Reviews

Drug War Heresies: Learning from Other Vices, Times, and Places

Every week seems to bring a new report on the failure of current drug policy. Rising levels of serious drug problems put new pressures on old systems that can barely cope anyway. Schools, psychiatric hospitals, and prisons continue to face fresh challenges.

People from most walks of life have a view on drug policy and legalisation. The views are not easily cast along old left and right wing politicallines.

Europeans generally think that European drug policy has been more pragmatic and sensible that of the United States. Robert MacCoun and Peter Reuter are senior American policy analysts who have attempted over the past decade to bring some rationality and measured perspective to drug policy choices. They root the drug debate within the broader context of the control of other social behaviours, such as gambling and prostitution. They also consider the issues of tobacco and alcohol.

Gambling was illegal in many places for much of the 20th century. However, in the 18th century lotteries were an important source of revenue for governments, universities (Harvard, Princeton, and Yale), and colonial administrations. Reports of social corruption and personal misery led to the prohibition of gambling. However, prohibition itself was in turn identified as an important sourceof police corruption.

Nowadays alcohol, tobacco, and gambling products are sold in markets that are subject to only modest regulation. Once socia lreforms diminish the controls on a behaviour there is a striking pressure to continue to liberalise the approach. In the case of gambling, tobacco, alcohol, and possibly cannabis, the vested financial interests have a strong lobbying effect, working assiduously to ensure further reduction in state control.

MacCoun and Reuter calculate that in several European countries cannabis users have on average a 3% chance of being arrested.Overall they conclude that the law is not much of a deterrent. Instead they explore the possibility that prohibition may have the "forbidden fruit effect" and actually increase young people's interest in illegal substances.

This book is without doubt the most scholarly and significant contribution to what has become a passionate but circular debate.MacCoun and Reuter's analysis and balanced interpretation of the international experience of cannabis policies is timely. One of the striking things about the international comparison is how weak the links are between different countries' actual policies and the current levels of cannabis use. This may result from the fact that many of the policies on the statutes are not actually implemented. Therefore variation between different countries' policies may be substantially less than is claimed.

If you are looking for simple answers you won't find them here. However, this book provides a framework for thinking through the different policies and it achieves a masterly level of evenhandednes -- except, possibly, on the subject of heroin prescribing. Here the authors are lured into coming off the policy analysts' fence and recommending further extension of heroin prescribing as part of the international treatment response. Heroin really is a seductive drug, even for policymakers.

However, overall this is an experts' expert book and it is likely to become the classic text on drug policy reform.

Michael Farrell, senior lecturer.

National Addiction Centre, Institute of Psychiatry, London M.Farrell@iop.kcl.ac.uk