Celebrity drug deaths remind us that criminalisation is both cruel and ineffective

This piece was commissioned by a national magazine immediately after the death of Phillip Seymour Hoffman, but when the piece was turned down because of lack of space last week, we decided to put it up on our blog.

Phillip Seymour Hoffman was not your typical injecting drug user, but he did share one essential factor in common with the vast majority of the other 16 million people who inject drugs globally – he was a criminal.  Russia, China and the USA account almost equally for around 6 million of this extensive cohort.  But that is only a tiny number of the drug war’s criminalised consumers, of whom there are an estimated 250 million, fifteen percent of whom are reckoned to be ‘problematic’ users.  This vast demand for drugs has created a market with an estimated annual turnover of £200 billion, the profits of which accrue mainly to a criminal fraternity at the consumer end whose wealth and power is immense.  It is US alcohol Prohibition writ very large.

Source: UNODC (pdf)

But what does this have to do with Hoffman, a brilliant actor who died alone with a needle in his arm?  He, like every other user of illicit drugs, was put in danger by the overarching policy of global prohibition – all drugs carry risks, but no drug is made safer in the hands of criminals and unregulated suppliers.  And drug users are put at further risk by criminalisation.  No matter what sector of society you come from, being branded a ‘criminal’ has a stigmatising, demonising, marginalising and often isolating effect on people who use drugs, particularly those who inject.  And whilst heroin isn’t the most social of drugs, it is no surprise that many people who overdose are on their own when it happens. 

One of the opportunity costs of spending £60 billion annually on the global war on drugs, is that vastly less is spent on health interventions. Global spend on harm reduction is estimated at around $160 million annually, whilst the estimated need is $3.2 billion – a large amount of money, but a tiny proportion of the drug law enforcement budget.  Despite the overwhelmingly skewed expenditure on prohibition, there are numerous interventions all over the world that have proven to reduce overdoses, limit the spread of blood borne viruses and all but eliminate the criminality associated with injecting drug use.  The large-scale programme of heroin prescribing in Switzerland, the decriminalisation of all drugs and greater investment in healthcare in Portugal, and the safe consumption rooms where users can inject under medical supervision (of which Germany has 28), are all real-world examples of how we can better protect the health and lives of users.  As an adage from the world of harm reduction goes, dead people don’t get to make positive life choices.  Health and safety must be the key principles of any civilised country’s drug policy, but the US has a terrible record on the implementation of harm reduction measures in comparison with, for instance, the UK.

Lastly, there is Hoffman’s possible link to Afghanistan, where 80% of the world’s illicit opium is grown, and from which heroin is derived.  The miserable trail of criminalisation runs all the way back from users to producer countries, where state fragility and lack of governance provide fertile ground for illicit drug production.  Helmand province is one of the prime examples of this process in action, where peasant farmers are obliged to grow opium for a pittance at the start of a market that results in vast profits for criminal gangs at the consumer end. 

US marines patrol with Afghan forces through a harvested poppy field in Afghanistan's Helmand province

The huge and tragic irony is this: at the same time as the horror show of prohibition manifests its terrible impacts, half of the world’s opium is grown for the legal opiates market, including diamorphine, the legal pharmaceutical equivalent of street heroin.  Indeed the UK has thousands of hectares of land under cultivation with opium poppy, the very same crop that we vilify in Helmand.  It is produced without being taxed by the Taliban, transported without the need for violence or corruption, and supplied through pharmacists and doctors, quality controlled, labelled and titrated into strictly controlled measures (unlike the wraps of heroin found in Hoffman’s apartment).

We can only wonder if Hoffman would still be alive had he been supplied with a legal equivalent of the illicit drug he was using.  We cannot know if he’d still be working on his next movie, and would have made the appointment to see his kids, had heroin users not been stigmatised in the way they are under prohibition.  However, we can be certain of one thing: criminalising him and his 16 million fellow travellers does nothing to improve their life chances, and everything to force them into lives of ignominy and isolation.  As civilised people, Hoffman’s death provides us all with yet another opportunity to learn and move toward a drug control system based upon responsible regulation, effectiveness and humanity.  The question is, will we take it?