmoreresourcesonseriousdrugcrime.Addaetal.(2011)foundthat,insteadofshiftingtheirresourcestotheinvestigationofseriousdrugcrime,policeappearedtoincreasetheirfocusonseriousnon-drugcrime.Thisshiftinfocusledtoafallinseriousnon-drugcrimebutitwasaccompaniedbyanincreaseincannabisconsumption,inpartbecausetheexperimentresultedinanincreaseindrugtourism(i.e.itattractedcannabisusersfromsurroundingdistricts).Drugtourismandtheshiftinpolicefocusawayfromdrug-relatedcrimewerenottheonlyuntendedconsequencesthat”owedfromtheLambethexperiment.Addaetal.(2011)reasonedthatanyadversewelfareconsequences”owingfromdepenalizationshouldbere”ectedinfallsinhouseprices.Theiranalysescon“rmedthisexpectation,withhousepricesinLambethfallingaftertheexperimentby6.1%morethanacrossLondonasawholeduringthesameperiod.Theseadverseoutcomesdonotnecessarilyvitiatedecriminalizationorpartiallegal-izationaspolicies.Theydo,however,showthatexperimentsindrugpolicyinvolvepotentialrisksaswellaspotentialbene“ts.Repealingdruglawsthatarefoundtocauseharmmaybemucheasierthanremovingtheireects.Indeed,asKleiman,Caulkins,andHawken(2011)pointout,dealingwiththeaftermathofafailedpolicyexperimentmaytakeyears.Evenso,theriskofunintendedconsequencesisnotthemostsigni“cantproblemfacingpolicymakerscontemplatingdruglawreform.Themostsigni“cantproblemisthatthemeasurementandcomparativeassessmentofsocialcostsindrugpolicyisfraughtwithdiculty.Manyoftheharmsassociatedwithdrug Australian&NewZealandJournalofCriminology47(2) use,suchaspublicanxiety,corruption,orpublicamenity,arediculttoquantify.Tomakemattersworse,thereisnopublicconsensusonwhatharmsmatterthemostoronwhatmeasuresGovernmentsshouldbepermittedtotakeinmanagingthoseharms.Somepeopleareprincipallyconcernedaboutthehealthandwelfareofdrugusers.Othersaremoreconcernedaboutthecrimeorpublicamenityproblemstheygenerate.Somearewillingtoseepublicmoneyspentprovidingherointodependentusersifitreducesdrug-relatedmorbidityandmortality.Othersregardsuchpoliciesasananath-ema.Someseeaggressivestreetpolicingasinimicaltopublichealth.Otherswelcomeanyactiononthepartofpolicewhichreducespublicdrugdealinganddruguse.Thespec-tacleofasuspecteddruguserbeingsearchedormovedonbypolicestrikessomeasanintolerableviolationofcivillibertyandothersasanentirelyappropriateexerciseofpolicepowertodealwiththescourgeofillicitdrugs.Thedisagreementsonthesemattersmayappeartobedrivenbycon”ictingassumptionsabouttheeectsandeect-ivenessofparticularpoliciesfordealingwithdrug-relatedharm.Tothisextent,theymightappeartobepotentiallyresolvablethroughresearch.Insomecasestheymaybe.Itwouldbeheroictoassume,however,thatalldebatesaboutdrugpolicyareessentiallydebatesaboutmattersoffact.Dierentgroupsinthecommunityweighthenatureandconsequencesofillegaldruguseandeortstocombatitverydierently.Policymakersignorethisattheirperil.Forthem,theinjunctiontominimizeharmalwaysraisesthequestionofwhoseharmtheyshouldbetryinghardesttominimize.Threeimportantpoints”owfromtheseconsiderations.The“rstisthat,fromastrictlyscienti“cviewpoint,itisimpossibletosaywhatpolicyminimizestheharmassociatedwithillegaldrugs.Thebestwecanhopedoistodeterminewhatpoliciesaremosteectiveinminimizingaspeci“cmeasurableharm.Givenwhatwehavesaidaboutthedicultiesofgeneralizingfromsmall-scaleexperimentstolarge-scalepro-grams,fromonedrugtoanotherandfromonelocationtoanother,“ndingtheoptimalminimizationstrategyforonedrug-relatedharmislikelytobeaherculeanchallenge.Andyetsolvingthatproblemwouldstillleavethegeneralquestionofwhetherthebene“tsassociatedwithaparticularpolicyareworththe“nancialandsocialcostwideopenfordebate.Thesecondpointisthatthequanti“ableharms,costs,andbene“tsofaparticulardrugpolicyarelikelytovarygreatly,dependingonthedrugandthecontextinwhichthepolicyoperates.Itis,forexample,onethingtodecriminalizetheuseandpossessionofcannabis.Itisquiteanothertodecriminalizeheroin,crackcocaine,andcrystalmethamphetamine.Thehealthanddependencerisksassociatedwiththeformerdrug,thoughveryreal,arenowherenearassevereasthoseassociatedwiththelatter(Nutt,King,&Phillips,2010).Inasimilarvein,itisonethingtodecriminalizeuseofadrugwherethestreetpriceofthedrugisveryhighandratesofinitiationintothedrugortransitionsfromcasualtodependentusearelikelytobecorrespondinglylow.Itisquiteanothertodecriminalizewherethepriceofthedrugislowandwherethedrugischeapandhassigni“cantpotentialtoin”ictfurtherdamageoncommunitiesthatarevulnerableand/orhavealreadybeendevastatedbyalcoholorsomeotherdrug(e.g.IndigenousAustralians).Evenformeasurableharms,theoptimalpolicyoptionsarefarfromclear.Thethirdpointisthat,givenallthatwehavediscussed,itwouldseemquiteunfairandunreasonabletosuggestthat:Thebiggestwinnersfromthecurrentpolicy Weatherburn [prohibition]arethoseinleaguewithorganizedcrimeandthosecorruptedbyit(Douglas&McDonald,2012,p.14).Suchstatementsdonothingtopromoterationaldiscussionofdefectsincurrentpolicyoralternativestotheprohibitionagainstillegaldrugs.Theremaywellbeacaseforreformingthelawsurroundinguseofillegaldrugs.Highlightingtheharmsassociatedwithexistingpolicy,however,doesnotinandofitselfestablishacaseforapolicychange.Tostartameaningfuldiscussionaboutalternativestoprohibition,someonehastospelloutanalternativetoprohibitionandexplainindetailhowitwillalleviatetheproblemsassociatedwithprohibitionwithoutcreatingequallylargeproblemsofitsown.Thiswillrequireanacknowledgmentthatdrugmar-ketsareagooddealmorecomplexthanparticipantsintheAustralia21roundtableonillegaldrugsseemwillingtoadmit.AcknowledgmentsSpecialthanksareduetoProfessorJonCaulkinsandDrJennyChalmersforreadingandcom-mentingonearlierversionsofthispaper.Thisresearchreceivednospeci“cgrantfromanyfundingagencyinthepublic,commercial,ornot-for-pro“tsectors.ReferencesAAP.(2013,February19).Sydneymanshotinlegsoverdrugdebt.TheDailyTelegraphRetrievedfromhttp://www.dailytelegraph.com.au/news/breaking-news/two-charged-over-Adda,J.,McConnell,B.,&Rasul,I.(2011).Crimeandthedepenalizationofcannabispossession:Evidencefromapolicingexperiment.Mimeo:UniversityCollegeLondon.RetrievedfromAnthony,J.C.,Warner,L.,&Kessler,R.(1994).Comparativeepidemiologyofdependenceontobacco,alcohol,controlledsubstances,andinhalants:BasicfindingsfromtheNationalComorbiditySurvey.ExperimentalClinicalPharmacology(3),244…268.AustralianBureauofStatistics.(2009).Recordedcrime„VictimsAustralia,2008(Cat.no.4510.0).Canberra:AustralianBureauofStatistics,p.11.AustralianInstituteofHealthandWelfare.(2011).2010Nationaldrugstrategyhouseholdsurvey.(Drugstatisticsseriesno.25.Cat.no.PHE145).Canberra:AIHW.Bammer,G.,&Weekes,S.(1993).Becominganex-user:Wouldthecontrolledavailabilityofheroinmakeadifference?Feasibilityresearchintothecontrolledavailabilityofopioidsstage2(WorkingPaperNo.4)Canberra:NationalCentreforEpidemiologyandPopulationHealth,TheAustralianNationalUniversity.Behrens,D.A.,Caulkins,J.P.,Tragler,G.,&Feichtinger,G.(2000).Optimalcontrolofdrugepidemics:Preventandtreatbutnotatthesametime?ManagementScience(3),333…347.Blumstein,A.,Cohen,J.,Roth,J.A.,&Visher,C.A.(eds).(1986).CriminalcareersandcareerVol1).Washington,DC:NationalAcademyPress.Borland,R.,Chapman,S.,Owen,N.,&Hill,D.(1990).EffectsofworkplacebansoncigaretteAmericanJournalofPublicHealth(2),178…180.Butler,J.R.G.,&Neil,A.L.(1994).Economicissuesinatrialofthecontrolledprovisionofheroin.Feasibilityresearchintothecontrolledavailabilityofopioidsstage2.(WorkingPaperNo.7)Canberra:AustralianNationalUniversityandAustralianInstituteofCriminology. 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