Should All Drugs—Heroin Included—be Legalized?

At the heart of cannabis legalization is the conundrum of what American society considers acceptable versus what it criminalizes. But history indicates that attitudes can change. From the years 1996 to 2017, support for cannabis legalization jumped from 25 percent to 64 percent. Analogously, the drug has been legalized in nine states and Washington D.C. As the movement spreads, it's worth considering a broader question: should all substances be legally available on the free market?

Before exploring the prospect of full-scale legalization, an understanding of the history behind contemporary policies is necessary. Dr. Carl L. Hart, a behavioral neuroscience researcher at Columbia University, has spent his career disproving the falsities behind drug laws. In his 2014 article for The Nation, he argues that America’s relationship with drugs has deep-seeded racist origins. Back in 1914, Congress passed the Harrison Narcotics Tax Act (HNTA) that regulated opium and Coca products. The legislation was passed with the help of a media campaign that associated cocaine with black men committing crimes against white women.

Despite not criminalizing drugs, the law set the tone for how policies would take shape for the rest of the century. This myth of a violent, intoxicated black person was later used to justify the harsh crack cocaine policies of the 1980s. Hart points to how this aggressive criminalization of substances has been a contributing factor to the mass incarceration of black people. In addition, tough employment practices make having a drug offense an impediment to succeeding in society. The Columbia University professor says his advocacy and research boil down to using “empirical evidence to guide public policy, even if it makes us uncomfortable.”

There are quite a few statistics that illustrate the incompetence of drug policies: 1.5 million people were arrested on drug charges in 2016; 72,000 people died of drug overdoses in 2017 alone; the United States spends more than $50 billion a year on the War on Drugs. Dr. James Cockayne, the Director of the Centre for Policy Research at United Nations University, claims that the War on Drugs has globally “failed to achieve even its own stated goals” that include “the reduction of supply of and demand for drugs.”

Maybe it’s time for the United States to change these “stated goals” altogether. No country has legalized all substances. However, there are a few successful instances of decriminalization. While legalization allows for the regulation, taxation, and selling of substances, decriminalization is when people aren’t arrested for possessing and using drugs. Selling and trafficking large quantities are still criminal offenses but drug policy is generally centered around harm reduction measures that prioritize safety and treatment. Hart likens getting caught with drugs in a decriminalized context to a “traffic violation” because one might “get a fine or warning” but wouldn’t “have to worry about getting arrested or having a blemish.”

Activists often turn to Portugal as a model for a more pragmatic and humane approach. Facing a breaking point with their heroin crisis, Portuguese lawmakers started looking into new strategies in 1999. They implemented a policy in 2001 that decriminalized drug use and funded a system of social workers, clinics, and treatment centers. Following decriminalization, Portugal saw a decrease in HIV infections, addiction, overdoses, and drug-related prison sentences. From 1999 to 2015, the amount spent per capita on “drug misuse” went down by 18 percent. Meanwhile, there was a 60 percent increase in addicts seeking treatment. In an article for The Guardian, Susana Ferreira attributes Portugal’s drug laws to a “major cultural shift” and argues that these policies were “merely a reflection of transformations that were already happening in clinics, in pharmacies and around kitchen tables across the country.”

Reforms have also been successful in Switzerland and the Netherlands. Skeptics would point out that there are many differences between these countries and the United States. The most obvious one is that while these European countries have universal health care, the U.S doesn’t. If the American government were to institute the Portuguese model, there would have to be a more robust public health sector to pick up the costs of rehabilitation, needle-exchange programs, outreach, and quality control of substances. That could be achieved through legislation. But to even get to that point, there needs to be an abandonment of firmly held moralistic beliefs towards drug use.

Psychedelics and cannabis activists offer a glimpse into a new kind of mindset regarding substances. Pamela Epstein, the founder and CEO of Green Wise Consulting, views cannabis as “an interesting mirror where we learn to address the sins of the past.” Through helping companies diligently abide by regulations and work within the system, Epstein hopes to take away the “stigma” of cannabis and legitimize it. The activist acknowledges that the legalization movement may very well pave the way for other illicit substances becoming legal for medical use, stating, “If cannabis can prove itself and differentiate itself from the regulated market, that will create a very strong foundation in which to have meaningful [discussions] about other psychedelic drugs.” There are signs that Epstein’s theory is gaining momentum.

As the Policy and Advocacy Counsel at the Multidisciplinary Association for Psychedelic Studies (MAPS), Ismail L. Ali is an advocate for the medical potential of psychedelics. Though drugs like MDMA, LSD and psilocybin have been shown to help with mental health issues, they are still federally regarded as Schedule 1 drugs and are deemed illegitimate for medical purposes. And even if psychedelics gain FDA approval, Ali worries marginalized people who lack access to health care will be “criminalized” for seeking treatment outside of the pricy system—an alternative to the traditional pharmaceutical model. Both Epstein and Ali balance their ideals with a shrewd pragmatism; they view their respective causes as a way to transform the medical industry but stress the need for regulations.

On the other side of the debate, Dr. DuPont, a psychiatrist and founder of the Institute for Behavior and Health, upholds an old-school moralism. He started out his career during the late 1960s in the amid New York City’s heroin crisis, promoting the usage of methadone to combat addiction. At first, he was for cannabis decriminalization, but changed his mind once he saw how more relaxed policies resulting in a higher rate of usage in the late 1970s. For decades, his research has had a single goal: cut use and sales through policies of “discouragement.”

DuPont is far from alone in being wary of the public health impact of more liberal drug policies. Dr. Sharon Levy, an adolescent substance abuse expert and Associate Professor of Pediatrics at Harvard Medical School, also has concerns. Despite being in favor of cannabis decriminalization, she’s against legalization because of evidence that commercialization has resulted in dangerously potent cannabis. Levy is noticing a rise in mental disorders and Cannabinoid Hyperemesis Syndrome. She notes that even if cannabis is restricted to adult usage, it's unreasonable to assume that young people gain access and get hooked. Levy notes that the current opioid crisis is a case study in the chaos that ensues when unchecked capitalist greed intersects with intoxicants. And hypothetically with full-scale legalization, corporations would be able to make harder drugs more addictive to increase demand.

For legalization activists, this can be resolved through careful regulations. But for skeptics, substances will always cause societal harm. Even if one views the reformers as overly idealistic, the argument for legalization is worth considering as a philosophical exercise in exploring the arbitrariness of laws. Hart wonders why society is perfectly fine with cars—which are responsible for thousands of deadly accidents a year—and yet has strong sentiments against drugs. When viewed from that standpoint, any fear of commercialization is rendered moot and solutions become straightforward.

For all-inclusive drug legalization, drugs must be treated like any other consumer products that have to abide by safety measures alongside outstanding changes in public health infrastructure. Most important of all, Americans will have to redefine the limits of their own freedom.